When my husband and I changed our health insurance in early 2008 I had to get a new neurologist for my migraines. It was a relief as my migraines had increased from 5 to 19 a month over the past 15 years.
Dr. Chris (not his real name) gave me a “Migraine Classic” diagnosis in the late 90s. He seemed unconcerned that my triptans (the medication) had increased from around five to over 20 a month. He knew I’d taken a 15-day triptan holiday in 2005 and spent much of the time sleepless, throwing up and in complete agony for hours. My triptan holiday ended on day 15 when I took a triptan pill after spending a day in pain.
Fortunately, the triptan holiday did result in four less migraines and six less triptan pills a month the next five months. However, by 2007 I was back with the same number of migraines and triptans as before.
There were immediate red flags when I spoke to Dr. Andy (not his real name) the next neurologist. A voice in my head kept saying “Niki, don’t be paranoid. Give him a chance!”
I lost faith when Dr. Andy, after a 30-minute interview, declared that my headaches were neck problems not migraines. Contrary to the leading migraine experts he believed my headaches were not compatible with migraines. He said they were too frequent (he’d not heard of rebound migraines), that migraines don’t switch sides, cause a sore neck or start in adulthood (mine started age 44).
He said he needed to do a 2-hour six-hundred dollar Electromyogram (EMG) and Nerve Conducting Study (NCS) to confirm the “diagnosis.” He would not tell me the possible diagnoses or treatments. Although I had recent records of normal MRIs and blood work he ordered the tests to be repeated.
He asked the same questions I’d filled out on his forms in an interrogative style, made little eye contact and forcefully pushed my bended arms down to test my strength. ( I was able to do the same thing with my husband’s arms a few hours later.)
I felt Dr. Andy’s diagnosis of “muscle weakness” had more to do with my insurance paying for his expensive tests. A migraine diagnosis brings little revenue for an expensive office, fancy furniture and a couple of secretaries.
After talking to my husband I decided Dr. Andy would not work out. I told my general practitioner and she referred me to Dr. Mary, another neurologist. She said there was no need to explain.
Dr. Mary’s knowledge, caring and toughness impressed me. After doing a thorough one-and-a-half hour evaluation she agreed with Dr. Chris, my first neurologist, that I had classic migraines. She studied my migraine history and shook her head, “You have rebound migraines,” she sighed. “Over twenty triptan pills a month is too many. It shouldn’t be more than 10. You need a 30-day triptan holiday.”
Tears welled up in my eyes. “I’m scared,” I moaned. “It’s hard to stop taking triptans when I’m in pain,”
Her eyes flashed, “If you want triptan prescriptions for more than 10 a month you need to find another neurologist. I won’t do it.”
I sighed. “You’re right, how do I get through this?”
“Whatever it takes,“ she said firmly. “I can prescribe Butorphanol, a nasal spray for a month.”
“Is it a narcotic?” I asked with apprehension. “I don’t want to get addicted.”
“Yes, but you’ll only take it for a month.” She also prescribed Nortriptiline 25 mg, an antidepressant preventive medication and recommended I take an analgesic (prescription strength anaprox) as needed. I cried tears of gratitude and relief as I drove home. I was aware that I was playing Russian Roulette with my health. How sad that I needed someone else to set limits and care before I could do it for myself.
I researched the Internet to get the latest information on triptan holidays and rebound migraines. I was shocked to discover that the first link was to an article I wrote about my 2005 15-day triptan holiday. The second and third links were to migraine forums where other migrainers shared their advice and experiences in response to my questions about triptan holidays.
Realizing my experience may help others I became even more determined to complete the 30-day triptan holiday. I wanted to know which migraines are real versus the rebounds, if triptan holidays really work and why there are no warnings about taking more than 10 triptans a month. I needed to do the research on myself not just for me but for all the migraine sufferers, their families and friends.
I chose not to take the antidepressant because the preventive meds I taken before (including this one) did not help in the past and had side effects.
When a migraine hit on day three of the triptan pill holiday I took a narcotic. Closing my eyes from the blinding light I collapsed on the couch. The throbbing pain in my temple moved with waves of nausea. Negative pictures of my life loomed large.
I clung to Eckhart Tolle’s teaching in “A New Earth. “Surrender to pain it’s not who I am. I’m consciousness.”
My breathe ebbed and flowed between the stabbing throbs. As the dark clouds of pain raced across the sky of my mind I repeated Tolle‘s words, “Pain is a doorway out of my ego prison.”
A friend kindly offered to do Reiki on me between seeing her clients. Within minutes my husband had turned the car around. I could not stop throwing up. Since I’d had nothing to eat it was mostly painful dry heaves. I went back to bed and mercifully fell asleep.
The following morning I was pain free. The world looked fresh and new.
When another migraine hit on day nine I again read Tolle’s book. I wept when he talked about the pain body and how the migraine belongs to my pain body not me.
Tolle made me aware how my mother and I hold the story of being unwanted children in our pain bodies. I saw that I could replace my critical voices or even drop the story. I pictured the pain in my head as a tiny black kitten and lovingly stroked its fur. For a moment the pain subsided. I told myself “It’s okay to have a sick body.”
Replacing the negative story with a positive one is progress. But to be fully present I must learn to befriend the space behind my stories (my inner body).
My head continued to throb painfully even after taking another narcotic. Thinking of Tolle’s infinite stillness I became peaceful and fell asleep.
I woke a few hours later refreshed and pain free.
Although the first week was difficult I was stunned when I only had three migraines and took three narcotics the first month.
It's been 18 months since I did my 37-day triptan holiday. I now average eight migraines and eight triptans a month as opposed to 20. The migraines respond more rapidly to the triptans and their intensity has decreased.
I’m grateful for my neurologist’s help and Tolle teachings.
I pray for good health but even more importantly now that I’m aware that behind my pain body is the infinite peace of pure consciousness. I no longer feel like a victim.