Monday, October 20, 2014

Migraine headache cycles and me...

Migraine headaches have been a big part of my life for the past 13 years. On January 29, 2001 I slipped on some ice at our hobby farm and landed on the back of my head. I had a moderate concussion with minor head injury, according to the doctors who treated me, over the following months. For me that concussion manifested itself with typical symptoms like fogginess, dizziness diminished cognitive clarity and a feeling that I had a blanket wrapped over my head. As time went on, though, I developed migraine headaches as a result of the injury. 
I do not remember every having migraines before my head injury. But, that head injury co-occurred with two huge professional commitments that I had at the time: full time teaching in a small liberal arts college and full time doctoral student at the University of Minnesota. I am sure it did not help that I took little time off of work and continued in graduate school (although I did miss a few classes). I persisted with both and my headaches followed me through every stage.
I started seeing a neurologist after about two years who prescribed a series of daily preventative that included a beta-blocker and an anti-depressant. There are strong results reported in the scientific literature that the regime helps to prevent migraines.  In addition, I took Imitrex, for acute migraines, injectables (which I had many) and tablets. My acute headaches persisted, although the cycle became longer in between them. When I finished grad school, my headaches became even less. But they were still there and would raise their glaring head when I least expected it.
When I started taking better care of my health in 2010, I thought my headaches would also decrease. They did somewhat. The cycles between headaches would go for many months now, but they were still there. Still there meant that I was incapacitated at times. When my headaches start up, I am incredibly sensitive to light and sound. I get sick in my stomach, too, but usually do not vomit.
            I continued to take preventative medications and of course the Imitrex when they were acute. I rarely missed work. But, I kept looking to see if there was something else that was triggering this insidious cycle of head pain. In January 2012, I went cold turkey and eliminated coffee and caffeine. My body responded with one of the longest migraine/rebound headache cycles I ever had: 22 days. Once I got on the other side of the caffeine withdrawal, the migraines decreased considerably. As a matter of fact, I went from having 6-8 a year to maybe 1. I thought I was nearly cured.
            Enter 2014: specifically summer of 2014. 2014 was a significant year for me because I had several bad bouts with asthma because of the very high pollen counts (I am basically allergic to everything outside!). The summer began with a switch to different series beta-blockers because the one that I was on decreased the effectiveness of my asthma medication. The switch began in late May. From late May until late July I was back in a non-relenting cycle of migraine headaches. I took more Imitrex in the summer months than I did since I gave up caffeine. By the end of June, the headaches had subsided, so I that I was done. But, no. I wasn’t. By the third week July they had started up again. I went to see my neurologist who prescribed a new drug for me: an anticonvulsant. I took this for three weeks, but could not handle the numbness in my hands and the dullness in my head. So, I went back to my other meds.
            As the summer progressed I began reading a great deal about migraines (specifically Mayo Clinic: From my reading, I realized that I was probably using too much Imitrex and developed what is known as medication overuse rebound migraines. In early August, I decided to stop all Imitrex for my acute headaches. It was tough, but I did it. At the same time, I eliminated Aspartame in my diet (another trigger).  I noticed that my body would go through a migraine cycle for 2-3 days with about a day in between and then the cycle would begin again. By Mid September, the cycles were getting longer and weaker. By early October, I was having only 1 or so every two weeks. Although it was very hard to power through these headaches, I was encouraged that all together as I went along each headache was less than the one before. This fact made we wonder what might happen if I started to take myself off of all medication. Would I have that same cycle?
By Mid October, 10 days ago, I decided to begin to tapper down my preventative meds. After 13 years, it was fairly obvious that they were not doing what they should have. I was also becoming concerned with some vague wobbliness that I felt might have been related to the long-term impact on my body of these preventative medications. Plus, Beta-blockers are not weight neutral. I reasoned that if I went off the Beta-blocker, just maybe I would be able to work on my last 35 pounds. After my experience of powering through the headaches without any acute migraine medication outside of Ibuprofen, I wanted to see how my body responded. 
It may be coincidental, but over the past 10 days I have not had a headache. I am now off all of my medications for migraines. It is too early to tell what will happen, but I am encouraged by how I feel so far.  After taking daily medication to prevent migraines for over 13 years, plus tens if not hundreds of doses of Imitrex, I feel it is time to see how my body responds on it’s own. So far my head feels good and clear. I am taking good care of myself and keeping up my exercise.
I have been a migraine sufferer for too long to really believe that they are gone. But, at this point, I want to continue to give no medication a try. I respect my neurologist, however, I known that if I had gone back to her in August and reported the unrelenting cycle of migraines, that she would have opted for a new round of different medications, including Botox injections. I am interrupting that medication cycle, to see what happens. I am keeping my fingers crossed that my chronic cycle has also been disrupted. 
I am not a medical doctor. Please take this overview as just what it is: a short history of my own migraines and what is working, not as advice for any reader. I will keep you posted. Michele