Posts Tagged ‘aborting a migraine’

I promised Parin that I would address this topic again and explain my point a bit clearer. It all comes down to semantics of the words dependence and addiction. I hope that it is sufficient to say that some medical websites use the words interchangeably, referring to the physiological need for a particular drug. For instance, here is the definition of dependence taken from the e-Medicine Health (a part of WebMD.com) website:

Drug dependence is the body’s physical need, or addiction, to a specific agent. Over the long term, this dependence results in physical harm, behavior problems, and association with people who also abuse drugs. Stopping the use of the drug can result in a specific withdrawal syndrome.

The Mayo Clinic also uses these words interchangeably. I think that for consistency, dependence should refer to physiological need and addiction should add the characteristics of psychological need and drug seeking behaviors.

To answer Parin’s question, no I would not consider someone taking insulin or thyroid medicine addicted or dependent because neither are drugs, but rather replacements for a hormone that is missing.

Getting back to the article. The author’s headline is down-right WRONG on 2 points. First, neither of these drugs (Fiorinal and Percocet) are Migraine drugs. The FDA has not approved their use in the treatment of acute Migraine, although some physicians prescribe them as Migraine rescue drugs.

As I stated in the original post, these medications carry with them a double whammy. Not only can unwary Migraineurs develop medication overuse headaches (MOH), but they also run the risk of becoming dependent on the butalbital in Fiorinal or the oxycodone in Percocet.


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I Actually Did It!

I took my own advice: I paid attention to the warnings. Friday morning my nose was running and usually I don’t notice this as a sign that a migraine was brewing. I was also tired, but that is nothing new; I am always tired.
I was leaving Bible study early because I didn’t feel well. I ran into 2 friends who were leaving because of a headache. I thought, “Uh-oh, when will the headache strike?” Within 5 minutes I could feel it. Then with no doubts, no wishful thinking hoping it will go away, I took my abortive. The headache part never got above a 5 and was gone in 20 minutes. I still felt “hung over” the rest of the afternoon, but NO headache.

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I would say that the answer to this question is a wholehearted, NO. And I say it after going to Boston, Chicago, Myrtle Beach, and Raleigh, NC all in the space of 6 weeks. Each trip I learned something new. I have found that stress added to other triggers will put me over the edge. I always thought of stress as being negative. But happy stress is still stress. I found this out after going to a wedding, bridal shower, and just plain excitement can help trigger a migraine. Planning and going on vacation is that kind of “happy stress”. In these cases, I expect a migraine.

I think that expecting a migraine is the best way to head it off before it gets me. Some may think that expecting to have a migraine is negative thinking and THAT will “cause a migraine”. I beg to differ. If I expect to have a migraine, I will be prepared. I will have my meds ready; I will try to manage my other triggers (poor sleep and eating habits, alcohol, dehydration, etc.).

Unless your destination is already a given, give thought to where you decide to go. If changes in the weather trigger your migraines, I wouldn’t suggest the Ohio Valley in the summer because of the higher probability of thunderstorms. The same suggestion would apply to the Eastern seaboard and the Gulf because of hurricanes.
You can check the
Weather Center-Air Sports.net for predictions on the chances for a thunderstorm in any given area. There are also barometric pressure maps as well. I like to choose places that have consistently sunny weather. I particularly like North Carolina for this reason.

If bright sunlight triggers a migraine, I would suggest a pair of good sunglasses rather than tell you to go somewhere cloudy. A sunglass buying guide can be helpful in your search for a good pair that protects your eyes, has good frame construction, and doesn’t break the bank.

Medications: for years, I tried to count out the number of pills I would need and dump them all in a bottle. I never, never got it right. Then, after the Boston trip (and being short of meds), I developed an Excel file that would automatically calculate the number of pills I would need. This only works if I remember what I take and I put the numbers in correctly. It worked for Chicago like a dream, but I still had to pick through a mountain of pills to find the right ones.

My 86 year-old mother solved the problem. (It actually my sister who devised this system.) Pill boxes! I never used them because they were too small. I now have 2 (AM and PM) and most of the pills fit. Now why didn’t I think of that?!

Rest and relaxation: every vacation needs a time of rest. I should take my own advice. Boston was a whirlwind weekend with sorority sisters I had not seen in 30 years. Every minute was scheduled. Chicago was a 3 day tag along with my DH. I went sight-seeing, saw long lost relatives, enjoyed the city. But I took time to rest every day. Raleigh was different; I accompanied my elderly parents from Myrtle Beach to Raleigh for my nephew’s wedding. It was stressful, but I carved out time to rest. There was 3 hours between the wedding and the reception. I took a nap. In Myrtle Beach when my mom was cared for, I went to the beach, walked, went swimming. I made sure the lay-over in Charlotte was adequate to eat and to rest.

Packing: pack light. The fewer items you take, the fewer you will have to take care of. You are on vacation. No one will notice you are wearing the same 3 outfits. If they do, they won’t say anything. Make a check list of things you need. This will require some forethought. What will you be doing? Where will you be going? Do you have access to a washing machine? I have 2 suitcases that are already semi-packed with travel sized: shampoo, toothpaste, toothbrush, body wash, comb, brush, and other things I have forgotten on previous trips. Don’t forget the charger for your cell phone. Allow extra room in your suitcase to bring home souvenirs.

One carry-on is enough for me to handle. I pack everything I can, even my dresses (if I have to wear one). I even have a travel purse that has only the essentials: abortive meds, handcream, lip balm, a pen, ATM card, one credit card, cash, driver’s license, and cell phone. It is small enough to fit in my carry-on.

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Headache & Migraine Disease Blog Carnival will be posting links to various blogs on Monday, April 14, 2008. The host is Somebody Heal Me. The topic this month is “Coping with Migraine and Chronic Pain”.

I have pondered this over the past several days. How do I cope with my chronic pain? (sometimes I don’t cope well) . What works for me?

The first thing that came to my mind is EDUCATION. This means educating myself about migraine and educating friends and family.

Educating myself is crucial. I can’t tell others if I don’t understand migraine disease. There several websites and blogs that contain so much information and support for migraine sufferers. You can find links to otherblogs and websites along the right-hand side of this blog. One website is My Migraine Connection. I can’t begin to say all of the information contained on this site. One important piece of information I have learned from this site is that migraine has a prodromal phase and a postdromal phase. If I pay close attention to my prodromal body signals, I can arm myself early and abort the migraine. Now I know that the “hung-over” feeling after the pain is gone is the postdromal phase of migraine and not necessarily drug related.

Educating Others: This can be a daunting task because there are untold numbers of people who believe that migraine is “just a bad headache”. I have been told, “I know what you mean. I had one once.” This requires that I take make requests based on my needs. I can’t just be silent when I need some accomodations. For example, my migraines are triggered by flashing lights. For some reason I cannot tolerate watching TV in the dark. This means I need to speak up and say, “No, please leave the lights on because my migraine disease prevents me from watching TV in the dark.” I need to educate my entire church family as to why they can’t turn the lights down when we are watching a DVD or video. Once I have made these requests, I can start educating my friends as to the nature of migraine disease and the consequences. Teri Robert has written an excellent letter designed to educate family and friends about migraine.

Be alert. This requires a bit of practice, but it is worth the effort. It may be extra-difficult for people like me who do things on autopilot. Every so often throughout the day I stop and take a deep breath. Then I am mindful of whatever I am doing. What do I hear? What am I seeing? How do I feel? What am I doing? I mindfully and deliberately pay attention to what I am doing NOW. I don’t think about what I need to do later. I live in the present. This exercise helps me recognize my prodromal phase.
Being alert may save me from awkward situations such as having a friend drive me home because I didn’t catch the migraine early enough.

Tips: 1. Have abortive medication handy.

2. Always have at least a swallow of water handy. I don’t have the dissolving Maxalt and I can’t swallow pills without water. So, I don’t drain my water bottle after my exercise class and when I leave the house I fill a bottle and take it wherever I go.

3. Get enough rest. I know this is hard. I hate to leave social events early. I usually was the last one to leave anything. But now, I leave by 9 pm so I am in bed by 10 pm. My friends know this and all I have to say, “It is getting past my bedtime.” Everyone laughs and I leave.

4. Eat regular meals. I have to admit I am really bad at this, especially when I am running errands and I miss lunch. However, I have found that being over-hungry is a trigger for migraine attack. I have an energy bar in my purse just in case I can’t grab lunch.

5. Know and manage my triggers. I am still learning to figure out what my triggers are at any given time because they change. However, being alert and conscious of them can save me in the long run. I know that changes in the weather can easily trigger an attack for me. So, now I keep track of the forecast and prepare myself accordingly.

6. Have at least one person who knows your pattern well. This person is my husband. He helps me manage some of my triggers. Sometimes he can tell when it is time for urgent care better than I can. He calls me a “high maintenance wife” and then smiles.

7. Have a support network. This can be physical or virtual. I have to say that I feel so much better after having found My Migraine Connection and the forums. It is so comforting to know that I am not alone. I also have a friend who will take me to the ER if my husband is not available.

8. Be positive. Yes, I have chronic migraine disease. Just saying that opens the door to changing the way I see my migraine attacks. I can choose my attitude toward this disease. I can make a conscious decision to have it run my life or not. Which is it going to be?: This disease will not run my life.

9. Consider prayer. I know that many people would not consider this option, but for me it is literally a life saver. Knowing Jesus as my Savior has changed my life. Prayer is my connection with Him and it brings me great comfort to know how much He loves and cares for me.

I hope these points will help you, my readers, to live and cope with migraine disease.

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Over the past 3 days we had had nice sunny, but cold weather, followed by high winds, warm weather and rain. And then more sun and cold. The barometric pressure was on a roller coaster.

I knew the weather was changing.

You would think that after all these years I would have seen it coming.

I didn’t;

just like other umpteen times the Enemy snuck up behind me and struck while I was asleep. You would think that at the first sign (a runny nose), I would have tried to abort it, but I didn’t. I just didn’t make the connection.

So, I woke up this morning with a full blown migraine.

So what is behind missing the warnings? Why do I time and time again fail to make the connection when it is most important? Is it denial? It won’t be this bad this time, I tell myself.

No, it isn’t that. There is no internal struggle; there are no voices telling me that I really should take some medicine NOW. No, I am completely unable to make the connection when it is necessary for me to realize what is going on and act on it.

I only see the connection when it is too late. I missed my one and only chance.

What now? Wait it out? Emergency Room? Our co-pays have doubled to $100. Will I get a doc who will believe me? That’s another post.

I could go see the neurologist for an IV. But I hate waiting for hours and hours in his office before I am seen.

Right now I can hardly think straight. I can’t make a decision. I just want it to go away.

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