A Persistent Need for Abortive Medication

I recently shared that I’ve been dealing with what feels like a semi-permanent, daily disaster of a chronic intractable migraine, one that began at the end of November and led to a diagnosis of bacterial meningitis, or an infection and swelling of a brain caused by bacteria in the cerebral spinal fluid.

What have I tried to break this migraine cycle?

I have seen two neurologists, my migraine specialist and a neurosurgeon during this time, and in the beginning I was hospitalized for multiple days, and no matter what has been suggested, I’m frustrated and devastated to say that nothing for me has broken this migraine cycle.

I’ve tried so many things.

Did my regular abortives work?

First and foremost, I tried my regular abortive medications. For severe migraines, I have been prescribed a cocktail of medications - a combination of an oral muscle relaxer, an intramuscular injection of an NSAID, an intramuscular injection of an antihistamine and IV fluids. It’s been so frustrating that no matter how many times I have repeated this combination, it hasn’t done what it used to do. It hasn’t aborted my migraine.

Which other medications did I try?

I also have two different oral migraine medications at home that I have tried - Fioricet and Nurtec, of which neither provided any relief at all.

With no success in reducing the pain or photophobia associated with this migraine, I have had several conversations in person and through MyChart messaging with my managing physicians.

They’ve provided several different courses of cycle breaker medication deemed both traditional and non-traditional, but none of those have had success either.

Did an occipital nerve block work?

Next - I was recommended to try injections. For the last two years, I’ve gotten Botox for migraines every three months, but this migraine started just after my fall dose. About two weeks prior to being due for my next Botox cycle, my doctor recommended trying an occipital nerve block. What I was unaware of when I agreed to this was that it would be INCREDIBLY painful. My migraine pain seemed to be originating from the occipital nerve, and to have four injections of lidocaine injected into that space was extremely uncomfortable. It left large lumps that took days to dissipate, and although there was a small amount of pain relief, it wasn’t significant and it didn’t last. I was devastated. I really hoped the pain of these injections would be worth it in the end and finally break the intractable migraine I’d been suffering with.

Did my Botox dose give me relief?

Then, I was hoping my spring dose of Botox would finally calm the repetitive throbbing in the back of my head, but I had no luck with this either. This was sort of my last Hail Mary approach at relieving the pain.

My doctor told me to give it two weeks to fully absorb and work to it’s maximum potential, but those two weeks have come and gone and I’m still sitting here, wondering if the pain in my head is just a thing I’m going to have to deal with for the long haul.

This is so discouraging.

What have I turned to now?

I'm now looking at what feels like a last case resort. The headache clinic my migraine doctor works for has an inpatient unit in a hospital about an hour from my house, and they focus solely on patients like me, with intractable migraines, using a combination of IV treatments, biofeedback, and other modalities of treatment.

If you've struggled with an intractable migraine and utilizing a persistent need for abortives, how have you broken the cycle? I'd be grateful for any suggestions you could leave below.