Migraine.

I am among the 18% of the female population who suffer from migraine headache.   My migraines recur at varying intervals:   I've gone years without any, and I've also had three in one week.   The first one hit me in 8th-grade debate class, and I thought I was having a stroke -- in the course of fifteen minutes I went half-blind (literally -- half my field of vision disappeared behind a shimmering, jagged veil), and then the headache, fatigue, and nausea arrived and took my breath away.  When my dad came to pick me up from school and I described the symptoms to him, he told me it was probably a migraine.  Oh.  So that was what my mom had been talking about for all those afternoons when she disappeared into a dark room to put a cold washcloth on her forehead. 

Some say they're triggered by foods or stress or hormones; I've never noticed any correlation to anything I ate or any stressors, but then, I don't keep detailed records of those.   I have learned that they are most likely to happen about a week before I ovulate, and after two of my pregnancies, I suffered my first postpartum migraine within days of my first postpartum ovulation.   It's not a perfect correlation, though;  I've had a few when I was pregnant, and the three-in-a-week happened when MJ was five months old and I was still deep in lactational amenorrhea.   (I watched carefully for an ovulation for weeks after that, but it didn't happen for five more months.)

For a couple of years before the Week of Three Migraines, my migraines had been curiously painless.  Still debilitating, because the shimmery blindness still cascaded across my vision and left me unable to drive, read, or take care of kids for an hour or two; and still exhausting, because after the "visual disturbance" passed I would tremble and need to lie down in a dark room for a few more hours.  But without the pain, hey!  I almost enjoyed it.  As long as I knew my kids were okay, cared for by someone else in another room, I could shut the door and just sort of float on the symptoms until they subsided.  Then I would go downstairs and eat an enormous amount of carbohydrates, and then it would all be over.   

The last few, though, really hurt.  So Mark finally convinced me to go to the doctor and get a prescription for Imitrex (sumatriptan succinate), which I gather is the drug-of-choice for occasional migraine sufferers these days.  Supposedly it is safer for the infants of breastfeeding mothers than are the ergotamine derivatives that are its alternatives.  You take it as soon as you have symptoms, and it's no good to take it unless you take it right away; so I guess I'll be keeping some in my car.  I will not know whether it's the right drug for me until I've taken it.

Whenever I take a medication, I always ask the pharmacist about its compatibility with breastfeeding.  As I reviewed the patient information insert, I realized I forgot to ask another question I always ask.  The insert says:

Do not use IMITREX if you are pregnant, think you might become pregnant, are trying to become pregnant, or are not using adequate contraception, unless you have discussed this with your doctor.

"Adequate contraception" -- what is that?   Everyone  who is using any contraception "might become pregnant," unless the contraception is removal of gonads or backed up by menopause.  Better not deconstruct this or I'll be here all day.   

I use NFP, and I have a lot of confidence in it, but my policy w.r.t. medications is always to act as if I "think I might become pregnant."     This means, for example, that I rarely take ibuprofen, which has first-trimester risks.   Anytime I might want to take it,  I consider how likely it is that I might be pregnant and not know it (only about half the time, mind you, is this situation even possible), and weigh that against the benefit of the drug (minor tension headache or rapidly swelling sprained ankle).

There is some data about the safety of Imitrex during the first trimester of pregnancy, at least with regards to birth defects.  Three hundred thirty-four first-trimester exposures reported in GlaxoSmithKline's data registry show no consistent pattern of birth defects nor a significantly high rate of them.   This does not mean, of course, that it is a good idea to use it when you know you are pregnant.  So I guess I will be using it with an eye on my menstrual cycle.  Since most of my migraines occur in the week prior to ovulation, when I am most certain I am not pregnant and when I can modify my behavior to practically ensure I will not become pregnant within a few weeks, it should not be a big problem.

Comments

[Linda]

Before trying Imitrex, have you exhausted safer combinations that may help you? I've had migraines for years and my treatment has had to evolve, but combinations of aspirin &/or acetaminophen &/or ibuprofen (never more than two different compounds and never over the recommended doseage) AND caffeine have helped ease the pain. I've even mixed up cocoa powder with whipping cream (or butter in a pinch) and some sugar because I found whatever's in the cocoa (caffeine again, I suppose) with the fat and sugar did the trick. I now take two ibuprofen with a caffeine-sugar-fat (usually a fake cappucino) chaser and it works every time. Good luck to you.

[bearing]

Well, the thing that helped me best up till now is two shots of vodka.

After I drank all the vanilla extract when a migraine hit me while I was over at my Mormon friend's house, I thought: Maybe this isn't the best way to treat this.

[Linda]

true enough

[Jennifer]

I've had migraines since I was in first grade. I've been on Imitrex (as needed) for about 6 years now. We've been ttc for 4 years (since our wedding July 2003). I've been told to only take the Imitrex after taking a pregnancy test or after my period starts. The headache specialist I go to explained that the Imitrex changes the way your blood flows through your body and because of that there is a risk of miscarriage. I'm in the Twin Cities - let me know if you want the name of the headache specialist. She is great.

[Christy P]

For a while I was doing a daily low dose aspirin as a migraine prevention technique, and it worked for me.

Another non-RX method that has had some success for me is the combination of Coca cola (not diet) and Tylenol Allergy Sinus (includes essentially sudafed, benadryl and tylenol). Follow up with a lot of water to counteract the dehydrators.

For some people, changes in the weather correlate with migraine onset usually a switch from high pressure to low.

FWIW, I used Zomig (similar to Imitrex) for a couple of years and found that I needed to up the dosage with frightening frequency. It is another that you take as soon as you feel a symptom, and I started by taking 2.5mg, but it was only a matter of months before I was up to 7.5mg. Once I tried (someone else's) Imitrex out of desperation, and it didn't work at all. Go figure - this is an art, not a science.

[Kim]

My history of migraines is very similar to yours. They started in the eighth grade and I had them throughout my life and could never figure out what triggered them. From age 30 to 35 they seemed to subside, but came back with a vengence at 35- one every three months or so for a year, then once a year till I was about 42. Since then, I'm 49 now, I've had them religiously every month for three days while on my period. I have noticed if I take magnesium and vitamin B6 (to aid absorbtion) the migraines are not as severe and sometimes go away. Fish is also high in magnesium. Imitrex does not work for me. Midrin works sometimes, but it probably isn't suitable for you since it contains a narcotic.

I have found it is a good time to pray while suffering with a migraine- anything else is impossible- so I guess its Our Lords way of telling me I need to pray. And don't forget to offer it up!