Migraine Update

For those of you following the long saga that is my migraines, I thought I’d give you an update. Today I met with my new neurologist and things are looking up. (Lots of potentially boring details ahead! Feel free to skip this post if you don’t care.)

First, the clinic was good. I got checked in and then got called back by a nurse who asked if I’d turned in my paperwork, and that was it. No weight check, no blood pressure check, no med check. Everything was done by the doctor. Very impressive. My only qualm with the clinic is that the waiting room is not at all friendly for photophobic migraineurs. Lots of windows and lights, with no dark places to hide.
The neurologist was great. She is the first doctor I’ve met with who’s acknowledged that she has migraines. She was impressed that I’d brought her headache diaries from last summer and from March through today of this year as well and had looked over them before coming in to meet me. She thinks that my problem is rebounding off my medications…i.e. that I am taking too much of my abortive medication which makes my headaches more resistant to it and then creates more headaches. (That’s kindof a simple description of rebound, at least, similar to antibiotic resistance, in a way.) So she wants me to lay off my abortive of choice, which is currently eletriptan (relpax). Then she upped the dosage of my preventative medication, topamirate, but that’s a gradual increase, to ease me up to 200mg from 100mg. Hopefully that will kick in in 4-6 weeks, but it will bring me up to the maximum dose for migraine patients (still far below the dosage given to prevent seizures, but more on that some other time). In the mean time, to keep my head calm, I’m taking dexamethasone which is a steroid/anti inflammatory. It should keep the my blood vessels in my head small, as opposed to large, as they are when I have a headache. Side effects include being “wired” or “bitchy” (quotes were my docs). So the idea is that temporarily, the steroid will keep my head in check while the topamax kicks in…then the topamax will keep doing it’s job and I’ll be better off.
Then, once my migraines are down to isolated attacks (i.e. not daily), we can start isolating incidents and finding triggers, which my neurologist says she really enjoys doing. This is something that should lower the number of migraines even more and/or put them within my control. So right now, I know that I can choose to drink a coke, but I’ll get a migraine. So there’s no one saying that I can’t drink a coke, but I know I’ll pay for it. But I don’t know what many of my triggers are, so I’m looking forward to discovering them, so I don’t randomly get floored by attacks right and left. One of her guesses as to why I’ve been having a rough month of it, other than the rebound, is that I’m affected by barometric pressure, and we’ve been having a lot of storms lately.
Another problem I’ve been having is that I’ve been having trouble sleeping because of my pain levels. My solution, unendorsed until recently, is to take half a benadryl in order to kick the pain (and any nausea) and sleep very thoroughly. The neurologist wanted me to move to melatonin for regulating my sleep (especially when on the steroids) instead of benadryl, for now, so that’s another switch as well.
I have another appointment in 6 week, this time with a nurse practitioner, but someone who the doctor works with and someone who specializes in headaches as well. This is also an improvement over my last doc who said he’d see me 4 months later after changing all my meds.
Some of you may read this and think that it sounds like a lot of drugs, and I suppose it is…but I was already taking 11 pills a day. So a total of 4 more isn’t that many… especially when 8 of them will all be the same drug, just distributed throughout the day.
I’m looking forward to this new regimen and found that today was better than yesterday, so hopefully that trend will continue. Even more importantly, I finally feel like I have a medical team that is willing to work with me on my terms, so I’m ecstatic! I’ll hopefully have a good update in a few weeks.