The long wait for medication to kick in

I began a new migraine preventive almost two months ago and—to put it mildly—it didn’t work at first.

(And yes, I am simultaneously working on a blog to update readers with “Kiss and Tell” news, but as it turns out, when life kicks your butt with health issues, you pretty much end up being forced to put them first. So let’s get those out of the way first and then I’ll fill in the missing pieces of the book tour summer.)

Let me hasten to add that most of the migraine preventives out there don’t work right away. They are powerful drugs that must be introduced to your system gradually and have long laundry lists of side effects. But if they work, they are worth the trouble. I began my Topamax regime at 25 mgs. nightly for a week; then 50, then 75 and finally to 100. My neurologist said if I got too sleepy or had trouble adjusting to any level for whatever reason, to stick there for a while before jumping up to the next dosage.

One month in, at the end of August, I was miserable. My migraine chart showed seven headaches for the month, and one had lasted multiple days. That is not a good month, friends. Only two other months this year have been as bad. (Yes, I keep records. Thank you oh-so-much, obsessive-compulsive tendencies.)

I knew one month wasn’t a long enough trial period for the medication, but I was in despair over my pathetic situation. In addition to all the days of painful headaches, the drug was causing some of the predicted focus problems, plus I occasionally felt very disconnected and drift-y. Since I live alone and don’t have a person that regularly fastens me back to Earth so to speak, this became an issue. My appetite decreased and I never felt like cooking because nothing ever sounded good to eat, probably due to the distinct metallic taste in my mouth. I even lost the craving for my beloved Dr Pepper; never would have believed it.

I tried to keep exercising, but it was a struggle. I started visiting a neighborhood juice bar for healthy smoothies because meals felt like too much of a chore. A friend told me she noticed the circles under my eyes looked like bruises, so I knew I needed more sleep. I felt more depressed every day, like I just couldn’t keep up with the self-care treadmill.

At the beginning of September, I told a friend I was prepared to shoulder a second month of “adjustment period blues” but fortunately she was thinking more clearly than I: She admonished me to call the doctor for advice. D’oh.

He recommended I up my dosage from 100 to 125 mgs.

Though I continued struggling for another couple of weeks, the weirdest thing happened shortly after I upped the dosage. It was so abrupt that I went back and checked my calendar. At 6 1/2 weeks after I began taking Topamax, I woke up one morning and suddenly felt clear again. The fogginess that had crept in, and the tendency of my thoughts to kind of drift off down side roads was abruptly gone. I regained my productivity and felt grounded and engaged in what was right in front of me. And having that clarity restored made me realize just how far afield I had drifted.

And here’s the miracle: With the Topamax dosage at 125 mgs., we’d found the dosage—for me—that pushed the migraines back.

For how long is anyone’s guess. I’ve been in the business of waging war on my headaches for almost two decades, and I know nothing lasts forever. But September will be over tomorrow, and this month has hosted only TWO migraines. Up till now, February was the month this year with the fewest migraines—and I had four that month—so a month with just two is pretty much heaven for me. A super month like this reminds me of how amazing a migraine-free life can be.

It was only two weeks ago that I shook off the Topamax fog, with its depressive tentacles and nasty, isolating tendencies. It’s tricky to know what part the chemicals played in final analysis, because fogginess made it all, you know, foggy (which is why I was not blogging or even Facebooking or doing much of anything, honestly). All I know is the end result is positive.

It makes sense to me that my body chemistry had to assimilate the drug over a period of time. For now, the combination is working very well. My pharmacist told me there is a good reason doctors start Topamax at small doses; many people have adjustment issues. I’m interested now to hear what my neurologist has to say when I relate my experiences during my appointment next month.

For now, I’m just grateful to be waking up day after day with no migraine aura.

For my money, that’s a miracle.