Saturday, August 28, 2010

Migraine Patterns

I realized a couple of things as I was preparing for my last doctor's visit. Although I keep a daily diary, I really don't look at my diary until I prepare to go to my next doctor's visit. My Migraines get worse in the summertime.

How often do you tally up your Migraine diary to figure out how you are doing in a given Migraine period? What I mean by a Migraine period is from one doctor visit to the next. I keep track of my Migraines in a daily diary, but I really don't look at it or analyze it from that diary.

As I prepare to go to my doctor, I transform my scribbled daily diary into a spreadsheet that spits out into a weekly and monthly graph. I can immediately see how my Migraines are evolving week after week and month after month. I also take the monthly Migraine values and add them to the end of a chart I've been keeping for almost four years. This gives me the visibility of how my Migraines have been doing over an extended period of time.

After evaluating my last set of graphs, I could see that my Migraines get worse every July/August and December/January for the last few years. I also take this graph and break it out by the doctors I've had over their given periods of time. On each doctor graph, I added in a trend line to easily see how my Migraines have reacted under each doctors care. It's really not as difficult as it sounds.

As I reviewed my graphs, I could see that my Migraines under my current doctor are still on a downward trend even through it is August and my Migraines are increasing as my annual tendencies indicate they would. I did have a good visit with her about a week ago where we discussed several paths we could take for my treatment. She went through the various medication classes and how my options are limited because of a medication I take for another disease. We decided together which way to proceed and that I will check back with her in another two months.

I am getting very discouraged with Migraine disease. I know that sounds funny; who wouldn't become dissuaded by chronic Migraines especially during their peak months and after having Migraines for most of their life. They are starting to affect too many other things in a negative manner now.

I try to question things in my control all of the time. I frequently question myself about the medications I take, different non medical options I can try and even if I have the right doctor for me at any point in time. Medications are frustrating because it takes a while to see if a new medication or dosage is helping before you can decide if it's helping or what to do next.

I also run through the pros and cons of my doctor. I believe she is still good for me. She is so much better than any of the previous doctors I have gone to for treatment. We definitely work together on my next steps. As a double check, I have taken the test; Is Your Doctor Right for You? a few times. She passes with flying colors whereas previous doctors had failed miserably even though I didn't need this test to tell me that. Other doctors had passed, but I knew I still needed to move on because they were good doctors and just couldn't help me with my Migraines.

My current doctor knows Migraines and Migraine medications. Although she is very good, I know she is not the top in her field, but I do believe she is still good for me right now. My doctor is also a member of the American and International Headache Societies and has gone to some of the conventions they offer.

I am also comforted in the fact that I do have my next doctor picked out, who is tops. It's nice to at least have that next plan if or when it is ever needed. There is nothing worse than not knowing where you need to go next. I've been there too many times in the past too; where you don't know who to turn to after and just stay with an inferior doctor getting substandard care. That is no good.

With this next doctor, my biggest hurdle is that money issue. I would have no right to complain about the distance to get to those offices even though it would be very tiring to get there. I hear all of the time how the money thing would be worth it, but it's just a hard thing to comprehend as bills pile up and unexpected expenses keep hitting home.

I don't know whether I should be encouraged or discouraged about finding this latest pattern of additional summer and winter Migraines. I think my Migraines are just getting the best of me lately and maybe because it is a peak Migraine period. I want to break all of these patterns now. I am ready to be Migraine free...



Jamie Valendy said...

I so understand and feel for you. Talk to your doctor to see if there might be something specific happening (I don't know, in the weather or something) during those peak times that could be causing the trend. Maybe it's an allergy or something in the air that you could take medicine for, just during those peak times. I know you don't want more medication, but maybe there's something going on during those peak times that can be at least partially controlled by you and/or your doctor.

I keep a daily diary of what I did, how I felt, and so forth. The diary is mainly for myself. My memory is bad, so I can look back and see what I've done, etc... It's in a spreadsheet form, and at the end, I leave room to write medication changes, medication side effects, weight (since this has been a big issue for me), menstrual cycle, doctor appointments/visits, major stressors, and major accomplishments - all for that month.

My doctor has me keep a calendar for him that has 3 months per sheet. At the bottom is the scale of the level of pain/headache, which I fill in for each day of the month. There are lines below each month's calendar, where I write doctor visits, medication changes, etc... So, for each day of the month, I write a number (I'm using a 1-5 scale - I actually started doing like "2+" if most of the day was a 2, but a good portion of the day was worse... it works for me), and I also write if I took any abortive medications that day (I would write "2M" if I took 2 Maxalt, for example). At the end of each month, I look for patterns and average up what the month was (if I did 2+, I count that as 2.5). This is a pretty easy way to look for patterns, how long my migraines tend to last, what medications are or aren't working, etc... I take this to each appointment (mine are every 6 weeks), so my doctor can look at the patterns too.

Sorry, I didn't mean to go on and on about that. Keep your chin up. I'll keep you in my prayers.

MigrainePuppet said...

This doctor is the only one I’ve gone to who has liked or even looked at the charts I have put together. It includes my intensity level, headaches, Migraines and the sum of the two. My daily and weekly diaries include the specifics like visits, med changes, cycles, symptoms and identified triggers.

I suspect I have more food triggers that I have to identify and probably some other triggers as well. Exercise and heat don’t help with my Migraines in the summer and stress has definitely been exasperating my Migraine triggers.

I will also need to keep a better look out for the different winter triggers when December/January rolls around. It can take so long to figure out these Migraine things, but definitely worth the effort.

No worries about the length of your comment. It helps when we all share with each other. Thank you sharing what you do and your experiences.

WinnyNinny PooPoo said...

MP: Has anyone wondered if you have a cluster component to your migraines? They can be mixed, and cluster headaches definitely "cluster" seasonally and can remit between clusters.

Know the issue about doctors - better the devil I know than the one I don't know!

MigrainePuppet said...

I've never really thought about clusters and will read more about them. I think these period of times are also associated with more stressful times which would mean I have to be especially careful with stackable triggers and need to identify other missing triggers so I can see if I can avoid or limit them. Thanks for your additional thoughts and ideas Winny.