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PostPosted: Tue Feb 16, 2010 1:50 am 
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Joined: Fri Jan 29, 2010 12:54 pm
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Hi, All: here’s my story, as concisely as I can tell it…which is to say, not very. I won’t always be so wordy, and it won’t always be me, me, me, pinky swear!

I had my first migraine when I was ten (I’m 54 now). It was horribly painful, left me temporarily half-blind, and made me throw up. It was terrifying. I soon learned what my triggers were, and tried all the treatments available back then, but nothing stopped the attacks. Fortunately, they only occurred once or twice a year. But even so, from that point on, my prayer literally every night would be, “God, thank you for not letting me get a migraine today, and please keep me from having one tomorrow.”

The intensity and duration of attacks got worse with age, although not the frequency. I continued to try many kinds of medications under my doctor’s care, and even had a complete neurological workup, but nothing helped. I did try whatever pain meds were safe for a young person to try back then, but I had to take dangerously large doses for any analgesic effect, so I was kind of treading on thin ice there.

Just for reference (and honestly, not for sympathy—I apologize if that’s how it seems), this is what an untreated migraine is like for me: first comes the “aura”, where I see spots, jagged lines, scintillations, and have only partial vision. This is usually accompanied by numbness in my hands, mental confusion, difficulty speaking, etc.

Next is pain—it comes in waves, then is constant--first one-sided, then my whole head and sometimes my face--I feel as though my entire brain is swelling and throbbing, I have allodynia (where the roots of my hair hurt) and although I consider myself a fairly rational person and am not given to flipping out over pain, I have been known to bash my head against the wall, because the pain of that is a distraction from the migraine pain, and I’ll give anything for even a few seconds of relief (in the migraine community, we are known as “headbangers”; this activity is more often found among cluster (aka”suicide”) headache sufferers).

Then the vomiting starts—for me, an average of 12 times (I guess it’s twisted to count, but I was curious); this stage of the migraine is especially rough on me because I’m emetophobic. The attack goes on anywhere from four to eight hours on average. Finally, the postdrome phase sets in--the pain and nausea subside, and I try to sleep. Which would be great, except that oftentimes, a few hours later, the aura reappears and the whole cycle starts again.

Anyway, in the mid-‘90s, triptans came on the market, and they worked like a charm, not just covering up the pain but actually aborting the migraine process and allowing me to function within minutes. And because I was still getting them infrequently, migraines became a true nonissue for the first time. I can’t tell you how liberating that was! I began to see all the ways my life had been stunted out of fear; it’s amazing how pain issues can creep so insidiously into your life and constrain your outlook, your activities, your personality…anyway, my world really did open up, and life was good.

Then five years ago, after intestinal surgery, I began having more and more attacks, to the point where they occurred every other day or even more frequently. I started seeing a neurologist, a migraine specialist in a very large and prestigious medical center, and we began to work on preventative strategies (I am currently on 3,600 mg of Neurontin and 200 mg Zoloft). We have been able to get the frequency down to 3 or 4 per month, and often even less, but I still have times when I’ll get one a day for several days in a row. My body tends to adjust to whatever preventatives I’m trying, so no strategy lasts for long.

In the fall of 2008, I had a mild heart attack. It was brought on by having to use triptans for several days straight; the medicine works in part by constricting arteries throughout the body, including the coronaries. Anyway, that was the end of triptans and the beginning of heavy pain meds for me. My neuro offered whatever med I wanted to try, and we went through Percocet (too hard on the stomach), Opana (hated it, made me high and gave me rebound headache) and finally plain Oxycodone IR.

I felt it was the ideal med for me, because--and nobody believes me when I say this--it didn’t make me high, never has (neither did Percs, same narcotic of course). I would be slightly sedated and had a mild sense of, I guess the best word would be “coziness” and reassurance, not even close to the euphoria I would feel with, say, hydrocodone or morphones. So it was a deceptively gentle (HA!) med for me that allowed me to get on with my day while killing my pain. The psychological effects alleviated the terror and depression I always feel when I have an attack, and life was good again.

That same year I began having what I thought were really nasty bladder infections, but the urinalysis would always come out negative. My gynecologist gave me a potassium tolerance test for interstitial cystitis, a condition where the mucous lining of the bladder wears away, directly exposing bladder and urethral tissue to urine. I tested positive. The disease comes in flares, and at its worst it feels like I’m peeing fiberglass or sand or something.

Guess I'd better jump to Part 2...

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

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  • Asst Clinical Professor, Medical College of Wisconsin

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