Not so bad this time

Boy, have I been slack here.

Let's see. Monday (the 20th) I had a pretty stiff headache. Gave myself a shot and it still took about 6 hours to feel better.

Tuesday and Wednesday were pretty good. Thursday the 23rd, Thanksgiving, I did pretty good until the evening. I was watching a movie on a big screen in a small room and started to feel lightheaded. I took a frovatriptan as the migraine was starting and felt better w/in an hour. Went home and went to bed only to wake up with the headache again. I got an icepack, took an Ativan and went back to sleep. I was then able to wake up without the headache.

Friday was great and Saturday was fine until about 11 am. I started to feel very sleepy and then noticed that my menstrual cycle was starting. Within a few hours I started to get a headache. By the time I decided to give myself a shot of DHE the pain was picking up to a three but never got past that. I think my worst symptom was the tiredness. It was strange, like all the energy was drained out of me. Within a few hours the pain and the tiredness was gone.

This was the first menstrual cycle in a long time that I didn't have really bad, burning type headache pain.

success in a syringe

The other day I described the body scan I do, or head scan, as soon as i become concious in the morning. This morning I was "50 % gone." Because I know that during this "hell week" or week of menstrual migraines that I will virtually have a really bad one every day, I decided to try to knock it out A.S.A.P.

Thursday evening when I gave myself the shot it went from bad to worse, so I was a little nervous. I had a fitting for a mouth guard @ 12:40 that I didn't want to cancel, but I had to take the chance and shoot up the DHE. I was confident that if the pain got bad that I could take the anti-anxiety medicine to help cope with the pain, and have someone take me to the doctor for an I.V. if I needed it. My hubs was sick with the flu today but I have a lot of friends who've offered to drive me when I'm unable.

First I took the compazine (anti-nausea med) because DHE can tend to make you nauseous. I waited 20 min. and prepared my syringe. When I was doing it I began to wonder if I even got the medicine in on Thursday afternoon.

Finally I psyched myself up and stuck the hurking 3 in. long needle into my thigh and slowly pushed the medicine in. I'm quite a good shot taker since as a child I spent seven years getting weekly allergy injections. It's just a little different shooting up yourself!

I know to keep your muscles relaxed or you can have a lot of muscle pain @ the site, and I am really good @ doing that even though I'm nervous. I probably gave myself about a 100 imitrex injections before. But as the medicine went in it really hurt and I had to just keep pushing it in. Fortunately it's only 1 ml. of medicine.

Almost immediately my thigh hurt so bad. I probably limped around for an hour. This helped me determine that I absolutely did not give myself a proper injection Thursday. It didn't hurt at all.

It's really no surprise I had difficulty Thursday as my pain was so high. Even when my pain is half that my thinking starts to really get impaired and slowed down. It takes me a long time to concentrate and think about something. This was what it was like when I was getting the syringe ready that day, but not today.

Also, about an hour after the shot my back by my shoulder blades was having a lot of pressure. Almost like someone was sitting on me. Then it would radiate to the front. I read the information that came with the medicine and it said if you have these symptoms to notify the doctor, advice nurse or pharmacist. I e-mailed my doctor but never heard anything back.

My side effects from the shot, except for that, were minimal. I mean, I'm not trying to downplay those symptoms, because they were distressing. If this is what it will always be like when I take the DHE it won't be like I can feel better and resume regular activity in an hour. It took about an hour for my head to feel good and then about 3 hours for the rest of my body to feel good. I took 2 Aleve which helped my back and chest immensely.

I was able to make my dental appointment and go for a short walk. Again, I didn't want to overdo it as I'm really gearing up for tomorrow. Especially with my husband sick now it is very important to me that I feel good to run the kids around tomorrow night. They will accept going along with someone else, but I know that my daughter especially will be disappointed if I am not able to go, and especially if my husband isn't able to go either.

Only time will tell though...

the calm before the storm...

Today started off as a great day. I went to a counseling appt. that was quite helpful, and then made dinner for my neighbors: baked chicken, spanish rice, homemade creamed corn and coffee cake. I felt great and was able to make time for a walk around the lake before going to the nurse treatment station to learn how to give myself a DHE injection.

While I was walking around the lake I was thinking about the fear I have about the frequency of my headaches and the pain level. I was thinking about the scripture in the Bible that says that the faith of a mustard seed can move mountains. I thought it funny that some Christians, including myself sometimes, criticize ourselves and others for not having lots of faith, for not having the faith of a mountain.

But then some quiet voice inside me said that's the exact opposite of what we are supposed to have. The Bible says it takes the faith of a mustard seed, a tiny little seed. I thought to myself how I feel like my faith has been stripped to an absolute bare minimum, to where there's just a tiny bit left. Sort of like being stripped back to the basics. Yet I know that I have just a tiny bit of faith, a mustard seed. A feeling of satisfaction came over me as I realized that that's all I needed. I felt joy and hope and breathed in the fresh air and soaked up the beautiful colors as golden leaves were blowing out of the sky all around me like rain.

When I was about 3/4 of the way done I felt the first tiny bits of pressure in my right temple. I rubbed some tiger balm on it and continued on. I was a bit sad that another was returning so soon and interrupting my terrific afternoon. As I reached the last intersection before the end of my walk I thought of my Grandmother who passed away a year ago. I thought about how much she cared/cares for me and how sad she would be to see how much I am struggling and I could feel her love for me and compassion for my circumstance.

By the time I reached the doctor's office my pain was increasing steadily to about a 3-4. I was definitely uncomfortable and not able to ignore it. I learned how to give myself the shot and should have taken one right then, but I was hoping to get home and at least get my daughter off to her soccer game and had no idea how quickly the pain was going to progress.

I got home w/in an hour of my appointment and my pain had skyrocketed to an 8. I could only talk in a whisper and it was a burning pain, the kind associated with my menstrual cycle, so I knew that this was the time I needed a DHE shot.

I struggled to concentrate as I prepared the shot as my thinking was so slow. I thought I had done everything right and injected the shot after psyching myself up. Within a 1/2 hour my pain was not improving and I began getting extremely nauseous and vomiting. With this happening, my pain reached a 10 and I laid on the bathroom floor near the toilet wriggling on the floor trying to get some relief.

My husband left our daughter's soccer game and found me on the bathroom floor. He hurried to get our boys ready who were starting to get rambunctious (which makes me want to scream obscenities when I am just wanting to curl up and die!) and we took them to my parent's house. Then he took me to Urgent Care where they gave me an I.V. so I could get benadryl, reglan and another DHE shot. After this series my pain did not improve and I was feeling anxious and like I was going to crawl out of my skin. It was horrible. They gave me a shot of Torredol, put me in a wheelchair and sent me home. This is the quick version. The long version would include an incredibly compassionate nurse who has now I.V.'d me at least three times and is recognizing me as soon as she sees me. I like her but not enough to see her again under circumstances like that!

By the time I get home and settle in for an hour my pain diminishes to a 2 and I top myself off w/ 2 aleve to hopefully get the inflammation down in my brain. I would sleep very soundly....

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.