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An Unexpected Pep Talk (Following Some Reflections on Wellbutrin, Migraine)

After crying over the royal family, I knew I needed an antidepressant sooner than it would take to convince my insurance company to cover Viibryd. Since the dizziness had almost subsided and I didn’t want to wait to get a prescription for yet another drug, I tried increasing my Wellbutrin dose to what it was before the four-day migraine attack in January. No additional dizziness. In fact, it finally stopped the residual dizziness that had kept me unsteady. I’ve been back at my pre-migraine dose for two weeks and am doing fine.

I’m frustrated with the constantly moving target that is my health, but I’m also fascinated by it. The migraine attack changed my brain and, through my reaction to an unrelated medication, I was able to see my brain change back to it’s pre-migraine state. I knew that would happen, but being able to observe it was unusual.

It’s just one of the many changes I’ve been able to observe in my body now that I don’t have a migraine all the time. I can feel fine, but if my feet are freezing, I know I’m in the early stages of an attack. I can be writing for hours and thinking at full capacity, then notice that constructing sentences has suddenly become difficult. Even when eating doesn’t trigger a migraine attack, it can hint at one for a while and I’ll have to stop working until it resolves, which is usually does within an hour without medication. These are just a few examples of the many new reactions I can see in my body.

It would seem like someone who has had chronic migraine for as long as I have would have figured these things out by now. That was impossible, though, because the migraine attacks never stopped. I didn’t have a clear idea of my prodrome symptoms because I never knew when a migraine was ramping up again. I had experienced the metal fading before, but only recognized it when I was already deep into the attack. Now I notice within a few minutes after the cognitive dysfunction begins.

Despite knowing that identifying triggers and prodrome symptoms would be crucial to managing attacks, it seemed like an elusive, if not impossible, goal for most of my time with chronic migraine. I kept trying, even though it was terribly frustrating and I had a lot of misattributions along the way. I’m glad I did. It’s even more valuable that I imagined it would be. I’m more able to avoid migraine attacks now that I was even a year ago and I can take triptans at the earliest possible moment, which reduces the total time I spend in a migraine attack. At least once a week, I take a triptan and only slow down for 30 minutes before I’m fully functional again. I had a “bad” one yesterday—at least really bad for how they get these days—the pain hit a 6 and I was down for six hours. That’s a Sunday drive compared to how they used to be.

I still credit DAO with most of my improvement and my diet is second, but the benefits of knowing triggers and prodrome symptoms continue to increase. With 40 foods in my diet still and only adding two new foods in the last seven months, I often feel like I’m stuck. Then I remember how much shorter my attacks have become and that my cognitive impairment has decreased so much that I’m able to write through more migraine attacks than I’ve been able to in at least eight years. I’ve changed nothing treatment-wise since September, yet, on average, each month is a little better than the last. It’s a slow, slow climb, but I’m still climbing.

I always worry that I sound like I’m bragging or showing people up when I write about my improvement. I share it so you can know that improvement is possible and that even when if feels like you’re totally stuck, you could be making progress that you can’t yet see. When you feel terrible physically, it can seem like you’re failing yourself by not actively searching for and trying new treatments. Sometimes holding on is the best you can do for a while. I know that’s terribly clichéd, but it’s meaning is exactly what I wish to convey. Know that it won’t always be this bad. Instead of criticizing yourself, try to give yourself some love. You need it and deserve it.

That turned more “rah-rah” than I expected. I won’t delete it because it’s something I wish I’d come across five years ago. Since I’m a cheerleader baring my heart, I want to add this: I may not know you by name, but I do think of you all and wish the best for every one of you. I haven’t been in the exact place that you’ve been in, but I’ve lived through years that I have no idea how I survived. I believe you can do it, too. It may not feel like it, but you can.

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My Latest Posts for Migraine.com: “Shoulds,” Comparisons & Prodrome

Oops! I’ve forgotten to share my most recent Migraine.com posts with you. They’re just like what I write for The Daily Headache, just published somewhere else. My latest:

  • Wrestling With Self-Criticism and “Shoulds”: “I have that nagging voice that says, ‘You’re so much better than you were. Why aren’t you doing more?’ I try reminding myself that ‘better’ is far from great, but I still feel like I’m not doing enough.”
  • Migraine Perspective: No Two Migraineurs are Alike: “Human nature is to assume everyone else experiences something the same way we do. Like snowflakes, no two migraineurs are alike. Our migraine attacks differ, as do our responsiveness to meds, our support systems, and our ways of coping emotionally differ.”
  • Prodrome: Migraine Warning Signs: “Tearing is the most reliable warning sign for me. Sometimes it is accompanied by yawning, but not always. Frequent sighing is often a predictor, though I also sigh a lot when I’m physically tired and it can be hard to tell which is which.”

Take a look around while you’re there. Migraine.com is a tremendous resource for information and support. I feel fortunate to be part of the team of patient advocates and to work with the Migraine.com staff.

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Dogs Could Alert Owners to Migraine Attacks Before People Notice Symptoms

Medical alert dogs are service dogs trained to warn a diabetic if their blood sugar drops or an epileptic if they have an oncoming seizure. Migraine is possibly another condition dogs can alert their owners to, according to a survey conducted on Migraine.com.

Over 1000 of you completed this survey and 54 percent of you reported that you recognized a change in your dog’s behavior before or during the initial phases of your migraine. Most people reported their dog became excessively attentive before or at the beginning of a migraine. People often described their dog as becoming “clingy,” “glued to my side,” and “Velcro dog.” Intense staring, frantic licking, pawing, and whining were also frequently described. Interestingly, over half of those recognizing a migraine alerting behavior reported that this typically occurred before any migraine symptoms, usually within 2 hours of an impending migraine. And this link between a change in your dog’s behavior and a migraine occurred consistently for about 60 percent of people.

I frequently referred to my last dog as Velcro. I thought she damaged from being in a puppy mill, but maybe she was just warning me of impending migraine attacks. Since they were nearly constant, I wouldn’t be able to tell between her normal behavior and pre-migraine behavior.

Seriously, though, this could be significant for people with episodic migraine. Migraine abortives work best if they are taken as early as possible in the migraine attack. If you are able to correlate a change in your dog’s behavior and your migraines, your abortives could be more effective.

Does your dog behave differently before you have a migraine attack?

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Postdrome (Migraine Hangover) into Prodrome and Repeat

Part 1
“Did anyone get the license plate of the truck that ran over me?,” the mom of my best friend in junior high used to ask when she was sick. That’s what I’m wondering today as I’m in a migraine hangover that has me feeling completely wrung out. Magnesium hasn’t brought me out of having chronic migraine, but it is no longer nearly constant. The experience of discrete migraine attacks and migraine hangovers instead of having one continually run into another is interesting.

Saturday brought the worst migraine I’ve had in awhile. It was a level 8 when it woke me up at 4:30 am and still an 8 when I awoke at 10. It remained at that intensity until 3 pm, then slowly tapered down to a 5 by 10 pm. Sunday, I was tired, dizzy, woozy and headachey. I wasn’t sure if I was experiencing the prodrome of another migraine or the postdrome of the previous day. I was pleased to discover that it was the latter, as we had people coming over in the afternoon for a barbecue. I felt decent and social from 3 pm to midnight, at one point even wondering if my pain was at a level 1! Then another migraine in the night and now, at 3 pm the next day, I am groggy, exhausted, nauseated, anti-social, and semi-brain dead and my head hurts.

I want to do some work — either respond to comments, input health expenses into a spreadsheet for taxes, or make chicken broth — but sitting on the couch, staring into space seems like my greatest capacity at the moment. Postdrome/hangover is so frustrating. I think I should feel fine because I’m not actively in a migraine, but I still feel like crap. Though technically I am still in migraine, it is just the post-raging headache phase of migraine. It is one of those times where I’m blown away by how complicated this illness is and frustrated that so few people have any idea that a migraine is not just a bad headache.

Part 2
The need to be productive overcame me, so I forced myself off the couch to start laundry and fill the dishwasher. After 30 minutes of being upright, I am shaky and dizzy in addition to my other complaints from earlier. I’m now wondering if this postdrome is turning into prodrome for another migraine or if I simply did too much too soon.

This constant wondering is frustrating, but also fascinating. I’m so interested in better understanding the process of this illness that regularly overtakes my body. Now that the migraine attacks aren’t constant, I’m experiencing what an individual migraine episode is like for most people. I’m also getting a better grasp on how incredibly debilitating my degree of chronic migraine has been.

I spoke with someone last week who has chronic migraine, too. She mentioned The Day-to-Day Life of a Chronic Migraineur, a post in which I chronicled my life over several days. Though she has five migraines a week, she also has a lot of pain-free time. We are both diagnosed with chronic migraine, which is defined as 15 or more headache days a month, at least eight of which are migraine, but the reality for each of us is vastly different.

Part 3
It is now Tuesday afternoon. I was indeed in prodrome for another migraine, then spent this morning in postdrome. Another migraine came on just after noon, but I was able to abort it with Amerge, so I’m out of the migraine-rinse-repeat cycle for now.

I feel a bit sorry for myself at the moment: I tell everyone that I’m doing so much better — and I am much improved from four weeks ago — but I also have to acknowledge that I’m still in some stage of migraine all but a handful of hours each week. I am thrilled to be doing as well as I am, just as long as I don’t pay too much attention to the fact that I still have chronic migraine that’s on the severe end of the spectrum.

*Sigh.*

The Postdrome: Migraine’s Silent Sister is an interesting article I came across while writing this post.

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Are These Pre-migraine (Prodrome) Symptoms?

Dizziness, tremor, hot flashes, fatigue, cold hands and feet, mental fogginess, nausea, increased pulse. I was excited to discover this cluster of symptoms and thought them to be warning signs, also called prodrome, that a migraine was coming on. The earlier a migraine is detected, the earlier it can be treated, thus increasing the likelihood it can be aborted altogether. At least a dozen times, I took a triptan when I recognized these symptoms coming on and avoided the migraine pain completely. I’d feel funky for an hour or two, then feel much better. Yay for triptans, or so I thought.

Grocery shopping one day, the symptoms hit and I didn’t think to take a triptan. The symptoms were so severe that my cart functioned as a walker. I felt awful when I got to the car and knew I should go home. But I really, really, really wanted to go to Goodwill.

I pushed through, risking worsening the migraine. I put on a hat, sunglasses and earplugs to get through the store and my decision-making abilities were severely curtailed. Still, an hour passed and on my way home I felt better than I did before I went to the thrift store. So much better that I spent the afternoon cooking and cleaning.

I began experimenting with not taking a triptan when the symptoms hit. They still lasted for an hour or two and then lifted. Exactly the same pattern as when I medicated for migraine.

Are these migraine symptoms at all or is something else causing these flushes of autonomic distress? My doctor speculates medication side effects and I’m going off my antidepressants to see if that’s the case. I have to wonder if they are part of some other disorder, maybe adrenal or autonomic. Any ideas?