Mackenzie's Fight for Cambia

Recently, I sat down to talk with my friend Mackenzie about her history of migraines. Mackenzie nannies for my daughter and lives with me and my husband, and we have previously discussed in length the medications we have both tried and failed to prevent or abort our migraines. I am grateful for Mackenzie sharing more of her story with me and the persistent attitude which led her to her current migraine treatment plan.

Introduction to migraine

You've shared an extensive health history with me, including your being a cancer survivor and a bone marrow transplant recipient. When did your migraines start - before or after your transplant?

My migraines started probably two years after receiving my life-saving transplant. Honestly, they were pretty mild at first. At the time, I found a neurologist near where I was living and was immediately prescribed Imitrex. The prescription worked to abort my migraines, but it made me super sleepy, so it was difficult to take unless I could rest afterward.

Worsening attacks over time

Were your migraines debilitating from the beginning? Or did they get progressively worse with time?

I went for several years without any major issues. Imitrex managed the migraines until I moved back to my hometown of Buffalo, NY, from LA in 2015, when they got much worse. I was experiencing migraines almost every single day for three months in a row. I was regularly taking Excedrin Migraine (which I later learned wasn't the best idea for chronic migraines) and utilizing my Imitrex prescription, but neither really provided me with any relief.

Weather changes were to blame

Looking back, I blame this significant increase in migraines on the change in weather. During my time in LA, the temperature and barometric pressure were fairly even without many ups and downs, and back in New York, the temperature varied significantly.

Cutting down the frequency of attacks

I returned to see a neurologist at that time. Once I "proved" to him that I was truly having migraines at an unbearable frequency and duration, he prescribed nerve block shots - which unfortunately didn't make much difference for me. Next, I tried Botox injections, but that wasn't something that I wanted to continue - I hated the feeling of my face being frozen. At that point, my doctor recommended alternating trigger point shots and SPG blocks. That finally broke my migraine cycle, and I alternated these treatments for probably 6-8 months. As my migraines improved, I weaned down on my treatments. I stopped the SPG blocks first, and I continued trigger point shots every six weeks for the next three years (until I tore my rotator cuff). Getting injections in my shoulder after that injury sounded too painful!

Honestly, since that injury, I haven't had that many migraine issues (2 years and counting!).

A long journey to treatment

Were you able to get diagnosed and treated for your migraines quickly, or was the pathway lengthy to find your current medication?

As I alluded to above, finding a medication/treatment that worked well and had little to no side effects was a lengthy process.

Did you go through several medication and treatment options before finding your current prescription? Were medications eliminated due to their ineffectiveness or their failure to work?

Both. I tried several medications between Imitrex and the two medications I currently take.

My current treatment plan

Is your current medication preventative or abortive? What was behind your/doctors' choice to use this type of medication?

The medication that provides me the most relief upon sensing migraine symptoms is Cambia, which is abortive.

I also take amitriptyline at night as well as a preventative. My doctor and I decided that a combination would be best for me.

Unknown triggers and headache side effects

Do you have typical migraine triggers?

No, I've never really been able to narrow down what triggers it. As you know, I receive IVIG infusions every four weeks due to my immunodeficiency. When I began that medication, I was quite nervous, as one of the first and most common side effects for patients is headaches, but I've been lucky not to experience this as a major issue.

If I experience a headache, I take my Cambia, and it gets rid of it immediately.

Getting ahead of the attack

Is there anything you can do when you feel a migraine developing to prevent its severity from increasing? I take my Cambia immediately. In what ways have migraines impacted your life? Has their impact changed over time?

At the height of my migraines, I could literally do nothing. I would just end up in bed, in the dark all day, every day. It wreaked havoc on my mental health. I felt unsuccessful as an adult, unable to work, and felt trapped inside my body.

An infusion cocktail

Since I found a treatment path that has worked for me and has broken the vicious cycle, migraines impact me much less on a daily basis. Occasionally, when I have a cluster of headaches or a migraine for several days, I have done the "migraine infusion cocktail," which is comprised of a steroid, Benadryl, Reglan, and magnesium. This combination has always provided me with relief.

Barriers to care

Have you come across any barriers that have prevented you from getting migraine care or treatment? If yes, please describe.

It was very difficult to get insurance coverage for Botox and Cambia, as my insurance required my doctors to prove that I had already failed other migraine treatments. Fortunately, they were able to prove that easily on both occasions, as I'd already failed multiple other treatment options. The frustration of bartering with insurance for medication approval I knew I needed to improve my quality of life will always irk me.

Stay persistent

Is there anything else you’d like to share?

I think especially when you're suffering with migraines (like when I was at the height of my migraines) - it's very frustrating to continually have to go to the doctors' office time and time again and prove that I've already failed other treatments and that the things we'd tried truly had given me no relief or were not sustainable treatment options. Still, it is worth being persistent and being a "squeaky wheel" because then you finally get the treatment that makes a difference.