My first experience with triptans
It was in the spring of 1995 when I first experienced using triptans to treat acute migraine attacks. I’d been a migraineur for twenty years, relying on way too much Advil, cold wet cloths, and a lot of suffering. I’d read about the development of Imitrex in a textbook a few years earlier. At the time I was pregnant, so I wasn’t permitted to try it yet. Fortunately I am one of the lucky few whose migraines improve during pregnancy. Still, I tucked the idea away, determined to get my hands on this new “wonder drug” as soon as it was medically safe to do so.
Barriers to access
This was in the days before patient assistance programs or online support groups. Even after my baby was born and weaned, I still faced some big hurdles.
Pre-existing condition limits
I was employed as a temp and had no company-provided health insurance. If I wanted insurance, I was going to have to pay for it all by myself. All the plans had limitations on pre-existing conditions, prohibiting patients from seeking medical treatment for a pre-existing condition for at least 6 months before agreeing to pay out benefits. Those 6 months were grueling. The thought of that long-awaited first appointment kept me going.
My very first headache specialist recognized the symptoms of Medication Overuse Headache right away. He insisted I stop using Advil immediately and keep a Headache Diary to identify my triggers. In the most compassionate way, he made it clear there would be no discussion of Imitrex until I broke the cycle of MOH. The next few weeks had me convinced that my head was going to explode. Gradually, there were fewer and fewer headaches. By the next appointment, migraine attacks were down to twice a week. That was quite a relief from near daily headaches.
The doctor was pleased with my progress. I had identified MSG, hormones, and let-down as my primary triggers and broken the cycle of MOH. He agreed to let me start using Ketoprofen 2-3 times each week to manage the attacks while waiting for that first Imitrex injection.
Waiting again was the hard part. There was such a concern in the early days about the potential side effects that the doctor required all first-time Imitrex use to be monitored in the office with an EKG and blood pressure monitoring. Attacks typically occurred in the evenings or weekends, so getting in for that first treatment was tricky. Even begging didn’t dissuade him. Finally, after several weeks of secretly hoping for a daytime migraine attack, one hit in the middle of the workday. I’ve never been so happy to get a migraine attack! My head was killing me, but I didn’t care. I called to inform the doctor I was coming. Then I abruptly informed my boss that I was leaving and might not be back until the next day… a risky call for the front-desk receptionist.
Upon arrival, I was escorted to a dark, quite room. The doctor quickly and quietly confirmed my symptoms were consistent with a migraine attack. A few minutes later, a kind, motherly nurse hooked up blood pressure monitoring and an EKG. She gave me instructions on how to use the injector and stayed close by while I self-administered my very first triptan. In 1995, only the StatDose injections were available. So the options were to learn to stab myself in the leg or do without. I wasn’t about to wimp out now!
The medicine worked quickly. My muscles all got very tight…even my chest and neck were tight. Then something amazing happened. It felt as though the medicine was squeezing the pain right out of the top of my head. The nurse was gone for about 30 minutes. When she returned to check on me, all the pain was gone. It felt like a miracle.
Lucky for me, my blood pressure and heart did just fine. I left the office that day with a prescription for six more of those precious injections, instructions to continue the headache diary, and renewed hope that maybe migraine was finally under control. Feeling amazing, I returned to work and bragged about my little miracle.
Waiting was worth it
It took so long to finally get access to Imitrex. This precious gift was available for just a few months before a move left me uninsured once again. By the time new coverage was available, a second pregnancy would still keep Imitrex out of reach. Another three years would pass before triptans would once again be a treatment option.
Twenty years passed before triptans changed my life with Migraine. It was another three years before they became permanently available. It’s difficult to comprehend how I managed to survive without them for so long.
What about you?
Some of you have found your ideal treatment, too. How long did it take to find the right one?
Some of you are still searching for your Migraine miracle. What do you do to keep going?
How much has your migraine disease changed or evolved over time?