Praise the Lord for Prozac....

I have had such a great streak since I started my 10 days (this time 12) of Prozac before my cycle on Dec. 12th. I had my typical migraine the night before my period started (23rd) but I also had a head cold and my period was late so I didn't realize what was going on. Instead of giving myself a shot like I should of I took a frova and it did nothing. So a few hours later I took another frova and it didn't help much either. I was able to go to sleep that night with the headache but woke up in the middle of the night with it. I considered taking percocet, but since it's not technically on my list I tried something else first. I took some bendaryl and an ativan, got an ice pack and went back to sleep. I woke up without the headache and eventually started my cycle on the 24th. *typical explanation for a drug resistant headache!

The 24th and 25th were fine and then the morning of the 26th I woke up with another one. It wasn't very strong at all but since I know what to do with my period headaches I went ahead and gave myself a shot. I tried to angle the needle in this time and my leg didn't hurt at all this time (except from the initial shot) so that was great. Of course I took the compazine 20 min. before and it really helped quite quickly. I was able to have a normal day. However, I did notice that all day I felt very agitated and restless, unable to sit still. Anxious I guess. I don't know if this was from the DHE, period or what but it was pretty annoying and I tried to distract myself as much as possible and went to bed early to avoid feeling that annoying feeling.
In 15 days I only had 4 headaches I had to treat, including 2 menstrual ones, so that is a great improvement. It will be interestng to see how I do now w/out prozac until Jan. 10th. That's 15 days. It's possible that prozac in general could help a lot so I need to pay attention to that. Also, since the 20th I've increased my Trileptal another 100mg. to 300mg. so that could be a factor but I was noticing improvement before that (because of the prozac).

when asked, a good friend will tell you the truth even when they know you don't want to hear it

I wrote the other day that I was considering checking into medical marijuana. My plan was to try it and then approach my doctors to get a perscription for it.

Well, I don't know anyone who uses it, where to get it, how to do it, etc. I have a friend who used to, so I asked him about it.

He knew what I wanted to hear, because I could hear the change in his voice when he said what I didn't want to hear.

"Get it through your doctor."

He suggested I ask my doctor FIRST and try it through them. He had a point, I quickly realized that it may not look good for me if I've tried it, more than once and THEN ask. Perhaps it would look like I was just trying to get what is normally an illegal drug. He had a point. Makes sense. But it's scarry. Which doctor should I ask and when?

I don't think I'll ask my neurologist because I think he wants to try a lot of different things, which I would still like to try. It just takes so blasted long.

I think I'll contact the pain clinic I went through and ask them what the normal protocol is on this. I know these people are "on my side" and want to see my pain managed. Perhaps its reserved for people who have pain everyday. I don't know. All I know is that for the past few weeks 2 days is the maximum I've had between headaches.

I have one right now.

I'm hoping that I could use it sometimes as a "rescue med" when I've exhausted the other supplies of medicine that I have here. I know you can use it regularly to prevent them but it's probably not the best medicine of choice for that. But it's better than nothing, which is where I'm at now in the midst of trying to find something to work.

With how long the process takes it could happen in a few weeks (finding something to prevent) or it could take a year or more. It's just such a stinking long process, and all I care about is today and tomorrow.

Also, since it's ten days before my period, today was my day to start prozac and I've decided to take 20 mg. everyday. I had the choice between 10-20 mg.

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.

just when i thought things couldn't get worse...

Today turned out to be a lot like yesterday. My day started off great. Woke up with a clear head and after taking the kids to school I went for a long wlak @ the lake again. This time I walked the whole stinkin' thing, about 4 miles. It felt good to be out in the crisp morning air and to feel the tightness in my legs from the exercise. I was feeling pretty emotional though and had to fight back tears.

Also, my mind was filled with worry and fear about the pain returning. I had to force myself to look at the trees, the birds and the ducks....force myself to think about the good things that were happening now, all around me. It was so hard. Within minutes my mind was back to the night before and planning what I would do if my pain came back.

After I returned home, about 1 in the afternoon, I again started to feel pressure in my head. Before the pain could really escalate, I drove to the doctor's office and went to the nurse's treatment center to get an i.v. magnesium sulfate procedure that was a standing order for me. They told me that they didn't give them @ this site, so an RN called around to see where I could go to get it. We discovered that I had to drive an hour to find a place that would do it, but I knew my husband would take me.

When I left home about 6 p.m. my pain was about a 5. By the time I got to the ambulatory care center @ Sunnyside my pain was about 6. I received the treatment and when it was over there was no change in my pain. Also, my blood pressure was 147/107 and the nurse who was attending me said that I needed to get my blood pressure checked again within a couple of days. We drove home and about 20 min. from home my pain was @ an 8 and I vomited. When we pulled into town I started crying and asked my husband to take me to the E.R. I didn't want to go home and just lay there suffering. I was soooo tired of hurting.

Of course the emergency room was busy, it always is, and it was a Friday night. My husband said, "Are you sure you want to stay?" I started crying and said, "I'm not leaving!!!"

I don't know how long we waited, it must have been two hours. I was completely miserable, agitated and full of anxiety when they called me back. I was at the point where all I wanted to do was die. In fact, I would have done anything for someone to just give me something so I could leave the planet. When they called me back to the room I started crying, first because I hurt so bad, and second I was hopeful that my misery would finally be over.

Of course once I got in there it would be at least another 1/2 hour before I got my first medication. Mentally I was really starting to lose it. At one point, I looked @ my husband so desperately and said, "I want to die, please just let me die..."

The first med they gave me in the i.v. calmed me down, the second was an anti-nausea medicine and the third was for the migraine. They also did a CT scan which showed nothing. After I got back to my room the ER doctor said something about me going home. My pain was down to a 5 but I was absolutely petrified to go home and told him that I had hoped my pain would be lower before I went home. He said they could administer the last medication they gave me again. That brought it down to a 2. But I have to say, either my anxiety, or the combination of meds, or both of these combined, caused me to feel completely drugged and very unsettled, like I was just squirming in my skin....it's hard to describe. I think the anti-nausea med was called compazine and the migraine med was seroquil (??) something with an "s" anyways! My blood pressure was still kind of high but lower than it was @ Sunnyside.

The weird thing was, that with this combination I didn't sleep, but I could hardly open my eyes for at least an hour. Very strange... according to my outpatient letter, the ER treated me for acute migraine headache, acute tension-type headache, acute uncontrolled hypertension and acute anxiety reaction.

After I got home (2 a.m.) I tried to go to sleep. I was really fighting some bad thoughts and so anxious about the headache returning. I called the 24 hour psych line and talked to a nice guy who gave me some really good suggestions. One was to follow up w/ a doctor the next day and talk about anti-anxiety medication.

I finally fell asleep about 5:30 a.m. and slept for an hour.

This is a day I hope to never repeat...

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.