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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 52. This is the beginning of the thread.
Posted by Dinah on August 20, 2008, at 18:45:28
I feel like I could drop down to once a week with no problem.
Ironic isn't it.
:)
Now, what to do with what seem to be near daily migraines, and I'll be happy. I wish my neurologist hadn't fled with so many doctors. Most headache neurologists just seem to push pain meds. :(
Posted by Partlycloudy on August 20, 2008, at 20:17:46
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
> I feel like I could drop down to once a week with no problem.
>
> Ironic isn't it.
>
> :)
>
> Now, what to do with what seem to be near daily migraines, and I'll be happy. I wish my neurologist hadn't fled with so many doctors. Most headache neurologists just seem to push pain meds. :(Mine have flared up, in spite of being on preventative medication - notably since my step daughter moved in with us. While I was out of town with my friend, I had *no* headaches - so I know mine are triggered by stress. Not that it makes them any better knowing that; it just feels like another betrayal by my body.
Or, as Roseanne Roseannadanna would have said, "It's always somethin."
Glad to hear therapy is going well for you :-)
Posted by Looney Tunes on August 20, 2008, at 20:36:12
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
Wow! That is great. I am so jealous...
I remember with my old T when therapy was smooth ~ no roller coasters. It was so satisfying. Congrats.I have migraines too and I have tried everything. You know I recently read something that they are beginning to believe that migraines may be related to serotonin levels. Interesting...
Posted by Annierose on August 20, 2008, at 21:28:26
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
Here's my advice ... if nothing is broken, then don't fix it. In other words, this is not the time to drop back in therapy (of course, sometimes financially it is necessary). Enjoy the connection and push forward.
I have also experienced more migraines this spring/summer than ever before. I discovered that cheese tends to trigger headaches and lots of cheese plus beer or wine ... migraines. So much for beer + pizza.
Posted by rskontos on August 20, 2008, at 22:19:22
In reply to Re: Therapy is going so well again, posted by Annierose on August 20, 2008, at 21:28:26
Dinah,
I am glad you are feeling so good, maybe I would just stay the course for a while longer first before the drop.
As far as migraines, the only thing I have found that works outside of topamax is magnesium combined with coQ10. Have you tried that. And I have recently heard of some home remedies that I though worth a try but I have been on topamax for 4 years and it has worked so well. I have decreased my dosage down to the least amount and still stay migraine free. With little side effects. If you are interested in the home remedies I will try to remember them. Because I am on the topa
I did not try them as I would not be sure they would work or it would be the topa.I used to have about 5-7 migraines a month before topamax. They were so bad as I was in a bad cycle at the end. Now I rarely have them since topa works well for me.
Good luck with therapy, and the migraines.
Maybe you can send you good therapy vibes over the net. I could use some. I am impressed with your progress. Maybe it is catching...LOL
rsk
Posted by Daisym on August 20, 2008, at 23:31:12
In reply to Re: Therapy is going so well again.Dinah, posted by rskontos on August 20, 2008, at 22:19:22
Someone told me today that they use acupuncture for migraines. I don't think I'd try it but then again, I don't get migraines.
I'm glad you are in a good space again. I'm always amazed at the cycles and how we work through them. I agree with Annie, don't change things too quickly - maybe try working on something that can only be worked on in a calm space.
Posted by Phillipa on August 20, 2008, at 23:59:16
In reply to Re: Therapy is going so well again.Dinah, posted by Daisym on August 20, 2008, at 23:31:12
Accupuncture would probably work great for migraines never had one but they run in the female population of past family. Imetrex is used for them if not on an SSRI. Phillipa
Posted by antigua3 on August 21, 2008, at 9:00:46
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
Ironic? I'd say it's great and you should be very proud of yourself.
sorry about the headaches.
take care,
antigua
Posted by Dinah on August 21, 2008, at 9:24:06
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
I'm not planning on changing anything anytime soon. I don't know why, but regular therapy keeps me relatively stable unless my therapist is not stable himself. I get bored sometimes, but I know from experience that I'm less stable without the therapy. I've never quite understood it, but I'm not going to mess with it unless I have a fair amount of free time to risk falling apart.
But when my therapist is not stable himself, I'm far more unstable than if I had no therapy at all.
It's hard to think of it as being anything but magic. But then, I think of the fax machine as being magic too. I know there are many people who understand it, but to me it's magic.
I really wish for those of you with less happy therapy arrangements, that you could create a relationship like we have. Last session I lightly mentioned (since he had just come back from training) that I always figured his sexual addiction clients would be more interesting for him as a therapist. He smiled at me with obvious amusement and told me I always underestimated our relationship. But I don't. Not anymore anyway.
I suspect my migraines may be weather related right now. The air has been heavy and pregnant with thunderstorms. However, it has to be more than that since sometimes thunderstorms don't bother me at all, and other times I get migraines every day for weeks. Possibly some are rebound since I've been hitting the migraine meds a lot. And maybe the inner ear stuff that was giving me constant migraines earlier in the summer is still a bit of a contributor. The tinnitis is lingering for sure.
For me, the migraines don't come during stress so much as after stress. But I don't see any correlation right now to that. I have noticed a very strong correlation to driving and the migraines. I've been good about remembering to use my sunglasses, but it's still a problem.
If my neurologist was still in town, I'd see her and she'd probably tinker with my migraine prophylaxis, currently 50 mg Lamictal. Maybe I'll look around to see if who else is out there. Or maybe I'll drive six hours each way to see her. She's worth it.
I was looking up vascular rhinitis, and found out any number of interesting things - including a link to migraines. I wrote about it on the meds board.
http://www.dr-bob.org/babble/20080814/msgs/847504.html
Posted by Dinah on August 21, 2008, at 11:35:18
In reply to :-), posted by Dinah on August 21, 2008, at 9:24:06
That I might be overestimating how well I'm doing. Not in therapy, that's great. But I'm very much in rational mode right now, since I have a deadline next week. I think I'm well defended against some of the not quite as good stuff. When I'm drifting off to sleep or just waking up, I know I'm feeling some fallout from the tropical storm.
But I'll worry about that later.
Posted by Partlycloudy on August 21, 2008, at 12:49:49
In reply to :-), posted by Dinah on August 21, 2008, at 9:24:06
> I was looking up vascular rhinitis, and found out any number of interesting things - including a link to migraines. I wrote about it on the meds board.
>
> http://www.dr-bob.org/babble/20080814/msgs/847504.html
>
>Huh. One of the things I've been diagnosed with is vasomotor rhinitis. Basically I present with allergic nasal symptoms, but don't test positive for any allergens. I've been treating it with Nasonex (it works very well).
But - depression. Anxiety. Migraine. Rhinitis. Do you see dots where I'm seeing dots, Dinah? I can't connect them, but I can see them...
PartlyCloudy
Posted by Dinah on August 21, 2008, at 13:24:24
In reply to OT rhinitis » Dinah, posted by Partlycloudy on August 21, 2008, at 12:49:49
I'm sure it has something to do with the autonomic nervous system. The thing I keep coming across in my google searches is acetylcholine. I think it's part of the adrenergic-cholinergic neurotransmitter axis. But I really don't know what any of it means, and I really don't know what can be done about it.
There also seems to be some hormonal connections.
What I do find rather sad is that all the health problems associated with this were once written off as psychosomatic, because practitioners couldn't find anything that looked wrong, and because they noticed that the patients tended to be anxious or depressed. Then they got the sophistication to do the tests and saw the physiological parts of the migraine, then discovered the neurochemical cascade that happens. And yet still they're slow at coming to the conclusion that the mental health portion might also have physiological underpinnings.
I know there are people who have mental health issues, perhaps because of childhood trauma, that can be resolved with therapy. I think for me it's important to accept I have a poorly regulated nervous system, and unless something changes at menopause, this is something that I'll have to work at controlling. I need to be careful about controlling stress, I need to do all those good healthy things that I don't always do, I need to continue therapy. And even then, who knows? If a migraine can be caused by a change in barometric pressure or flickering lights, who is to say what odd and apparently unconnected things can cause an upsurge in anxiety or depression?
It might make more sense than some more traditional cycle pattern. And as you've probably heard me say too often, I've thought all along that my proper diagnosis was "nervous system of an overly inbred cocker spaniel".
My therapist thinks I shouldn't think of it as exclusively negative. That there are advantages to it too. And while I do see the advantages, I see them a bit better when I'm not having one migraine after another.
However, I'm really not good with all this neurotransmitter stuff, so it's entirely possible that I'm misunderstanding everything.
Posted by Nadezda on August 21, 2008, at 13:56:47
In reply to Re: OT rhinitis, posted by Dinah on August 21, 2008, at 13:24:24
I'm delighted that your therapy is going so well. Hope it keeps up-- but you'll work through the momentary disturbances. It's great to know that you can, I imagine. That seems to be one of the big accomplishments of the recent times.
I don't know much about migraines-- but I'm very sorry that they're bothering you.
As for being defended-- and upcoming deadlines-- mmm... maybe, but maybe you're just enjoying the time-- and the good things you've achieved.
I hope I don't seem relentlessly upbeat today; I'm not sure why I would be. I'm utterly worn out by this trip and a cold that I've been suppressing. I'm afraid I'll feel compelled to take a hike or go to the beach when I feel like getting back into bed and watching television and doing crosswords (although there's nothing-- absolutely-- on) all day.
Nadezda
Posted by Partlycloudy on August 21, 2008, at 13:57:27
In reply to Re: OT rhinitis, posted by Dinah on August 21, 2008, at 13:24:24
All I've been able to gather is that the reason the Nasonex works in controlling my rhinitis symptoms is because it suppresses the acetylcholine receptors - which makes sense. I would suppose that's also what the triptine type of migraine treatments had been doing - though I'm now on a preventative regime of Zonegran, an anticonvulsant. We just increased the dosage on that because I've been getting a LOT more headaches.
But I definitely see a connection between these issues being present in myself in these particular combination. I might bring it up with my allergist the next time I see him (he's the most broad-minded and engaging of my current specialists) and get his take on what the connections might be.
PC
Posted by Dinah on August 21, 2008, at 14:16:49
In reply to Re: OT rhinitis » Dinah, posted by Partlycloudy on August 21, 2008, at 13:57:27
I'd love to hear what he has to say.
I bookmarked some of the sites I found, but I started bookmarking rather late into the search so it's mostly variations on the top two. I don't have a lot on the migraine or IBS or GERD connections.
http://www.webmd.com/a-to-z-guides/nonallergic-rhinitis?page=2
http://www.biopsychiatry.com/acetph.htm
Do you think it's possible that the stormy thundery tropical weather lately could be affecting your frequency of migraines?
Posted by Dinah on August 21, 2008, at 14:21:33
In reply to Re: OT rhinitis, posted by Nadezda on August 21, 2008, at 13:56:47
I'm not worried enough about the deadlines. I need to worry more.
I do think the trust that he cares about me is very new. I am enjoying it. I break up my therapy into chunks of time based on trust. The first five years I learned to trust him, then there was a big leap of faith at five years. In the second five years, I learned to trust the trust, if that makes sense, and it was another big leap. Then everything got messed up because of Katrina and the delving into deeper levels we were starting was aborted, and maybe that moment will never return. Now I really really trust that he cares about me, which might not have happened without Katrina. But I recognize clearly that he still will probably terminate me some day because of something in his own life. I'm not quite sure how I reconcile all of that. Or maybe I don't need to. Maybe I've given up the need to reconcile. Which would be a big jump too.
How was your trip? Was it nice enough you'd consider repeating it? :)
Posted by Jouezmoi on August 21, 2008, at 17:56:16
In reply to I think it's probably also true..., posted by Dinah on August 21, 2008, at 11:35:18
OMG ! Someone who is just like me. The rhinitis/ sinusitis, migraine (right now I have had this one coming and going for more than a month), snxiety, depression, and you can add mitral valve prolapse and prinzemetal angina (both linked to migraine) to my list.
Its all neurochemical, and I suspect that my depression/ anxiety is also. I have had the happiest childhood and most pampered life, so no one can seem to source my 'psychological' problems.
Posted by Dinah on August 22, 2008, at 8:23:11
In reply to Re: I think it's probably also true..., posted by Jouezmoi on August 21, 2008, at 17:56:16
My family certainly had their issues, and those things may have contributed to causing some disturbance in my neurochemicals to begin with I suppose. Although I can see some genetic links to my mother's family as well. For whatever reasons those things are messed up now.
I suppose there are still people, including doctors, who think that migraines and all the other things are problems caused by neurosis or something like that. But I'm glad that others are acknowledging that they might have a common cause but are all very real and have a biological root cause.
I wish there weren't others like us, but I suspect in the future they'll discover that an awful lot are.
Posted by rskontos on August 22, 2008, at 11:06:02
In reply to :-), posted by Dinah on August 21, 2008, at 9:24:06
Dinah,
in doing additional research regarding migraines and allergies, I ran across this. Sometimes the only relief I have found when I do get an extremely bad headache that maybe migraine in nature or sinus or I just don't what the heck it is and I currently don't have a med from the neuro for when I do get a bad headache is I put ice in a small baggie and place it first on the back on my neck, and then on my head where the pain is the worst. So far it has always worked. I have never thought to use it as this article suggests.
here is the link I hope it works.
http://www.freepatentsonline.com/5527351.html
It even suggest doing it prior to extreme pain and as a preventive even when there is no pain.
Very interesting. Check it out.
rsk
Posted by Dinah on August 22, 2008, at 16:38:50
In reply to Re: :-) » Dinah, posted by rskontos on August 22, 2008, at 11:06:02
That does look interesting, and I can understand the theory behind it too. I'll give it a try.
I think at least part of my problem is that I wait too long to take meds because I know I've taken so many lately. Using this technique might be a good alternative to just waiting.
I'm glad you told me where it is they were describing, though. I'd have never understood what part of the body that was.
Posted by Dinah on August 23, 2008, at 10:05:21
In reply to Therapy is going so well again, posted by Dinah on August 20, 2008, at 18:45:28
I was telling him what I wrote, about how I sometimes got bored but found therapy helpful anyway. He suggested that if I got bored, we could maybe walk to the nearby park for the session to shake things up I guess, unless I'd freak out about it.
I politely declined to go to the park, and acknowledge with equal politeness that I would indeed freak out.
He asked me why, and I found myself totally unable to explain it. I know I've talked about it here without trouble, but the most I could say to him was that I didn't think he could be my therapist/mommy outside the sacred therapy space. He acknowledged that he didn't understand.
Of course it's not as simple as that. If there was need, I could meet him just about anywhere, and recognize that he could carry the therapeutic space with him. In fact, I have experience of that. But that would be a purposeful meeting and a conscious creation of the space.
He's not the same outside his office. He's more matter of fact. He feels different. But even if he could consciously maintain his therapy self, it just wouldn't feel right... Therapy belongs in that room, or wherever the substitute is for that room, because therapy is not real life. It's a bubble, a sacred bubble.
I know other people have done this. And I'm not entirely sure why I'm not willing to even try. I even know I couldn't explain to him even as much as I've explained here. I'm way more aware of these things than he is.
Posted by Dinah on August 23, 2008, at 10:23:12
In reply to Nope, not this, posted by Dinah on August 23, 2008, at 10:05:21
It's my boundary, one I've kept consistently. I don't need to justify it even to myself.
Posted by twinleaf on August 23, 2008, at 11:24:50
In reply to It really doesn't matter, posted by Dinah on August 23, 2008, at 10:23:12
I don't find it at all hard to understand your point of view. Your therapist's office really is a sacred space for you, and has been for a long time now. Going for a walk involves so many things that may not be therapeutic. It might start to feel like friends getting together- you might both start to talk about the weather! It also might feel suspiciously like a date that you had not planned on having!
My analyst once mentioned that during his work as chief of psychiatry at Chestnut Lodge, he would often start his work with severely ill patients by walking around the grounds with them. (apparently there were about a hundred acres of fields and meadows then with paths running through them) But he said that, as soon as a patient was able to do it, he wanted them to come to his office, because he felt that the therapy could become more real and effective there.
His office is so special to me. I love the paintings, all the books, the photo of snow-covered mountains on his open laptop- it's such a special place- where things happen which couldn't happen anywhere else.
Besides, I'd feel self-conscious about taking a walk together. I'm very tall for a woman- 6 feet, and he's only about 5'9"!
Posted by Dinah on August 23, 2008, at 13:52:20
In reply to Re: It really doesn't matter » Dinah, posted by twinleaf on August 23, 2008, at 11:24:50
Sometimes it makes me a bit uneasy that he doesn't *know* these things. And even more uneasy to try to point them out to him. Like maybe I'd be bringing something to his notice that he hasn't thought of, and that might have a negative impact on our relationship.
Yet I've read in books and on this board that it isn't *that* uncommon, so maybe he doesn't have a gap in his knowledge base. At least part of it has to be me. If for some reason his office was inaccessible it would be different of course.
I think we've recently reached an even deeper level of trust with each other. I casually mentioned something a while back about my reasonably good relationship with my husband probably being one reason I never felt any sexual or romantic transference towards my therapist. Since then, I've noticed he seems more relaxed about things like this, or about mentioning his wife. In turn, I'm more relaxed, and in fact mentioned something very (objectively) embarrassing of a sexual nature to him the other day without covering my face or asking him to close his eyes. I'm somehow thinking he wouldn't have suggested this if he didn't feel really really comfortable that I wouldn't get the wrong impression.
I really really like that we're comfortable with each other. But comfy or not, I value therapy far too much to want to allow any permeable barriers. Or perhaps I should say that I know which barriers would compromise the structure of therapy for me, and I don't want those barriers to be permeable.
Posted by twinleaf on August 23, 2008, at 14:04:09
In reply to Re: It really doesn't matter » twinleaf, posted by Dinah on August 23, 2008, at 13:52:20
It's wonderful that even though your relationship together has spanned thirteen years, new, closer, deeper and more profound things are occurring between the two of you now. It's like a well which can never run dry.
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