Chronic Migraine, Coping, Diet, Treatment, Triggers

2012: A Year of Remarkable Personal Migraine Progress

Exactly one year ago tomorrow, I had a massive breakdown. Sobbing, I proclaimed that I wanted out of this life. I didn’t want to fight anymore; I didn’t want to live with chronic migraine any longer. I even wished for cancer so that I could choose to not treat it, thus dying without technically committing suicide.

Today, my head pain is at a level 4, which is the highest the pain has gotten in a week. In the past four months, the pain usually topped out at a 5, occasionally a 6. Still far from comfortable, that’s way better than daily pain that hits a level 7 or 8, where I was last January. I don’t know how these pain ratings appear to anyone outside my body, but to me, pain reduction of even a single number is cause for celebration.

In the 11 years that chronic migraine has been the focus of my life, last year was the first in which I made significant progress in reducing the severity of attacks. I tried more than three dozen medications in that time and countless other Western and alternative treatments and diets, none of which had any effect. To see any progress is amazing to me; to now be at a place where I expect even more improvement than I currently have experienced is astonishing.

Though you’ve read about my progress through the year, here’s a summary of what’s working for me:

Magnesium: Although I had been on magnesium before with no success, I noticed an improvement  increasing the dose to 700 mg. After trying IV infusions to see if they would be more effective (they weren’t), I ultimately pushed my daily oral dose to 1,000 mg.

Cyproheptadine: The starting dose of 4 mg was enough for me to feel a bit better. Each 4 mg increase brought additional relief until I hit 16 mg, which didn’t seem to be any better than 12 mg. I’m back at 12 mg, though will probably try increasing it again, to be sure that I wasn’t just having a bad week the first time I tried 16 mg.

Diet: It has been a year since I started an extreme version of a traditional migraine elimination diet. Until a month ago, the diet was horribly frustrating. It seemed like both nothing and everything I ate were triggers. I wondered if there were other aspects of foods that I was unaware of that could be triggers. Then a reader mentioned that she feels better when she avoids foods with histamine. This started major research and an even more drastic diet to cut out amines and salicylate.

The initial improvement started to look like a fluke as the migraine attack severity returned to previous levels. A week ago, I switched from ground dark turkey meat to skinless chicken breast as my main protein source and the migraine severity dropped to a level 4. I’m still tweaking the diet and waiting to see a nutritionist. It will be a long process as I test out foods I’ve been avoiding, but I really think histamine and salicylate content in foods and body/beauty products is a major component of my debilitating migraine attacks.

I have so much more to tell you! There’s a detailed post about the diet coming later this week. First I needed to write this overview to remind myself of the massive improvements that 2012 brought. Sure, I still feel worn out and discouraged at times, but every little bit of progress shows me that chronic migraine is necessarily not a life sentence. A year ago, I was convinced I’d never escape that prison.

I was basically the prototype of chronic intractable migraine. (In a bizarre sort of way, that sounds like bragging.) Ten years with no improvement. Countless doctors, naturopaths and all manner of traditional and alternative health care providers have given up on me. I had given up on me. If I can see improvement, so can you. The struggle may be long and arduous, but there is always, always hope. Hang in there.

Chronic Migraine, Coping, Treatment

Cyproheptadine for Migraine Prevention

The entire time I’ve been on cyproheptadine (about seven weeks), I’ve alternated between wanting to gush to you about it and feeling an immense need to keep quiet, lest I put its effect in jeopardy. I’m more superstitious about this medication and its efficacy than a starting pitcher in the seventh game of the World Series. I fret over the strangest things, afraid that any change in my symptoms or dose could mean an end to the relief.

Cyproheptadine is not new or novel; in fact, the brand name version, Periactin, is no longer made. It is an old antihistamine often used to children with migraine. I tried it a couple years ago and, although it is known for causing drowsiness and is sometimes used as a sleep aid, it made me jittery and unable to sleep. That first trial lasted only a couple days. This past summer I was so fatigued (turns out I was deficient in vitamins D and B12) that I decided maybe the side effects I experienced on cyproheptadine the first time would be welcome.

This time I had the more typical side effects of drowsiness and increased appetite, but also had an immediate reduction in the severity of migraine pain. The side effects were the strongest the first week I started the medication. I’ve increased the dose twice and each time have noticed the side effects for two or three days before they disappear. So far, I’m two pounds heavier than when I started.

Cyproheptadine’s maximum dose is 36 mg; I’m on 12, where I plan to stay for at least another month to see if I get any further benefit the longer I’m on the dose. For now, I’m enjoying many days where the pain ranges between a level 2 and 4. Only twice in the last month has the pain reached level 6 and I’ve even had a couple hours at level 1. At least, I think it was — I have no memory of what level 1 feels like.

This is the land of rainbows and unicorns!