Lou's Migraine Blog

The neck spasms have come back recently. While it appears that my migraines were triggered by neck spasms caused by grinding my teeth (particularly while sleeping), wearing a mouthguard at night has not been a total cure.

With the neck spasms, they can come and go (much like the migraines I had in the past), and luckily I can see the warning signs coming and take the medicine (Baclofen or Soma) needed to quell them.

Hopefully they'll go away soon and stay away. Hopefully.

Monday
April 23, 2007

I've been migraine-free for almost six months now. Controlling the muscle spasms in my neck has proven to do the trick. I take 1-3 Baclofin pills per day as needed (some days are better than others with the spasms) and I take a pill called Taxaflin (sp?) before bedtime that helps ensure that I don't wake up in the middle of the time with searing pain shooting through my neck and/or head.

Also, I have moved to the Nashville area (specifically Smyrna, TN), which may (or may not) have an impact on my migraine situation.

Thursday
February 15, 2007

It's been almost three months (since Thanksgiving Day 2006) since I had my last migraine. The reason? Baclofen, which has controlled the painful neck spasms that a doctor pinpointed as the cause of my migraines.

Unfortunately, over time, the Baclofen has become less effective. One pill a day became two, and now three (or four.) I have to keep the damn things in my car at work. They don't have any effect on my mind (it's not Soma) but, believe me, I'll take it over a migraine.

I went to the doctor this afternoon directly from work; the doctor prescribed me a new prescription for some muscle relaxer I'd never heard of before. We'll see how that works out; if it doesn't work, it'll be back to the Baclofen for me.

On top of the prescription, I received an injection in my hip of a steroid of some sort. Not that I'm going to turn into Chris Masters circa 2005, but it was funny to get a shot of "the juice." If I go into a roid rage, you'll know why.

Supposedly the steroid is to help stop the muscle spasms; wish me luck with it. But the main goal, preventing those horrible migraines, is being achieved... and, for now, it's Mission Accomplished.

Sunday
December 24, 2006

It's been nearly a month since my last migraine attack. The frequent use of Baclofen to treat neck spasms seems to be doing the trick.

I went to the doctor for a prescription refill earlier this week (and also because I was briefly, but violently, ill with one of those 24-hour bugs.) Another attempt to get a prescription for soma proved unsuccessful; apparently that doctor's office has something against prescribing it, as every attempt for even a small amount has been rebuffed. I wanted to try it and compare/contrast the results with how Baclofen worked to treat the spasms.

Yesterday afternoon I went to the Hollywood 27 cinemas with my parents to see the movie We Are Marshall. It was an excellent film, but the second half in particular was bothersome as I suffered some pretty severe neck spasms. The pain from the spasms wasn't so bad as the worry that it might trigger a migraine before I could take another Baclofen pill. Luckily I made it, but I suppose that sort of worry comes with the inexact science of treating migraine headaches and their triggers.

Monday
December 11, 2006

I suppose that, in some ways, it's a good thing when I haven't updated this in more than a week. It's a sign that things might be improving.

During my long trip to Nashville (Wednesday night through Sunday morning) I was migraine free. My last full-blown migraine was on Thanksgiving morning, and it seems that my Baclofen as-needed approach is working.

On Friday of this past week, I had some severe muscle spasms that did require several doses of Baclofen, above the maximum per day amount of three. But I figured: I could take five (which I ended up doing through the course of the day) and not get a migraine, or end up getting incapacitated by a migraine attack and then having to use an Imitrex. So the Baclofen won.

The neck spasms aren't fun, don't get me wrong, but it's more of an annoyance pain. I can deal with it, and while it is uncomfortable, it's a far cry from the excruciating pain of a migraine attack.

I've stuck with the no sugars, limited fried meats approach, though I really don't know what affect that has on migraine headaches. But things have been better on that end since I made the switch, so I'm going to stick with it.

Friday
December 1, 2006

I've been migraine-free for a week now, thanks in no small part to the Baclofen that I've taken. For the past two days I've had to pick up my bottle from home to take a pill because of neck stiffness/pain at work, but the Baclofen has done the trick.

During my trip to Nashville, my Mom asked me if I would have to take medicine for migraines for the rest of my life. The short answer: I don't know. Hopefully they'll go away and stay gone. But, until I know for sure, I'm going to take whatever medicine I need to take to fend the migraines off.

Wednesday
November 29, 2006

Baclofen continues to be my friend. Thanks to that muscle relaxer, I made it through the rest of the trip to Nashville migraine-free. I've had some muscle flare-ups in my neck, mostly at night, but it's nothing that the Baclofen couldn't fix. I've taken up the habit of carrying Baclofen and Imitrex with me at all times, which might seem excessive, but if you've dealt with migraine pain... you should understand.

I've maintained a prohibition on most sugar (with the occasional breakdown for some sweet tea) and I've done my best to avoid fried meats, but the Chick-Fil-A breakfast drive-thru menu limits your choices as far as that goes. French fries have been a no-no as well. Whether that actually impacts my migraines, I don't know, but I'm probably much healthier for it, so there is at the very least some benefit to it, along with whatever payoff (psychosomatic or otherwise) there is with it relative to migraine attacks.

Sunday
November 26, 2006

I went migraine-free through Wednesday night, when I drove up to Nashville for a long Thanksgiving with my family. Unfortunately, in my rush to pack for a six day trip, I failed to stop by CVS to obtain my refill of Baclofen. Moreover, because of this mistake, I figured that I was out of luck until Friday, though I learned later that the CVS near my parents' home in Nashville had actually been open on Thanksgiving Day. The lesson? Don't presume that your pharmacy will be closed on a holiday.

My last remaining bottle of Skelaxin was my fill-in choice, as the few Baclofen fills I had were, unfortunately, sitting on my nightstand in Alabaster. But, having been migraine-free since Sunday, I thought maybe I'd be in luck.

Think again. I woke up on Thursday morning to the sound of the alarm clock on my cell phone, 6:30 AM, bright and early. It is set to go Mon-Fri, but it isn't equipped for holidays off. As it turned out, I felt a migraine onsetting, and I popped an Imitrex quickly. At that point I discovered another problem: I only had four Imitrex pills in the pack that I brought with me. With six days scheduled for Nashville, I knew I was in a tight spot.

I used the first Imitrex pill... which by 7:30 kicked in, allowing me to sleep for two additional (pain-free) hours. I was able to enjoy Thanksgiving without any migraine pain.

On Friday I woke up with my neck hurting, a usual precursor to a migraine. I called up CVS and attempted to get them to transfer up my prescription. But, naturally, it was complicated: I was out of refills from my old prescription, though I had brought in a new script which had the updated prescription information. However, I had to pay cash for it as my insurance would only cover one bottle of Baclofen per month. The Nashville CVS tried to get my insurance company to cover it, as the doctor's orders had changed (calling for 1-to-3 pills a day, vs. just one) but they couldn't reach them, with my insurance company apparently taking that Friday off.

Making things worse, the people at CVS worded the explanation in a way that made it sound like they couldn't reach the Alabaster CVS store to confirm the prescription refill. Confusing? Try living through it. I had another, unrelated prescription (Effexor) that I was able to get transferred, but because of the communication breakdown, I was without Baclofen for another day. In an attempt to avoid a migraine (I could feel the pain beginning to shoot into my head), I went ahead and took Imitrex #2 of 4.

Yesterday (Saturday) afternoon I went to CVS and finally was able to pick up the Baclofen. One thing I've discovered is that, with the onset of neck pain, Baclofen helps to alleviate the spasms that cause the pain (and which eventually trigger the migraine.) The "take one to three per day" for me works out better with taking one as needed vs. taking three at night, which only serves to knock me out fast asleep. I'll take drowsy but pain-free over alert and tortured.

The Baclofen has worked with the "as pain begins" application (versus nighttime only), as I didn't have a migraine yesterday and haven't had one today.

Tuesday
November 20, 2006

It's Tuesday night... and still no migraine. I've been holding my breath today waiting for one to hit, but I've apparently been given a reprieve.

One thing worth noting: I've entirely quit eating sweets or fried meat, and that has correlated with the subsiding of the migraines. The sweets I had phased out last week, and I phased the fried meat out of the cycle on Sunday.

To be fair, I haven't entirely cut meat out of my diet, though I haven't had any red meat in awhile. I do have some cereal with processed sugar, and I must confess to having sweet tea at lunch today, but that's it. I'm not sure that there is necessarily a connection, but it's definitely worth my time to continue this to find out if the correlation goes beyond coincidence.

Monday
November 20, 2006

For the first time since I started this migraine blog, I am happy to report that I've made it through a day without having a migraine. We'll see how the overnight goes; I've felt some neck pain that is usually a precursor to a migraine, but that is a mild, nagging pain (as opposed to the brutal force of a migraine) and is entirely tolerable.

One thought with yesterday: the confused state of mind I was in might have been a symptom of the Postdrome phase of my migraine. Usually I don't have this, but as I referenced before, they sometimes leave people with a "washed out" feeling of irritablity, listlessness, and impaired concentration.

Sunday
November 19, 2006

I made it through the rest of yesterday with no migraines. So far, so good, right?

This afternoon I felt stiffness start in my neck, which is usually a sign that a migraine is going to hit. The first two times, I took a Baclofen and seemed to fix the pain.

The third time? The pain was in my neck... and starting to go into the right side of my head. Now, I've been looking for an Imitrex alternative (because of the 9-per-packet Imitrex limit and only getting insurance coverage on one packet per month), so I've tried Maxalt, which my doctor gave me some samples of on Monday to try. I also took a Bupap, which is a migraine pain reliever.

Maxalt failed me on Wednesday night, and I'm disappointed to report that it failed me again today. I had been watching the movie Black Hawk Down, and the pain started creeping into my head at a quickly increasing rate. I put the movie on pause, flipped on the Colts/Cowboys game (turning the volume down low), and laid on the heating pad I have, face-first.

When, after an hour and a half, the pain hadn't deteriorated, I went ahead and took an Imitrex. Soon after, maybe 15 minutes later, the pain went from severe to moderate, presumably because of the medicine I had taken before. But unlike Imitrex, the pain wasn't entirely alleviated for me. They say that different triptans work for different people, and apparently Maxalt doesn't work as well with me, taking longer to kick in and then not entirely blocking the migraine. Live and learn.

The Bupap (I presume) did leave me feeling a little crazy/loopy, which I don't recall having had as a response from the medicine before, but with all the pills I took today it's hard to say what caused what. Understand this: the pain is severe, and when you're hurting you'll take pills until the pain goes away. I cannot stress enough how bad the pain is. Maybe I'm just cursed with a low pain tolerance, I don't know, but a migraine dehabilitates me like nothing else I've ever experienced. The combo of the severe pain, the light/sound sensitivity, and the fact that this has been going on so long creates a very frustrating series of problems with which to deal.

What I don't understand is why the migraine switched sides on me this past week. I've historically been a left-side sufferer, but it's like the migraine beast in my head decided to shift over to the right side just variety's sake.

I had a kind person contact me tonight to suggest that I try an all-veggie diet, which helped her solve her migraine problems. I feel strongly that diet has nothing to do with my migraines (they have been diagnosed with being related to neck spasms), but I'm willing to try most anything (within reason) to find a solution.

Saturday
November 18, 2006

Another day, another migraine. Last night I took three Baclofen pills, and they seemed to do the trick. However, I woke up at about 4:30 AM this morning with a pounding migraine. It's a double whammy when it wakes me out of sleep; there are no warning signs to be able to take a triptan in anticipation of a migraine hitting, and it cuts into valuable sleep time.

Fortunately for me, I have today off from work (with it being Saturday and all.) I took an Imitrex, laid down, and when it kicked in I actually checked e-mail for a little while before going back to sleep as sunrise arrived in Alabaster.

The Imitrex did the trick; I slept until just before 11 AM, waking up in perfect time to watch the early college football games.

This afternoon, during the Michigan/Ohio State game, I felt neck tightness begin to hit. In a pre-emptive move, I took a Baclofen, which seems to have worked going into the early evening. Michigan/Ohio State (and Auburn/Alabama) is certainly no time for a migraine!

Friday
November 17, 2006

I knew that a migraine was brewing yesterday when I felt neck pain/stiffness for much of the day at work. It's like when you hear thunder and see dark clouds in the distance; you know that the electrical storm is coming.

Unfortunately I left my bag of medicine behind at my brother's house, and I went directly to my parents' house for dinner. The neck stiffness got worse there, though I was able to be my usual self without too much trouble.

Difficulty hit with my Dad being tied up at work until late, not arriving home until 9:30 PM. We work for the same company, and I had some important information to discuss with him that couldn't wait. Again, life doesn't slow down for a migraine. I could feel the pain starting to creep in by the time he made it home, but we talked and went over the files that I had. By the time I left, it was 10:30 PM, and the migraine had arrived like a hurricane making landfall.

Driving with a migraine is not recommended. In one of those bizarre turns of things, I had to stop to fill up my work truck with gasoline, and I pulled into the Mapco Express on Harding Place near I-24. The area has deteriorated since my high school days, and there were maybe 4-5 thug looking guys blasting music and hassling at least one person who was filling up her car. Luckily people tend to leave me alone, as being 6'2" with a shaved head and a goatee usually sends a message, real or perceived. But I would have surely felt anxiety about the situation were it not for the fact that my head was hurting so bad.

I arrived, took an Imitrex, three Baclofen (the bottle says you can take 1-3, and my doctor reiterated that to me on Monday), a Bupap, and a Xanax (taken for anxiety) and then waited for them to kick in. They hit, and I fell asleep, exhausted.

Thursday
November 16, 2006

It's hard to believe that things could actually get worse with daily migraine attacks... but they have.

Last night was especially brutal. I came home from work and laid down for a nap at about 5 PM. At 7 PM I woke up with an excruciating pain in the right half of my head. Normally Imitrex is my medicine of choice to put out the migraine fire, but yesterday's column alluded to, because of my hard run the past few weeks, my supply of Imitrex has started to dwindle well below the five-or-six package supply that I had stored up.

What's unusual is that my migraines have usually been left-side attacks. This was not my first right-side migraine, but it was easily the most intense, horrible one I've suffered on the right half of my head.

I took a Maxalt and a Bupap. I know that I was told to save the Bupap for cases where the medicine didn't work, but this was especially intense. It's bad when it wakes me out of your sleep (I'm a deep sleeper) but this was beyond brutal. Unfortunately, this turned into what I term a "super migraine", one that fights through the triptan. I'd only had Imitrex fail to work on round one once or twice before, but the Maxalt *and* the Bupap failed me.

Migraines can bring nausea, and it had been awhile since one had been so bad that it made me sick, but this super-migraine did the trip, causing me to throw up.

Complicating things was the fact that I needed to drive to Nashville last night, as my job has me working out of our Nashville-area office two of the five days per week. But instead of being on I-65 in the company truck, I was laying face-down on a heating pad that my Dad has generously let me borrow. While not a cure, the heating pad can provide some relief.

Once I was sure my nausea had passed, I took an Imitrex. This was at about 9 PM. Normally it takes one hour for the "Immy" to kick in, and this was no exception. Right at 10 PM, the pain subsided, and I was able to pack and hit the road. I made it to my brother's house by a little past 2 AM; at 6:30 today I was up and getting ready for work. This is life as a migraine sufferer.

Imitrex, like all triptans, doesn't provide any sort of buzz or high; it causes the "inhibition of pro-inflammatory neuropeptide release." But it works, and that's really all that matters to me. While migraines have lead to me studying up on that particular area of medicine, many of the particulars are over my head.

The Prodrome phase (the pre-game show of the migraine attack) is almost always punctuated by the feeling of stiff muscles in my neck, usually on the left side. The Aura phase is one that I usually experience, seeing "stars" (photopsia) and/or zig-zag lines of white light. Then there's the Pain phase, which feels like lightning shooting through my head. I've used the expression that it's like an ice pick going through my brain, which might be slightly off, since it's more like nerves pulsating pain than the pain of a cut. It's actually worse than a cut, if you can believe that. Wikipedia describes it in medical terms that explain it better than I seem to be able to do:

"Current thinking is that a phenomenon known as cortical spreading depression is responsible for the disorder. In cortical spreading depression, neurological activity is depressed over an area of the cortex of the brain. This results in the release of inflammatory mediators leading to irritation of cranially originating nerve roots, most particularly the trigeminal nerve that supplies the sensory systems of the face and much of the head."

Light and sound sensitivity is intense at times during the Pain phase. This is especially difficult, since at least talk radio or music can provide a distraction from the throbbing, pulsating pain.

If there's any saving grace for me, it's that the Postdrome phase (after the pain) usually doesn't have the "washed out" feeling of irritablity, listlessness, and impaired concentration that some experience with it.

Wednesday
November 15, 2006

I've suffered from migraine headaches since August 2000, soon after I turned 23. I'm 29 now, and I'm in the midst of the worst migraine spell of my life.

For the past four weeks, I've been plagued with almost daily migraine attacks. At the encouragement of friends, family, and medical experts, I've started a migraine blog on here. I'm not doing this to elicit sympathy; I'm doing this to keep track of what's going on and why it is happening.

The problem I've encountered is that GlaxoSmithKline, the company that makes Imitrex, is only authorized to sell nine per month because (I believe) of how testing was done for the drug before it first came out in the 1990s. However, the way that my migraine scourge has worked is that I'll have them hit in bunches. A few weeks of almost daily attacks, and then perhaps a few, or even several months, without any. Before this latest crop, I hadn't had any migraines since before I moved to Alabama in March 2006.

Initially I tried figuring out what triggered my migraines, which at the time I didn't recognize as anything more than brutal, insane headaches. I was working overnights at WSAZ-TV in Huntington, WV, and the pain was so intense that I ended up calling out sick for a couple of days because I simply was in no condition to work.

The first trip to the doctor failed to lead to a migraine diagnosis. I was given some lortabs, which were nice and all, but didn't provide that magic relief that sumatriptan (Imitrex) can bring.

Various doctors in Huntington, and then later in Tampa, failed to diagnose the problem. I don't have "triggers" that cause them. I've done variable tests with food, seasonings, beverages (including alcohol), supplements, even the part of the country where I live... all for naught.

It took a physician's assistant to finally diagnose me in the summer of 2005. He had the doctor write me a script (prescription) for Imitrex... and I finally had my cure.

It turned out that neck spasms are the cause of my migraines, at least according to the diagnosis of X-Rays that he had me have taken. I'd had two MRIs done before since the pain began, to make sure that I didn't have a brain tumor or such, but they had been inconclusive. That... or the doctors involved had simply been unable to pinpoint the problem.

Unfortunately, with how my migraines attack in bunches, the nine Imitrex limit (which is all my insurance would cover per month, and I think all that most insurances cover) snapped me early on following my diagnosis. It was 5:30 AM, and I woke up with the migraine from hell. I had a refill available from Walgreen's, and I literally got there at 7 AM and was waiting for the pharmacist to open up shop. I paid $160 or so (the exact amount escapes me) for nine pills, but I didn't think twice about it.

Fortunately, that was the only time I had to pay such high prices, as my migraines subsided and I was able to build up a supply of Imitrex. Like clockwork, every month I had it refilled. When the next bunch hit in late 2005, I was prepared.

Along with the Imitrex, I was put on a muscle relaxer called Skelaxin.

When I moved to Alabama in March of this year, the new doctor switched me from Skelaxin to Baclofen. And, at first, that seemed to work great. Neck pain was limited, and migraines were non-existent. But, having learned from the past, I saved up my Imitrex like a squirrel stashing away nuts for the winter.

That lead up to October 2006, where the latest run of migraines has begun again. I went to the doctor two days ago (November 13, 2006) and I was given some samples of Maxalt, a different type of migraine medicine (rizatriptan benzoate.) Triptan is the important part; according to Wikipedia, Triptans "are a family of tryptamine drugs used as abortive medication in the treatment of migraine and cluster headaches." Also, due to the pain, I was prescribed a drug called Bupap, which I read is designed to fight the pain of a migraine. "Only use these if the migraine medicine doesn't work," the doctor told me. I'm not sure why, since there's nothing narcotic about Bupap, but I'll follow his advice.

I used a Maxalt yesterday when I felt a migraine coming on, and it blocked it successfully. If I can use multiple medicines to block the pain, I'm all for it.