How Has Your Treatment Plan Evolved or Changed Over Time? Part 1
There's no one size fits all for migraine patients and some treatments that may work at one point can no longer be effective over time. We asked our advocates how their treatment plans have evolved or changed over time. Here's what a few of them had to share.
Effective treatments can vary over time
Anna: "Early on in my chronic days, when the attacks were almost daily and it seemed that just about anything could trigger an attack, there were very few treatments that seemed to help. It took years of preventative daily medications, supplements, gentle exercise, meditation, and smarter use of abortive medications to finally bring my attacks below ten per month. Then I was able to incorporate more things. For instance, I was able to exercise most days without triggering an attack, and I could watch tv sometimes (what a treat!).
After pushing myself too hard professionally, I've taken a step backwards. I don't blame myself for the increased frequency; it's only natural that we want to push ourselves to do the things we love sometimes, even if it is not always the best thing for our bodies. Now exercise and tv are back in migraine trigger territory. The good thing is, I trust that if I keep reflecting on my habits and tweaking them to include more self-care, I can get out of this rut. It's just a matter of time.
It's so important to recognize that effective treatments can vary drastically not only between patients, but even for a single patient over time. Until there's a cure, trial and error and patience will be the glue that holds us together!"
Migraine specialist re-evaluates my treatment plan
Holly: "My treatment plan has evolved in response to my changing condition. I recommend that everyone with migraine be treated by a migraine specialist rather than a doctor or neurologist. The condition is so complex and requires someone that has the kind of training and background required to be able to respond to your particular needs. I’m grateful to have a migraine specialist who re-evaluates my treatment plan at every appointment.
That said, some parts of my treatment plan have remained constant for many years. I was one of the first people to have Botox injections for migraines before it was even FDA-approved. While the treatment does not eliminate my migraines, it decreases the intensity of the attacks and that is priceless."
Focusing on trigger reduction
Sarah: "When I first got diagnosed, I tried just about everything available to break the constant cycle. Unfortunately, I found I can’t take the most common abortive medications (DHE-based meds or triptans), and I have not yet found a preventative that works. I have, however, had some very severe side effects to many of the preventatives that work well for other people. (Topamax and SSRIs, I’m looking at you!) Now that I know this, however, I’ve adjusted my treatment plan away from prescription management and more toward working on trigger reduction in hopes of lengthening the period of time between attacks.
I avoid bright sunlight and dehydration. I wear specific lenses for computer work and anytime I’ll be under fluorescent lights. I work hard on stress reduction and try my best to exercise regularly. I also get regular supplement shots to offset my MTHFR mutation and avoid folic acid in foods as diligently as possible. This last has helped a lot. Folic acid is apparently a huge trigger for me—if I eat anything with enriched flour, I am nearly guaranteed an attack...
Managing individual symptoms
...So, I work to reduce my exposure to triggers. Then, when the attacks eventually increase again, as they do, I work to manage the individual symptoms: nausea, pain, etc. This obviously is not a good plan for most people. Preventing the attacks would be better. Since I haven’t had any luck with that, however, and I can’t take most abortives, this is the best option for me personally. And really, I think, that’s what we’re all working to find—a treatment plan that works best for us."
Stay tuned for part 2 where other Migraine.com advocates share how their treatment plan has changed for them over time!
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