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.

Fun with riddles!

Q: How are headaches like potato chips?
A: It's impossible to stop at just one, no matter how much you want to!

Okay, not such a funny joke.
Saturday, the day of my last post, the Relpax never really did the trick. I suspect it kept the migraine from developing to its full, vomit-inducing potential, but it was still bad enough that I spent most of the day -- from about 2 p.m. on -- laying in bed, sleeping off and on and reading when I could.

Sunday was okay. I woke and rose from bed rather gingerly, waiting to see what my head was going to do. There was a bit of an ache, but I think it was mainly a leftover kind of deal. So I went about my day, got some things done, laundry, dishes, feeding the plants. I even went out for a bit in the late afternoon to fulfill a social obligation.

But by about 8 p.m., a very definite pain was developing. Hoping for the best, I went to bed about 11. When I got up to pee around 5 a.m., it seemed like everything was fine.

I woke around 8 a.m. and lay in bed reading for nearly an hour. By the time I got up it was clear that the headache was still hanging around making a nuisance of itself.

I have so many things I wanted to get done today. If I take the Relpax, I might dodge the pain, but it usually zaps any motivation. If I don't... well, who really knows?

The trouble is, if I'm going to have any reasonable expectation of the Relpax working, I have to take it before I eat. But that means I either have to fast until I decide it's warranted, or take it before I'm really even sure I need to.

Honestly, I think one of the most annoying things about my migraines is all the choices I have to make. I'm really not very good at decisions.

This morning I said to Hell with it and took a risk.

I decided to see if I could knock the sucker out with exercise before I gave in and drank the Koolaid (so to speak).

I needed fuel to exercise, and I decided a smoothie might be a good compromise. Unfortunately, all I had was chocolate soy milk (bought in a weak moment, it has been sitting in my fridge unopened for months). Now, I don't think chocolate is a "trigger" for me, but since it is for some people, I'm a little superstitious about it (another bad effect of migraines on me -- I've been meaning to write about that for a while now -- sigh...)

But by this point I was all gung-ho on my plan. I'd made a decision and I wasn't going to be derailed by details.

I made the smoothie, laced up my running shoes and headed out into the sultry late Southeast Texas spring. I decided to walk at a brisk pace to a running/walking track about a mile or so from my house, run around that, maybe twice, then run home.

On the way there, I could already tell that my body was not really up for a run. For one thing, I'd strained my back a bit hauling around bags of mulch for my garden and shoveling the same.
So as I was passing the nearly empty parking garage at St. E, I had a brilliant idea: I'd walk up the levels -- it would be nearly as strenuous as running, but without the impact.

So I did that. Just to up the ante, I even walked up the stairs a time or two. Then I continued on to the walking track, breaking into a low jog once or twice, then backing down when my lower back throbbed in protest. All through this, my head still hurt.

I got home and it still hurt.

Paid some bills, sorted through some papers -- still hurts.

Well, I tried.

I think the exercise cure works best for tension headaches -- though I was really hoping a good endorphin release might do the trick. Maybe I didn't go long enough or hard enough, but it was getting rather hot and exhausting myself in the heat might backfire and just make it worse.

So now I'm back to square one. Take the Relpax? Or risk it?

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.