Thursday, November 29, 2012

My Battle with Migraines and Endometriois

Oh hey! Blog post number 2! Look at me! Right.

This post is surprisingly not food related. But I wanted to share my journey with a few health struggles I've had in hopes it may help others.

Since I was a teenager, I have suffered terribly from endometriosis. It's kind of a hush hush topic because who really wants to talk openly about her period with co-workers, employers, and even doctors? It's an uncomfortable topic. But it's a real, debilitating condition that affects 1 in 10 women.

There have been points in my life where I have missed school or work due to the excruciating pain I've been in. I've even fought with doctors who wouldn't listen to me or tried to convince me there was nothing that could be done. I finally demanded to be seen by a specialist and since finding Dr. Yanushpolsky at Brigham and Women's Hospital in Boston I've been managing endometriosis (after two laproscopic surgeries) with hormonal birth control and a good old fashioned narcotic called vicodin.



(The last time I saw my surgeon she recalled that I was the single worst case of endometriosis she had ever seen in her career. High five for me.)

So things on that front were going pretty well...until the migraines started.

I hated to admit it but the migraines started just after I had my second surgery and started on a new pill (ortho cyclen). I LOVED this pill. It kept my pain in check and did what it was supposed to. The last thing I wanted to admit was that these pesky headaches were becoming quite regular and cyclical. Even on the pill, a week before my period, I would get headaches for days on end. The only relief I could get would be to go to sleep (popping a vic...not recommended) and the next morning I would feel like I had a "migraine hangover" with cloudiness and feeling unsteady on my feet.

This past summer, I visited my mum in Australia and the headaches had been getting pretty frequent at this point. I had some form of headache almost every day while on my trip. And when I got home, after 24 hours of travel, I had the worst migraine in my life. I thought I was going to die. It came with light and sound sensitivity, vomiting, the works. That was the last straw for me.

I saw the doc the following week who instructed me to stop taking my pill for fear I was at risk of stroke. Turns out combined BCPs are not recommended for women with migraines that are accompanied by aura (which I wasn't entirely sure I had). I also stopped drinking alcohol completely for almost an entire month.

Unfortunately, stopping my pill did nothing to HELP the headaches and quickly made my endo worse. So here I was stuck between two evils: The one thing that helped my endo is no longer safe for my migraines so I am suffering with BOTH. And I was certain that migraines and endometriosis were related to each other somehow.

I had an MRI, saw a neurologist and after giving triptans a try (which worked to stop migraines but didn't prevent them from happening all together), I finally resigned myself to trying preventative drug therapies.

For my endo, I started taking the mini pill. This was a giant failure. I pretty much got my period every two weeks and landed myself in the ER one night with what felt like a twisted ovary or ruptured cyst. They found nothing of course because you can't actually SEE endo on an ultrasound or in any other tests other than cutting open and taking a look. To top it off, I had a migraine in the ER that night, too. And that was after I had been taking low doses of the anti-depressant nortriptyline for a few weeks. Not long after that, I had a migraine for three days which also landed me in urgent care at the insistence of my co-workers so I could finally get some relief. I took so many triptans didn't even touch the migraine pain and the doc was mighty concerned about an overdose.

So apparently in a low dose, nortriptyline doesn't really help with depression because I was certainly feeling more depressed than ever in my life. It gave me cotton mouth and crazy dreams and the migraines weren't really happening any less frequently. I was pretty much a walking medicine cabinet at this point, taking too much advil, too many triptans, anti-depressents and progestin, NONE of which were helping ANY of my problems.

After speaking with Dr. Y about all my options and worry that a progesterone only pill was making me more depressed (oh and gain ten pounds by the way), it really felt like I was running out of options. But I took her suggestion and started a treatment for endometriosis with a drug called norithindrone which is basically the same synthetic form of progestin found in the mini pill. Except I started taking a super-dose of it; 14.5x stronger than the pill.

At the same time I threw my hands up in frustration with my doctors about the migraines. I had a feeling that the next recommendation would be to take either a stronger dose of the nortriptyline or some other preventative drug like topamax. But I didn't like either of those options. I was tired of taking drugs and feeling like a crazy person. I was tired of having to constantly take immitrex (which I now carry in an injectible form for fast acting relief!). So my doctor sent me ALL the literature she could find about treating and preventing migraines.

I finally decided on giving some natural remedies a try, figuring if it didn't work, then fine, I'd try what the doctors recommended. So I did a lot of research and reading on supplements like B vitamins, magnesium, and an interesting herb called butterbur (which sounds like something out of Harry Potter).

I marched myself down to Whole Foods and stocked up on all of them and some additional CoQ10, an anti-oxidant to promote heart health.

I have been taking the following regimen for almost a month:

Daily: drink at least 48oz water (which I know is still not enough but I try to AT LEAST drink that much).

Morning:
200mg Vitamin B2 
100mg Butterbur extract (right now I'm using a generic form but will switch to Petadolex when I run out).
200mg CoQ10
15mg Zyrtec (for good measure and allergies)

Evening:
Another 200mg Vitamin B2
Another 50mg Butterbur extract
2 melatonin at bedtime (whatever I got at Costco)
I recently added a horse pill of calcium/magnesium/zinc as well. (Magnesium is also said to help reduce migraine as it's a natural muscle relaxer but be careful not to take too much! The Zinc I wanted for my skin).

During the day I've been taking magnesium in the form of a powder you add to water. Not sure how effective it is or not but I'll probably stop now that I'm taking a pill which contains 500mg of magnesium anyway.

Presto. Dudes, I'm serious. Since starting the above routine, I have had only TWO headaches that I would consider migraines. I've felt a few zings here and there but nothing that didn't go away by drinking some water or taking my next does of vitamins. To be fair, one of those was on Thanksgiving during which I had coffee late in the day, stuffed my face, laughed A LOT and maybe had a few adult beverages. The second was definitely after adult beverages which helped me identify a threshold for alcohol triggers.

A word about triggers: I tried. I tried to track them and I really came up blank. I mean, I pretty much had a headache ALL THE TIME so it was impossible to tell what started it and what made it worse. But I DO know that alcohol does make MY particular headaches worse. So I've cut WAY back on my booze intake (le sigh).

As for the endo? The norithindrone is keeping everything at bay so far. A few breakouts on the skin and we'll see what my next period is like, if/when that happens. But I'm good with it for now. 

I'm a convert. Nothing has helped as much as what I've been doing. I don't know if it's one element, all of them combined or what and I really don't care. I'd much rather take a zillion vitamins a day than immitrex, vicodin, advil, and trips to the ER.

If you're suffering from migraines, I urge you to try some natural remedies. Talk to your doctor and do plenty of reading. For MYSELF, I feel safe and confident about this treatment.

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