Trauma + Insomnia = Perfect Storm for a Migraine
As someone who has struggled with migraines since childhood, I know I have a few very identifiable triggers. Unfortunately, I've also learned that often, when a migraine is coming due to one of these things, there's not much I can do to stop it besides brace myself and use all of the tools at my disposal to weather the storm.
On the regular, my hormones are one of the biggest causes of my migraines.
Migraine medications and pregnancy
In the past, I've written about the challenges of finding migraine medication safe for conception and pregnancy. I've spent the last four years in and out of fertility treatments, pregnancy, postpartum, and now pregnancy loss recovery. My hormone levels haven't been stable in longer than I can remember, and migraines have been an unfortunate and unpreventable part of my journey to motherhood.
A post-miscarriage attack
This fall, I experienced a post-miscarriage migraine that landed me in the emergency department after 5 excruciating days. Ever since, I've worked on having better support, better communication with my doctors, different medications, and better plans in place to support me in dealing with hormone-based migraines right from the start.
The beginning of my pregnancy
At the beginning of this month, I was almost 11 weeks pregnant with our rainbow baby. After two early miscarriages in the past year, we were so grateful and so hopeful for this miracle via in vitro fertilization.
Writing that now makes my heart ache so much.
The pregnancy started as twins, and the first baby, our daughter, had stopped growing around 6 weeks gestation. What I thought was finally a miscarriage of our daughter at 11 weeks gestation ended with a spontaneous delivery of both babies, together, one who hadn't grown very long, and one, our son, who was fully formed and almost into the second trimester.
Physical and emotional trauma
In short, it was a significant physical and emotional trauma, resulting in a devastating pregnancy loss. This entire experience, from the start to the present day, obviously also caused massive fluctuations in my hormones. Additionally, as most traumas do, it triggered my insomnia at its highest level. During the first few days after delivering my son, I slept only in short increments and only during daytime hours.
If you're thinking, wow, that sounds like a perfect storm for migraine, you could not be more correct.
Insomnia and grief led to an attack
The first few days post-trauma involved very little sleep, way too much thought, a lot of intense crying, and navigating the feelings of being both numb and in shock. As soon as those things wore off, the migraine arrived.
Back to my previous medications
I felt grateful that I had a few different medications available to me at home, prescriptions that weren't safe for pregnancy but were now okay to use since my baby had passed. I started with Rizatriptan, added in Ubrevely, utilized my Nerivio device and Headache Hat, and spent about 24 hours in a silent, dark room. I was starting to think I wouldn't be able to fight this migraine on my own when I remembered the Ketoralac injections I'd been prescribed for situations just like this.
Communicating my Ketoralac experiences
I'll be honest, that injection is what saved me from the infusion suite at my neurologist's office, or worse, the emergency department. With each use of this medication, I send an electronic message to my migraine specialist detailing the circumstances surrounding the need for the medication, the triggers that caused the migraine, the length of time prior to utilizing the injection, and the timeline of symptom reduction after injection. It helps us continue monitoring my treatment options, my dosing requirements, and an overall handle on my migraine trajectory.
I am grateful
I would not have been able to manage this situation at home last year. It makes me increasingly grateful for my specialist, the advocacy I've done for my care, and for having multiple treatment options available for me while in a migraine crisis.
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