Wednesday, November 6, 2019

Headache Clinic, Aftermath



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.

9 comments:

bignate said...

Yikes! What an ordeal!

Dylan said...

I’m glad you’re finally getting some answers. Are you able to get the generic to Migranal, dihydroergotamine? I used to use it and my insurance paid everything except $45 per month copayment. I do have decent insurance (one of the very few benefits of being a public educator).

Joe said...

Dylan, my pharmacy usually goes for the generic first of one is available. So I’m not sure about what they did this time.

JiEL said...

You're health and meds insurance stuff are so for those companies to make money on the back of the Americans.
Here, with universal health care and Medicare, what ever my prescribed meds, I only have to pay the first $85 and the rest, whatever the cost of the meds, is paid by our provincial health care system.
Not to mention that any doctors or surgery or hospital visits are FREE.
In July 2017, to give you an example, I had a surgery to take out 6 inches of my colon with a small cancer tumor. Got in the hospital for 4 days and NO charge for that.

When I see Sanders and Warren battling for universal health care in USA and more, all the backlash it causes, I'm flabbergasted that in such a wealthy country you are waiting gazillions of dollars on army, wars, guns, space race etc,,, But many are repulsive to help ALL Americans to be safe with their health.

Not surprising because USA is based on a savage capitalism system that makes those insurance companies going for money, money, money not caring about the population that cannot afford it.
Many are going bankruptcy after bad health and bills to pay that are astronomical.

Thank God, I live in Canada.

Anonymous said...

I do hope the specialist is right in her diagnosis and that the remedy WORKS, Roderick

Dave R said...

It's all about pharmaceutical company's need to make money. I had an Ophthalmologist who insisted on prescribing expensive drops rather than the cheaper generic. I switched doctors. My new doctor took me off drops completely.

HuntleyBiGuy said...

I hope the meds do the job for you, Joe.

naturgesetz said...

I certainly hope the doctor will be able to get your insurance to pay for the meds she prescribed.

And a pharmacy refusing to fill a prescription is weird. I understand about being concerned about interactions, but ultimately, they're supposed to do what the doctors tell them.

Hopefull relief is on they way.

Joe said...

Naturegesetz, normally the pharmacy would just follow the doctor’s directions, however, the warnings were very severe and they are just looking out for my well being.