How I Manage Changes in Therapy Regimens
Last updated: May 2023
Over the years, I have battled migraine disease, I have been through more treatments and therapy regimens than I care to remember. Thankfully, with the advent of medical portals combined with pharmacy records tracking medications and procedures is easier for me. Tracking therapy regimens, however, is more challenging as I must do that manually. One thing is consistent about changing up any treatment for me. It stresses me out. Every single time. Unfortunately, stress and anxiety are significant players in the game of triggers.
Why is changing treatment so complicated?
Like many people who live with migraine, I have a train of comorbid conditions that accompanies me on my journey. A change in treatment for migraine or any of the cars in my train is potentially troublesome. A derailment is possible at any time. It’s not always negative, though, as there are many times when I have adjusted treatments without incident. I have always been one to research possible changes in my therapy regimens. My wife is also my most prominent advocate and research assistant. Together we come up with pros and cons for the things I might consider to hopefully improve the management of a condition.
What migraine treatments have I been using?
Recently I have been forced to listen to my body again, but I have more wisdom and flexibility now. My last disagreement with my body did not go well! I have two areas that I will be making changes in during the coming months. One is for a deteriorating back issue, and the other is my old nemesis, migraine disease. I have been using Emgality for just over two years. It has done a great job in reducing the pain piece of a migraine cycle for me. That is a huge win. It does, however, start to wane the week before my next injection. This usually results in more severe attack cycles with higher pain levels. I use Nurtec ODT as an abortive and a Nerivio device to help with these breakthrough cycles. That being said, my latest appointment with my migraine specialist was focused on the treatment efficacy and some new symptoms that were showing up during the severe attacks.
What changes am I trying to make?
I have been fortunate that some of the CGRP drugs have helped me effectively manage my attack cycles. In that spirit, I began researching Vyepti infusions. My doctor also knew I was thinking about it, so she was prepared to discuss my questions and concerns at the appointment. We spent about forty-five minutes discussing Vyepti as well as some additional treatments, and we settled on starting the process of making the change from Emgality to Vyepti. One of the biggest hurdles for the CGRP drugs with my insurance has always been convincing them to approve the treatment. Luckily, there is a team of people who specialize in this angle of patient advocacy in the facility my specialist is located at USF/TGH (University of South Florida/Tampa General Hospital) medical center.
What am I doing in the meantime?
While I wait for this change to take place, or not, I will take time to work with my other doctors to address the stress and anxiety that builds up inside me. Getting approval is not so stressful since my hand in it is small, but the thought of leaving behind a working treatment in hopes of finding a more effective one weighs heavily on me. My migraine specialist and I agreed that I would not stop Emgality until we knew if Vyepti would be covered by my insurance. She also comforted me up front by saying I could go back to Emgality right away if we found Vyepti was not going to be a good fit for my body. Mindfulness and meditation are helpful tools for me to keep stress and anxiety in check.
Have you experienced stress and anxiety when faced with changing your therapy regimens? How do you handle these often inevitable changes? Let me know in the comments. I’d love to learn from your experiences.
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