Posts Tagged ‘triptans’

Some things never change

February 15, 2010

I woke up around 7 a.m. a week ago today and before I raised my head off the pillow, before I even opened my eyes, I felt the sickening ache and realized I had a migraine.

Aside from the fact that I can’t figure out how the heck my flagrant act of — gasp! — sleeping could induce a migraine, the crummy couple of weeks I’ve experienced battling my headaches makes me realize I’d sort of hoped that retirement might banish them entirely.

I’ve fought migraines for 15 years — they pitched tent when I entered perimenopause around age 40. I wrote about my exploits and efforts to control them several times while working for the newspaper, and was always amazed at the outpouring of response. But with more than 40 million Americans suffering alongside me, I guess I shouldn’t have been so surprised.

Despite my long history with the headaches, and this recent bad spell, I retain the belief that one day I’ll have a migraine free life. Though my head is wonderfully clear today, the percentage of days when I wake up and begin to feel the dreaded aura behind my left eye is much too high. My current medication is Maxalt (and I believe I’ve now sampled ALL the triptans, thank you very much) but it just doesn’t seem to be able to fight recurrence anymore, which is a huge problem with triptans (the best meds to fight migraines these days). I’ll take Maxalt at, say, 10 o’clock one morning, feel sick for a couple hours while the medicine kicks in and banishes the pain, have a fairly productive afternoon and evening, go to bed ever-hopeful — and wake up to the exact same thing the next day. My neurologist recently prescribed an anti-inflammatory to take at 12-hour intervals to try to arrest this tendency, but this nasty rebound effect is a well-known side effect of triptans.

Almost two years ago I participated in a yearlong study through my neurologist, testing a new drug in a different family from the triptans. “The next generation meds” my doctor called it. Not once in that entire year did I have a migraine recur, so it’s pretty obvious I was receiving the new med (which was being compared to Maxalt in that study). Every time I visit my neurologist, like a broken record, I ask, “When is that test drug coming on the market?” When the FDA approves it, he says, bracing for my incessant whining, which he knows is coming.

Meanwhile, thank goodness, I have qualified for insurance coverage for Botox treatments to stem the migraines. In another research study, this one for 6 months, I got shots to the head and neck to deaden the muscles and nerve endings that transmit the pain of migraines, and though it is pretty tough to sit through 30 shots, I long ago got used to enduring unwanted procedures in order to treat my migraines. My headache load — which 5 years ago caused to me take medication as much as 30 times a month — is now down to 4 or 5 headaches a month. As long as my Maxalt works, and I keep the recurrence rate down, that’s a tolerable number for me.

Which is why this recent spate of rebounding headaches has put me so out of sorts. I lie in bed at night and plan the following day — I’ll post a new blog, make a grocery store run, go to the condo and work on the book the rest of the day — but by mid-morning all is in disarray.

When the aura first starts, there’s the sheer disbelief that kicks in — I CAN’T be getting another headache, can I? Then you try to gauge how bad it is. Can I slip by and fool it? Mainline some caffeine and maybe, just maybe, avoid getting a full-blown migraine? Then there’s the disappointment, when you realize nothing you’ve done is going to keep the headache from coming. Then comes the surrender, when I tear open the foil packet of Maxalt and take my medicine. It works, you see, but it also makes you feel lousy for at least an hour before it does. Your head still pounds, your throat gets thick, simple expressions like smiling seem gigantic. Right before I take my medicine, I feel angry. I guess because I know I’m about to lose one more battle in this long war. But immediately upon taking it, I try to give myself a pep talk: OK. It’s all right. You’ll feel better in a couple hours. You did the right thing.

Negativity + migraines is lethal, so I do try to keep it at bay, but let’s not kid ourselves: I get really mad about them some days. I blame myself or circumstances or anything handy I can find, even though I know better after living with and studying this disease for all these years. My next Botox treatment is still a month away (I think 85 days between treatments is normal) so I’m trying to resign myself to the interim. I’m on Day 3 now with no headache and am feeling so clear and happy, but to get there, I did something a bit unorthodox. But I figured, what have I got to lose?

Here’s what I did, and it’s worth noting I would never have felt I could do this when I had a full-time job . . . I possess way too much guilt for that. Last Thursday, when another recurrence happened, I took the entire day and fought back against the headache with everything I had — except medicine. My theory was that I wanted to break the medicine’s cycle. I rested and didn’t read or strain my eyes, I put ice on my neck and forehead, lay down in a dark room, put cucumbers on my eyes, went for a reflexology treatment, ate healthy foods. At some times I felt very sick, at others I felt OK. By bedtime, I thought I might be OK. The pain was mild enough by then that I could fall asleep, hoping my experiment would prove to be successful the next morning.

No such luck. And I did NOT have the stamina to endure another day of pain, so I took Maxalt around 8 a.m., as soon as I knew. BUT . . . I have been headache free ever since! Though you never know what actually works, perhaps I broke the cycle and got the medicine out of my system long enough for it to be effective again. Whatever the reason, I’m just thrilled to feel normal again. It’s my third day of no aura, no sick disappointment in the pit of my stomach, no rearranging of the day’s agenda to accommodate a pounding head. Yay!

Anyway, lots to do, so I better get to it — now that I have energy to burn. I’ll blog again soon about the possibility of moving my entire life into what has previously been my work studio. Yes! Roomie may actually be selling the house. Change of address imminent after 7 years in our Florida paradise house. Is it any wonder my to-do list is out of control?