My MOH detox diary

I am embarking on an MOH painkiller-free detox, and I feel like it will be slightly easier if I can share my experiences with others (particularly people who understand). So I’m going to post updates on this thread documenting how I go.

First, some context. My ‘normal’ migraine pattern averages out to around 3 days per week with migraine – hopefully fewer than 15 days per month. I work full-time as a high school teacher. My definition of hell is standing in a stinking hot classroom in summer with a stabbing headache and nausea while trying to teach a classful of teenagers.

I know that everybody doesn’t agree with MOH, but I am a believer. For quite some time I have been taking daily painkillers (usually aspirin or ibuprofen or sumatriptan). My MOH is exhibited in two ways. First, my migraine frequency has increased to virtually every single day. Second, every now and again I will get terribly sick – a piercing headache and bad nausea that lasts around three days. This is not migraine – I can tell the difference.

I have been advised that to successfully detox I need to get down to no more than two days per week with painkillers (and five days with nothing! Yikes!). Only once I am at this level will any kind of preventative drug work. The MOH makes preventatives useless.

So here we go.

Here is my first update. Even though I only started this thread today, I have been off painkillers for three days now (counting today). For the first two days I was already sick with the MOH sickness I described above. Today I have had a slight headache which has hovered at around 1 to 3 out of ten without getting worse. I have been off work for two days sick.

Tomorrow will be my first day back at school while detoxing. Wish me luck!

well done josh, keep ging. i did it and altho it was hell to go through my migs are sooooo much better and i dont get them every day!! good luck!!!!

Brave decision. It is always quite difficult to be completely honest with yourself when it comes to taking painkilllers and to observe all symptoms, in such detail.
IT is great that you did that and that you have decided to do something about it, as well, in order to improve your quality of life.

It is a sad fact of life that if you take your painkillers daily, they simply stop having any effect, so it becomes a viscious circle of more painkillers, and more headache.

Quite recenty someone else here went through the same process with quite a good outcome, so it will be interesting to read about your progress. It all sounds quiet encouraging.

However, if you find that at some stage things become too much for you, do not give up.
Go to see your doctor or neurologist, and ask for more help, something which will not upset your plan.

Here in UK and in US it is also possible to have the MOH treatment in hospital, it often includes treatmnet with DHE45 intravenous injection, but this needs to be done under suprvision as some people can have bad reaction. BUt for most people it works very well indeed.
Good Luck.

Update: Day 4, 9:00am

Well, so far, not so good. Last night I got a killer migraine. I held out until midnight and then I took a triptan. I needed another this morning at about 6am. So today will be one of my two days where I am allowed to take something. But I have had to call in sick at work again. I already think I have used up all of my sick days.

Thanks for the encouragement. I have gotten to the stage where I can't really see much hope for the future, and I can't see how I can keep working full time. I really hope this works.

Update: Day 4, 7:00pm

What a day (so far). As I mentioned above, today turned out to be a meds-allowed day. I ended up having to take 3 Imigrans and 3 ibuprofen. I have never had to take three triptans in one day before, but the migraine kept coming back. The last one I took at 4:00pm, so it has well and truly kicked in now and I just have some residual background pain. I am hoping and praying that the headache doesn't come back tonight, that I get a good sleep and wake up feeling normal. Perhaps I am being overly optimistic.

One weird thing that happened today was that I had a brief period where I couldn't stop pacing the house, couldn't focus on anything and kept breaking out into tears. It was bizarre. The feeling passed relatively quickly but it scared me.

Tomorrow I hope to go to work (school) for the first time this week, if I wake up feeling okay. My poor students have been struggling without a teacher all week. I am worried, though, that I will go and then the pain will rear up while I'm there.

Josh, we are all different, and I applaud your efforts.
I tried to stop medication because i was concerned about MOH.
Both the GP and my neuro told me to not, because, having had a go, and given I do have breaks I didnt have the right "symptoms" of MOH.

With the agitation you mention, that could be medication withdrawal, but you took more Triptans than acceptable, so it could also be that. It is so hard to call.

The neuro said, I have chronic pain,not MOH.
All I am saying is, some people go through this Hell and nothing changes.

Of course to quit is the only what to find out, and I understood, it was no medication at all.
Not the 2/3 times a week. That is what one strives for after the "detox", not during.

I have never tried again. To be honest I just cant stand the pain.
I would be looking for a window to jump out of.

BUT as I say, we are all different. And some people have found it works and they are much better.
I hope, given how hard this is for you, that it works for you.

Good luck.

I am so sorry about your unbearble pain, and worries about work.

I wonder who is suprvising your MOH treatment and what options you were given, when you decided to proceed with the detox.

"it was no medication at all.
Not the 2/3 times a week. That is what one strives for after the "detox", not during"

This is what we understand in terms of MOH, procedure.
In the first days you cut down all painkillers, all triptans everything that could have caused MOH and after you are h'ache free for few days, you can start taking them again, but no more then 2 days a week.

I wonder if you were advised correctly in the fisr place, or perhaps it was not explained properly to you. Did you see a neurologist, who specialises in migraine treatemnt?

After you aer h'ache free you are also given a preventative medication, which helps with reduction of pain levels, and decreses frequency of migraine.IT can be very effective.

I fear that because you might not have been given the right advice, you are going to be unnecessarily discouraged, and that you are adding to your suffering unnecessarily by taking medicines too soon, and therefore you have to go through the withdrawal, time and time again and never clear you system properly.No wonder you are in agony. I am so sorry.

You sound so determined, and so considerate of yoru studenst, but I am affraid now you really need a good doctor, who could give you the right support. This is very important.
This can work, so it is worth trying.

It might be that the best and quickest way for you to tackle this, is to ask to be admitted to hospital for few days and have DHE45 treatment, which is often use here and in US, to get rid of the worst headache during the withdrawal, safely.

Maybe your studens will miss you when you aer in hopsital, but it might be best for you in a long run. If you give up, as you said, this might seriously affect your ability as a teacher.

Do not get dicouraged. This is difficult time, but you will get through it.
Do keep in touch!


.

Update: Day 5, 9:30am

I woke up this morning at about 4:00am with a mild headache. As I lay in bed considering going in to work today, the headache started to get worse until it was about a 7/10 by 6am. So I called in sick again. Since then I've been lying in bed with an ice pack on my forehead. Surprisingly, the headache has actually improved in the last half hour or so, without any painkillers. This is a positive sign. It's probably only a 2 or 3 right now. This is unexpected.

I told my principal at school what is going on and he has said that there are options, such as accessing long service leave in advance or something. They are being very supportive, which is good.

In answer to your questions, yes it was a headache specialist that I saw, and she advised me to go down to 2 days per week with meds. This was both for the detox and continuing afterwards.

I have tried several preventatives before (Topamax, propanalol, sodium valproate, sandomigran) but none worked. Perhaps this was because I had been taking daily painkillers at the time. I'm going to start on Gabapentin soon for a trial. If this doesn't work I will probably retry the sodium valproate. But the key thing is staying off daily painkillers in the meantime, which is my biggest concern.

Hello Josh

Thank you for sharing your experiences, day by day. I find it very interesting. I was a disbeleiver in rebound migraines until this last year when I wound up with daily migraines and nothing worked anymore. I used to convince myself that the migraines were degenerating with my age, but I was wrong. It was the painkillers that was taking me down. I've recently detoxed myself and I am feeling quite wonderful now, regardless of the migraines. I also learned a lot in the process. I get a lot less migraines now and handle them only with a Triptan now.

For myself I went back on propanalol and even though it only works for 6 months, that is enough to get me through this rough time. The detox was a rough time at times but I rationalized that I had worse days and hung in there. For me I had codeine to get off of too.

Keep up the good work. I am your #1 fan. You are doing a great job and your efforts will have a good outcome.

Enigma wrote:Hello Josh

Thank you for sharing your experiences, day by day. I find it very interesting. I was a disbeleiver in rebound migraines until this last year when I wound up with daily migraines and nothing worked anymore. I used to convince myself that the migraines were degenerating with my age, but I was wrong. It was the painkillers that was taking me down. I've recently detoxed myself and I am feeling quite wonderful now, regardless of the migraines. I also learned a lot in the process. I get a lot less migraines now and handle them only with a Triptan now.

For myself I went back on propanalol and even though it only works for 6 months, that is enough to get me through this rough time. The detox was a rough time at times but I rationalized that I had worse days and hung in there. For me I had codeine to get off of too.

Keep up the good work. I am your #1 fan. You are doing a great job and your efforts will have a good outcome.

Thanks, Enigma. I also had been saying to myself that the migraines were getting worse with age, but perhaps it is just the painkillers. I'm hoping to be able to cope with just a couple of triptans a week after I get back to 'normal'. I really appreciate your words of encouragement - it is so easy to get depressed and feel hopeless.

How long did it take you to detox?

Update: Day 5, 8:30pm

This turned out to be a pretty good day. After waking up with a headache like I said earlier, it gradually faded away and I've been mostly pain-free all day. I'll be going to bed feeling good for the first time in a week.

Let's see how tomorrow goes.

This is such wonderful news. I am so pleased for you.

I am also able to get rid of most of my h/aches in the same way, by waiting rather then taking painkillers.

However, at times, the h/ache instead of getting better gets worse, and this is when I take triptan. My migraine can last between 3/5 days and after that, I have totally painfree periods, which is great.

I am also on preventative, and I think that this works for me since my h/ache no longer reaches those high levels of pain, as they use to.

You are making a great progress.
I think it lifts our spirits to feel that we are more in control of our pain.

I was thinking about you yesterday, and what a hard time your country is having with all those horrid disaters one after another. It all all looks horrendous.
I hope that you have not been too badly affected.

joshp wrote:
How long did it take you to detox?

4 weeks, but it wasn't 4 weeks of total suffering. First week was weening. Second week there was only 2 days and one of which was in the bed all day as suffered the worst migraine and only had triptan and a couple of Toradol*** (from Doctor). NO CODEINE. Oh it was bad. The next two-three days I felt like I had the flu and was naseated and kept telling myself that I could ride out the flu so I could ride this out too. As the week went on, if a migraine started, I took triptan only and if that didn' help after an hour maybe a couple of Toradol with food. Then slowly, day by day I started to feel better and better in the third week. Week 4 I had a migraine every day at around 4 pm and took a triptan, then near the end of the week, I took ibuprophin for migraine instead and it worked. This week, I've had 3 days, no migraines. I am in the fifth week now and feeling better than I have in years.

Now I know, I have real migraines coming so I have a plan to not go back on pain killers. The plan is to take triptans and let them work for 2 hours. If it is so bad that I need a pain killer, then I will take it, otherwise, let the triptan do it's work before I mask it. That is how I used to do it years ago.

I beleive now that it is not okay to let a migraine run wild, but it is okay to have a pain for a while. That is my new thought pattern.
I really am hesitant to take any more pain killers now. They did make my migraines worse in the end and reduced my quality of life.

***Note about Toradol - it is a NSAID from doctor and it is basically a super aspirin. I took two and I wouldn't say it was a great painkiller. If you are seeing the doctor, then ask for a few, but don't expect the pain to disappear miraculously. With our pain, it's much the same as all the other aspirins in that it just takes the edge of - in my opinion.


Keep up the good work, Josh. Hope this helped

Josh- I have read this post from start to finish twice. I am interested to see where it goes. I don't really have much though, but something you mentioned about taking the 3 triptans in one day. I don't take any triptans at all. I have tried them and got no relief what-so-ever. One of the things I had to consider with each different one is the side affects. For whatever reason, when I take a triptan, my heart rate elevates, I am very agitated and can't hold still. I can't focus, and even my breathing is faster. It is a very odd feeling for me, and I tried to determine if they were helping enough to ignore that part of it. I have the same sort of reaction to DHE. I had one dose of that, and was promptly put on a cardiac monitor. I just could not breathe and my heart felt like it was going to beat out of my chest. I have never tried that again. I have had similar symptoms with various withdrawls from medications. So anyways I just thought I would chime in a bit.

Josh-I don't think we've "met". I am a long timer here but haven't been posting much lately. I am getting the impression you're not in the States. So my suggestion might not be available to you.

If you are finding yourself still fighting daily pain, could you ask your doctor for a steroid pack? I believe the brand name is Medrol Pack. It's a 7 day approach with the largest number of tablets being taken the first day while gradually going down over the course of a week. Sometimes, prednisone or similar steroids can break the pain.

I went through MOH in 2001. I was taking Fioricet and Fioricet with codeine. Fioricet is a barbiturate and is well known as an MOH drug. I would be in pain and take my meds and the next day, at exactly the same time, my head pain would return with a vengeance. It was horrific.

I know what you mean about MOH headaches feeling different than migraine. I wish you lots of luck in your endeavor.

£eslie

Stephgood, I read with interest what you said about triptans making you feel uncomfortable and restless, sometimes breathless and my heart is racing. This happens to me at certain times, and it is scary, but not at other times.

So, now what I try to do is this:
instead of taking my usual 100mg dose of sumatriptan, I take 50mg, then wait about half hour before I take another 50mg - this has desired effect on my migraine, but seems to prevent those unpleasant side effects.
I hope this helps.

Update: Day 6, 9:00pm

Today wasn't too bad. I actually woke up feeling really good and clear headed. By around noon I felt the familiar pressure building in my head which developed into a proper headache, peaking at around 4 or 5 out of 10. I was worried that without painkillers it would keep getting worse until it was a full blown migraine, but happily it began to fade and by about 8pm, it was completely gone. I'm pretty happy with that result, considering that I took no drugs at all.

Overall, this is going better than I thought it would. I feel like I'm coping. I just hope that it pays off.

I still occasionally freak out a bit thinking about the future - returning to work and only being able to take meds 2 days per week.

keep going, what youre describing is exactly the pattern mine took as the drugs are detoxing out of you! well done ! the pattern is so clear less drugs less pain!

Good luck Josh. I'm glad you spoke to your boss and found him supportive.

It's important to have MOH ruled out (or in good cases ruled in!), it helps our Drs treat us. I went through a four month holiday and unfortunately did not have MOH. But, it helped the Drs to move on.

I hope you find your answers.

Update: Day 8, 8:00am

Yesterday was the best day so far. I woke up with a slight headache (a 2 at worst) but by about 9:30am or 10:00am it was gone, and the rest of the day I was fine. I even managed to go outside and do some gardening in the afternoon.

Today so far seems the same. I woke up with a mild headache. It hasn't gotten any worse, and may even be getting better.

After today I will have gone 8 days with only using meds on one day. I would not have thought that possible a week ago.

Update: Day 10, 8:45am

The last couple of days have followed a similar pattern. Mild headaches that tend to go away on their own. My target is to go through a whole day headache-free. So far so good today (although it's early).

Good for you!

Here is an encouraging story...I received a call from my cousin. We haven't seen each other in a long time. She has chronic daily headache and migraines. She had taken Darvocet (a narcotic) for many years. Not every day, but almost every day, and sometimes three times daily. She was in bad shape. Very bad pain. Her older doc (in a small town) did not let her try Imitrex. He prescribed Darvocet and a few preventatives.

Darvocet was recently pulled from the market in the U.S. Her doctor retired at the same time. She saw his partner. He did not want to prescribe any narcotics. He did prescribe Imitrex. It works for her migraines.

By not taking Darvocet, her HA's have improved a lot she said. All her pain ramped down, and Imitrex takes care of the migraines, for the most part.

I asked her if she felt badly about all the years she suffered so much because of the treatment she received. She said she tries not to think about it.

Cheryl

Update: Day 12, 8:00pm

Well, I have to say that I feel great. Yesterday I had a full day with no headache at all. I was even able to mow the grass. Today I had a very mild headache in the morning that passed quite quickly, and I've felt really good ever since.

I have now been eight days with no painkillers at all, and I feel better than I have felt in months.

Hi Josh,
I'm glad you're feeling better. I've only taken a handful of NSAIDS in the past two years and limit the number of triptans I take. I average one migraine a month which is down from 3 a week 2-3 years ago. I wish you continued and increasing good health.