New neurologist

Yesterday I saw a new neuro-the first neurologist I've seen in the US.

I had been dividing topamax into two doses. She told me this was unnecessary because topamax has a long 1/2 life. I think she said 18 1/2 hours. So dividing it increases my risk for side effects. She told me to take the full dose at bedtime.

Triptans have not been working for me very well lately. They are the only abortive she prescribes. She has a big sign in the waiting room and examining room that says no narcotics and no marijuana. I got a prescription for a different triptan and told her I would be back if it didn't work. She also said she wants me to limit the use of triptans because I am over 55 and at risk for stroke and heart disease if I take them. I rarely get more than 2 migraines a month so that shouldn't be a problem.

No more stemetil(compazine)and cafergot. This neurologist does not prescribe any anti emetics because she says triptans should take care of nausea if taken early enough. Sometimes, with a low level migraine, I can abort it with one stemetil and a nap. She claims ergotamine causes pulmonary sclerosis and it is no longer sold in the US. It is a shame because it worked well, especially in an emergency, as long as I took it occasionally.

She told me that, at most, 2 migraines a month, my disease is well controlled. I'd like to get the migraines down to 0. I have had 3 month stretches without one but they come about once a year.
I mentioned my limited diet as a partial reason for so few migraines and she replied that diet has nothing to do with it. She told me changing diet is only effective in children. I really believe that diet has played a part, although it could be the end of menopause that changed the pattern. I guess I never will know for sure because I intend to stick with the diet.