Physician's Assistants? Topamax? Your opinion. Please read

Hi all. Need your opinion here. In short, I am still on the Topamax, 100 mg. Been on it now for 19 weeks. Tolerating the side effects which for me, have overall, been minimal or at least, tolerable. Up until now, haven’t had any major headache issues. I still don’t know if the topamax itself stopped the headaches or they just morphed, as before I started taking the med, they had stopped on their own. However, recently, I have been having back of the head, stress-type headaches more often, some times every day. They are not as intense as before, but they are there none the less. They come and go, and if I can tough them out I do, but I often have to take OTC Aleve to help with them. I thought they were due to overendulgence of bad food (just had a big bday recently!), as I haven’t been eating properly for a while, but it’s been a few weeks and I’ve tried to eat better and they are still there.

So, now I am wondering, is the Topamax working? Should I continue to stay on it? My gut says yes, stay on, for why not? I still need to see if these headaches that just started up continue. Plus, since I tolerate it pretty well, I might as well. Sound reasonable?

Now, the twist here is that I am overdue to see my neurologist doc. They had me on a waiting list and I never heard from them, so I called. I found out my doc is on maternity leave and her patients are being covered by the physician assistants. (There is another doc there, but he has his own patients.) She won’t return until March, so I have to see the physician assistant. I know these folk are well-trained, but I wonder how much help he/she can be in this area and my situation? I mean, I am a new patient - only just started with this doc and this med. Any thoughts on this? I guess I don’t have much of a choice. I can’t go 9 months on the med without some sort of followup. However, I also don’t think this person is going to really say much other than what I have already decided above myself. I don’t think it makes a lot of sense to go off the Topamax now and I frankly don’t want to unless under my DOCTOR’s supervision if I am going to start another med. I’m sure you understand.

Any imput on this would be appreciated. I guess my other question is how much help can this physican assistant really give me?

Thanks, Bonnie

Hopefully before you Dr. went on maternity leave she wrote up treatment plans for all her active patients. If I were you, I would go to an appointment and see what the physician’s assistant has to say. I know I have been treated by physician’s assistants in the past and like them better than the dr. and in some cases found them more knowledgeable.

Give it a try.

You m entioned decrease in head pain, but what about other symptoms (dizziness). has that improved since being on the med?

The balance issues were already taken care of with my other meds (Klonopin and Tofranil) and were less of a problem to begin with; the Topamax is strictly for the migraines. I’ve only had occasional woozy episodes and one actual “rocking” sensation recently (which is a total new experience).

so great that those other meds took care of your dizziness. maybe you can see what PA has to say, and take it from there. I can surely understand you being uneasy about not seeing a physician for so long. but, if that’s the physician who helped rid your dizziness, I’m sure you are quite thankful for her.

Well actually, the physician who is on leave is NOT the one who helped with the dizziness. She is only helping with the migraine, as that is her speciality. I am seeing a different neurologist for the balance. He recommended HER for the migraine stuff. They both know of each other and MAV in general, but have specialty areas, thus why I see them both. Two heads are better than one they say.

I should note btw, that when I am getting these headaches now, I am getting a little woozy. Not surprising of course, but just thought I’d throw that in.

Well, I’m going in to see the P. Assistant on Monday, so if anyone has any other thoughts/comments on all this, please share. Thanks.