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13 February 2006

The infamous REBOUND HEADACHE

Are you familiar with this phenomenon? In my life, it has taken on a life of its own. What follows is an all-too-real example of it.

On Friday night, I wasn't feeling up to par--but what else is new? And is it fair to say I wasn't feeling up to par when my par is usually not too high? I wasn't feeling up to a healthy person's par, I should say. I thought I would be okay to go out with friends. Unfortunately, the headache got worse rather rapidly and I could feel my brain throbbing as I walked with a friend to my car and was trying to figure out which party to attend next. (No, my social calendar is usually not packed--but I did have two get-togethers I'd promised to drop by.) We decided to drop by my house before the parties, and as soon as I sat down in my faithful recliner, I realized that the Migraine wasn't going anywhere. In fact, it was making itself more known by the second. After being home for 20 minutes, I asked my friend if she minded if we skipped the parties. I dropped her off at home and then went to bed, avoiding the Relpax because I wanted to see if I could sleep it off.

Sleeping off a Migraine is something that used to work for me, but it hasn't done too well by me for the last several years. Perhaps it was just the quiet passage of time that temporarily cured the pain. In any case, now I am caught in the all-too-common dichotomous nature of Migraine treatments.

1. We are told to take our Relpax (or Imitrex, or whatever drug you need to kick a Migraine out) at the first sign of Migraine. I can't do this because I have CDH and have the first sign of a Migraine almost every hour of the day. I usually must wait 'til it gets progressively worse.
The more you let your body get into the pattern of getting Migraines, the more easily the pain comes back the next time, having mastered the neural passageways and routes necessary to dilate and constrict the arteries and veins.
2. If one takes a reactive Migraine drug like Relpax or Imitrex, he or she can expect to get another Migraine in 12-48 hours. This is what's dubbed "the rebound headache." Our poor patient will either suffer through this second Migraine or take another Relpax to fight it off. If a third rebound headache occurs, she's not to take another Relpax. One cannot become dependent upon this drug, so one ends up in agony much of the time if she's already suffered through two Migraine episodes in a row.

Back to this weekend. I awoke on Saturday morning with the headache being even worse than it was the night before. After stumbling about the house for an hour or so, I sucked it up and took a Relpax along with 500mg of Naproxen (my doctor's prescription, not my own addition). Within 1 1/2 hours, I felt great. I've never felt so wonderful as I do when the drugs have kicked in & there's no trace of a headache for a few hours. Sigh. All-powerful me! I went out with friends, visited a neighbor, went to a play, and stayed out until 3 or 4 AM.

Sunday morning? Yep. Migraine. Not a hangover headache as I had initially thought (& half-hoped). I took Relpax (plus the Naproxen, of course) and eventually felt good.

But I can't ever feel entirely good, knowing I'm utterly dependent on ridiculously, unfairly expensive medication. My pain this weekend cost a lot in terms of psychological and physical strain, but it also cost me lots in U.S. dollars: about $55 for prescriptions my plan no longer covers.

When I think about it in those terms, a ghost of pain shoots through my head. As usual, it's time to avoid this topic and pretend I'm "normal" in the hopes of having an okay day.

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