Friday, June 04, 2004

ADVENTURES IN MIGRAINE

For the last couple days I have been having a migraine. The pain has awakened me the last 2 mornings and the sharp pain in my left temple has been throbbing on and off like Harry Potter's scar. Yet I still ponder - maybe it's allergies? maybe it's sinus? maybe it's barometric pressure? maybe i need to buy new pillows? And I take Excedrin Extra Strength or Claritin, or I stretch my neck out.

Only after I've exhausted all the options and the pain persists and worsens and my vision starts to blur and I get nauseated do I take Frova, my new best friend. It takes a while for it to work, but it does eventually. And while I greatly appreciate the pain relief I do not welcome the extreme fatigue that accompanies it. The profound exhaustion that makes any activity beyond getting home and laying in bed feel like way too much. I feel old and tired. But the pain is gone.

My migraines have evolved from the time I began having them in my late teens. I would get blinding headaches but I was able to lay down and go to sleep and when I woke up they were gone! Whee! I didn't actually get diagnosed as having migraines until I was 23 - I was shopping with my roommate at Ralphs on a Saturday morning. I was in the habit of nicking candy from the candy bins and eating it while I shopped. I knew it could be considered stealing, but it was only a couple of sesame candies. Not a handful. Just one or two. We finished shopping and were standing in line when I began to feel really awful - nauseous, dizzy, sweat broke out on my upper lip - as we got to the cashier my vision started to break up. Like there were big, black spots around which I could see bits of the store and the lady standing in front of me. I shook my head trying to clear my eyes. Everything went completely black and I waited to pass out. I was sure that would come next as I stood there gripped the counter in front of me. I could hear Jill and the cashier asking me what was wrong and they sounded really worried. And I wasn't passing out so I was going to have deal with being blinded at Ralphs and the only reason I could imagine this happening was that I had stolen candy and know I was being punished.

I said in a voice that seemed really loud that I was fine just go ahead and check me out. I was freaking, but not so much that I wanted to go through the mortification of having the paramedics come blazing into the parking lot and having to come clean about stealing the candy and went blind as punishment. We got outside, with me clutching the basket and shuffling along, and I told Jill to leave me there, but make sure I wasn't standing in traffic, and go get the car. I figured we'd go to the hospital after stopping by the apartment to put the stuff that might spoil in the frig.

As I stood there I put my head down on the handle of the cart and focused on breathing and not crying in public. Gradually my eyesight came back and it was weird, first there was light, and then it was really blurry but came into focus like a camera lens. By the time Jill pulled up in the car I could see normally as if nothing ever happend. I had been given a reprieve and I swore that I would never steal again, not even a 2 cent piece of candy. We got the groceries in the car and as Jill drove us home all of a sudden I got the most intense pain in my head. Pain so severe I was sure I was going to die. But I didn't. Instead the minute we got home I opened the door and threw up in the gutter. The pain lessened a bit, enough for me to get up the stairs and into my room where I lay in the dark for the rest of the day.

I didn't go to the hospital because I have a deep fear that some emergency room error will kill me and I was still breathing and everything. I was just in a tremendous amount of pain. Too much pain to even imagine getting vertical and going to the hospital. By the next day I was fine, but I was also scared enough to make a doctor's appointment. I went to see a neurologist and they hooked me up and did an EEG and a neurological evaluation and everything was fine. The diagnosis was vaso-dilation migraines. My understanding is that prior to the swelling of the vessels in the brain that manifest as migraine my vessels dilated first, shutting off the flow of blood, specifically to my eyes.

So I was placed on Fiorinal daily for about 2 years when I took myself off because I wasn't having migraines anymore. And I did really well up until 6 years ago when they came back with a vengeance. Thankfully they've come up with a lot of new drugs for migraines but some of them make you feel almost worse than the migraine. Imitrex is one of those where I was completely distracted from the receding pain by the fact that I was so dizzy I could barely make it across the room and had to lie in the fetal position for an hour before I could walk normally.

There's also my predisposition to headaches in general. Because I don't get aura or any of the other "warnings" that some people get I don't know if I'm having a migraine of one of the other kinds of headaches that I get - sinus, allergy, stress. And those can all be migraine triggers so while it might start as one it can evolve into the extreme headache that is migraine.

A few months ago I was no longer responding to any of the medication. I took Imitrex and the pain didn't go away. I took Relpax and the pain didn't go away. One night after taking all of the alloted dosage of the migraine specific meds I dug out some leftover Vicodin and took one thinking it would at least take the edge off. It didn't so I took another which also didn't make it hurt any less but did make me pass out. Feeling sure that I was going to die I made an appointment with another neurologist and once again got a clean bill of health upon examination.

He gave me Frova which has been working and I'm still trying to figure out what my triggers are... okay I know what they are - red wine, sugar, hormones (or pms which is when I really need the red wine and sugar), but it's also weather changes, stress, flourescent lights, flashing lights, really strong perfumes (got on an elevator once with a woman drenched in Eternity and got off with a migraine). There's always that fear in the back of my head that it's an aneurism or that I'm going to have a cardio-vascular accident - that's what they call strokes in the ER.

I think I handled this all much better when I was younger, I have turned that corner where my focus is less on all the things I'm going to miss out on and more on all the horrible things that could happen and render me paralyzed. I carry Frova and Lactaid and digestive enzymes and bandaids and wet wipes in a ziploc baggy in my purse, and I never go anywhere without it.

When did I become my Nana? Actually she only carries bandaids and doublemint gum so I guess she's doing better than I am.

Oy.

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