Genomics

I don't remember when exactly it was but maybe like eight months ago, I went to my OB/Gyn for a routine appointment. When I was done with my doctor, I was asked to go into another room to be "swabbed". I didn't ask a lot of questions, because those who know me, know my motto in life is not to ask questions I don't care what the answers are. You need me to be swabbed, I'll be swabbed. It wasn't really presented as a question either. I guess I could've declined, but why? I assumed that if they're asking me to do it, it must be necessary. I know they said it was some kind of test having to do with genetics that sounded cool but you know, I have a very short attention span.


Greg Young is the guy who works for Gulfstream Genomics, the company that does the testing, told me that the test would tell Dr Wiener (my doctor), and me what medications are metabolized best by my body and what doesn't. This was extremely intriguing to me.

The main reason I was so interested in this testing is that I have had migraines, terrible migraines, since I was a kid. I'd say they started when I was about six or seven. I know it was before I could swallow pills. Migraines run in my family on my father's side. My mom got a headache like once a year so she never really got it and honestly never really investigated doing much about it. I don't remember how I figured it out- maybe from getting pain pills from a wisdom tooth extraction when I was in college, but most over the counter pain medications never seemed to help. College for me was in the mid-90s so I was given Vicodin or Codeine or Oxycodone. Yes, those are strong. And addictive, but I don't have an addictive personality to substances. Sugar and cake, yes. Drugs and alcohol, no.

I'd gone to so many doctors since college because of insurance changes and moving, and they've all given me different prescription meds that are supposed to work for migraine. Fiorecet, Celebrex, Imitrex, etc.Yet they never did. Only opioids, which are not prescribed for migraines. Before opioids became an epidemic, they could be prescribed whenever in however many pills. It's crazy that I could say I have excruciating back pain (which I've had since 2004) and get the pills but not for vomit inducing migraines. It's all pain. I'm no scientist, but pain is pain.

I had a horrific incident with an unscrupulous general practitioner. He'd prescribed me oxycodone for the migraines. I cut them up into four pieces each because they make me tired and I wouldn't be able to function if I took more than a quarter. I ran out of pills before my honeymoon in 2006 and I called the office. They told me I needed to come in to the office to get that prescription. I went in and loudly I was told by the doctor in front of the full waiting room that I couldn't have those pills for migraine and basically implied that I was like a junkie or something. I was so mortified. If they'd told me over the phone I couldn't have them, I wouldn't have gone in there. He'd given them to be before for that. It had taken about a year to use them so it's not like I'd been back to try to score. I felt like I could never go back there and didn't. I also was out of pills so I was back to just trying to live with the pain.

I also was embarrassed. I felt like I legitimately need these pills. I was treated like a liar. People who don't have migraine have no idea how debilitating it is. It's not "just a headache". I've missed events, like the Harlem Wizards game my husband was playing in for a school fundraiser, because I was laying on the bathroom floor in between vomiting. I was afraid to ask any doctor because I had PTSD from the last time. And I only really have an OB/gyn as a doctor. I just never found a general practitioner I felt any connection to like I do with the person who delivered my son. Plus, having another doctor just seems redundant. My doctor does my blood work like every six months and knows me.

I can't live with the pain of migraines though. At some point in 2012, I couldn't live with the back pain either. I told Dr Wiener about my back and he ordered an MRI. I had the MRI and it turns out I have bulging discs and degenerative disc disease. Because of that, he could prescribe me the oxycodone and did. I'm actually willing to deal with the back pain and only take the oxycodone for the migraine.

What the oxycodone does is just take the edge off the pain. It takes it down to a dull pain where I don't feel like I'm going to throw up and I'm not crying in pain. That's all I want. Dull pain is a cake walk and I can live with that. Knowing that I could never predict if I'd be able to get a refill, I really had to know my pain threshold to decide to whether to use one of those quarters. To me it's like being lost in the woods with only enough food to live for a short time and having to ration it out. By the way- to illustrate how sparingly I use them, it's 2018 and I'm only now almost done with them. As an aside, I also have a strong suspicion that a decent amount were stolen from my house. I really don't know by whom, but I just know they're missing. And NOW, the doctor can't even prescribe them anymore. I don't even want to think about how screwed I am.

This brings me to the genomic testing Gulfstream did. When my test came back, it turns out that my body doesn't metabolize most common pain medications well and that's why nothing was working. Advil, Motrin, Celebrex - none were good, and I have it ON PAPER NOW. Funny (or not funny) enough, I'd had a terrible experience with Celebrex years ago.

When Dr Wiener and Greg were going over the test results with me and I saw how almost no pain meds metabolize well for me, I got truly emotional. I finally felt validated for what I'd been saying all this time. That I wasn't a junkie for asking for what worked for ME. I don't know if it would work for someone else. I'm not a doctor and I know this is a highly addictive drug for most or many people. I just knew for damn sure what does NOT work for me. In my mind it's like toddlers and cold medicine. Because some parents made poor decisions using cold medicine to make their kids sleep and overdosed them, all kids under six are supposed to suffer with "natural" remedies that DON'T WORK. Everyone gets punished.

I don't know why every doctor's office doesn't use this kind of test. I know with the neurologist, before I got my Botox for migraine, for insurance purposes of paying for it, I had to "fail" two or three medications before they'd okay the Botox. Insurance had to pay for three visits, three medications, and I had to pay co-pays and waste time. I had to waste time in pain. If they'd just given me the test or I could've brought the test results had I had them already (I didn't), we could've skipped all that. I don't know why everything has to be made more difficult than it needs to be.

I'm not sure how it works - as in, I'm not sure how Wiener ended up having this company come in. But he's always on the cutting edge of what's new. Last I saw him, he was deciding to bring a Cool Sculpting machine into his office. I guess the idea is that you have a baby, aren't happy with your post baby body. and you freeze your fat away. I think that's brilliant.

Insurance should pay for the testing. I have Horizon Omnia Silver and they paid. They'd be crazy not to pay. It ends up helping them in the long run. They don't have to pay for medications that don't work or appointments people don't need. I will say that without insurance it would be very expensive. Somehow the wrong code was entered when it was put through insurance. I ended up with a bill for 4k then another for 8k or something like that. It was a mistake for me to be billed but that's about how much it would've been if I had to pay for it. Before you let anyone swab you, check with your insurance first to make sure they're going to pay.

The other part of why this is great is that treatment can be more accurate.When I went back a month or two later, I got swabbed again. I didn't ask why but then the next time I came in I asked what the last swab was for. Greg said that it was to check to see if I was taking what was prescribed and if it was still working. So I guess it's like a check up that's more accurate than relying on a patient's word. When it comes to my health, I like things to be as accurate as possible. The way to do that is to have checks and balances. Not everyone is honest or remembers to take what they're supposed to take.

So Dr Craig Wiener offers this cutting edge technology. It makes me feel confident in my doctor knowing he's always adding the newest technologies to make patient care better. I feel like every time we turn around, we're being offered less for higher costs (in terms of insurance). I want to go where I'm at least offered the latest in what can be offered for optimum care. I don't know what I'm going to be able to do to alleviate my migraines any, but at least there's info on what doesn't work with my body. That's a step in the right direction!

Comprehensive Women's Care of Paramus: https://www.womenscareparamus.com/

See the photo below. That's just a random page in alphabetical order of different medications and how they would or wouldn't work for me. I have no idea what most of those are for, but you're tested for everything. Notice though, what it says for Celebrex. And note that I mentioned above that I had a terrible reaction to it years ago. Had I had this test, I'd have known not to even take it in the first place!