Severe Low-Pain Migraine: A Description

I have discussed in previous articles the fact that the CGRP trial drug has relieved much of my severe pain but not what I always considered “secondary” symptoms (nausea, allodynia, tinnitus, brain fog, aura, photo/phonophobia, red swollen nose, fatigue and insomnia, depression and anxiety). Last night, I had all those as well as aphasia, which doesn't happen too often.

Weather trigger and persisting symptoms

The weather had been extremely humid and rainy for a couple of days. So humid that the thin wooden banister on our staircase was seeping and sticky. I had been waking up with pain and treating it successfully with Imitrex tablets, but those other symptoms remained. I was to drive up to Michigan for my last CGRP injection and had to cancel; I slept most of the day instead. Thursday was much the same.

In the evening on Thursday (which was just last night, as I'm writing this), I planned to stay and watch the girls' Cinderella rehearsal. Right before leaving I began to feel a sharp pain on the right side of my forehead. I slapped a Salonpas patch on it and took some acetaminophen with caffeine – I had run out of all other oral meds (fortunately I was able to fill them today). And so, we drove the seven minutes to the high school auditorium where our rehearsals and performances are held.

Pushing through low to moderate pain

I sat in one of the cushioned seats and began to receive texts from another board member who was having trouble getting into the group's storage locker where she and her husband were to locate and load some set pieces into their truck. I went to speak to the student director about it and quickly realized I was dealing with more than my usual brain fog. My pain was still at about a four, far lower than the usual pain level with which I had associated these types of symptoms before the CGRP trials. I thought again about how without the study drug, this particular migraine might have been a killer, one that would land me in the ER.

Instead, I had low to moderate pain that had allowed me to drive the girls to rehearsal and stick around, but these other symptoms are annoying and sometimes debilitating too. I tried to tell S, the director I was speaking to, about the storage locker issue, and my mind kept going blank. Instead of the name of our theatre group, what came out of my mouth was the word “festival.” S's eyes blinked with confusion behind her glasses as she looked up at me. I sank down into the seat next to her and sighed. “I'm sorry,” I said. “My migraine must be a progressing a little faster than I thought.”

Esclating symptoms and aura

I managed to get the correct combination to the storage locker and text it, and as I sat and watched the final scene being blocked I felt a wave of heat start at my feet and move up to my face, increasing my nausea. I closed my eyes and saw pricks of light, the familiar combination of clear squiggles and fireworks. My stomach heaved and I stood up shakily and walked quickly out of the auditorium, through the empty cafeteria to the bathroom.

Um yeah, I needed to get home. I splashed water on my face, feeling momentarily better after emptying my roiling gut. John didn't respond to my texts so I called and he picked up. “Hey, I'm really sick and need to come home. Can you drive back up here to bring the girls home?” He said he could and that he was sorry I was getting worse. I signaled X and Zo that I was leaving and thought again about how a year or two ago, I might have been stranded because the pain would render me incapable of driving. I was uncomfortable, but could definitely drive.

In the parking lot I saw a friend, the dad of another cast member and favorite of both my girls who helps with carpooling. I approached his car and asked who he was taking home that evening and he told me he was expecting to take his daughter and both of mine, which was news to me but worked out perfectly. I told him the situation and that I would tell John he didn't have to come up after all, and he said “Go home and get well.” I'm very lucky to have such support in both my theatre and dance families and I never take it for granted.

Sleeping it off

I arrived home without mishap and told John he didn't have to drive up and he encouraged me to go straight to bed. Even though my pain had even lessened to a three, I decided I should use one of my precious remaining Zembrace (Sumatriptan) injections. I only had two left and can't get any more injections at all until my insurance situation is resolved – the generic 6 mg ones cost $400 for 6; Zembrace $250 for four 3 mg injections. I lay on my side in bed and pulled the cap off the Zembrace, gritting my teeth as I pressed it into my thigh.

Even after I took Benadryl, Dramamine and Zanaflex, which would normally knock me out quickly and send me to migraine-repairing dreamland, I felt twitchy and agitated. It was a pretty unpleasant night, my sheets feeling like sandpaper, until I finally drifted off around one AM.

The weather broke overnight. When I woke up at 8 am to cool, crisp air blowing in through my window, my head felt much more clear. The girls and I went to pick up my prescriptions, and I ran into a friend who sometimes teaches our theatre workshops and is the mother of the director of Cinderella. After the girls hugged her she looked up at me and said “It's a whole new day for you, isn't it?”

I smiled at her. “Yes. Yes it is!”

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