Navigating the world of migraine management and treatment is a lot like performing detective work. From tracking down and avoiding triggers, to researching medications and methods for relieving pain, being attentive to the day to day considerations of living with migraine can be like working on a lengthy, thorough investigation. Heck, many of us even wear the detective garb: sunglasses to filter out light and dark, cool clothing are some of my personal go-to’s. Migraine also has a lot of mysterious qualities: it affects individuals very differently, it can change over time, and treating it can be a lifelong, evolving process. One of the most elusive, detective-like aspects of living with migraine though, for me, has been researching medications that are out there and accessing treatment.
Trouble with finding relief
Let’s face it: it would be nice to be able to walk into a doctor’s office, tell them about migraine symptoms and triggers, and immediately be given tools and medication to solve the problem and get relief. But that isn't how migraine treatment works, at all. For starters, a lot of the journey for getting treatment for migraine for a lot of people is finding a doctor who can help in the first place. Even neurologists are not always specialized enough to help find a management plan that works.
Then, there is the medication. For some, finding any medication at all to help proves to be moot, and for many others, we have to settle on medication that causes us to feel sick in other ways, like intense nausea. Migraine treatment and management can also be worlds different between individuals: what works for one person living with migraine has the potential to adversely affect someone else living with the disease, so getting recommendations from others for what helps isn’t always fruitful.
Comorbidities and limitations
As someone who lives with comorbidities, including asthma and idiopathic anaphylaxis, I have to be very careful and thorough when adding new medications to my management plan, to ensure that they interact alright with other medications, as well as to make sure nothing I take exacerbates any of my other illnesses. This makes the detective work even harder, and more crucial.
One treatment out, one lesser in
As thorough as we may be as migraine detectives, oftentimes management and care turn up unexpected consequences. I was really surprised to learn recently that I had been prescribed and taking a beta blocker for hypertension and migraine that was not safe for me to take. Yep, I got a call from my neurologist’s office and was told to stop taking my daily sustained release medication immediately because it was unsafe for folks who have asthma. Oddly enough, it was my insurance company who called the neurologist’s office to tell them that the medicine could not be prescribed to me! Obviously, this was a bit shocking because I had been taking the particular medication for three months. I had also told my neurologist that I was a lifelong sufferer of asthma during my new patient intake, so I felt a bit miffed that this was something that went under the radar for several months.
Of course, I was angry, frustrated, and annoyed, but this just confirmed for me how necessary it is for patients to be their own researchers and advocates. I also began to wonder how much of the asthma symptoms I had been experiencing were related to the medication all of this time. My neurologist’s office prescribed a new medication that is supposed to treat both migraine and hypertension, without causing asthma exacerbation, but unfortunately it doesn’t seem to be as effective in migraine treatment as my last medication. This is one of the frustrating things about migraine: it seems for many of us we never quite find relief or just when we think we have, things change.
It seems as though, for many living with migraine, constantly going through changes with treatment is common. In my case, this latest change was due to an interaction with another illness, but for many, side effects can precede the continuing search for treatment. It seems as though trying to find relief and ways to cope with migraine can leave us searching for clues for what works and what doesn’t work for us, and unfortunately, we can come up empty handed, with only hope for relief as a driving factor to continue our investigation.
What are some of the challenges you face as a migraine detective? Let’s discuss in the comments!
Can you tell when a migraine attack is coming?