The Diagnosis....

Today I went to my neurology PA to get my diagnosis. I woke up with a headache and had taken something for it. On the way to the appointment the headache subsided a bit. We also stopped @ Starbucks on the way for what would be my last breve latte.

I was very nervous before he came in, hoping that I had given him all the correct information @ our last appt. He began by explaining the neurological processes of a migraine. My aftercare notes state that according to "research done in 1995... a group of cells at the base of the brain, present in all humans, may cause migraines in some people as a result of an increased or unstable firing pattern. This in turn may promote inflammation of blood vessels in the covering of the brain and alterations in blood vessel caliber."

Basically, what he was saying is that migraineurs have "irritable brains" in that the irritability is the inflammation and the tendency towards inflammation that occurs.

Both my husband and I found this information extremely helpful. In subsequent days, I would remind myself of this during some of the most excruciating migraines I have ever had. Instead of thinking that I was just an unlucky person, randomly smited with the misery of migraine, I reminded myself of the information I had learned, and realized that my pain would subside once the inflammation in and around my brain was diminished.

His first issue to address was my menstrual cycle. He said I had "probable menstrual migraines." It was decided that I would discontiue oral, continuous, birth control pills as they did not seem to be helping. According to him, two thirds of people don't receive benefit, while one third do. He let me do the math, and we all agreed that I was in the majority and not the lucky minority.

This was scarey stuff to hear. Because off of the birth control pills, I would revert to the pattern of 4-7 days of my worst migraine pain that was slow, or non-responsive to my usual treatment methods, resulting in a strain on my mental health. Yikes, I was a tad bit freaked out, but at the same time, completely in agreement with the decision.

He suggested that I learn how to self inject DHE, a medication I had received a few times in Urgent Care treatment through I.V. He said to use this for my menstrual type migraines and could be used 2-3 times during that week. (I think that's what he said anyway, that's what's on the bottle...).

Next he addressed the frequency with which I treat migraine and how this causes a rebound pattern. We all agreed that it definitely seemed like that was happening to me, as for the last four weeks I had been dealing with almost daily headaches. And, trying to carry on my normal activities like taking the kids to their soccer practices and games, helping out in the classroom, attending a chronic pain support group and other activities, I was constantly trying (it seemed) to get my pain under control so I could function. I had been trying to vary the medications I used and not use too much of one thing for fear of rebound or the medication becoming ineffective. Unfortunately, it wasn't working out as I had planned.

His suggestion, therefore, was to only treat 2 headaches a week.

Yikes, even on a good week I clearly had 3. This was going to be hard but I understood why he was saying it.

It was decided that my daily migraine med, lamictal, would be increased another 50 mg. and that I would start MigreLief, a product that contains riboflavin, vitamin B2 and feverfew (2x daily), stop drinking caffeinated beverages, discontinue use of excedrine migraine and tylenol and replace it with 2 Aleve with either migraine reversal medication I was using (frovatriptan or DHE).

I may have felt like I was being asked to step off a cliff, but it wasn't without a partially stocked, and well thought out, backpack of survival supplies....

I continued to manage the headache I had gotten in the morning with Tiger Balm and completed a very busy day, too busy I might add. But I was able to attend my last Pain class as well as my son's last soccer game, my other son's end of season pizza party and a harvest party at our church.