#Weaning and #Migraine – Treatment Update

My little man will be 19 months old on the 12th, and with his increasing independence comes a number of changes, both for him and for me.

I’ve been practicing baby-led feeding and baby-led weaning, which means we’ve had fewer struggles than we might otherwise have had along our journey but it also means the weaning process is taking significantly longer than it otherwise might. That being said, my son took the lead on night weaning about four months ago, and I am happy to report that we are now officially done with the 2 a.m. (and 3 a.m. and 4 a.m.) feedings. In fact, we’re down to just two nursing sessions a day: one before nap and one before bed. Neither lasts longer than 15 minutes, and I’m hoping to drop both soon. While this is really good news for me (I can’t wait to have my body to myself again), it is also not so good news.

Hormones change and fluctuate a lot during pregnancy and breastfeeding. They also change when we begin to wean, and again when we finally drop that final nursing session. For some women, this isn’t a super big deal. I’m not one of those women.

As I shared on this blog, my migraines were terrible during the first half or more of my pregnancy. They eased up a little during the third trimester and were largely absent during those first few postpartum months. Then, they kicked in again, and as we’ve progressed through the postpartum period and into the toddler years, they’ve gotten worse. This is due in part to the hot and ever-changing Texas weather and in part to weaning.

Weaning related migraines are nothing new. If you search the internet, you’ll find a large number of women discussing how much worse their migraines got when they stopped breastfeeding. Somehow, though, it was something I wasn’t entirely prepared to experience.

Unfortunately my expectations had little to no effect on reality.

The last eight weeks have brought a migraine more days than not. While I have a lot of non-prescription tools for coping with migraine and a supportive family, it’s become necessary to go back on medication. Thankfully, Kellymom.com, a wonderful resource for nursing mothers and their doctors (my neurologist even references this site), offers a pretty in-depth look at almost all of the common migraine and pain medications. Taking both the website’s information into account and the age of my son (babies older than 3 months usually aren’t as affected by medication in mothers’ milk as much as younger babies), my neurologist and I have crafted a new plan. For those who wonder:

  • I’ve started amitriptyline as a preventative. As of now, I’m only on 10 mg once a day, but I’m working myself up to 30 mg. We’ll reevaluate my progress when I go back for a follow-up at the end of the month. I’m still taking 400mg of Magnesium as a preventative as well.
  • I have prescriptions for a tablet version of Prodin for use as an abortive. I also have a few samples of a Zomig nasal spray, though I haven’t used it yet. (Triptans generally don’t work for me, and I figured I would wait to try this until I’m completely done weaning, just because it makes me more comfortable. Despite the fact that I’d heard somewhere that triptans were no-nos when breastfeeding, Kellymom.com actually says Zomig is “moderately safe.”)
  • I also have Fioricet and Promethazine tablets and a nasal spray version of Toradol for use as rescues.

I haven’t used most of these medications yet, as I try to avoid medications as much as possible. I have taken two of the Fioricet tablets, but so far I’ve experienced little relief. I’m hoping the amitriptyline will bring help. If it doesn’t, I believe we’re going to try a calcium channel blocker, which is one of the only preventatives I haven’t tried yet. If that doesn’t work, we’ll wait until my son has decided to completely give up nursing and then try a few other things. I trust that eventually either time or a medication will help.

Times They Are A Changing

This week, my life changes. Forever.

Seems dramatic, I know, but the truth remains: This week marks the arrival of two major changes that will drastically affect my life every day for the next 10 to 20 years. The first is that my husband and I – for a variety of very good reasons – have decided to homeschool our almost 10-year-old daughter. I’m withdrawing her from public school today, and she will begin homeschooling tomorrow. The second is the arrival of our son.

If anyone had told me two or three years ago that I would be a homeschooling mother of two at 29, I would have told them they were crazy. If they had insisted that, further, I would be making two such drastic changes – birthing a new baby and beginning to homeschool –  in the same week, I’m fairly certain I would have written them off as certifiable.

It’s funny what a year can do.

As a wife and mother, I am excited about these changes, and yet, as a woman who values her time alone, a full-time professional writer, and a migraineur, I’m concerned. I’m worried I won’t have enough time to sit, think, and read. I’m worried I won’t be able to begin (never mind, complete) my 2013 writing goals. And, I’m especially concerned that the added responsibilities, stresses, and disruptions inherent in having two children at home 24-hours per day, every day will wreak havoc on the careful truce I have managed to negotiate with my migraines.

For the past month of my pregnancy, my migraines have laid relatively dormant. I have a mild attack about once per week, but it’s always tolerable and it rarely lasts longer than 12 hours. For me, this is a dramatic reprieve – one I am hoping might continue past my delivery date on Friday. Knowing my triggers (namely: sleep changes, eating changes, lack of sleep, loud noises, and stress), though, it seems unlikely. And, so, the question remains: Am I completely nuts for attempting any of this, let alone all of this, right now?

I guess I’ll just have to tell you Monday.

It Can’t Hurt to be Prepared

My son will be born sometime in the next seven weeks, and I’m anxiously attempting to get everything ready. My husband, bless him, has dealt well with a wife whose ideas of preparation include making and freezing soups (two months in advance); stocking up on toilet paper, Ziploc bags, shampoo, laundry detergent, and stamps (two months in advance); and purchasing Vaseline and infant Tylenol (also two months in advance). I’ve seen a few eye rolls, and I did have to explain why I felt it was necessary to purchase the infant car seat/stroller system and the wearable infant carrier at 32 weeks, but overall I think he sees my preoccupation with preparation as a benign symptom of the eighth month of pregnancy. For me, however, it is something much more.

Based on my pregnancy, labor, and delivery 10 years ago, I already know that I have to have a c-section this time around. As a second timer, I’m not too worried about the surgery itself. However, I am very aware of the limitations it will place on me afterward: I cannot climb up or down stairs for two to three weeks (which will be difficult seeing as we live on the third floor); I am not supposed to do housework for at least four weeks; I cannot drive for six weeks; and I’m not supposed to lift anything heavier than my baby or begin exercising for up to eight weeks after delivery. For me, this basically means I’ll be living on my couch for the first four to six weeks with an infant attached to my breast.

I also have migraines, and those migraines often affect my energy levels, my speech patterns, my vision, my concentration levels, and my ability to handle light and noise. They often come on quickly, ramping up to excruciating and debilitating within as little as 20 minutes, and they’re most frequently triggered by lack of sleep, changes in eating schedule, lack of exercise, stress,  dehydration, and hormonal changes – all commonly experienced by the mothers of newborns.

Taken together, these two things (the impending c-section and the ever-present threat of migraine) mean I absolutely must be prepared for my return home before we’ve ever even left for the hospital. The more plans and preparations I can make now, the less I’ll have to worry about or tend to when we get home. Granted, if everything goes according to plan, I still have seven more weeks to wrap up any last minute food prep and laundry tasks, but – as many of us know – things rarely go according to plan, especially when infants or migraines are involved. Adding them together seems to ensure a chaotic start.

I can only hope my relentless drive to prepare helps in the months ahead. I’d hate to spend the first couple of months of my son’s life curled up in pain, unable to soothe his cries because they hurt my head too much. Just in case, though, I’ve decided I’m going to start experimenting to figure out which earplugs block the most noise. We’ll call it one final pre-baby preparation.

With the Dawn of the Third Trimester, Migraines Return

I entered my third trimester of pregnancy last Friday, and within days my migraines returned. Those of you who have been following this blog may remember that I spent my first trimester primarily in bed, watching TV shows on Netflix and trying to distract myself from the relentless pain. Then, about mid-way into my second trimester, the migraines eased up and my energy returned. Now, it seems my reprieve has come to an end.

Once again, I find myself suffering with a migraine almost every day. Thankfully, though, they’re not as painful or as symptomatic as my first trimester migraines. Unfortunately, with the lack of sleep, the extra weight, and the dehydration that so characterizes the third trimester, it’s unlikely that I can do much to reduce their frequency. So, with only 11 weeks left to go, I’m crossing my fingers that my relative good fortune continues.

How about the rest of you pregnant ladies? Where are you in your journey, and how are you feeling?


Some Relief in the Second Half of the Second Trimester

I’ve been pretty silent over the last six weeks or so, and I apologize for that. At first, I was still reeling from high-intensity migraines almost every day of the week. I also was completely overwhelmed with school. Now, at 22w6d pregnant, I’m thankful to say that I’m feeling significantly better. I’m 100% done with school (for forever, not just for the year!), and my migraines are down to about 1 or 2 a week. This is good news, and I wanted to make sure to share it with y’all in order to offer hope to the others of you out there who may still be struggling through the first half of your pregnancies. May relief and joy come your way soon!

Early Second Trimester Migraines

A couple of weeks ago, I wrote a post about chronic migraines and pregnancy in which I expressed my hopes that my migraines would get better as I entered the second trimester. So far, those hopes have not been realized. In fact, my migraines have been worse in the past two weeks than over the past two months combined. And, it seems I’m not alone.

Many of the pregnant women on the Whattoexpect.com forums who are (like me) due in October report suffering from debilitating migraines. Often reported statistics indicate that 50 to 90% of women with migraines experience an improvement in their migraine frequency and pain levels during the second and third trimesters of pregnancy. Apparently, neither I nor the other women in my forum group are included in this majority.

I have not had the chance to ask the other women who are reporting problems if they suffer from migraine with or without aura. Evidence seems to suggest that women without aura tend to do better in pregnancy than women with aura. Based on this findings, I (a chronic migraineur with aura) had expected to see little to no improvement in my condition over the course of my pregnancy. But, of course, that didn’t keep me from hoping.

Now that I’m in the fourth month of pregnancy and the early part of my second trimester, that hope is starting to wane.

Known as the “planning trimester,” months four through six are supposed to be the best months of pregnancy. The months in which you have the most energy and can really prepare for the baby’s arrival. The months in which you finish up any outstanding projects (like the book I’m supposed to be writing and the thesis that’s due in just a few weeks). The second trimester is when you’re supposed to do all the prepping and planning that you were too sick to do in the first trimester and that you’ll be too tired and too big to do in the third.

While I have managed to put together our baby registry and figure out what baby proofing items we need to buy from my bed, I certainly don’t feel up to finishing my projects, renewing my exercise routine, or preparing a nursery. (Heck, I can’t even clean my bathroom, despite that fact that every venture beyond the bathroom door leaves me in a slight state of disgust.) In short, I’m so tired and suffering from so much pain that most days all I want to do is bang my head against the wall, sleep, and cry.

To the other women out there who are suffering from the same thing: my heart goes out to you. Hopefully, better weeks and months are yet to come. For now, I’ll be crossing my fingers and hoping that the energy boost I’ve been promised will come by month five at the latest.

Chronic Migraines and Pregnancy

Information about migraines and pregnancy is hard to come by. Most books on migraine rarely touch the topic except to say that if you become pregnant your migraines may get better, get worse, or stay the same. It’s apparently different for everyone. It also seems to vary depending on the type of migraine (chronic versus episodic, with aura or without), and the woman’s stage of pregnancy. Overall, this means that women with migraine have much less knowledge about what to expect when we’re expecting.

My husband and I discovered we were pregnant nine weeks ago. I start my second trimester in five days, and all I can say is this: The first trimester was hellish; I hope the second is better.

I spent the vast majority of the last two months in bed. It seemed like every pregnancy symptom I had (morning sickness, dizziness, fatigue, dehydration, headache) was exponentially amplified by a bout of migraines that disappeared at night only to arrive again the next morning. Luckily for me, I could drag my laptop into bed with me and get some work done in between the pain, nausea, and bone-crushing exhaustion. Unluckily for my husband, my ability to work and live from bed meant I pretty much stayed there for weeks.

I’m glad to say I’m starting to feel a little bit better as we approach the 14th week of pregnancy and the start of the second trimester. The morning sickness has ebbed, which means the only nausea I experience now is related to my migraines and thus usually occurs at night (when the migraines are at their worst) instead of throughout the day. My energy is starting to pick back up a little, and I’m hoping that means I will be able to start exercising again (which is an important aspect of my migraine prevention plan). At the very least, I would like to be able to take a walk every day. We’ll see how that goes.

In the meantime, I’m going to try to stay hopeful. Without information about what to expect next trimester, I am going to cross my fingers and believe my migraines will get better instead of worse. We’ll have to see how that goes.

If anyone out there with chronic migraine has had to deal with the disease through pregnancy, I would like to know more about your experiences. Did they get better at some point? Did you come up with any tricks that helped ease your pain and discomfort? Thanks for any tips or words of comfort you can share.

Coping (or Not) without Medication

I’m about at the end of my rope.

For the past three weeks, I’ve had a migraine almost every single day. If it’s not there when I get up in the morning, it’s there by 3 p.m. By 6, I can barely eat dinner with my family. All I want to do is crawl in bed and sleep. But, I can’t.

Even if I’m able to make it to bed (instead of trying to power through one more project), the pain is too intense to sleep. So, I watch a dimly lit movie or TV show on my iPad (very quietly), until I get exhausted enough to fall asleep in spite of the pain.

I can’t read. I can’t spend time with my husband or my daughter. I can’t think. I can’t do anything, except survive the migraine and hope it’s gone by the time I wake up.

I’m trying to stay grateful. What I’m experiencing now isn’t as bad as what I went through in 2008. I don’t have one every day, and it’s not a constant level 7. But, I fear it’s getting there. The migraines are coming closer together, and I’m terrified that I’ll be locked in that old cycle once again.

Worse, because my husband and I are still trying to have a baby, there’s little the doctors will do to help. It’s been almost a year since I went off birth control and quit most of my migraine medications, and we’re not pregnant yet. If the doctors won’t help now, how will I possibly make it through the months of pregnancy and breastfeeding – whenever they finally arrive?

I feel like I’ve tried everything, but there must be some medications or treatments out there that have passed me by. Does anyone have any suggestions? I haven’t tried Midrin, though I’ve heard there’s a manufacturer down here in Texas who is making an equivalent now. Have any of you tried it? Did any of you take it while you were trying to conceive?

Surviving Migraine Medication Free

Being held hostage by my body is (sadly) not an unfamiliar feeling for me, as I’m sure both other migraineurs and chronic disease patients of all kinds can understand. The things I can’t do when hit with a migraine attack can include: reading, watching a movie, listening to music, leaving the house, tolerating light, moving without pain, and speaking properly. I also can’t be anywhere with fluorescent lighting for too long, or out in the summer heat for more than a few minutes, without fear of setting off an attack.

When I was pregnant nine years ago, I felt much the same way. I had a troublesome pregnancy, and there wasn’t much I could do except come home from work exhausted and sleep the night away. I also couldn’t work out (my heart rate got too high), relax in a hot bath, or indulge in a much-needed margarita or glass of wine.

Now, my husband and I are considering having another child, and even though I’m not pregnant yet, I’m already feeling the effects of what lending my body to another human being will mean.

My 52-year-old mother died suddenly and unexpectedly just a couple of months ago, and I’m not sleeping well. My anxiety levels are high, and my exercise routine has been interrupted. All of which equal increased migraine symptoms. But, my neurologist (understandably) won’t prescribe me anything for sleep, anxiety, or pain, in case I become pregnant.

I understand that this is one of the trade-offs of pregnancy, but I’m not sure how I will be able to survive the coming months (until I get pregnant) plus the 40 weeks of actual pregnancy without medication. I have chronic migraine with aura, and it is quite likely that my migraine attacks will only increase during pregnancy. It would be beneficial to know how other chronic migraineurs have managed to make it through pregnancy. Have any of you readers suffered through pre-pregnancy and pregnancy medication free? How did you do it? Would you be able to do it again?

As always, I appreciate your comments.