Another one

Yesterday I woke up the headache and numb arm and decided to take one of the naproxen.  It worked well for about 2 hours and then the headache returned with a vengeance.  I'm allowed 3 a day if I double the ulcer treatment while I'm taking them but I decided to stop at one and tough it out.  The day was not as bad as the last migraine day, and while I slept OK last night, the "dagger" part of the headache was still there this morning.  So I took another naproxen and things eased sufficiently to allow a trip to the supermarket in the morning.  These painkillers are better than nothing and if they don't kill the headache they certainly kill the ever-present arthritis pains!

If I get another inside 10 days I'll need to think seriously about starting the topiramate.

False Alarm?

Last night I had some of the symptoms of a classic migraine arriving: feeling of elation followed by a numb left arm and visual disturbances. I went to bed expecting the worst, but despite not sleeping well, woke today without a headache. Now, at 9pm nothing has yet developed.

I got the Naproxen and Topiramate prescription from the neurologist today but as the Topiramate were in capsule form and I was supposed to take half a 25mg tablet to start with, I asked the pharmacist to replace them with tablets. These should arrive tomorrow. The Naproxen are to take if I get a severe headache which would normally have me reaching for the Co-codamol. I also have extra Omeprazole to take along with the Naproxen so that my gastric problem is not exacerbated.

Whether or not I start the Topiramate immediately or wait and see what the headache frequency is as I come of Co-codamol remains to be decided (by me!)

Cold Turkey

I woke up with a migraine, or maybe codeine withdrawal symptoms if the neurologist is right, at 3:30 am on Saturday. Not yet having the medication which he thought would reduce the suffering of avoiding co-codamol, I decided to avoid it anyway and spent the day in a darkened room with the severe headache waxing and waning until it became more bearable in the late evening. We'd booked to see "Australia", but I couldn't make it. Slept well that night and had a nice day on Sunday including lunch out at the Old Butchers in Stow: a fine restaurant, full to the brim.

Back Again

The migraines did not go away: I just began to feel that writing the blog was keeping the problem more alive than it should be. Since June 2007, I've had fairly regular migraines despite taking tight control of the diet, and the sleepless nights have been fairly common in the absence of amitriptyline. The only medication which offers any headache relief remains co-codamol. A couple of weeks ago I had a really bad classic migraine which left my left arm feeling numb for several hours and worried me sufficiently to go and see my GP. She refererred me to a neurologist and the appointment came through for last Sunday a.m.

The self-proclaimed headache specialist gave me a thorough check-up, and wanted an account of the progress of the migraines since they started at the age of 12. He turned out to be a fan of amitriptyline and anti codeine-containing analgesics. I haven't got his letter summarising the diagnosis and treatment yet but the first thing he wanted to do was to get me off co-codamol. Even at the rate of no more that 4 tablets per migraine, and a migraine every 7-10 days, he suspected that I had become dependent on the codeine and was suffering from codeine withdrawal symptons after a week without any. The new regime will involve a three week course of an NSAID to allow coming off codeine without too much pain, a doubling of the ulcer-preventative to stop the NSAID aggravating the ulcer problem, and then a new anti-migraine prophylactic in conjunction with a minimal dose of amitriptylene to improve sleeping. I'll provide the details when I get the letter.

Mixed Messages

I suppose the fact that I'm not thinking of writing this as regularly as I used to means the misery really is less than it used to be. However immediately after writing "Better Times" I had less intense than normal but nevertheless unpleasant common migraine. Maybe the very act of focussing on the blog is triggering something! A horrible thought.

Yesterday I had to cancel a day out with a friend because I awoke with another common migraine and felt incapable of driving. It did not last past lunchtime but I began to think that the minor liberties I'm taking with the diet are likely to be causing these more frequent attacks. These liberties are mainly sating my craving for fruit by risking muffins with currants and dates and also an apple pie. I've also been trying a little potato salad and this afternoon had some blackcurrant jam for the first time since starting the diet. More sinfully perhaps I had a chicken baguette for lunch at a cafe on Tuesday and this turned out to be really nice - far spicier than anything tasted in the last few weeks. (Surprisingly this did not upset my stomach.) I could argue that rather than taking liberties, I'm adding back foods in a controlled fashion to see whether they have any effect. Unfortunately, everything I add back seems to have an adverse effect.

Looking back to April when I first came off amitriptyline, there is however no doubt whatsoever that I feel heaps better. Equally theres no doubt that the "heads" are less troublesome both in frequency and intensity. Sleep patterns continue to improve, and while I still get up between 5am and 6am most days, it is a pleasure to be up, often in the garden, on these still calm summer mornings.

For the last 3-4 days the gastro problem has been better so maybe the persistence with Zoton is paying off.

Better times

Shortly after writing last Thurdsay's post I had a classic migraine; the full aura and a few hours of subsequent headache and sickness, but as I've recorded previously, these are minor events compared with the common migraines which in recent times have been the main source of misery.

Since Friday its been a very good spell, with clear head and somewhat reduced stomach pain. I saw the doctor today, and while he had hoped for better results from the Zoton, he's asking me to stay on it for another six weeks prior to reducing the dose by half for a fortnight and then stopping.

Normal again?

It's a week since I last wrote and I'm trying to remember the details. Overall I'm now pretty convinced that the diet is the key to the reduced frequency of migraines. I've had one relatively minor migranous event in the last seven days, and this hangover-like incident followed a very nice three-course meal out at a good restaurant this Tuesday. I woke up with a bad head on Wednesday morning early, took 2 Solpadienes and by lunchtime it had faded. I also ate out on Saturday night and while there were no immediate ill-effects I feel this in some way contributed to "going over the top" with Tuesday's meal. In neither outing was it possible to avoid some of the no-no items in the migraine diet, and I feel while I can take the occasional risk*, two within the same few days leads to trouble. This was the case on the cruise, and once over the top I need a few days of careful eating to detox and get back to normal.

Looking back at the early days of coming off amitriptyline, I realise how everything seemed magnified in the first few weeks: all the little worries and concerns were amplified to the extent that I was really depressed and could not see the point of not starting to take it again. I seemed to be screaming silently all the time. It was a true addiction and one that I am now well rid of. Dare I say I feel normal again - mentally, and at the moment the migraine frequency and intensity is lower than it has been for ages.

Sleepwise, things are still disturbed. Some nights I get through without sleepers and others I don't even though I've taken some. I suppose I feel things are getting better but very gradually: either that or I'm less concerned about sleeping less.

One new issue - I hesitate to add - is a recurrence of the ulcer symptoms I suffered from about 15 years ago. The doctor has decided to put me back on Zoton for a month to see it this controls the unusual "ache" which is not burning and not ordinary indigestion. When I first had this someone said these symptoms were migraine related. Now I wonder if they're migraine-diet related.

* By "risk" I mean some gravy with the main course or a dessert with some summer fruits in. Alcohol, citrus fruits, chocolate, cheese and all the other common triggers never pass my lips.