February 27th, 2009
A clinical trial was begun this past fall, of sumatriptan delivered by transdermal patch. Sumatriptan, the first to be developed of the triptan drugs, is a Migraine abortive, which acts directly on the trigeminal nerve to abort a Migraine attack in progress. It was available only as the brand-name, Imitrex, until the past couple of months when the pills and the injectable form came off patent and were approved as generics. Triptans can be taken by about three quarters of Migraineurs and are effective in aborting a Migraine, if taken early enough, roughly three-quarters of the time.
Regarding the patch, I think it’s a good idea. The injections work better than the pills for most people, me included. Bypassing the digestive system seems to limit side-effects, especially nausea, and personally I’d love to have the faster absorption like the injections without the major ouch of giving myself a shot! That said, I imagine the manufacturer is happy to have something they can patent and charge top dollar for, now that the pills and injections are out in generic. Call me cynical… but only partly!
I have to applaud every advance in Migraine treatment, small though it may be. And though you may call me a broken record, I am still your fired up advocate here and want to point out that we have had no new medications developed for Migraine, other than the triptans, in the past 15 years. So a little yay for another way to deliver triptans.
A way bigger yahoo! would be for more effective abortives, that could be taken by people with heart conditions, AND for effective preventives without hideous side effects that are actually developed for Migraine disease, not hand-me-downs from other diseases. Call me crazy? Well, a girl can dream!
– Megan
Patchwork quilt image courtesy of LePetitPoulailler.
Tags: imitrex, Migraine abortive medication, Migraine medication, Migraine preventive medication, sumatriptan, transdermal patch
Posted in Advocacy, Medicine | Comments (0)
November 24th, 2008
Imitrex – the trade name of the drug sumatriptan by GlaxoSmithkline – is at long last out in generic form. Imitrex was the first of the triptan class of drugs to be released, and is therefore the first to be coming off patent. When Imitrex came out about 15 years ago it revolutionized treatment of acute Migraine attacks. Triptans work not as pain-killers but work directly to abort the neurological process involved in a Migraine attack. Although they are contra-indicated for some Migraineurs, particularly those with cardiac-related problems, they are tolerated by most, and make it possible to greatly limit the impact of a Migraine attack.
Kerrie at the Daily Headache reported last week that injectable sumatriptan is now available in a generic form, and the Wall Street Journal announced today that Dr. Reddys Laboratories has launched the generic version of sumatriptan tablets. This is great news for Migraineurs – Imitrex has been one of the more expensive triptans on the market, retailing for anywhere from $15 – $25 per pill. Many Migraineurs, myself included, have found ourselves in ongoing struggles with our insurance companies, which limit us to 4 (or 2, or 6) pills per month, forcing us to choose which Migraines to treat and which to suffer through. I am still fighting for reimbursement of over $200 for Imitrex that was prescribed, and which the insurance company said they would pay for and didn’t. But that’s just another health insurance headache story.
– Megan
Tags: generic drugs, GlaxoSmithkline, imitrex, Migraine attack, The Daily Headache, triptans, Wall Street Journal
Posted in Current Affairs, Medicine | Comments (3)
June 1st, 2008
Well I had an exciting night! I passed out and fell on my face in the bathroom! The good news is that though my nose is very bruised and I’m getting a bit of a shiner on my right eye, nothing is broken, there’s not much pain this morning. I have succumbed to the nasty virus with fever and coughing that my son had for ten days. Danny came down with it after Adam was back on his feet for a few days, and I bit the dust (so to speak) a couple of days after Danny.
What makes this all the more exciting is that I have anaphylactic allergies to most analgesics. So there’s nothing I can take for fever. Luckily I’m not very prone to fevers; I often get the same virus as everyone else but minus the fever. Not this time. I’ve been lying around now for two days with a fever and a nasty painful cough. The coughing hurts my whole body and jars my head enough to wake the migraine monsters.
Around midnight my head pain was resolving into a migraine so I went into the bathroom with the Imitrex package. I was very feverish and not thinking too straight. I thought I’d first take my temp and then read the
Imitrex packaging to see if there was some reason not to take it with a fever – there isn’t, and that doesn’t really even make sense, but anyway… I didn’t want to wake Danny up because he was sick too.
So I sat on the toilet lid and put the thermometer in my mouth. I was very woozy and could hardly sit up. So I put my feet up on a little stool, put my elbows on my knees, and started putting my head down on my
hands. The next thing I knew I was on the floor in excruciating pain with bright lights flashing in my right eye. Someone was making this horrible wailing noise and it turned out it was me. The whole family came running in. I was so disoriented, I had no idea where I was or how I got there, I just knew my eye and nose hurt and my glasses were pressing into my eye. I don’t know if the glasses saved me from getting more hurt or if they made it worse. They didn’t break. There’s a big bruise and cut on the bridge of my nose.
The kids got me ice packs and Danny helped me up – he was going to support me back to bed. Next thing I know I’m very peacefully and comfortably asleep on the floor and he’s saying, Megan, Megan, can you hear me? Apparently I just kind of slumped and slid out of his arms back onto the floor. So weird. He got me back to bed and I slept the rest of the night. I’m still coughing and feverish and weak and I’m staying in bed!
I don’t know if it was the fever or the migraine or maybe both that made me pass out. What a mess!!! Just to make this all the more dramatic and interesting, my long-awaited headache specialist appointment is on Tuesday. I will call first thing tomorrow to get in to see the internist, and find out if the Headache Center wants me to come in. I “only” had to wait 4 months for this appointment – I really don’t want to give it up! I’m perfectly willing to go in not feeling well, but if I’m in danger of passing out it may not be a good idea.
Never a dull moment!
– Megan
Blue tile floor image courtesy of Jason Meredith
Tags: Adam Oltman Porcher, Adam Porcher, anaphylactic shock, fainting, fever, imitrex, migraine, viral infection
Posted in Medicine, Rant | Comments (6)
May 23rd, 2008
That’s what I’m doing today. It’s 5:00 and I think I’ve missed status migrainous by about 4 hours. Status migrainous is a condition where a migraine has continued for 72 hours without a 4 hour complete break in
pain while awake. It is a serious condition which carries an increased risk of stroke due to long-term dilation of the blood vessels around the brain. I am lying in bed with my fingers crossed because my migraine seems to have finally broken after about 68 hours.
The pain started Tuesday evening and has varied from about a level 2 on a 1 – 10 scale to about a level 8 or 8.5. It has varied from itchy nagging pain all over my head to furious pounding pain in both temples. It has been a particularly sneaky persistent presence, sending me strange nightmares. I have woken up two mornings in a row with the sense of something awful sitting on top of my brain, waiting to pounce. I have used 4 doses of Imitrex on it. Finally today, after all of today in bed, most of yesterday, and half the day before; and after 4 expensive, befuddling and nauseating doses of Imitrex, I think the pain is gone. I’m afraid to move in case it’s just asleep and I wake it up again. For many of you, this will sound quite familiar.
Nearly all of my plans for the last few days have gone out the window. What have I accomplished? I did have an important business conversation with my husband. I did gather up a list of all the homework my son has missed while he’s been out of school with the flu. I did wash a few dishes here and there. I did about 20% of the business work I had on the agenda for the last few days. I helped my daughter find her uniform for work. I’m about to be really ambitious and dig up some pretty pictures to illustrate this post. Other than that, I have been taking care of myself.
What does that look like? Today, and the past few days, it has looked like sleeping late, staying in bed in my pajamas for much of the day. Today it involved not even taking a shower so as to keep my head quiet. Anyone who knows me will tell you how much I hate not taking a shower! It has looked like saying no to even talking to my family when the pain level was high. It has looked like keeping track of how long this migraine has gone on, diarying about it, and calling the doctor for help. I spoke to the nurse this afternoon and now have a plan in place for what to do if the migraine doesn’t break, or recurs, over this holiday weekend. I’m happy to say the Emergency Room is not the first line of defense in the plan!
I went on the My Migraine Connection forum to connect with my buddies over there and gripe about this long migraine. One of my friends told me she was proud of me for taking care of myself. It was a revelation to me, a welcome one, to realize that I have been doing that – taking care of myself!
After 30+ years of migraines, coaching others to accept their disease and build the best life they can around it, I still struggle with acceptance. After basing my self care on meditation and relaxation exercises and building my life around my illnesses, I still fight tooth and nail. I didn’t take an Imitrex Tuesday night because I wasn’t positive it was a migraine. Maybe I could have prevented the following days of pain if I
hadn’t been in denial then. Regret is pointless. Great thanks to Gret for reminding me of what I am accomplishing today. I am taking care of myself. The shower will still be there tomorrow. Chances are, so will the dirty dishes. And the newsletter I owe to you, my subscribers. And the garden beds to weed.
Wherever you are, whatever you’re doing tonight, remember to take care of yourselves. I hope for all of us a pain-free tomorrow.
– Megan
Tags: imitrex, Migraine pain, self care, status migrainous
Posted in Managing | Comments (2)
January 17th, 2008
“Do not go gentle into that good night,
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.” Dylan Thomas
What’s important is to know what to rage against. How do I fight the good fight, and not the losing battle? It does me no good to fight the fact of my disease – where my fight is best placed is in finding help for myself and others, learning more, educating more, fighting to live a good life. But I forget that, frequently. I’m sure you never do that – I must be the only one who gets angry at this stupid disease!
Tuesday night I felt the steel band tighten around my temples. The gentle light behind the stained glass shade began to drill unbearably into my eyeballs. Dinner was cooked and eaten, homework done or well underway. My plan for the evening involved chatting with my husband, paying bills, loading the dishwasher, some reading. Nothing ambitious or exciting. My plan did not involve a migraine.
I laid my head on Danny’s chest. “Another one?” he asked. I nodded. “Why don’t you go upstairs?” “I will,” I said, “I’ll just try and load the dishwasher.” (Fighting the disease.) “Don’t overdo it,” he said. So I went into the kitchen, and put a plate, a glass, a fork into the dishwasher, bending slightly. The pain gathered over my right eyebrow for its opening move – a faint whack. “Okay, that’s enough!” I said, and laughed a little. (Acceptance.)
So I went upstairs, turned the lights low in the bedroom and settled in. The pounding was slowly starting, so I took my Imitrex. It was 8:30 at night. I could have gone to sleep. I could have read a little and gone to sleep. But I was mad. I was downright disgusted. I wanted to be entertained. I turned on the tv. The flickering screen bothered me, but the pain never got intense enough for me to back down. I stayed up until 11:30, watching a movie I wasn’t even enjoying. I had to keep the sound low to protect my head. I had to mute the commercials and avert my eyes from them. At 11:30 the migraine began to break through the imitrex. I went to sleep.
I woke exhausted at 6 in the morning, on insufficient sleep, to the kitchen fill of dishes. My son was grumpy and didn’t want to get up. I was the world’s most put-upon human being. I plunged my hands into the greasy dishwater, yelled at my son, and cried. My head was tight, threatening another round. But I pulled myself together, made the kids breakfast, got the dishwasher running, the kids out to the bus, checked my work schedule and went back to bed for an hour. I got up and went to work – realizing that it wasn’t the kids or the dishes or even the migraine I was mad at, it was me, my own self, for not taking care of me.
Acceptance is not giving up. Acceptance is going with the flow, with the grain, in the groove. Acceptance is the feet on the ground. Inspiration, striving, creation, possibility is the arms reaching for the sky. Let me have my feet on the ground and my arms up to the sky. God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference. Viva la difference!
– Megan
Reaching for Serenity
Tags: acceptance, anger, Dylan Thomas, imitrex, migraine, rage against the dying of the light, serenity prayer
Posted in Managing, Musings | Comments (2)
January 12th, 2008
Thanks to MJ for my topic today. I’ve got the Carly Simon song “Anticipation” stuck in my head now, which is rough because I only remember half the tune and the lyrics. But the final refrain says “Stay right here, ’cause these are the good old days, these are the good old days, these are the good old days…” (Just you wait ’til I figure out how to get an audio file in here and I’ll have you humming it too.)
Yesterday I wrote about Fridays… getting nostalgic about a time when I used to go out on Friday nights. It’s easy to get nostalgic when your head hurts – I can even get nostalgic for last Saturday, when I didn’t have a migraine or a sinus infection! How about Thursday? That was a good old day!
Truth is – I never went out every Friday. Plenty of times of I was happy with a pizza and crappy tv. PJs and slippers and a game of Scrabble. We did eat out a lot on Fridays, because who wants to cook at the end of the work week? But we lived in a big city, had disposable income, didn’t have kids yet, that made it easy. And sometimes Friday was dinner and dancing – a movie – time out with friends – it did happen!
My Frigraine Friday wasn’t too bad. Imitrex worked for awhile; I got some work done but didn’t overdo it; Danny made an easy comforting supper; we watched “Blithe Spirit” – an old Rex Harrison flick – and ate chocolate truffles. The headache is still with me today, but mild. (I refuse to call it a Saturgraine… that would be silly!) I’m well enough today to write this. This morning I made a dent in those Friday dishes. I have plenty to be grateful for. Look at this girl here – Kimi doesn’t long for the good old days! A good belly-scratch makes it the best day ever!
So what’s yer point, Migraine-brain? It’s hard to keep perspective when your head hurts. It’s always dangerous to draw conclusions when you’re down. Am I glad to be where I am today? I’d rather the house was cleaner, the funds were bigger, my dress size was smaller, my migraines were fewer, shorter, weaker… Would I pay money to be 25 again? I would not.
Here’s to finding the joy in where you are, right now. Wherever that is.
– Megan
Wickity-Whack but still ticking
pizza image courtesy of wEnDaLicious/wEnDy
Tags: anticipation, Carly Simon, imitrex, living in the moment, managing life with migraine, migraine, nostalgia
Posted in Managing, Music | Comments (0)
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