Link to AP Article: Avoiding the painkiller-overuse rut in migraine

>1/26/09 Edit to remove expired iCopyright link
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Avoiding the overuse rut in migraine

I don’t often link to articles, or report on other people’s reporting. Generally, I’m an original content kinda gal.

And I hadn’t planned another column here at Sparkling With Crystals until after Christmas. This one’s a downer too. Forewarned is forearmed.

But an article has appeared, written by Associated Press medical writer Lauran Neergaard, that clearly states a very serious problem for migraineurs that must be overcome by us, or by the medical community, or We together. Hopefully, it’ll be addressed by We.

And it finally cracks open the seal on some of the long-term effects of a category of early intervention medications that were sold to us migraineurs twenty years ago as the savior, the “shoot up and you’ll be back at your desk in 20 minutes” final resolution, triptans. Lauran Neergaard does not come right out and declare that triptans contribute to the progression of Migraine Disease but she does say that they become a risk factor for development of chronic migraine when use reaches 10 days a month or more. It seems to me that the objective of her article was to promote the value of prevention, which I am SO ON BOARD about that it cost me the services of my most recent doc.

If you haven’t read the article yet, please do so. Then come back here. The link to the article will remain here for one month courtesy of iCopyright.

For Migraine, I’ve seen more neurologists than I can remember by name. The last doctor I saw for Migraine was a Migraine specialist. They’re supposedly trained to contend with Migraine Disease from the Western Medicine corner of the ring. This guy was a dud, and I should capitalize that but I won’t.

He said that because I’d had so many years of under-treated Migraine pain, the pain nerve pathways in my body had become too ingrained for him to do much good. He said, “You’re really not worth my time to treat.”

Yep. Quote.

Too many years of under-treated pain to be worth the time of Dr. Breathtakingly Arrogant.

When last we spoke, I told him I would NOT take any more Imitrex and wanted instead to concentrate on migraine prevention. Imitrex caused the muscles in my neck to contract and close off my airway, I told him. Last time I took it, I told him, I was directed by my then-neurologist to go to the emergency room because she wasn’t able to stop the medication reaction and restore my free breathing. Nor did the emergency room care to restore it either. I was sent home untreated. This happened in March 1995.

When last we spoke, Dr. Breathtakingly Arrogant and I discussed alternatives to one of the four U. S. FDA-approved Migraine prevention drugs, an anti-seizure drug called Topamax (.pdf file). He told me to stop taking Topamax when I complained of side-effects that now have moved the U. S. Food and Drug Administration to put box warnings on other anti-seizure drugs commonly used for migraine such as Depakote (.pdf file). I tried Depakote many years ago, but got no relief from it. Just made my hair fall out.

He said that Migraine trigger management for prevention wasn’t especially effective either since most people’s Migraine attacks are caused by what he called “uncontrollable triggers”, things that we can’t avoid or stop like weather changes or exposure to other people’s strong perfume.

And that was it. If I wasn’t going to use Imitrex or any triptan as an early intervention medication and wanted only prevention--I refused pain medication that he offered until he absolutely insisted that I have something--I was gone.

This article succinctly explains being on the horns of the Migraine dilemma.

There are plenty of early-intervention medications and treatments both prescription and over-the-counter for a Migraine specialist and migraineur to try other than triptans. There are MOUNTAINS of preventative meds to try too. And I'm talking proven treatments, not shady internet offerings luring folks by promising a Migraine "cure" which simply does not exist at this time or promising to "eliminate Migraine" which may be simple management techniques that one may find at MyMigraineConnection for free.

Sure, to give a preventative a fair shake, one shouldn’t give up on it sooner than three months, unless there are side effects that cannot be tolerated. And sure, that means that in a year’s time, a migraineur may only be able to try at most four meds, or combinations of meds, to give them a fair shake.

Which means that a person might have a year, two years, ten years, who knows how long before an effective prevention regimen presents itself. And for someone like me, who has had what the AP writer called “stunning” 15 days or more of pain per month for decades, that’s a lot of time in pain.

Lots of time for those nerve pathways to become ingrained. Not worth the time of Dr. Breathtakingly Arrogant to treat.

Libchik had the first real debilitating Migraine attack of her life last week. She a migraineur too and so is her sister Aikichik. Libhchik's biggest deal is menstrual Migraines and even those she doesn’t get every month. But she had a whopper last week. She said her clothes hurt to wear, her hair hurt, her face was pale, and when I became concerned she told me I was giving off so much energy that she could feel it tactically.

She came to me the next day, after the attack was completely over, gently took my hand and looked right in my eyes. She said, “You’re the bravest person I’ve ever known. You have Migraine, and you don’t complain.” Later, I cried. My child "gets it".

I have only one more thing to say about Migraine and the horrors of it. I’m a force to be reckoned with during an attack. I would tell you to go to hell, but I wouldn’t want you anywhere near me.


Copyright 2008-2009 Parin Stormlaughter, Sparkling With Crystals, ALL RIGHTS RESERVED. I do not grant reprint permission under any circumstances. Contact me to request permission to link. And remember that if my work gets published anywhere else, I'll pray for you. And perhaps take legal action. Rest assured, prayer is far more powerful.