Monday, June 08, 2015

Migraine Update - Migraine and Headache Awareness Month

National Migraine & Headache Awareness Month

June is Migraine and Headache Awareness Month, so I thought it would be a good time to post about the current status of my chronic migraine illness. When I planned to do this a few days ago, I was all optimistic about how well things were going. Then today happened. 

First of all, today. Actually, to get to today, I have to explain the last week or so. I had a three-day migraine last week that was triggered by storms, but made worse by the fact that I was in need of my Botox. The migraine was not only longer than usual, but was more intense than my migraines have been lately. In any case, I survived with my Imitrex, Cefaly, and a couple of doses of tizanidine (a muscle relaxer). I got my Botox treatment on Thursday, which wasn't fun, but was much-needed.

Unfortunately, Botox doesn't kick in immediately. I started having prodrome symptoms on Saturday night and woke up at 2am yesterday morning with a pretty high-level migraine (7/10). This migraine was triggered by weather and hormones. I didn't sleep much at all last night, so I was back up to an 8/10 this morning. I was supposed to have my annual physical today, but went in for an acute migraine visit instead. Normally, I would just tolerate this  kind of headache on my own, but I already had the visit scheduled and needed to keep the appointment because I needed to get medication refills. So, I got my meds refilled and ended up getting Toradol, Phenergan, and morphine. The migraine isn't completely gone, but I'm feeling a lot better!!

Overall, though, my chronic migraine disease has been stable, if not a bit improved since the first of the year. I have one to three migraines per week. The migraines generally last less than twenty-four hours, which is probably the one improvement in the last couple of years. I haven't been to the Emergency Department for acute migraine in over a year and to the clinic for acute migraine for probably about a year.

I recently stopped taking amitriptyline since my mood and headaches have been pretty good. I figured that summertime is a good time to try to stop it. My main reason to try to stop is because of side effects, and, in fact, I have lost about 15 pounds and am not eating nearly as much. Of course, part of the weight loss is because I'm obsessing on exercising because I want to keep my mood under control. Overall, though, stopping the medication has been successful.

What is working for chronic migraine and my other diagnoses these days?

  • Topamax - This is the base of my treatment. It's an anti-seizure medication that I take twice a day. The cognitive side effects are still problematic, but I'm not interested in trying to change it.
  • Citalopram - I'm using this for depression and it's working well. I have very few side effects, so I'm happy.
  • Botox - Thankfully, the treatments are only every three months. I'm needle-phobic, so 31 injections into my scalp is not my idea of a fun time!! It seems to be helping, though. I can tell when I'm ready for another round of injections every three months. My neurologist came up with another fun thing this time - an injection just underneath each eyebrow! I love it - NOT! We'll see if it helps. In any case, we're definitely continuing Botox.
  • Exercise - This is mostly for mood and general good health. My main exercise is walking, but I've developed metatarsalgia of my right foot (the ball of my foot hurts). I'm seeing the podiatrist tomorrow - Yay! I'm also doing yoga, which seems to be helping my flexibility and overall fitness. Also, Yay!
  • Tizanidine - I've been using this muscle relaxant at night for sleep, but I've also found that it works well for acute migraine. Granted, it makes me dizzy as all get out, especially since I use 4mg for acute migraine. But, it works.
  • Cefaly - This device makes me look like Wonder Woman or Arwen or some alien. It works by pulsing electric current across my scalp. I use it once a day and then if needed for acute migraine. I'm finding it pretty helpful.
  • Triptans - These medications are still the basis for acute migraine treatment. I was using Imitrex because it is the cheapest, but the side effects are pretty unpleasant. My neurologist has decided to try me on Relpax which didn't give me too many side effects on this last migraine, but it also didn't help much. Of course, nothing till the Toradol and morphine helped. In any case, if insurance covers the Relpax, I'm going to try that.
I still have a fair number of fibromyalgia symptoms to deal with. The standard line is that treatment is exercise. I'm exercising every day that my head will let me, but the FM symptoms don't really budge much. They aren't debilitating, so I just keep pressing on.

My depression is pretty well controlled. Citalopram is my primary medication, but I'm also using exercise and counseling as part of my management regimen. Now that I'm not on the amitriptyline, I have to pay attention to my sleep. I am not sleeping as late as I used to, but I have more energy, both of which I attribute to the medication change. I also do mindfulness meditation along with my daily prayer which is no small contribution to my depression treatment.

That's where I am with my chronic migraine and other chronic illness symptoms. There isn't a cure for chronic migraine which is why Migraine and Headache Awareness Month is so important. Research for effective treatment and an eventual cure is desperately needed. The disability from migraine is huge! And that's just MY disability - LOL! Seriously, the amount of time from work lost due to migraine is significant. We need to treat migraine like the serious disease it is.

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