A possibly tedious recounting of my four-headache week...

Last week was not a great week in my head.
The headache I woke up with Monday faded away before noon, which was a great relief.
Tuesday was okay.
Wednesday started out fine, but by lunchtime the noise was starting up in my head and it became that question of whether to take Relpax or risk the consequences -- a question I had to answer before eating lunch.
If I time it just right, often I can take it just in time so that it's bad enough so I am certain it was necessary but not so far gone that it won't do any good. I've gotten pretty good at gauging that, generally. On Wednesday I decided to take it, and I think it was justified.
It made me feel really, really sleepy as it sometimes does, but I managed to get through the day.
Just as it was taking effect I was interviewing two geology professors at Lamar University. When it hits me hard like that I often wonder if other people notice something odd about me -- like maybe they wonder if I'm on drugs, which I am, but not maybe the way they think.
Anyway, I got through the day and did most of what I meant to do.
Thursday, by late afternoon, my head began to ache.
Generally, I try to avoid taking Relpax two days in a row, as I think that's too often. And so far, it hasn't often been necessary (that is, since I got off the cycle of rebound headaches, which is the reason I limit my use of Relpax in the first place).
Anyway, out of sheer desperation, I took a whooooole bunch of ibuprofen -- about six 200 milligram tablets. It made me feel a little weird, but miraculously, it seemed to do the trick.
Who knows -- maybe the headache would have faded away on its own.
Friday was okay.
But Saturday, I woke up with a headache -- and I had to work.
I thought about trying the ibuprofen again, but I didn't have any at home. My assignment was to cover a historic gun exhibition in Orange (about 20 miles from Beaumont, where I live) so I got ready for work and drove over there, stopping at a convenience store for ibuprofen. I took five, and I think it might have blunted the progress for a little while. Hard to say.
But two hours later, it seemed to be building again.
I left the museum where the exhibit was being held and went back out into the heat and got in my un-air conditioned car.
I felt afraid to take the drug (because of the side effects) and afraid not to (for obvious reasons).
I looked around me, trying to read the landscape -- maybe it seems stupid to believe in signs -- it's not exactly that I think mystical messages are planted for my edification, it's more that I think my subconscious will use the objects and activities going on around me to help me navigate. Either way, maybe it sounds goofy.
Anyway, I saw nothing much that stood out to me one way or the other and drove on apathetically.
It occurred to me that the consequences of doing nothing could be extremely painful and at the same time, I realized that I WANTED to take Relpax.
So I did.
And again, I think it was the choice that most helped me get through the day I had planned.
Part of my day Saturday was training a new reporter on the duties of the Saturday shift, and I'm pretty sure that would not have gone well with a raging headache -- much less a full-blown migraine.
And this very green rookie reporter would not have been able to cope on her own with the Saturday routine.
So, all well and good.
But I woke this morning with a faint pain in my head.
Nothing major, but waking with pain is usually a poor start to a day.
I have an obligation later today -- but I don't think it would be appropriate for me to take Relpax again.
I was doing so well there for a while.
Granted, this week my period started, which makes it more likely for me to have headaches, but I don't always have FOUR the week of my period.
It seems to go in cycles that way -- but when I get into a bad patch like this, I'm always afraid it's never going to end -- that this is just going to be my life from now on.
It's especially worrisome because, from what I've read, migraine is not considered a disability. Which seems odd to me.
True, for many people, they are not a daily or even weekly occurrence. But when they are, they make it very difficult to work and be productive.
I'm not really sure how this fits in with my ambitious mission statement of finding solutions and cures and all that.

Getting old

That's a little play on words -- the title of this entry, I mean.
It's just my little way of being funny about having a headache that's creeping into its third day and how it's making me worry about aging.
Anyway, it started Saturday and it's now Monday morning.
At no point has it been totally debilitating -- it's just kept me from doing some things I wanted to do and made things I did do less enjoyable.
I guess I should be grateful it isn't any worse.
But wretch that I am, I'm not grateful. I just want it to stop already.
I've been assuming that this is a hormonal thing, that I'm sliding into menopause (kicking and screaming) and that there's no telling where it will end.
The fact that I woke up early this morning (4 a.m.-ish), too hot and had to turn the a/c temperature down a couple degrees does nothing to dispell this illusion.
But who knows? Maybe it's something else.
A sinus thing?
I should be getting ready for work now -- though going to work sounds about as thrilling as a root canal just about now.
I'm working Saturday and this should be my day off to compensate, but my editor asked me to wait and take off next Friday because a lot of people are on vacation
I guess if it starts getting bad I'll go home.
IMHO it should start going away soon. I was waiting for that to happen yesterday afternoon and evening, but...

Anxiety

I just left work without finishing the story I was working on for tomorrow.
It was -- well it just wasn't my day.
I wasn't sure what I was going to do on the inauguraton, but when I joked to my editor that I didn't think Obama would share with me the note Bush left for him, as per presidential tradition, Dan's ears perked up.
He wanted me to write about the tradition, suggested I call the LBJ library, etc.
Well, it turned out the tradition only goes back to Reagan, but in looking for more information on it, I came across a bunch of other inagural traditions started by various presidents, so I thought I could put together a nifty little story on that.
I even thought I could bring "real people" (which is what journalists call people who aren't elected officials, bureaucrats or other expert types) into it by asking random people if they had any inaugural traditions of their own (getting trashed, eating seafood, whatever...).
But from the start, it went nowhere. I looked up the names of a bunch of presidential historians, and tried to call and/or email them.
I called our local university, was referred to a particular professor who was not available. So I left a message.
In the meantime, as I said in my last post, an off-key big brass band started playing in my head.
I did everything I could think of to get my story together before everything went south, but I couldn't seem to get any sources.
I guess I could have tried to do it all off the Internet and see if it would fly, but they seem to frown on that sort of thing.
In any case, my ablity to make progress deteriorated as the pain advanced.
I knew I really just needed to go home, but I hated to go to Dan and beg off my story.
HATE IT.
HATE IT.
HATE IT.
I always feel like people think I'm making it up anyway, when I say I have a headache.
I decided to keep trying though, and I finally managed to get a Washington D.C. presidential historian on the phone live and in person.
He immediately cut me off. He was tired and chilled to the bone, he'd been up since before dawn blah blah blah.
I couldn't even bring myself to beg.
I hung up and went to Dan and told him I'd tried, and my head was killing me and I didn't have any more try left in me.
He was pretty nice about it. But he made some comment about seeing a doctor.
Well, I just saw a doctor, who gave me Seasonique, which, after I read about it on the Internet, I was too scared to try.
After giving it some more thought, I decided to give it a try next month after my period.
Of course, I didn't tell Dan all this. I just said I'd been to doctors, and all they ever do is throw drugs at it, and there are all sorts of other issues with drugs, like rebound headaches, which I'd already done and it wasn't pleasant, but then again, nothing was really pleasant anymore, so I'd have to come up with something, then I burst into tears and rushed away.
It's been ages since I cried, and I didn't want to today, because since crying has always been something that's given me a headache, I figured if I already had one, it would make it worse.
I cried half the way home (and thank God didn't get in an accident).
I'm just afraid. I'm afraid the headaches will get worse and I won't be able to work, then I guess I'd have to move in with my mom.
I love my mom, but living with her is another thing entirely.
I feel so stupid.
I'm just in this very unpleasant spot -- not really sick enough to be considered disabled, but not really well enough to function adequately.
I didn't really want to admit it's getting worse, but I think it is.
And I don't know what to do about it.

Sunday night

I went for the bike ride. Rode only about 10 miles, but since I haven't been riding much and half of it was riding into the wind, I think it was a decent workout.
My head feels pretty much the way it did before I left, but hey, at least it's not worse! So, you know, thanks for small blessings.
Anyway, I'm glad I got off my ass and did something.
Now if I could just get started on my novel...

Sunday

It's Sunday and as usual I have a long to-do list, a lot of distractions -- and pain behind my eyes.
It isn't bad. Just bad enough to keep me at home, frittering away my day with not-too-demanding tasks like laundry and paying my bills, between rest breaks mostly spent laying on my bed reading one thing or another.
Is the pain going to get worse? Or will it go away?
I don't know.
I think maybe exercising would help, but I feel just crappy enough that the effort to get dressed and get out on my bicycle is uninviting. Because of course, if it doesn't help, the exertion will be unpleasant to my achy-breaky head. It's also a very bright, slightly breezy day. A pretty day really, but one that seems a little abrasive, someone.
So I'm in limbo. Can't decide what to do.
I've spent too many weekends like this and it depresses me. That doesn't help anything. Being depressed only makes it harder to make an effort.
I know.
Poor me.
I have a load of wash in the drier, just about done and a couple of bills that need to be paid, then I will get dressed and get on my bike and go for a ride.
If it doesn't help -- at least I tried. And it's not a bad thing to get a little exercise, after all.

Hormones or sinuses?

Well, it's both.
I think.
Five years ago when all this really started becoming a problem, I remember a female friend about my age (41 then) saying something about declining hormone levels.
I didn't want to hear that.
I'm not ready to think about menopause.
But over the years, it's been there in the back of my mind, lurking.
So in December, when the pain was starting to interfere with my job and my life, I decided to go see my gynecologist.
We talked and she suggested I try birth control pills to help even out my hormones.
I left with a six month supply of Seasonale.
But then I started thinking about some of the questions she had asked me.
I'd been making all these assumptions about hormones, but when I considered the pattern of my headaches, it didn't make complete sense.
Sure, I usually got a headache or two or three around my period, but I also did the week after that and the week after that.
Was I overlooking the sinus aspect of it?
I had been taking Tylenol sinus medicine when I thought it might be sinus pain (sometime a tricky call) but it hadn't been working lately.
Maybe I needed to try something different.
So I went to the drugstore and looked around. I got some nasal spray for sinus pressure.
The next day (Dec. 31) when my head started to hurt right on schedule, I hit it with that.
The pain stopped, and I didn't have another headache for several days.
I noticed that the stuff said not to use it more than three days in a row (or something like that) so I picked up some pills for sinus pressure relief.
Those got me through last week with minimal amounts of pain.
So, the moral of the story is, don't let your fears blind you to your options.
But -- the hormones are still a factor.
My period started yesterday and with it came a nasty headache.
It started in slow, and I took a sinus pill even though I could tell right away it wasn't a sinus headache -- just wishful thinking, something I'm all too prone to fall into.
I took a nap, hoping I could head it off by relaxing.
There was no stopping it.
By nightfall, there it was.
Not the worst migraine, just bad enough to keep me in the house in my robe all day -- in bed most of the day.
I try to avoid taking the Relpax I've been prescribed because I know from past experience taking it too much leads to rebound headaches -- also, sometimes the Relpax makes me so tired and spaced out I end up just laying around in bed all day anyway.
When I was younger I never had a headache that lasted longer than a day, but in recent years that's changed.
So when I awoke at 5 a.m. and my head was still pounding, hoping to have a slightly more productive day Sunday than I did Saturday, I popped a Relpax.
I suppose it helped.
The pain dulled to a low-grade ache.
Anyway, I didn't mean to drone on this way. My point is, now I'm thinking about the hormonal aspect of it again.
But I'm leery of the Seasonale. So I got online and started doing some research. I promptly found a Web site with literally hundreds of posts from women on problems associated with Seasonale: excessive bleeding; severe cramps; weight gain; nausea; hair loss; sexual side effects; depression -- and migraine headaches!
Today would be the day I'm supposed to start the stuff if I'm going to, but now I'm scared.
I think I'm just going to have to wait another month and see how it goes.

A little background

I've been prone to headaches all my life, but up till the spring of 2004, things were fairly manageable.
In past years, while I had headaches two or three times a month, mostly they were easily managed with ibuprofen.
I learned that regular exercise, riding my bike, yoga, things like that, helped a great deal to keep things under control.
I had what I would have termed a knock-down, drag-out migraine only once every two or three years.
And even those -- they never lasted longer than a day, I could usually sleep through the worst of them, and when I woke up they were gone.
Then, early in 2004, things started to change.
I began having headaches that ibuprofen wouldn't cure, and they started progressing with greater frequency into intense migraines.
I got my first prescription for a migraine medication -- Relpax -- that spring.
I only took it once that spring -- I was at work and it made me feel very strange. Kind of fatigued and spacey. It noticeably affected my ability to do my job.
Things settled down in the summer. I didn't feel the need to take Relpax again until perhaps late August or early September.
It wasn't uncommon for me to have a headache or two while I was on my period, but I started having more and more of them.
One month I would have them three or four days in a row.
The next month it would be six or seven.
Then, by November, I was having them every day.
Maybe I should mention here that when they first started, I tended to think the headaches were stress related. I did -- and do -- have a stressful job.
In the past, I'd found exercise was a good prevention and cure for tension headaches, so I began getting up an hour earlier than normal each day and going for a bike ride. Now, I love riding my bike, but even more than that, I love sleep. I hate getting up early, so I want you to appreciate what a sacrifice I was making.
But it didn't work.
Usually by late morning the headache was starting its faint, annoying buzz, which by afternoon reached a crescendo.
I treated the headaches with Relpax -- the only thing I'd found that worked.
I knew it wasn't right for me to be taking the stuff every day, so I trotted on back to the doctor. She put me on another prescription drug, Topamax. It's a seizure medication that is also used as a prophylactic for migraine.
I started out at the minimum dosage, and it worked pretty well at that level for a while. After a couple of months, it stopped working, so the doctor increased the dosage, and it went along that way for a while until about eight months later I was at the maximum dosage, which made me feel kind of sick all the time and eventually stopped working and I was taking it and Relpax every day and honestly, between all the side effects of both of them I don't know how I functioned.
So back I went to the doctor, who prescribed an antidepressant, tofranil.
So I tapered off the Topamax and onto the tofranil which worked, again, for about eight months, then gradually stopped being very effective and I was back to treating the headaches with Relpax every day.
I had this gut feeling that taking the Relpax was part of the problem, but I think I was too scared to put it to the test.
Let me just insert here that I had also been to a neurologist, had an MRI and ruled out brain tumors as a cause.
Also somewhere in there, I'd gone to an allergy doctor, who tested me for allergies. I tested positive for dust mites, some tree and weed pollens. He gave me samples of various allergy drugs that didn't seem to do a damn thing for my headaches.
He wanted me to get allergy shots, but wouldn't let me do the shots on my own, wanted me to pay him $20 a pop to administer the shot. I balked, both at the cost and, well, I was afraid the shots would only make the situation worse... maybe that's wrong.
Anyway.
When the tofranil stopped working, the neurologist (whom I didn't much like) prescribed a blood pressure medication, which promptly made me so sick I couldn't take it at all. She was out of town that week, so I went to my regular doctor, who said a newer, time released version of the drug would solve the problem, but it didn't.
I understand all about adjusting to medicines -- but I knew that something that made me this sick was all wrong for me.
Then a friend emailed me a link to an NPR story about a doctor who had written a book about migraines.
He had compiled a list of all the foods that could trigger migraine, and it was way beyond the usual red wine, chocolate, MSG, etc. migraine sufferers are told to avoid.
He also explained about rebound headaches -- which taking Relpax too often could cause.
So at this point, I realized my gut feeling had probably been right all along.

But instead of just stopping cold turkey, I decided to go to another doctor in search of a cure.
He told me there was no cure for headaches and I left his office with two new prescriptions -- one of them another anti-depressant.
Maybe I needed it, 'cause I drove home totally depressed.
After giving it some serious thought, I decided to get off prescriptions meds.
I did not do it in a smart way.
I stopped taking the tofranil, and after a few days when this didn't seem to be too rough, I thought I'd stop the Relpax.
Well. The reason stopping the tofranil didn't seem too rough at first was possilby because my body didn't realize I'd stopped right away or something.
But about the same day I decided to stop the Relpax, everything hit at once.
I had possibly the worst migraine of my entire life.
I was up half the night and vomited three times.
I lay on the cool tiles of my bathroom floor most of the night moaning, feeling like someone had hit me in the head with an axe.
I wished someone would hit me in the head with an axe.
There's a line from a Joan Didion essay on migraines that comes to mind at moments like these: “That no one dies of migraine seems, to someone deep into an attack, an ambiguous blessing.”
Well. I lived through that night.
And I somehow got through most of the next year free of prescription meds (though not free of headaches, unfortunately)
I tried the NPR doctor's diet, cutting out quite ordinary foods like cheese, nuts, onions and bananas, among other things.
I tried this for about three months, I think.
As far as I can tell, my triggers aren't food-related (however, the one thing I remain skittish about, avoiding like the plague, is MSG -- I always ask if they use it at restaurants)
I've explored many possible explanations for my headaches: allergies, hormones, sinusitis. I've traveled down many a treatment avenue: acupuncture, chiropractors, herbs, progesterone creams, nasal washes, reiki.
There are still others I haven't tried: biofeedback, massage, botox (don't laugh -- I've heard it helps some sufferers).
Sometimes it seemed like something was working for a month or two, but then they would get bad again -- so I never really know if something works or if the headaches just naturally ebb and flow.
This past year, I returned to occasionally using Relpax, keeping it down to two or three times per month, to avoid rebounds.
I had first thought about doing this blog a couple years ago -- just after I quit prescription meds. I thought perhaps it could help me and other sufferers find ways to cope with the misery of chronic headaches.
I never got around to it till now. Maybe because I had a pretty bad December. Eight headaches, five of them that pretty much put me out of commission for the better part of a day, another that likely would have, except I took Relpax.
And I had one yesterday. Not unexpected, as it was the first day of my period.
It wasn't even close to the worse one I'd ever had, so I tried to just tough it out. But when I woke at 5 a.m. and it was still hanging around, I caved in and took the drug.
As I'm writing this, I still have a nagging pain behind my eyes.
Perhaps the worst effect of my headaches is the self-pity, the way they make me hate my life sometimes, the fear that they will get even worse and more frequent...
I'm not the most cheerful person you'll ever meet, and headaches don't help much with that.
I'm sorry this was such a long entry. I don't know that it's of any earthly use to anyone, but I felt I needed to show the road I'd been down, some of the things I've tried.

Welcome to my head...

And a frightening place it can be at time. Mind you, I'm not claiming that the bats in my belfry are anything more than run of the mill bats -- my metaphoric demons are nothing more than your fairly ordinary, garden variety spleen-devouring imps o' Satan.

No.

What I'm talking about here is the chemistry of the place. Of which I really have only a rudimentary understand -- although I can describe the effects in all their glorious technicolor gore. And likely will, at length, if this goes as I plan it to.

But I don't just want it only to be me whining about the pain.

What I want is to proceed in a methodical direction toward answers, solutions, even a cure, tho doctors tell me there isn't one.

The demon I'm here to exorcise is called Migraine, and as anyone who's tangled with her knows, she's one mean, scary bitch.