Migraine

For 30 plus years I was "blessed" to have Migraine with Aura. I knew when they were coming and could medicate as needed. When I started preventatives almost 2 years ago the auras have morphed but continued. The past two months I have definately had migraines without aura and am struggling to know when to medicate. As I still have 2-4 migraines a week I am very careful to not jump on early signs of a migraine because it may turn out to be one that is only moderate and i can make it through without meds.

So my question is for you who have Migraine without Aura...how do you know when you are getting a migraine? Yes, I have read all the Prodrome signs but My body isn't always consistent giving me warning signs although most start with the pain above one eye and then moves to the side of my head from there. Do you wait till the pain is moderate to take a triptan? I just feel like if I wait that long I don't know if they will work as well. Triptans don't always work for me anyway, even when I have a full blown 15 minute aura and know I am medicating asap.

Frustrated as usual but grateful for your help,
lisa

I hear ya, Lisa! I very rarely get any type of warning aura and if I do, I know that Migraine is going to be one tough cookie to treat.

So, since I also normally wake up with my Migraines, I base whether or not to take a triptan on how high the pain level already is. Not the best way to do it, but since I wake up with them, I can't treat it any other way. If it's a full blown Migraine when I wake up, like a 6 or higher, I take Zomig NS because it works quickly.

If it's left over from the day before, or comes on later in the day, I take my Frova or Amerge when my pain level is around a 3 or 4. Not the best way to do it, but, like you, I'd hate to take an abortive if my pain level isn't going to be that high.

Again, like you, my triptans don't usually work for me either but since I've been on Lamitcal, I've noticed they are starting to bring that pain level down to where I'm not stuck in bed and can function for a few hours before I crash and burn for the rest of the day.

Studies tend to show that migraine meds work best when taken as soon as possible during the attack. To me, this means as soon as it is apparent that a migraine is in progress. Most of mine come on gradually, whether with or without aura. I don't wait to see if the pain ratchets up to a moderate level. A migraine could go on for hours before that happened with me, and that's way too late. Triptans, especially, have been shown to not work well if you wait a while to take them. That really sounds like it jibes with what you've noticed.

Droolie, you bring up an VERY important point that I failed to address. It is important to catch the Migraine as soon as possible so the triptans have a better chance to work.

What I failed to explain with my own experience is that I have Migraines several times a week so I need to "pick and choose" which Migraine will get treated with an abortive so I don't end up in MOH.

My apologies for not making my own circumstances clearer...blame it on day two of this Migraine

I thought your post was plenty clear, Laura! I'm only speaking from my own circumstances. Either way, though, I've got your back!

Lisa -

I am not sure if I've ever had a visual aura; I occasionally get a sensory aura. But the vast majority of my Migraines are plain old without aura. so I've struggled with this too. I don't take a triptan at the very first twinge of pain, because I have learned that I very often have a twinge, or several, that doesn't develop into anything. So I move around to see if the pain increases with movement, and wait until I'm pretty clear that it's not going to go away. That said, I try not to wait until the pain level is high, because just as Droolie said that could take a while and then be too late for the triptan to be effective.

Actually i talk to myself a lot, and sometimes it helps to listen. This may sound nutty, but if I notice that I keep saying to myself "my head hurts," and if I've heard myself mutter that a few times, it's a pretty good indication that this is a Migraine.

As to the "which one do I treat since you can't take the triptans too often" dilemma - I mostly treat the first two Migraines in a week. It's my experience that I am less likely to get into a pattern of recurring Migraines if I treat every one I can. That is, treating the first two in a week seems to make it less likely that I'll have a third that week. I mark them on my Migraine calendar and use a rolling week. Hope that makes sense.

- Megan

Thanks Laura, you were clear, or at least my migraine brain understood what your migraine brain was saying. Migrainese? You and Droolie just reaffirmed what I was thinking and doing medication wise, so thank you.

Megan, I think I was once told to alternate my triptans with Midrin, so as not to take them back to back but it makes sense when you say it. I will have to double check with my MD. And everything made sense until the sentence which ended "mark them on my migraine and use a rolling week." You lost me at rolling week, assume typo or my migraine head, pick one.

Gratefully,
lisa

I have migraines without aura. When I was taking Topamax, my migraines would come on really fast and I would have no warning signs. Now that I'm off Topamax, I notice that nausea is usually my first warning sign. Sometimes I also get panic attacks right at the onset of a migraine. It feels like something is going on in my brain and it makes me feel strange. Once in a while I will wake up with a migraine, but mine almost always start in the afternoon.

Peggy

I also have migraines without aura.

I understand your dilemma on when to take your triptan. I have the same problem. I constantly have some form of head pain. It's hard for me to know when to take my triptan. Especially because almost every day my head gets over a 5 or 6 when I know I should take something. Most of the time, as the day goes on my head pain increases. Sometimes it escalates dramatically, that's when I take my triptan. Other times I usually try to stick it out in hopes that it doesn't get worse. I know it's not the best way to do it, but I also know that I can't take an abortive every day. I find the whole process frustrating.

Wish I had some advice to give you, but as you can see, I need some too, lol
Meli