migraine investigative work

I've been having a string of frequent (assumed) migraines lately. I've had a constant headache for 11 years (diagnosed NDPH), so its often tough for me to know whether it is a migraine until it is very obvious, with severe pain which is way worse on one side and nausea, then it takes hours to get it under a control with multiple doses of Sumatriptan and Zofran.

Nearly every migraine starts in the evening. For awhile I was getting migraines at most 1-2 days a week and they were relatively easy to treat, so I didn't focus much on it. However, lately I had a week where I took a triptan every day, and the week before that, I took one more days than not. Plus the nausea was very difficult to control and I used up my stockpile of Zofran.

However, sometimes I think when I take a triptan at the first sign (like we are told) it may not be a migraine every time, as sometimes I feel better so much sooner than other times. I get severe pain just from the NDPH sometimes, and have stomach issues which cause nausea at times, so sometimes it is just a false alarm.

If I take a sumatriptan, the pain subsides back to baseline, and 24 hours after I took it I feel migrainey again: Is it (1) the same migraine which had been suppressed that whole time by the triptan, (2) a new migraine, or (3) something else?

I had thought it was the same migraine coming back, but I recently read sumatriptan only has a 2.5 hour half life (way way less than I thought), so that makes it seem more likely to be a new migraine.

If it takes 2-3 hours until after taking oral sumatriptan until I am feeling better, does that mean the migraine more likely went away on its own rather than responded to treatment?

Sorry for the long-windedness. I just really want to try to figure out some of my triggers. Seems like I either get migraines too infrequently to figure it out (I tracked every single thing I ate for months one and didn't get a migraine the whole time, so I gave up for awhile), or too frequently to figure it out.

Verapamil seemed to be helping for awhile (less attacks and they were more treatable), then it stopped helping, so we increased the dose and I'm considering adding in Nortriptyline too, as I tolerated it in the past.

The good news is that I've tried most everything for the NDPH so I know what I can and cannot tolerate (much more of the later). Botox was glorious for the migraines (not a single one the whole time), but horrible for the daily headache, so that isn't an option.

I have a neuro who is kind of a headache specialist, but he only wants to see me every 2-3 months, trying 1 preventative during that time. However, most of the time I can't tolerate what he prescribes, and it is crazy difficult to work with the office and have him call in something else.

I think next time I will just ask for a list of suggestions to take to my primary doctor, who pretty much will prescribe what I ask for within reason. I do enough research on my own to probably just go straight to my primary doctor though, especially if it is a mainstream med. Its more the obscure stuff that he won't be comfortable with that I need the neuro for (like Namenda or Ketamine). Best wishes.

I read your post, and I would like to respond but I am extremely busy this weekend, so it will have to wait, but in meantime can you, please, explain what NDPH stands for,  I live in UK and I am not sure what this abbreviation means.
I hope you have better day today
Mini

new daily persistent headache

Hi, sorry I took such a long time to get back to you, but I have other health issues and have not been coming here for long time but today I came here to post the news about completely new development in M treatment and realised that I did not write back to you.
If it takes 2-3 hours until after taking oral sumatriptan until I am feeling better, does that mean the migraine more likely went away on its own rather than responded to treatment?


This was also my experience with sumatriptan. It took about 2-3 hours to work and often it stopped the attack completely, but at other times my M would return next day (like yours) so I took another sumatriptan, and so it went for 3 sometimes 5 days, until the this particular attack of M ended.

I got use to it and it did not worry me too much that sumatriptan took 2-3 hours to work, as long as I knew that it will work. And it did. I was always grateful for that, since I remember times before sumatriptan were there was nothing, absolutely nothing that would work, and it was hell, horrendous, a nightmare especially when you have young family to take care of.

As I mentioned above in my post about new M treatment I no longer suffer from M, but over decades of suffering every form of headache and M and, like you, trying to find some answers, some rationale to the insanity which is caller MIGRAINE in all it's complexity I nearly drove myself insane.

Yes, trying to find triggers, is one of the best ways to help ourselves, but it is also extremely difficult task since it is often not just one, but a combination of several factors that will trigger M. For example bright sunshine day is fine one day, next day it will cause a blinding M, just because we slept badly, or had Chinese meal last night, or a college at work is wearing a strong scent etc. BTW each of these triggers might cause M anyway, even if it is not a bright day. So you see what I mean?

Made a list of such triggers, including all the food, wine etc (there are such lists on internet, combine several of them since they vary) and observe them in connection with your M.
But try not to be too analytical because you will drive yourself mad. Use common sense and trust your intuition, and you will find your answers. I am saying this because, like you I was over-analytical in the past and at times this caused me much anxiety and stress (when things did not make sense) and stress is very bad for M, it is a powerful trigger.
One point I wanted to make is that my neurologist Prof Goadsby use to say that if you suffer from M, all type of head pain is yet another form of M. Mine varied so much in terms of frequency, severity and where the precise location where they occurred in my scull, it was all M in it's various demonstrations.
Anyway, with the discovery of the antibodies and new treatment for M, let's hope this is a new era in M treatment, which like discovery of sumatriptan will bring relief to future generations of sufferers.
I hope you find some answers that will make your M, in all it's forms better, soon.
With best wishes
Mini