#Weaning and #Migraine – Treatment Update

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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.

March #Migraine Blog Round Up

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March was a slightly busier month than February (at least here at The Migraine Chronicles), but I have to admit – more happened than I had the chance to write about. Hopefully, April will see that begin to change. In the meantime, here are some great posts you may have missed:

My Posts

Other Favorites

That’s it for this month. Happy reading!

Did I miss something you found particularly helpful? Share it here.

Melatonin for #Migraine Prevention

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I was finally reviewing my backlogged RSS feeds this afternoon (after months and months of being too tired to even glance at them), and I came across a wonderful post by Diana Lee on Migraine.com about melatonin and migraines. It seems a study released in 2004 and discussed at the American Academy of Neurology (AAN) 65th Annual Meeting in 2012 indicates that taking 3 mg of fast-acting melatonin between 10 and 11 every night significantly reduces migraine frequency with little to no side effects.

As someone who is always looking for scientifically sound natural remedies and supplements for migraine treatment and prevention, I think this is terrific news.

I currently take magnesium, B-2, and CoQ10 supplements for migraine, and I would certainly be open to adding melatonin to this list. (I have a call in to my pediatrician to find out if it is okay to take while nursing. Online facts were inclusive.) Until then, I’d like to hear from all of you.

Have you tried melatonin for migraine or would you be willing to try it based on the study?

Soon-to-be Nursing Mama’s Migraine Toolkit Wish List

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As I lay on my bed last night, suffering with a level eight migraine and wanting to throw my head against a wall, I realized something important: my migraine toolkit is going to need a serious upgrade to go with the new baby.

I plan to nurse, which means almost all of the medications that are off limits now will continue to be off limits for the near future. Additionally, however, my essential migraine prevention plan (which includes getting up and going to bed near the same time every day, eating on a regular schedule, and exercising daily) will be largely irrelevant. I will not be able to tell a new baby that he or she needs to stay in bed a little longer or learn to sleep through the night because otherwise Mama gets a migraine. Nor will I be able to curl up in a dark room when he or she needs to nurse or be changed, or even just wants to play. In short, the life I’ve set up to deal with my chronic migraines is going to be sacrificed for the sake of life with a new baby, which means I’m going to need a new set of tools to deal with the many, many migraines that I’m sure to experience over that first year.

While it may not be common (or accepted) to add a plethora of migraine-relief tools to a baby registry, I’ve decided I should go ahead and make up my “nursing mama’s migraine toolkit wish list.” So, here it is:

1) SootheAway Device, with Front & Side Head Pad, Occipital Relief Pad, and Eye Relief Pad;

2) A freezer full of nutritious frozen meals (for the days I just can’t get up to cook);

3) Bimonthly cleaning help;

4) Comfortable noise-reduction earphones.

That’s all I can think of for now. Does anyone else have any non-drug treatment ideas to share? I keep imagining trying to hold and soothe a crying baby while experiencing the kind of migraine pain I had last night, and I have to say it scares me. Any help would be appreciated.

Tales from the Trenches: The Ever-Elusive “Right” Migraine Doctor

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My migraine adventure began sometime in late 2007. I don’t know how long the migraine had persisted before I realized it wasn’t going away, but at some point I decided to see a doctor. At the time, I never considered I might be suffering from a “migraine,” I just knew I was in a lot of pain. And, it wasn’t the first time.

Around 1998, I had what I considered a very bad headache. I was in high school, though, and figured I could power through. I had work to do, friends to see, and a younger brother to attend to, so I gritted my teeth and self-medicated until it finally went away – in 2000.

For years, I was mostly headache free. I would have one every once in  awhile, but I figured everyone did. And, since they always went away, I didn’t bother about them too much. Until 2007 – when everything seemed to change.

I went from my PCP, to a neurologist, to an ENT, to special migraine doctor after migraine doctor. I finally had a diagnosis (intractable chronic migraine with aura), but no one could fix me. I saw the “best” migraine doctor in the country – the doctor everyone assured me could help – to no avail.

From city to city, I tried every triptan there is, a number of drugs I’d never heard of, day-long infusions, and more. I was poked, prodded, scanned, and examined. I was (mis)diagnosed with Meniere’s disease and had to undergo routine ear screenings every three months for two years. When it turned out I didn’t have Meniere’s, I was diagnosed with migraine-associated vertigo and told there really wasn’t much anyone could do.

At the time, there were no headache specialists in my city, so I saw my neurologist (who, I felt, had pretty much given up on me) and a pain management doctor on a routine basis. I underwent yearly MRIs and exams every few months. I was on Oxycontin three times a day, just so I could make it to work, Klonopin, a half dozen supplements, and every preventative in the book – and nothing helped. The pain didn’t go away – for two years.

Then, I moved to New York, and decided that since nothing helped, I was going to stop everything. No doctors, no pills, no exams. Nothing. I was going to do what I had done in high school – grit my teeth, self-medicate, and hope that eventually my life would return to normal. And, it did – kind of.

It’s now almost five years later, and I’m no longer considered “intractable.” While I still get migraines more days then not, they usually go away – eventually. It could take hours, more often it takes days, but I usually get some relief at some point. Now that the cycle is somewhat broken, I’m still holding out hope that I can get to a mere four migraines or less a month. And, I’m still looking for the doctor who can make it happen.

I’ve been loyal to my neurologist for years, even going back to her once I moved back from New York, but I’ve recently started looking into some other options. My city does have several headache specialists now, and I’m trying to get consults to see about switching. I’ve seen one, and since he didn’t offer anything I haven’t already tried, my search continues.

I wish we had more doctors, more – and better – medicines, and more options for care. Unfortunately, though, not much has changed since my grandmother went through this same thing fifty-plus years ago. We do have triptans now, which are lifesavers for some – including my grandmother, who still gets migraines a couple times a week – but they don’t work for everyone, including me. And, they’re contraindicated in many others. We also have some ergot derivatives, but not all of us can take those either. (I, for instance, see a ton of black dots and pass out if I take Migranal.)

There is a lot of push in our community right now to draw attention to the need for additional migraine research. I can only say that my experiences have shown me that we desperately need that attention. We desperately need more money for migraine research, and more funds to send neurologists and other doctors to school for specialized migraine training. In short, we just need more. Until then, however, I’ll keep looking for the ever-elusive “right” migraine doctor who can help.

Coping with Occipital Neuralgia Without Medication

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Surviving migraine without medication is difficult. Treating occipital neuralgia without medication seems downright close to impossible. Now, it looks like I’ll have to do both.

A headache specialist finally serves my area. I typically prefer female doctors, but every headache specialist I’ve ever encountered has been male. This one was no different. What was different, however, was I didn’t have to drive over three hours to see him. And, he came up with a treatment plan (that didn’t involve a million medications I’ve already tried) within the first visit.

Unfortunately, it was a treatment plan I can’t commit to following.

Dr. G. believes I may have occipital neuralgia, which is complicating my migraines and triggering them more often than they would otherwise be triggered. However, the only way to diagnosis the problem is to treat it, and see if the treatment works.

I’ve actually been down this path before. In 2008, a pain management doctor believed the same, and gave me a single occipital nerve block. It didn’t help, and so we didn’t repeat it. Dr. G. believes we may have given up too early or that my migraine (which lasted from mid-2007 to mid-2009) was too entrenched to shake. A nerve block now might provide some relief.

But, I can’t take it, at least not without putting efforts to conceive on hold for at least two months. The nerve block includes a steroid, which is contraindicated in pregnant women. The steroid remains active in the body for up to two weeks. If I need two, they’d be given at least three weeks apart. Therefore, Dr. G. won’t do it unless I agree not to get pregnant for at least two cycles.

I’ve decided I’m not going to do that. So, I’ve been digging for natural treatment options that could relax the neck muscles and perhaps provide some relief. I’ve also been trying not to spend hours and hours at a time reading or typing with my head at a downward tilt. (Apparently, that aggravates the nerve.)

So far, I’ve read that massage, heating pads, and meditation may help relax the area and calm the nerve. I’m interested to hear if any of you suffer from occipital neuralgia, or migraines triggered by occipital neuralgia. Do you have any tricks for relieving the pain? What works for you?