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Defining “Better” & Improving Even More (I Think) After a Magnesium Infusion

I’ve been “better” since going up to 700 mgs of magnesium on February 7, but I, like always, am struggling to explain what that means. I met with my headache specialist yesterday and had to encapsulate my improvement in a short, concise statement. I said that the severity and duration of the migraines has lessened, but I haven’t noticed much difference in my quality of life. That I definitely feel better, but that hasn’t translated to increased productivity. (Not productivity as in producing widgets in a factory, but in getting my butt off the couch and getting basic things done.)

I know I am better because I can usually shower without having to rest afterward. When I do have to take time to recuperate, like Wednesday night, it seems that 10 minutes of rest is sufficient for me to then put on lotion (a huge chore when I feel bad) and get dressed. It has been more than a month since I’ve had to drag myself straight to bed post-shower. This is a major quality-of-life improvement for me, though not one that really leads to increased productivity.

The numbers from my headache diary show major improvement. The headache specialist looked the diary over and also remarked on the improvement. I have only hit a level 8 once since increasing the magnesium and it was for 10 very long hours. In an average week, I reach level 7 three times and it stays that high for about three hours. Compared to level 8 at least once a week and level 7 six hours a day, five days a week, the improvement does qualify as “major.” Unfortunately, when the baseline is “feeling-like-hell-and-can-barely-get-off-the-couch,” even major advances don’t take me very far.

Though the pain levels have improved, I’ve been struggling with significant nausea, fatigue and lethargy. The nausea may be the magnesium or it may be coincidence. The fatigue and lethargy may be migraine or the effects of Amerge, a triptan that I’ve started taking a lot more now that I’ve identified an occasional visual aura. Sorting out symptoms of the disease from side effects of the medications used to treat the illness is so complicated!

I took all this information to my headache specialist and his first reaction was, “Let’s give you an infusion of 1,000 mg of magnesium and see if that’s really what’s helping you.” I was thrilled and a little afraid: What if the magnesium, which I’ve regarded as magical, isn’t actually helping and my improvement is an unexplained fluke? On the other hand, maybe magnesium really is what my body needs and going in for weekly infusions will be the trick to getting my life back. With every new treatment, I try to keep myself from getting overly excited about the possibilities, though the secret hope is always that this will be “the one.”

Though getting an appointment at my headache clinic involves waiting lists, phone tag, and sometimes months of waiting, treatments move quickly. I was in the ambulatory infusion clinic an hour later and Marian the nurse was wrapping her lucky tourniquet around my arm. She claimed to sacrifice a chicken every morning to make the luck hold, but perhaps the ritual went awry yesterday. The first attempt at putting in the IV didn’t work and, following descriptions of my vein rolling under the needle (ick!), she had to try a second time. Once it was in, all I had to do was lie back in the cushy recliner, pull up the heated blankets (I seriously wonder how much a blanket warmer would cost), and play Words With Friends for an hour.

At the start of the infusion, the pain was a level 5 and I was tired and nauseated. We’d left the house at 8:20 a.m. and I had awoken with a migraine. I had managed to eat a few crackers so I could take my morning meds, plus I’d taken an Amerge and a Zofran, both of which make me sleepy. At the end of the infusion, the pain was down to level 4, but I was even more tired and had added grumpy and hungry to the list of complaints. I wasn’t sure if the magnesium infusion had done anything and was too scared of the potential ramifications to think much about it.

My sweet husband drove me home so I could eat and nap. As I fell asleep, I imagined the magnesium coursing through my veins, spreading out into my cells and improving their function. The cells, wearing party hats and throwing confetti, were drunk on mineral fortification. I woke from the nap with my pain at a level 3, where it stayed until 9 p.m., at which point it dropped to a 2(!). Today, I’m back to a 3, even through another aura (and Amerge and nap).

Could magnesium be the white knight who sweeps me off my feet and makes my dreams come true? Are my expectations too high this early in the relationship? If I let myself fall head over heels, will I pay the price in heartbreak?

OK, Kerrie, take some deep, soothing breaths and let go of the “what ifs.” I’m going to enjoy this respite for what it is, however long it will last. On the agenda: Prepping for a barbecue and making ice cream with friends tomorrow, drafting a blog post on the business Hart and I are starting, exercising, showering, enjoying the delightful smell of orange blossoms, and whatever fun activities strike my fancy.

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Relpax Aborted a Migraine!

I woke in the night with the early stages of a migraine. After trying to wishing it away, I took Relpax. Triptans (migraine abortive drugs) have never been effective for me, but though it might work since I caught the migraine at the beginning. It did! I was exhausted this morning, but had very little head pain. The last couple months have been so bad that I’m extremely grateful.

WebMD’s triptan overview is excellent. Check out specific drug websites for detailed information on each one:

I’m dropping off my Relpax prescription right now!

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Generic Imitrex (Sumatriptan) Tablets & Injections Available in US

piggy bankTablet and injection versions of generic Imitrex (sumatriptan) are available in the US. Doses are 25mg, 50 mg, and 100mg tablets and 4mg and 6mg injections (kits or pre-filled syringes). Patients have reported prices between $35 and $200! Imitrex’s patent doesn’t actually expire until February; a reader suggested it might be less expensive then.

The generic hasn’t been as effective as the brand name drug for some patients. In Generic Imitrex (Sumatriptan) — Is it as Effective as Brand Name Imitrex, blogger Doc Shazam writes:

…I have taken 2 of “Dr. Reddy’s” generic sumatriptan tablets with almost no relief of headache symptoms, but a plethora of side effects, including aching muscles, nausea, “light headed” feeling and general dis-ease.

Read about other patients’ experiences in their comments on earlier posts on The Daily Headache:

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Migraine Abortives (Triptans) & Serotonin Syndrome

Migraine abortive drugs called triptans can cause the potentially serious serotonin syndrome in rare cases, according to a study in the May 15 issue of the New England Journal of Medicine. Serotonin syndrome is a known risk when combining antidepressants and triptans. The new study shows that triptans alone can cause serotonin syndrome.

Serotonin syndrome is most likely to happen when you first start taking the medication. It is very rare and, even if it does happen, the remedy is to stop taking the medication. According to Migraine Medications May Cause ‘Serotonin Syndrome’ in the Washington Post:

The average age for someone experiencing serotonin syndrome associated only with triptan therapy was 39.9 years, and the most common symptoms included tremor, stiffness, palpitations, high blood pressure and agitation, according to the study.

Five people required hospitalization, and two cases were classified as “life-threatening.” Four of the 11 cases cleared up within an hour of treatment.

“It’s very rare and not likely to happen,” said Soldin of serotonin syndrome. “And, you just need to stop taking the drugs when it does happen. If you’re taking these medications and you have strange muscular, mental or hyperactivity symptoms, contact your doctor.”

Not sure if you’re taking a triptan? The seven available are:

  • Imitrex or Imigran (sumatriptan)
  • Maxalt (rizatriptan)
  • Amerge or Naramig (naratriptan)
  • Zomig (zolmitriptan)
  • Relpax (eletriptan)
  • Axert or Almogran (almotriptan)
  • Frova or Migard (frovatriptan)

Read more about serotonin syndrome in these posts:

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National Headache Foundation Answers Frequently Asked Questions

In one comprehensive page, the National Headache Foundation responds to common questions about migraine as well as tension-type, cluster, sinus, rebound headaches. The short answers include links to comprehensive information. Questions include:

  • Does weather affect migraines?
  • What are the triptans?
  • What alternative therapies are used to treat migraine?
  • What is biofeedback?
  • Are headaches hereditary?
  • What type of doctor should I see to diagnose and treat my headache?