Saturday, May 24, 2008
The (Nearly) Ever-Present Headaches
Well, yesterday I was able to carve out some time to go see the doctor again. I've been having pretty severe headaches behind my left eye for several months now. For some reason, it's becoming nearly impossible to take time off from work, so I was fortunate to get this crammed into the 14 other things that needed to be done on my day off. My doc had previously thought it was just a sinus headache and an x-ray had confirmed that I had some sinus infection (although pretty minor and on the right side of my head). So I took all the antibiotics but still was getting headaches pretty regularly (usually at work and usually about 4-6 times a week). To kind of keep track of them, I started doing a headache log and after a month of recording it brought it back to the doc. Next week he'll schedule an MRI and after taking a look at that determine if I should go see an ENT or a Neurologist. But in the meantime he gave me a few samples of a migraine medicine and told me to try those, taking them at the first sign of headache. So I come home and put the medicine on the table and then leave to go watch Indiana Jones with my friend C. Of course, half-way through the movie, a headache pops up. It's about a 3 on a 5 point scale, so it hurts, but I can still function. Then we go eat. By the time I dropped C off, it was hurting pretty bad (not quite crying bad, but close). So I zipped back home and took the first migraine pill. Not working, but I have to wait two hours until I can take the second one. In the meantime, people show up at the house and I feel obligated to stay out and visitate rather than go lie down (at this point it had dropped a little bit, maybe a 3.5 out of 5). I took the second pill and it was still hurting, and then I finally just went to my room, turned off all the lights and tried to sleep. I woke up and I felt a decent amount better (about down to a 2) - taking Aleve and getting a bite to eat took care of the rest of it. But all told, I had a headache for approximately 7 hours, and it wasn't fun. I've got to find out what the deal is. And of course, the obligatory Arnold quote: "It's not a tumor".
Posted by Brien Louque at 8:28 AM
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Sorry if I'm telling you what you already know, Brien, but you should keep the medication with you, especially considering the frequency with which you're experiencing pain. Most all of the migraine medications available these days are migraine aborters that work by constricting blood vessels; the most common class works by binding to serotonin receptors in blood vessels. If serotonin is already bound to the receptors, the medication can't do a whole lot to abort the headache--so if it's not taken very soon after symptoms start, or preferably even before that if you experience auras or other warning signs that you're about to have a migraine, it's not going to do much at all to help. Even when they're used properly, though, migraine aborters can take a couple of hours to kick in. Two older classes of migraine medication blood vessel constrictors of a more traditional variety (one is ergot based, so if you start thinking that people are witches, you'll know why), but they still don't work nearly as well once the blood vessels are already fully dilated.
There is a newer medication called Topamax that's designed to be a daily maintenance drug to ward off migraines, but since it won't really work at all if it's taken at the time of a migraine (i.e., it's not effective at aborting migraines), it doesn't sound like that's the drug the doc gave you.
Finally, because the serotonin system is implicated in migraine headaches, some people are prescribed antidepressants as a preventative. But again, that doesn't sound like what the doc gave you, and many antidepressants are dangerous to take with migraine-specific drugs because they can cause an excess serotonin load in your brain.
The main point, though, is to keep a supply of the pills with you wherever you go so you can take them as soon as possible when you feel a migraine kicking in. Again, sorry if I'm telling you stuff you already know. I guess I'm kind of a pharmacy nerd, but drug information always sticks in my head for some reason, and having two nurses and a doctor in my family means I'm exposed to a lot of drug information that I wouldn't know about otherwise. Good luck!!!!
I was bouncing over to post what I learned during my law school headaches, whcih was that if you don't take the meds immediately upon the first sign, they don't work, but I see Beorn beat me to it. 'Course, they always made me sleep, so taking them on the road can be tricky.
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