Neurology, like most of medicine, has different disease prevalences as the seasons change.
In Phoenix, for example, July-August is migraine season. When the monsoons roll in the afternoon several times a week, my office phones ring merrily with requests for early triptan refills and medication changes.
In December, you may think of Hanukkah, Christmas, eggnog, gifts, latkes ... but at my office I think of seizures.
The calls start around Thanksgiving and continue until after New Years. Breakthrough seizures become common. People travel and leave their pills at home (calling scrips to out-of-state pharmacies is a holiday ritual here). They go to parties and are up late, and forget to take their pills. Or simply the combination of more frequent alcohol use, holiday stress, and sleep deprivation does the trick.
This time of year, with kids out on breaks, family trips, visiting relatives, parties, and shopping, always makes those "well, you’ll have to stop driving until ..." discussions even uglier.
After years of experience, I try to warn people in advance. At routine appointments I tell them that the holiday spirit (or spirits) aren’t conducive to medication compliance and discuss ways of remembering to take pills. Usually it works, but there is always someone caught up in the season of travel, sleep deprivation, and stress who forgets.
And so, as the (not particularly cold) Phoenix winter comes, my staff and I prepare for neurology’s peculiar rite of winter.
Dr. Block has a solo neurology practice in Scottsdale, Ariz.