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January 23, 2001
My neurologist appointment was a gigantic waste of time. I rather suspected it would be, but went because everyone thought I ought to.
We left this morning at 7:45, and arrived a few minutes late at Brackenridge hospital. I registered, and signed consent forms to be treated. Which is funny because I wasn't treated at all. There was a great deal of confusion about who referred me and where my paperwork was, but they went ahead with my vitals. I weigh 141.5, and my blood pressure is 112/79. I'm put in a room with my mother who came to help with Jake. And so all three of us are waiting. Shortly, a doctor-type person comes in, and introduces himself as Dr. L. I describe my migraines to him, and he duly asks questions and writes things down.
He questions me about who referred me, and about what the last neurologist had to say over two years ago. When I told him that she had wanted to do an MRI, but that we couldn't afford one, he actually asked me if that was safe to do during pregnancy. He didn't know because he wasn't a neurologist. (sigh)
He quickly tested my reflexes, and proclaimed me perfectly normal. And then left to go talk to the neurologist on call, a Dr. S, about the safety of an MRI on a woman who is 6 months pregnant. And we waited. We waited for two hours. Jake took a nap in my mom's arms. Mom had expected to be back at work by this time, and we hadn't even seen the neurologist. Nor would we. Dr. L came back, apologized for the delay, and explained that they couldn't give me Imitrex because I was pregnant (which I knew), but they were going to give me a prescription for *Demerol*. Yes, Demerol, the drug they give laboring women. I told him that I already had a prescription for Fioricet, and asked why I couldn't just take that. And he said I could, leaving the comment kind of hanging in the air.
I explained to him that I didn't come all this way and wait all this time just to be given addictive pain killers. I wanted to know that I wasn't having strokes, or a tumor, or something equally deadly, and to do something to *prevent* these migraines. He assured me I wasn't having strokes because my reflexes were very normal, and that if I had a tumor the headaches would never go away. And he said there wasn't really anything they could do to prevent the migraines while I was pregnant.
I asked him about the things I had been researching. I asked him about Selective Serotonin Reuptake Inhibitors, which were originally designed to treat depression, but was discovered to prevent migraines almost entirely, and some were safe to take while pregnant and nursing. He seemed puzzled and said Dr. S thought Demerol was the best choice for me.
I asked him about tricyclic antidepressants, like amiltryptaline, which is safe to take while pregnant and nursing, and has been shown to prevent migraines, and in fact my mother has been taking it for 6 years for fibromyalgia and hasn't suffered one migraine in that time. He said I wouldn't want to take that particular drug because it can cause liver damage with prolonged use. My mother was stunned. No doctor has ever told her that risk, and it isn't in any of the paperwork she has on the drug.
Dr. L went on to say their normal course of action would be to prescribe Imitrex or a beta blocker, both of which cannot be taken during pregnancy and both have side effects I'm really not interested in. And he seemed to think that I had come there planning to demand Imitrex, because he kept coming back to it even though I never once mentioned it. In retrospect I think that was the only solution, along with beta-blockers, that he knew of for migraines, not being a neurologist himself.
He told me to come back after the baby was born.
So.
I wasted half a day, and Mom lost half a day's wage, just to get a prescription for Demerol from some intern. I never saw the neurologist, I never had any special testing, I was not told anything useful at all. I can only believe that this is the way people with Medicaid are treated. I'm sure that if I had had 'real' insurance I could have seen a private neurologist and had a meaningful conversation. As it was I got the run around.
The kicker is that I don't get these migraines when I'm not pregnant, so coming back after the baby is born will be exceedingly useless. Also my Medicaid benefits expire 2 months after the baby is born, so I could only afford treatment for those two months, and then I'd be cut off.
So that's that. I'm not even going to fill the prescription for Demerol. I have Fioricet left, which actually does something to the spasming of my blood vessels in my brain, whereas Demerol would just knock me out. I've *never* read or heard of anyone being given Demerol for a migraine. It's simply ridiculous.
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