Dr. Herzog is a really nice man! We talked about my headaches and he asked if I have always had headaches and I said I had them occasionally as a child but nothing severe and he kept saying well that is not common. He said children should not have a headache of any kind, severe or not.
This helped him to determine that my headache is probably not all from the Chiari. He has put me on a drug regime, that I am to follow until my next appointment in July.
The medicine is actually to help alleviate tension/pressure headaches, which is what he feels I have that is more prominant than the Chiari and could cause the Chiari to act up.
I will take this medicine every night for week. After a week if I don't see a decrease in headaches I will take 1/2 a pill in the morning and 1 and night for a week. If this doesn't decrease I will take 1/2 a pill in the morning, 1/2 at lunch, and 1 at night until my follow up visit. He also gave me a different muscle relaxer to take with the pain medicine but I can only take 8 total in a week. If that doesn't work I am to use the pain medicine with all that, that I had originally be prescribed by my neurosurgeon! Did you get all that???
He wrote it all down for me. And like my PCP who had the analogy of calling a zebra a horse he also used an analogy of fleas and ticks. The ticks are the underlying (tension) headache and the fleas are the Chiari.
He too thought holding off on the surgery was a great idea and said that in 6 months when I go back to Dr. Michael (neurosurgeon) to have him do another round of MRIs, to check the herniation. He said that if the herniation stayed the same then to continue this plan, but if the herniation changed he would advise surgery.
The reason for this is because the longer we let the herniation become. the more likely it is for other symptoms of Chiari to appear and having the surgery would keep them from occuring.
But like everything there is a risk in the surgery as well. HMMMM.