The Closet Professor

As I told you on Monday, I went to the headache clinic at Dartmouth-Hitchcock to be assessed for my headaches. I loved my neurologist down there. She was very nice and very thorough, unlike the neurologist I saw here who was just an arrogant ass. This doctor is also a professor at Dartmouth Medical School. Anyway, after a full assessment, she diagnosed me with chronic migraines. She said though I had some of the symptoms of cluster headaches before, I didn’t meet the most critical of the criteria for cluster headaches and had been misdiagnosed. She also said that besides the occasional seasonal sinus headaches, all of my other headaches were actually migraines, some just acting in atypical ways. However, they were migraines nonetheless.

She stopped all previous headache treatments because they were helping but not completely doing away with the headaches. From here on out, I am not even allowed to take any over the counter medications for pain relief. She first prescribed me Emgality, a monthly injection for my migraines. For milder and moderate headaches she prescribed Anaprox and Vistaral. For major headaches, she prescribed me Migranal. This is where it became tricky. First my pharmacist was worried about interactions with my other health issues (diabetes and hypertension) and my other medications. I did discuss with the pharmacist that we had talked about all my medications, but the pharmacist still would not give me the medication without speaking to the doctor. Furthermore, they did not keep Migranal in stock and would have to order it. That’s all well and good, but the other pharmacist called me yesterday and told me that with the coupon that said it “could reduce the cost to as little as $5” it was still going to cost $1900 dollars a month. My insurance had denied the medication. So they are working with the doctor to try and get pre-authorization for the medication. Incidentally, I looked up the cost of one months supply without the discount card or insurance, and it was $16,000 dollars a month. So it is still up in the air about whether or not I will get the Migranal, because even with the coupon, I cannot afford $1900 a month. Now if one of y’all is a benevolent millionaire with money to spare, there is a donate button over there and if you’re willing to pay $1900 a month for my Migranal, I’d greatly appreciate it. Since I doubt that will happen, I will wait and see if the insurance company authorizes this new medication.

My new doctors goal is not to just make me feel better but to totally eliminate the migraines. Oh and one other little side story about Monday. I had seen the doctor which took about an hour and a half, then I saw a research assistant to be enrolled in the National migraine study which took another hour, and then I headed to the pharmacy at the main hospital to pick of my Emgality. The Dartmouth-Hitchcock Pharmacy is able to cut through the red tape of insurance companies a lot easier than my local pharmacy for this particular medication. So after another hour of paperwork, I got my first dose of Emgality which I was supposed to take when I got home. By this time, it is lunchtime and I went and had lunch then headed home, which is about an hour away from Dartmouth-Hitchcock. I get about 20 miles from home and the pharmacy calls. They had given me the wrong dosage. I was supposed to take two injections the first month and one each month after that. They had only given me one injection pen. So I had to go to the nearest exit, which was about five miles away and turn around and head back to the hospital. By the time I’d gotten the second dose and back home, I then went to my regular pharmacy to pick up my new prescriptions. By the time this was over, it was after 4 pm. I’d left the house at 7:15 am for my 8:30 appointment. It had been a long day. Add to that, I did have a massive migraines on Monday.