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Delaying the Inevitable With Triptans (Yet Another Migraine Superstition)

Do you ever feel like taking a triptan only delays the inevitable? After three days in a row in which I noticed major tooth sensitivity (my current reliable prodrome symptom) and taking naratriptan within 30 minutes of its onset, a migraine has walloped me upside the head (pun intended). The attack is as bad as they get these days (knock on wood) and I’m completely wiped out. While the pain is only a level 4, I feel like my bones are made of wet dishrags and my mind is as muddled as the mint in a masterful mojito.

As I understand the science, triptans do, in fact, abort migraine attacks and each subsequent attack is a separate entity. But as a chronic migraineur, it doesn’t seem like that’s happening. Instead, I wonder if I would have gotten this migraine attack out of the way if I’d not taken the naratriptan Tuesday (and Wednesday and Thursday). Forget the fact that the weather is changing today and that I haven’t slept well all week. And that The Doctors’ description of TheraSpecs was spot on and the TheraSpecs site had great traffic yesterday, thus relieving my anxiety and potentially triggering a “letdown migraine.” These don’t factor into my superstitions.

As I think myself in circles, I wonder how many headache specialists grasp the magnitude of the mental and emotional aspects of migraine. Even though they aren’t trained to help us deal with these components, they should be aware of how deeply migraine affects not only our physical state, but our mental and emotional well-being as well. If I ruled the world, every headache clinic would employ therapists who understand migraine’s reach and can equip migraineurs with a toolbox to manage the non-physical parts of migraine.

I write this from a mental fog, so please excuse me if this meandering post makes no sense. I think it contains at least one important nugget of information, but I won’t know for sure until I re-read it after this migraine passes.

13 Responses to Delaying the Inevitable With Triptans (Yet Another Migraine Superstition)

  1. Lisa says:

    Hey Kerrie,

    I find I often have these thoughts too. It can be rather frustrating and I want to turn them off. I often compare the onset of a migraine to the onset if a fibro flare. When a migraine is coming, I have the option to take an abortive. When a flare is coming, I don’t have a pill option. Is there less of a psychological game involved when there is no pill involved? Maybe a little. I often wonder about taking the abortive and timing it right, etc. if I wait too long it won’t abort it–but only control it if I’m lucky. If I take it too soon–did I really need it? With my Botox, life style changes, TheraSpecs and preventive meds, sometimes the migraine doesn’t amount to anything. So I always want to wait–but if I do, it may be too late.

    I’m saying all this to reinforce what you are saying–doctors may not realize all the physiological play involved in this disease.

    However, does the therapist really need to be focused on knowing the ins and outs if what we go through? I’m undecided.

    My neuro actually had a therapist in his office at one time (he had to move so now refers patients to him in a separate office). He had never had a migraine, didn’t deal with chronic pain or illness (at least not mentioned), but was willing to listen and worked with meditation as a way to help. I found the sessions very healing. I’m not sure if the therapist needs to know all of what we think about and go through before they ever see us, though it would be nice to not have to explain it to yet another person. I do think being part of a support group where you can connect to others and validate these kinda of thoughts to know its not just you can be very helpful.

    My conclusion: I’m thankful for support groups, and pages like your blog, where I can go to not feel so alone, bounce ideas off of others, receive feedback, etc. I also think my therapy was essential to emotional healing that I needed after having faced what was hopefully the worst I will face of chronic migraines.

    Not sure if this was in point–but hopefully so!

  2. Kate says:

    “I wonder how many headache specialists grasp the magnitude of the mental and emotional aspects of migraine,” you said. — Always a good question.

    Early on, (one year into my now 12 years of disability due to CDH or CDM or whatever it’s called now), I wanted to see a therapist – one who specialized in pain management. He said to me: “Well, you’ve been a woman of leisure for whole year now, how does it feel so far?” So much for HIS grasp of chronic pain.

    Fortunately, my Neurology, headache-only, specialists (the ones I’ve stayed with), have been absolute masters of understanding & empathy & respect. But I know that is not always the case. I’ve lived enough years of this now that I just don’t stick around if a doc is clueless or mistreats me, and I also don’t hesitate to tell him/her what I think. This wasn’t always the case, of course, especially when younger. There were times I burst into tears and couldn’t speak, feeling so overwhelmed by the lack of understanding on the other side of the desk.

    For me it took some of the wtf, if you know what i mean, that came in my forties, for me to put myself on equal footing with doctors.

  3. Kate says:

    Also:
    *** This month’s HARPER’S MAGAZINE has a great article: “An Uncommon Pain; Living With The Mystery Of Headache”. !!!!!!

    The writer’s headache disorder is not exactly migraine, but she still does a great job, in a widely read and respected publication, describing much of the suffering, from the symptoms, to the confusion of diagnosis, to the medication trials, to the impact on one’s life and self image, etc, etc…

    I SO OFTEN wish there would be more media coverage of what this illness is like for us – psychologically, emotionally, logistically, etc.; instead of the same old articles about “new” treatments I already tried 14 years ago, or about the bad bad pain med (YOU try living without them during a migraine), or the “rebound” headaches, yadda yadda yadda…

    So, YEAY! Please, journalists – more of the THIS!

  4. Lisa says:

    A woman of leisure??? Yeah… Lol. Not so accurate! And good points, Kate!

  5. Nilofer says:

    This is a little off topic but the NYT just ran a very interesting “Think Like a Doctor” article about a very unusual migraine. Makes me wonder if this mechanism could occur on a lower, more prolonged level or if it only happens in an acute way:
    http://well.blogs.nytimes.com/2013/05/03/think-like-a-doctor-an-unusual-headache-solved/?ref=health

  6. Chronic daily HA/Migrane for over 45 years. Fibro, ms, TMJ and cerebral aneurysms for 20 years. I have no more hope. Good luck to you able to carry on.

  7. Timothy Bauer says:

    To Nicky:

    Saying a prayer that you find some relief.
    One day, one hour, one minute, one moment at a time.
    Hang in there!!!

    Timothy Bauer
    Reno, Nevada

  8. Thank u Timothy…

  9. Lisa says:

    Dear Nicky,

    I second Timothy. No one could say it better than he did. I too find inspiration, and hope, from Kerrie’s blog.

    Lisa

  10. Please hang in there Nicky. I know how terribly difficult it can be and that bleak times feel like they’ll never end, yet they always do. You’re in my thoughts.

    Take good, gentle care of yourself.

    Kerrie

  11. Kerrie, Lisa and again Timothy, your kind words are greatly appreciated. Nicky

  12. Bureinato says:

    If I’m at work (office job w/ computers) I tend not to take the triptans until I leave. Somehow the brain fog and wrung out muscles is “worse” than pain. I doubt I’m productive in either mode, but I have a hard time (mentally) taking the triptans if I can’t go right to sleep for a min 3 hour nap.

  13. Jo says:

    Thank God I’m almost headache free after many years since starting Metoprolol and Tirosint for Thyroid issues. But I used to feel the same as the writer. I could take pill after pill for a few days, but it just felt the migraine just wanted to run its course anyhow anyway. Until I took nothing and just let it come till it was over. Still wondering why, but grateful for immense relief. I know the suffering, praying relief for you all.

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