What Happens When We Change the Treatment Goal Line?

By Holly Harding

2 min read

“I found this one special pill and it completely stopped my migraine attacks!”

I can’t tell you how many times I’ve seen these statements. I read them with a mixture of disbelief and envy. I know we are all made so differently that it is possible that some people can attain a complete turnaround in their migraine attack frequency with a given treatment. For them, I’m thrilled. For me, not so much. I’ve not had that kind of luck and I’ve tried everything out there. I’ve learned that looking for a cure sets me up for failure. Because when I try a treatment, and I don’t attain a full stop in my migraine condition, I experience huge disappointment. It’s emotional – it’s physical. It’s brutal. It makes me throw my hands in the air and that particular treatment out the window. And it’s now happened countless times.

What are my migraine treatment goals?

I’ve found more success in auditioning treatments by shifting focus away from finding a total cure to instead seek ways to make the condition more manageable. There is less disappointment when we evaluate treatments for how they address our migraine symptoms. For instance, one treatment may address our nausea, while the other decreases attack frequency.

With the stakes a bit less high, we may be more open to continuing with a treatment that provides relief, even if it’s not complete. The goal can then be about chipping away at the multiple symptoms of migraine until we experience substantial relief.

Do the side effects outweigh the symptoms?

Of course each time we add on a new treatment approach we are inviting more side effects to manage. And when side effects rival our symptoms, we have to weigh carefully the worth of every treatment.

What happens when the medication is effective?

It’s likely happened to most of us. We try a treatment that abates one symptom just to find that with that break comes a complicated side effect. Whether it’s weight gain, drowsiness, hair loss, constipation, etc., a hard and personal decision comes into focus. We must ask ourselves whether the side effect is more troublesome than the symptom it addresses.

Is this treatment combination safe?

Another important issue that we need to consider is the overall safety of taking multiple medications in combination. This is a topic that needs to be carefully weighed with our doctor and pharmacist. We also evolve, so it can be that the combination of medications that worked for us at one time, shifts to not working as well years later due to aging or hormonal shifts.

Why can't there be easy answers?

Just like there being no easy cure, there are also no easy answers when it comes to migraine or the management of this complex condition. It is about personal decisions, careful research, and consultation with our migraine specialists and pharmacists. This site also provides a safe space to share your thoughts and questions as you continue along your migraine journey.

How do you approach migraine cure vs. relief? And how do you handle the side effects that come with an effective medication? We welcome learning from the lessons of your migraine journey in the comment section below. Thank you for being a part of the community!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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kateymac Member
<inline-mention username="Holly Harding" user-id="3755969"/> I like this topic, Holly. I can remember the appointment when my headache specialist told me we were moving, from trying to get rid of this thing, to pain management. Over the course of about five years, we had tried all reasonable options to try to get back to my previous level of episodic migraines and my previous level of high functioning. Also, I needed a rest from trying med after med after med. He didn’t say there was no hope, but the shift in treatment goals was heartbreaking, for me. I cried all the way home in the car. At the same time, though, I felt a degree of relief from accepting reality and taking a break from the fight. I was exhausted. I was especially exhausted by the let down after every med trial that didn’t work. That process was wearing on my soul. In the ensuing 20ish years, I’ve tried a new med or treatment here & there. But my goals are simply to manage this illness as well as I can. I’m very disappointed by what migraine has done to my life. I feel that loss every day. However, I also feel relief when I remember to live within my limitations. Adjusting my goals took the pressure off. I do the best I can, and there’s still plenty to enjoy in my life. Thanks, Holly! - Kate🌷
1. kateymac Member
 <inline-mention username="Tracy Hannigan, MOstMed, ACE-HC" user-id="3908580"/> <inline-mention username="Tracy Hannigan, MOstMed, ACE-HC" user-id="3908580"/> Thanks for your reply to my post, Tracy. I love that you could feel the cry that I described. That’s the great thing about this site. Others who have chronic migraine, or chronic pain/illness, can understand with such a great immediacy and shorthand compared to the rest of the people in my life. Mostly, they’re all pretty good, but they can’t really “get it” the way people “get it” here. Some of the moments in managing this illness can be quite dramatic and profound. The fact that I know you all exist & understand, so easily, really helps me to let go of those in my life who don’t. I feel no need to convince anyone to believe me. I don’t need their validation, because I know I can get that here. Kate 🌷 
2. Holly Harding Moderator & Contributor
 <inline-mention username="kateymac" user-id="3784217"/> Hmm- what a lovely and unique experience you had with this doctor. How do you feel about your current doctor? That must've been for sure a bit terrifying when your original doctor left his practice. I have that "perfect' doctor now and I fear his retirement! Warmly - Holly (team member)
azreynolds Member
Good topic, Holly! It's interesting when you talk to people who have been fighting migraines for only 5-10 years, how their different their attitude is from those of us who have been fighting it for fifty plus years. They usually think of their migraine as an enemy or a monster that they are going to battle until they finally win by beating it to a pulp. They haven't come to grips with the reality that they may have to live with this monster for the rest of their life, and making peace with it is the last thing they want to do. I too felt that way, and I remember it was disheartening when I accepted that I would always have migraines. When I found Dr. Bowersox, the optometrist who prescribed my binasal occlusion lenses for my migraines, he confirmed I had actually suffered a traumatic brain injury when I fell as child. It surprised me that I wasn't more upset about it, but rather relieved to hear his diagnosis. At least there was finally a reason for my migraines! But perhaps my easy acceptance was more because the year before, I had read your article, Holly, and I was already learning to live my life of pain with a new found gratitude. Talk about changing a goal line!! It changed my entire life! And my husband's. I'm still looking for the magic pill though. I will continue to try whatever my neurologist suggests, but for me, now, it's not the most important goal anymore. It would be nice to always have a magic pill that will work, but if not, I'll continue, like I have...doing my best, but focusing on the little things that bring me more joy than a migraine brings on pain. Hope you are well. Annzie
1. Tonya Henry Moderator & Contributor
 <inline-mention username="azreynolds" user-id="3677307"/> thank you for sharing that!!! I am glad to hear that Holly's article helped change your perspective. The way we view things can certainly make a difference. I too hope for a cure or magic treatment one day. I will continue to hope that day will come. I hope you are doing well tonight! (Tonya, team member).
2. Holly Harding Moderator & Contributor
 <inline-mention username="azreynolds" user-id="3677307"/> Hi dear Annzie- I always love your wisdom and insights. I absolutely agree that coming to fully embrace acceptance is generally something that doesn't happen til later in the migraine journey. It's absolutely logical that we spend the first number of years (sometimes decades) trying to fight against this beast. I know we've discussed before the similarities of the 5 stages of grief to what it's like to live with migraine. Denial, anger, bargaining, and depression all come before acceptance. Each one of those stages is important and must be worked and lived through fully before we move to another. And yet- those stages aren't always linear, either! We sometimes waffle back and forth through the stages as we struggle through all the challenges that come with chronic pain. But acceptance- that always seems to come last and it must be earned. I love what you shared about learning about the binasal occlusion lenses as well- because you found those AFTER you'd already found acceptance. Acceptance doesn't preclude our continued search for relief - it just puts it into a more healthy context. We aren't so desperate for every treatment to lead to a cure. The stakes aren't as high so in some ways, when we encounter a win- or a big a-ha moment - like you did - it's a wondrous surprise worth celebrating. You got a major puzzle piece that helped you more fully understand the origin of your migraine condition. Not all of us get to experience that. It's huge. I'm happy for you, lovey. Sending you a big gentle hug. Warmly - Holly (team member)