Have you ever wanted to drill a hole in your head to reduce your migraine pain? You’re not the first to think of this technique – trepanation, the official term for drilling a hole in one’s head for relief from brain-related diseases, has been used as a migraine treatment throughout history, with evidence of it’s use even found in prehistoric cave paintings. It was thought to be effective by either reliving pressure around the brain or releasing evil spirits. In case you’re considering it, please know there’s absolutely no evidence supporting trepanation as a migraine treatment. During a migraine attack, it may feel like the pressure is too high in your skull or that your brain is pushing against your skull, but neither of those things are genuinely happening. There is no physiological change to the actual pressure within your skull. And, of course, while migraine may seem like evil spirits infesting your brain, that’s not happening either. So, in addition to being phenomenally unsafe, trepanation won’t even do anything to relieve migraine. I conceived of this post as a way to share a bit of history and make a joke about drilling a hole in your head as a way to relieve migraine pain while simultaneously creating a great Halloween costume. Reading about the procedure quickly made me realize that trepanation is nothing to joke about. There are people and even an international organization promoting the use of trepanation for improving brain function and achieving higher consciousness. I’m scared to find out for sure, but I wouldn’t be surprised to find DIY trepanation instructions on the internet. What started out as a joke has me really weirded out. I’m pretty sure you all know trepanation is only a migraineur’s daydream when we’re desperate for relief. I don’t want to insult anyone by assuming you’d actually drill a hole in your head. Still, the desperation for migraine relief is unbelievably powerful (I’ve proven this to myself time and again, most recently by malnourishing myself for months). In those moments when it seems like every other treatment has failed and a person is nearly delirious with pain, I could see trepanation appearing to be an almost reasonable option. Just to be clear, it’s not. Trepanation: Don’t try this at home! Profile photo of Kerrie Smyres Now in her late 30s, Kerrie has had chronic migraine since she was 11. She’s been writing about migraine and headache disorders on her blog, The Daily Headache, since 2005. Kerrie is also the cofounder of TheraSpecs, which makes eyewear for migraine and photophobia relief.
This is one of the many symptoms of Migraine with Aura that sidelined my personal life. It was also breaking news when Serene Branson suffered transient aphasia in the middle of her live news report.
Aphasia is an acquired condition in which the patient loses the ability to do one or more of the following: speak or understand speech, read or write, perform or understand mathematical tasks.
Aphasia can occur suddenly or over a period of time. In the Migraineur, it is usually a symptom of aura and comes on suddenly. It feels a bit like this – One moment you are speaking and understanding a conversation, and the next moment *POOF*you’re in another country, confused and completely out of your element and out of control.
Thankfully unless the Migraine patient suffers a condition called persistent aura, or permanent damage occurs due to a Migrainous stroke, aphasia is temporary. It comes and it goes. Physicians call this Transient Aphasia, because it is not a permanent deficit. It does not require therapy to overcome.
What happens during an attack of aphasia?
It is now understood that Migraine aura is the result of an electrical wave that pulses across the brain called Spreading Cortical Depression. As the unusual electrical wave spreads across the brain, our neurons fire in an abnormal way and our brains can become confused. We see things that aren’t there. We may feel, hear or smell things that aren’t there too. Even our sense of time and space may be altered. As the spreading cortical depression hits the parts of our brains responsible for these and other functions (such as language) we experience strange aura symptoms.
There are two different parts of the brain responsible for language. They are called Broca’s area and Wernicke’s area. Each area controls different parts of language — 1. Function, and 2. Understanding.
Broca’s area is responsible for function — speaking, reading and writing words and numbers. (Words and numbers are all part of language) Aphasia in this area of the brain is often called non-fluent aphasia or expressive aphasia, because the individual has lost the ability to speak words or sentences, although the ability to understand language has not been affected. The patient will struggle to find the right word or number, and not be successful. The reason these patients have aphasia has nothing to do with loss of motor skills in forming words — it is a neurological phenomenon.
Wernicke’s area is responsible for understanding words and numbers. Aphasia in this area of the brain is often called fluent aphasia or sensory aphasia, because although the patient can speak using mostly normal words, they are often nonsensical – as if the words’ meanings had been re-arranged. The person speaking has no idea they aren’t using language correctly and will often be shocked when later presented with a recording of their conversation. They also cannot understand what anyone else is saying to them.
There are many different ways to classify aphasia, but those classifications are usually restricted to permanent deficits. When the aphasia is caused by Migraine, it is usually and simply called transient aphasia. A patient suffering aphasia is called Aphasic.
Migraine patients often may not simply suffer aphasic symptoms from one or the other area, but mixed types. Additionally, one aphasic experience may not be as severe as the next — or vice versa. Just as each aura is different, each experience with aphasia may be different too. Knowing how our brains work normally and during a Migraine is often helpful however, in relieving stress from the unknown.
Knowledge truly is power! I sometimes have aphasia — what can I do?
Carry a wallet card explaining your condition: These cards can be purchased from various aphasia websites, or you can simply create one yourself that says something like: “Hello, my name is ______ and I sometimes suffer transient aphasia as part of Migraine aura or side effect of a medication I am taking. This means I may not be able to understand or speak to you right now. To help me, please call ________.” Don’t forget to warn the person (or doctor) whose phone number you’re using that they may receive a call. Help them by providing them with instructions you would like them to give the caller such as: How to contact someone for transportation home. Where your medical information is located. Where you store your medications so a helper can get them to you. How to contact your spouse or physician.
Carry an instruction sheet that includes the information above, as well as contact information for significant others who can help you.
Carry a small pad and pencil with you.
Carry a smart phone with GPS tracking enabled. An example of one program that allows “friends” to see where you are is: Google Latitude
Consider creating a one button text code to a loved one that indicates your situation when you’re alone.
Remember to create an auto dial number for ICE on your phone (In Case of Emergency) and direct it toward someone close to you who is usually available. Emergency personnel depend on these numbers and will look for them. Multiple ICE numbers can be followed by #1, #2, etc. May also code APHASIA with an emergency number in your phone too. This will help emergency personnel or helpers to assist you.
Remember — no matter how confused and alone you feel, You. Are. Not. Alone.
What can my loved ones do to help me?
Keep paper and writing tools handy “just in case”.
Use gestures if necessary.
Speak slowly and carefully and give plenty of time for single word responses.
Use drawings or pictures to be understood
Educate yourself about Migraine and aphasia so you can advocate for your loved one when they have lost their own voice.
Plan ahead and practice — what will you do if you receive a call from someone trying to help your loved one?
Be ready with hugs of encouragement. Don’t lose patience. Give plenty of time for your loved one to try to communicate with you.
Be sure to summarize a thought or idea you think they have and give them the opportunity to nod or shake their head to indicate their agreement or disagreement.
Remember this is a temporary situation beyond their control. They are alone and scared.
After the attack is over, review together what happened and make any changes to your plan necessary for the next time.
Aphasia and Migraine medications
Aphasia is sometimes a part of Migraine aura (often mistakenly called Complex Migraine — an antiquated term) but it can also be a side effect of preventive medication you may be taking for your attacks. Be sure you cross check all your prescriptions for this potential, no matter how rare they may list it. Gabapentin and pregabalin are two examples of medications that list aphasia as a potential side effect. Do you know of any others?
If you have recently (last 6 months) changed your preventive and suddenly are experiencing transient aphasia, consider talking with your doctor about it. Any changes in your normal Migraine pattern needs to be discussed anyway. Your aphasia may be a symptom from your medication and changing meds may be warranted to see if the symptom disappears on its own. Your own aphasia may be short and not affect your life much at all. Then again, it may be serious and even necessitate major life changes like it did with me. Either way, it is a severe symptom that you will want to be sure and minimize. This means education and becoming proactive.
So, I had my appeal hearing on the 15th. The Judge told me he would send my notification letter out to me as soon as possible. I was so happy I had won, it never occurred to me that I may have to wait an undetermined amount of time for proof. I can’t apply for Medicaid without it. My bills are still rolling in. My service cat needs a vet visit. I have a tooth that needs a crown. I have two payments left on the root canal therapy I had done due to extreme pain and infection. My medical insurance went up to over $500.00/month. I have monthly payments due to allergist, pain management, psychologist, past due medical bills, prescriptions, etc. The money is gone. I have no options for income of any type. I have no one to borrow from or get a loan. I don’t know why I thought my troubles would be over the second that I won my appeal. I’m in limbo. Not a good place for me with my depression and anxiety issues. I am already too into my own head. Too much time to think and worry and stress about anything and everything. I need an end date. I need to be able to plan. I need peace of mind. In the meantime, my medical issues are not under control. I have treatment options that I cant afford. I can’t help but think that I would feel better emotionally if I felt better physically. Oh well. I guess it’ll be awhile until it’s all lollipops and candycanes.
I feel like this woman is living my life and vice versa! Please follow her blog for heartfelt insight into living life with chronic pain. P.S. Migrainista, please stay strong and #AlwaysKeepFighting! Much love! Lollipops & CandyCanes
I am a married woman in my 30s who is living with chronic migraine pain and Fibromyalgia. Join me as I try to figure out how to live my best life despite the pain, fatigue and such.
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A Little Slice of a Chronic Pain Life
TUESDAY, OCTOBER 20, 2015
A Little Slice of a Chronic Pain Life
I had plans for today. Reasonable plans that included getting 2 quick errands done, cleaning the bathroom and doing one load of laundry. I planned to have plenty of rest between these activities and to go ahead and give myself the entire day to get them done.
But I woke up with a migraine. I was pretty sure I would because I had one last night when I went to sleep. I took my rescue med before even getting out of bed and added in some Ibuprofen once I had a little food in my stomach. After a quick nap the pain was more manageable so I went ahead and took a shower.
Now I’m sitting on the couch feeling mentally and physically exhausted; feeling hung over and achy throughout my body. I can still feel the migraine pain under the medication, which means as the meds wear off later this afternoon the pain will get worse, which means I’ll go to bed with a migraine and wake up with the same migraine – just like today.
I will probably take at least 2 naps today. One as soon as I’m done here and then again after I walk Gypsy around mid-day. I’ll work hard to pull myself together to heat up leftovers in the microwave for dinner tonight but it’s possible hubby will have to heat up his own and I’ll end up with a Clif Bar thanks to my nausea. Thank God for leftovers.
It’s safe to say my reasonable plans for today and tomorrow have to be abandoned. I’m already reworking the plan in my head. I can push off that trip to Target – maybe stop on my my home from the doctor’s office on Thursday. Who knows, I may even feel a little better by then. I can probably squeeze in that load of laundry as a way to get myself moving. It’s important to move periodically. The bathroom can wait. Gyspy needs a nail trim so I hope tomorrow isn’t quite as bad as today so I can take her to the groomer. But her nails might need to wait until next week because I have doctor appointments on Thursday and Friday. Honestly I wish I could just sleep until my appointment on Thursday – but that’s not how life works, is it?
Ah, life with chronic pain. Full of uncertainty, altered plans, lost time, pain and a whole list of other symptoms and consequences. Ufda!
Posted by Migrainista at 10:17 AM
So, after almost four years of doctor visits, tests, medications, treatments, reports, blood work, pain, stress, panic, anxiety, chronic daily migraines, fibromyalgia, insomnia, depression, and countless forms and paperwork, I was approved by SSDI for Disability benefits. I had been denied twice before. And probably would have been a third time if not for my attorney and law firm. I did so much research about the SSI and SSDI programs, I have numbers and percentages stuck in my head. 900,000. That’s the backlog of cases yet to be heard by a judge. There are so few offices and judges and so, so many people in need. I consider myself extremely lucky to be done with the process and to have received a favorable outcome. My stress and anxiety level has dropped tremendously. My pain level remains the same, but hopefully now I will be able to afford some of the treatments that I couldn’t earlier. I am still crying relieved, happy tears and have been since the bench decision was reached on the 15th at my hearing. It’s been such a long, energy-zapping, faith-testing, soul-searching, emotional roller coaster ride. I’m saddened that I had to fight to prove that I’m as sick as I say I am. Especially to people who don’t know me or see my endless struggle to get through every minute of every hour of every day. I was a case number to them. Quickly forgotten as my case was dismissed and the next began. The judge in my case was respectful, empathetic, and compassionate. He has my undying gratitude and thanks for treating me as a person and an individual. Well, I’m officially “disabled” now. I am not going to think of this as a sad designation, but as a means to an end. I see myself as a capable, strong, brave fighter. I have had to be to live through this and to continue to do so. I refuse to think of my condition as a permanent disability. I have to believe that there is proper treatment out there for me. Something to give me my life back. To allow me to live, instead of just survive. I want to thank everyone who has supported me since the beginning of this nightmare and those I’ve met along the way. My mother is number one on my list. My hero, my inspiration, my heart. You’ve never stopped loving and caring about me and I felt your prayers and positive thoughts each day. You’ve kept me strong and pushed me to #AlwaysKeepFighting. I love you with all of my heart! To those chronic pain warriors out there still fighting for Benefits that you so rightly deserve, I stand with you! You have my admiration, empathy, and love! You are not alone!
What it’s like to live with an invisible disability By Emma Miller, Columbia University October 13, 2015
VOICES FROM CAMPUS
Voices: What it’s like to live with an invisible disability
“Not only does fibromyalgia cause your school work to suffer, but your social life suffers as well,” she says. “I was a young, ambitious, 20-something girl in Manhattan and couldn’t do half the things I wanted to, because of the lack of energy caused by constant pain.”
“Not only does fibromyalgia cause your school work to suffer, but your social life suffers as well,” she says. “I was a young, ambitious, 20-something girl in Manhattan and couldn’t do half the things I wanted to, because of the lack of energy caused by constant pain.”
Some disabilities are visible, and some are not. And for college students trying to balance their education and their health, invisible disabilities pose unique difficulties.
After all, how can schools accommodate a disability you can’t even see?
According to Deb Hileman, a spokeswoman for the Invisible Disabilities Association (IDA), invisible disabilities run the gamut.
“The term “invisible disabilities” can refer to debilitating pain, fatigue, dizziness, cognitive dysfunctions, brain injuries, learning differences and mental health disorders, as well as hearing and visual impairments,” she says. “They are not always obvious to onlookers, but can sometimes or always limit the daily activities (of the people they affect).”
But figuring out how to level the playing field for students affected by these disabilities is not an easy task. From op-eds about how to best accommodate diabetic students to debates about whether students with anxiety disorders should be permitted to keep emotional support animals, it can be hard to know just how to accommodate students whose disabilities are not physically apparent.
Fibromyalgia is just one example of such an invisible disability. While you likely wouldn’t be able to tell the difference between a student with fibromyalgia and a student without it just by looking at them, it’s a condition that can seriously affect students’ performance in school.
“Fibromyalgia (FM) is a common and complex chronic pain disorder that causes widespread pain and tenderness to touch,” explains Jan Favero Chambers, president and founder of the National Fibromyalgia & Chronic Pain Association.
“Both men and women with fibromyalgia often experience moderate to extreme fatigue, sleep disturbances, sensitivity to touch, light and sound, cognitive difficulties and a number of other overlapping conditions, such as arthritis.”
To Emily Thornton, who was 20 when she was first diagnosed with fibromyalgia, these symptoms are all too familiar.
“I have pain in my joints,” she says. “I have intense fatigue that lays me out for hours—sometimes days—at a time. I have aches that make it hard to move, and sometimes the pain gets so bad that I can’t walk or breathe.”
At the time of her diagnosis, Thornton was a sophomore at Fordham University-Lincoln Center in New York City, studying theater performance. And while she successfully graduated last spring, her fibromyalgia didn’t make that any easier.
“I often fell behind in my school work, especially in my purely academic classes,” she explains. “I had to take time off to sleep, and then I’d use all my energy to attend theater rehearsals. That was definitely not a sustainable solution.”
And according to Chambers, Thornton’s experience is quite common. “Students (with fibromyalgia) may miss class due to fatigue or pain,” she confirms. “And they may fatigue easily, so saving extra steps getting to class matters. Carrying a heavy backpack instead of a wheeled briefcase can cause muscle spasms and neck pain. Lack of sleep exacerbates fibromyalgia, and can put a college student into a fibro flare — a sudden increase of pain and symptoms.”
Some of the accommodations Chambers recommends that colleges make for students with fibromyalgia include giving students extra time to complete tasks that require hours of focused concentration; providing ergonomic seating; providing natural light instead of flickering, florescent light; and offering make-up exams, classes or assignments when symptoms become debilitating.
I was diagnosed with fibromyalgia at the beginning of my sophomore year of college,” she says. “I remember the doctor doing a pressure point test, where he pressed firmly with two fingers on different parts of my body. Everywhere he pressed, it ached, like he was pushing on a bruise. I had always thought was a normal experience — so I was surprised when he told me, ‘For everyone else, that doesn’t hurt.’”
The doctor prescribed Rosett one medication after another. The first medicine Rosett tried gave her nausea and vertigo; the second left her lightheaded and prone to passing out.
“With fibromyalgia, medication is really just a crapshoot. People come in expecting there to be some cure, but there’s not, and that can be really frustrating.
“When I flare up, my muscles ache, and I feel nauseous and exhausted,” she says. “One huge factor for me is stress — so I try to cut down on stress by sometimes allowing myself to skip a class, or to watch a movie instead of doing homework.
But Rosett says that sometimes creates a different kind of stress.
“In college, there’s such an emphasis on being productive all the time — and I sometimes feel like I’m being held to a standard that is so easy for everyone else and so difficult for me.”
“And it’s hard because you have less credibility when your disability isn’t visible,” Rosett explains. “People doubt you, or just think you’re trying to get out of work.
So how can students best support their peers struggling with fibromyalgia and disabilities like it?
“One of the most important things students can do to support friends with invisible disabilities is to believe them,” IDA spokeswoman Hileman stresses. “Sometimes we have our own ideas about how much a person with illness or disability should be able to accomplish for their condition to be ‘real.’ We should not make judgment about what a person may be able to do by how he or she looks.”
And Emily Thornton agrees.
“We do not need to be told by professors, deans or peers that our pain is not valid. Having people tell you ‘it’s all in your head’ or to ‘suck it up’ — that makes me want to scream,” Thornton says. “It’s not in my head and I fight all day, everyday, to even stay upright.
“We don’t need professors and administrators to give us a get-out-of-jail-free card, either; we just need our colleges to help us come up with solutions to help us get our work done without killing ourselves over our school work. We need help finding a balance.”
Emma Miller is a student at Columbia University and a fall 2015 USA TODAY Collegiate Correspondent.
accommodations, Americans with Disabilities Act, Columbia University, disabilities, Emma Miller, fibromyalgia, Fordham University, Invisible Disabilities, VOICES FROM CAMPUS
A note from Lollipops & CandyCanes: I am unfortunately unable to work or continue with school due to my invisible illnesses. I thought it was interesting to hear from someone fighting so hard to be “normal” in an “abnormal situation.” Stay strong Emma!
Migraine in America: Data Demonstrate Need for Better Treatment Options By Migraine.com—September 21, 2015
Migraine patients typically try a variety of treatments across their journey, whether they be prescription medications or alternative therapies. The Migraine In America 2015 online survey gathered insights from 4,502 patients currently diagnosed with migraines in hopes of better understanding their treatment experience, as well as satisfaction and overall medication behaviors. Among the patients who participated in the survey, over half experienced 8 or more migraine attacks each month, and almost half experienced migraine symptoms on 15 or more days a month.
Examining the type of treatments currently used by migraine patients, abortive/acute prescription medications were the most common (66%), followed by OTC pain medications (57%), preventive/prophylactic prescription medication (47%) and rescue prescription migraine medications (39%). Among those treatments tried and abandoned, complementary and alternative therapies had the highest abandonment rate (42%), followed by OTC pain medications (36%) and preventive/prophylactic prescription medication (35%).
Looking at usage among the lesser common migraine treatments, 40% of patients have used antiemetics throughout their journey, however less than 10% were currently relying on them for relief. Nerve blockers or pain blocking treated were once tried and abandoned by 18% and continued to be used by only 7%. Eight percent of patients surveyed have tried the Cefaly® device, however half of these patients have ceased its usage.
Among preventive migraine medications, antiepileptic drugs were currently used by 31% of patients, and antidepressants by over 26%. While over half of current antidepressant users having suffered from depression and/or anxiety, so usage may also be to treat these conditions and not migraine exclusively, they still had a 53% abandonment rate.
Despite having the highest abandonment rate among preventive treatments (59%), antiepileptic drugs had the highest level of satisfaction among current preventive users (51%). Similarly, oral steroids were among those with higher levels of satisfaction for preventives (48%), but also a higher level of abandonment (45%, with only 4% still using). Following antiepileptic drugs, beta-blockers had the second highest abandonment rate (54%, with 15% still using).
Among lesser common preventive treatments, Botox® for Chronic Migraine was currently used by 18% of patients surveyed, however had been abandoned by 16%. Calcium-channel blockers have been abandoned by 35% of preventive users, with only 7% reporting usage at the time of the survey. And in the bottom among current preventive users, serotonergic agents were only currently employed by 1% of patients, and 11% have tried and abandoned.
Despite all the available options, it’s important to remember that few of these options were developed specifically for the treatment of migraine. Therefore it’s not surprising that the overall satisfaction level, with even the most commonly used migraine treatments, remains at only about half of users.
Abortive or Rescue Treatments
Among abortive/rescue medication users, triptans were currently used by over half (55%) and anti-nausea medications by 39% (abandoned by 34%). Among those abortive / rescue medications with high abandonment rates, prescription NSAIDs were the leader (50%, with 29% still using), followed by prescription analgesics (45%, with 45% still using) and then triptans (38%).
Ergot derivatives had a very low current usage rate (6%), and over a third of abortive/rescue users have tried and abandoned (35%). Despite having a 36% abandonment rate, 1 in 4 abortive/rescue users still turn to prescription muscle relaxants.
Three out of 4 of patients who use abortive/rescue medication cited they would initiate treatment within an hour of suspecting they were getting a migraine (37% immediately and 38% within 1 hour), only 8% waited over 2 hours. Of those who usually waited more than 2 hours, they typically didn’t want to overuse medication (62%) or waste it (57%), as well as ensure that they really were getting a migraine (54%).
Over 2.5K patients (more than half of those surveyed) had used a triptan within the past 3 months. About 1 in 4 had used 2 or more forms of triptans within the previous 3 months
88% – Tablets
17% – Injection/Needless injection
15% – Fast melts
8% – Nasal Spray
Within the branded triptan medications, Imitrex had the highest usage rate within the previous 3 months among tablets (30%), among nasal sprays (3%) and among the injections surveyed (9%). Among current triptan users, most had been using their current medication for over a year – with Imitrex tablets having the highest proportion of long term users (86% having had used over a year).
Overall, triptan users were satisfied with the efficacy and tolerability of the medications they had used in the previous 3 months, with at least half of patients reporting being satisfied or very satisfied. However, it is not surprising that 35% of abortive or rescue medication users indicated they would consider switching medications if their current stopped working for them and 28% had thought about it sometimes. Very few have ever thought about it (4%) or have considered adding something to their current treatment plan (4%).
CAMs and Self-Medicators
Self-medication was currently being used by a small proportion of patients surveyed (11%). Marijuana was by far the most commonly used among current self-medicators (59%) and illicit drugs the least (5%). Whereas 71% of patients had tried or were currently using complementary and alternative therapies for their migraines; 29% were still currently using at the time of the survey.
Among current therapy users, sleep/rest (37%) and dark rooms (35%) were prominently employed, as well as being consistently utilized by at least half of their users. Additionally, diet (30%), hot/cold therapy (29%), massage (26%) and caffeine (26%) were therapies patients currently turned to. While these therapies were common, those alternative therapies that patients were apt to consistently leverage for preventive purposes were dietary supplements, such as magnesium, riboflavin, butterbur, CoQ10, and feverfew.
While a variety of alternative therapies have been used in attempt to reduce or stop migraine symptoms, many patients have not persisted with those they have tried. Chiropractic care, caffeine use, and acupuncture were the most discontinued therapies, having been tried in the past but no longer used (56%, 47% and 43% respectively).
Medication Behaviors and Viewpoints
Although a majority of patients had insurance, nearly half of patients spent more than $500 last year on migraine related treatment and therapies (46%). Another 19% spent between $251 and $500 to cover their migraine related care.
Patients typically filled their migraine medication prescriptions at a chain pharmacy (46%). Over a third of patients (35%) reported typically waiting at the pharmacy for their migraine medication fill, and half usually would drop-off and return within 24 hours.
At some point in their treatment journey, three quarters of patients had withheld taking a medication to spare it for another time. Side effects also played a role in medication avoidance for over half of patients; 72% of those surveyed have stopped a medication and 73% have avoided a medication at some point due to side effects.
Patients were asked to rate their agreement with statements on a 7-point scale (7 = Completely agree), to better understand their treatment viewpoints. Average ratings with each statement are shown below, illustrating migraine patients’ determination to find a treatment that is effective for them:
5 – I have tried everything possible to manage my migraine symptoms
5 – I actively seek out information about the latest migraine medications
4 – I would rather make changes to my lifestyle and or diet than take medication for my migraines
4 – I try to avoid migraine medication as much as possible
Overall, 17% of patients surveyed were aware of new migraine treatments that have been recently approved or are going to be available soon. Zecuity® had the highest awareness level (33%) and moderate level of likelihood to try (52%, Top 2 box on a 5-point likelihood rating scale); whereas CGRP had the highest likelihood to try rating (73%), but a lower awareness rating (17%).
Although there are a great number of treatments for migraine available between those that are preventative, abortive, and rescue medications, most patients have tried several of these treatments, indicating that their migraines are not well managed. Data from this survey further support the need for new, more efficacious treatments for migraines than are currently available.
Welcome to Fibromyalgia Symptoms
When people have issues with chronic pain, muscles often become tight, which can easily worsen pain.
Tight muscles can also cause legs, arms or other muscles to ache, which can worsen how someone with fibromyalgia feels because they have to deal with an aching body nearly every day.
Tight muscles can also cause knots to develop over tender areas that when touched can cause tremendous pain for some fibromyalgia sufferers. One way to help get muscles loose is to take prescription muscle relaxants.
Muscle Twitching with Fibromyalgia
People with fibromyalgia not only deal with sore, aching muscles, but they may have muscles that twitch as well.
Muscle twitches occur when the brain tells the muscles to move, even though you may be sitting or lying still. When this occurs, which is often at night, it often disturbs sleep or keeps people awake.
One cause of tense muscles and muscle twitching is stress and anxiety. Muscles tend to tense when people are under a great deal of stress, which can be caused by dealing with fibromyalgia on a daily basis, on top of work and/or family stress. Anxiety often causes the body to tense as well, which worsens muscle pain and twitching.
Twitching muscles can be treated to help reduce or stop it altogether. If the problem is severe, doctors will usually prescribe a muscle relaxant or an anti-spasmodic medication. The medication your doctor prescribes will depend on what your doctor thinks is causing the problem.
Types of Muscle Relaxants
Some muscle relaxants work to reduce pain as well as loosen tight muscles, but not all muscle relaxants work in the same way.
Muscle relaxants vary greatly from each other, so some of them may work better than others to help reduce pain and loosen muscles for people with fibromyalgia.
Most doctors begin patients with the lowest dose possible to keep them from feeling sleepy during the daytime.
However, a drug can work differently for each person who takes it, so doctors may adjust the dosage or change the medication if a muscle relaxant doesn’t work for one of their patients.
Some of the lightest sedating muscle relaxants include:
Metaxalone, which is sold under the brand name Skelaxin. The recommended beginning dosage is 200 mg.
Tizanidine, sold as Zanaflex, has a recommended beginning dosage of 1 mg. It comes in a 4 mg tablet that is scored two ways in order for it to be divided correctly.
Muscle relaxants that are considered to be benzodiazepines include:
Clonazepam, which is sold as Klonopin, has a recommended beginning dosage of .25 mg.
Diazepam, or Valium, has a dosage recommendation of 1 mg.
Alprazolam, or Xanax, has a recommended beginning dosage of .125 mg.
Benzodiazepines are used for many purposes, including treating anxiety, depression, insomnia and as a muscle relaxant.
Some of the most heavily sedating muscle relaxants are:
Cyclobenzaprine, which is sold as the brand name Flexeril. The beginning dosage recommendation is 5 mg.
Baclofen, also known as Lioresal, also has a recommended dosage of 5 mg.
Along with loosening tight muscles, these drugs can help reduce pain and restless leg movements that often accompanies fibromyalgia.
As a result, many people find it easier to sleep when they use these drugs before they go to bed. Taking them can promote a deeper sleep as the patient doesn’t have to deal with pain or restless legs while they are trying sleep.
How Muscle Relaxants Work
Tight muscles are not only painful, but they can make your body feel stiff and sore. The tendons and ligaments will also feel tight because the surrounding muscle tissue is squeezing them when they are tense.
While using topical ointments can help reduce the pain from tense muscles and help relax them, a prescription muscle relaxant works better for most people with fibromyalgia.
Along with helping muscles loosen up and relax, they also help block pain signals being sent to the brain and they help mask muscle pain.
With less muscle pain, the body can fully relax and allow the sufferer to rest more comfortably at night. It will also be easier to move around and do daily activities with the body more relaxed.
The Side Effects of Muscle Relaxants
Just as with most medications, muscle relaxants have side effects of which those using them should be aware. Along with being addictive, muscle relaxants may have several other physical side effects.
It is important that you follow your doctor’s directions when taking them because they can interact with other medications, which can lead to impaired thinking and functioning.
The side effects from muscle relaxants can range from mild to severe, though the more severe side effects are uncommon.
Some brands of muscle relaxants can leave a bad taste in the mouth or they can cause dry mouth as well for some people who take them.
Some people may also experience upset stomachs, nausea and/or vomiting. The most common side effect that occurs when people take these medications is drowsiness.
While drowsiness is common when taking muscle relaxants, some people may also experience feeling lightheaded, they may be unsteady on their feet or their thinking could be “foggy.”
Impaired thinking, eyesight or decision making can be experienced by some people taking muscle relaxants. People taking them should not drive or operate machinery after they’ve taken a dose of these medications.
When used with other medications, the efficacy of muscle relaxants could be increased, which can make taking them dangerous.
When used with alcohol, the sedative effect can be increased, which can cause dangerous impairment. It is also important to ask your doctor about possible drug interactions if prescribed a muscle relaxant.
These drugs have several benefits for those with fibromyalgia, including a reduction of pain, helping the body to relax and prevent muscle twitches.
Pain runs like blood through my veins. It is a part of me. It’s not happening to me. IT IS ME! Every pain, noise, light, touch is amplified. Times 1000! The glare coming through the window. The landscapers outside with their tools. The jackhammers in my skull that never let go. The clothes I’m wearing hurt my skin. Everything is blown so far out of proportion. My nerve endings are on fire. Nothing eases or soothes. The pain meds dull my senses a bit, but not enough. I sit in my bed, in my room, in my house, in my bubble. Scared to go out where I have absolutely no control. At home, I can close the blinds, wear noise cancellation headphones (to dull outside noise, but not my internal pain), try to find comfortable clothes to wear. The sheets on my bed hurt me. I can no longer distinguish the migraine “fog”, from the Fibro “fog”, from the medication side effects “fog.” I don’t know which reactions are from my illnesses and which are from side effects. My life is lived on a continuous loop of blurred vision, balance problems, falling, not sleeping, not eating right, nausea, vomiting, trying to be understood while not being able to articulate words, the crushing blackness of depression, the panic attacks, the insomnia that leaves me even less able to fight every day. I try to remain hopeful. A treatment that helps, a procedure that gives me relief, a cure. And yet, I cry all the time. I grieve for the me I was not so long ago. I cry for the days passing me by with my participation. I’m not living, I’m surviving.
So, this morning I said to Mom, “I feel so much better about the Hearing. I’ve finally realized that I have done all I can to make it a positive outcome.” And I had. I did my research, sent all of my findings to my law firm, confirmed with SSDI that I would be there on Thursday, and spoken with my lawyer. It was out of my hands. All I could do now was stay in this new positive frame of mind and show up to the Hearing.
Then the phone rang. My law firm contact told me that they hadn’t received my medical records from Dr. Pain or Dr. Panic yet. They were requested back in August and September. When called that morning by the law firm, Dr. Panic’s office insisted that I was not a patient of theirs. Needless to say, but I will anyway, I lost it! I asked what that meant for my case if the records weren’t received in time. I was told the Hearing would go on, but the record would stay open until subpoenas were issued and my records were received by the Judge. This meant a decision could be delayed even longer. I broke down and couldn’t stop crying. I was angry, upset, scared, panicked, and beyond speech. So much for my positive mindframe. Gone! Just like that! I’m so fragile right now. I feel like I’m teetering on the edge all of the time. Anticipatory anxiety. My lawyer assured me they would take care of the issue of the medical records and for me to leave it to them. That is what they are getting paid for, but it’s hard to give up control and leave it in their hands. I feel like I haven’t done all I can. So I’m stressed once again. It’s going to be a long week. Please send positive thoughts and vibes my way! Better days ahead.