The Migraineur

October 29, 2007

When Inderal Meets Low Carb

Filed under: diet, health, inderal, low carb, medication, mental health, side effects, sleep, weight loss, weird — by psipsina @ 11:03 am

I’ve commented before on how disturbing Inderal dreams can be.

Last night I dreamed I was eating in my college dining hall.  I had half an English muffin.  Then I went back for the second half.  Then I had a croissant.  Then a bagel.  Then another croissant.  You know where this is leading, don’t you?

I’m sure the “fat is all in your head” camp will say that this is because I miss these foods.  On the contrary, this was not a dream of desire.  It was a nightmare.  It was like I dreamed I was eating poison.

October 28, 2007

Neurology Appointment on Wednesday

Long-time readers of this blog may remember that about 3 months ago, I tried to make an appointment with a neurologist who specializes in migraine, and was told that he was booked until late October.  I made the appointment, my PCP prescribed Inderal, and I haven’t had a migraine since.

I’ve been wondering whether I should keep this appointment, since I’ve been completely migraine-free since starting Inderal, and perhaps I could free up the appointment for someone who really needed it.  I decided to call and describe the situation.  The receptionist talked me out of cancelling, saying that I should come in and be evaluated, because if I cancelled the appointment and later started having migraines again, it would be another 3 months before I could get an appointment.  “I see this happen all the time,” she said.  If the doctor had evaluated me and the migraines came back, he could consult with me by phone if necessary.

OK.  I did not cancel the appointment.  It’s probably for the best.  I want to ask if he’s heard anything about ketogenic diets for migraine (thanks to all my readers who have provided information sources, by the way).  I’m also more than a little concerned about Inderal’s affect on insulin levels, but it seems to be working so great against migraine that I’m reluctant to stop it without asking some questions.  I want to ask him exactly how Inderal works, and whether there are other drugs that affect the same brain pathways without raising insulin levels.  And of course, if there are other drugs, I want to know what side effects I could expect.  Finally, while this isn’t a problem at this time of year, Inderal is somewhat bothersome during hot weather, when my normal, non-drug-influenced BPs already run a little low; it would be nice if I could find an alternative before next summer – I felt limp for much of July and August.

I’ll confess that what I want to hear is:  ketogenic diets work extremely well for migraine; there’s a high likelihood that I won’t need Inderal as long as I stay on a low-carb regimen; and if low-carb does not completely resolve the migraine situation, there are other prophylactic drugs that do not raise insulin and have very few side effects.

Yeah, right, I can hear my fellow migraine sufferers say.  Well, a girl can dream, can’t she?

September 13, 2007

4 Weeks

Filed under: diet, health, hope, inderal, low carb, side effects, weight loss — by psipsina @ 10:50 am

Just a quick one.

 My weight is still at 155, where it’s been for two weeks.  In spite of sticking very closely to the low-carb diet.  (I solemnly swear that the highest carb food I’ve eaten in the last two weeks was a tomato.)  In spite of my daily 4 to 5 miles of walking.

Is it the bloody Inderal?

It’s hard to avoid being discouraged, so here’s my list of good things about the  low-carb diet:

  • I haven’t regained any of the weight I lost.
  • My waist is down an inch, from 33 inches to 32.  (Maybe someday my waist will be under 30 inches again!)
  • Those jeans that Land’s End sent that were a little too small fit a bit loosely now.
  • Those jeans that Land’s End sent that fit just right are rather loose now.
  • Those jeans that Land’s End sent that were a little loose are almost embarrassingly loose now (think plumber butt). 
  • I think the neuropathy in my hands is totally gone now.  At least, I don’t find my hands falling asleep for no apparent reason.
  • My knees hardly hurt at all.

OK, so it’s still a pretty good thing, isn’t it, this low-carb lifestyle?  And the food is amazing!

September 12, 2007

How Do I Make This Decision?

The Dilemma:

On the one hand, I have a dozen or so health problems, major and minor, that seem to be related to a futzed-up insulin/endocrine system:  PCOS, excess weight (though with a BMI of 27.5, I am not clinically obese), neuropathy, joint pain, acne, and apparently even my cracked heels.

On the other hand, Inderal, that fabulous, fabulous drug that has kept my migraines completely in check for the last 99 days (99 migraine-free days!  after having a migraine 2 to 6 times a month for several months, this is like a miracle) has as one of its side effects increased insulin resistance.

I know that insulin resistance that is induced by a high-carb diet can be treated with a low-carb diet.  I wonder – can insulin resistance that is induced by a drug also be trated with a low-carb diet?  Because if it can, there’s no dilemma – keep taking the Inderal, keep avoiding sugars and starches, and all will be well.

But if it cannot, how on earth do I decide between the misery of migraine and the misery of insulin-related disease?  Diabetes is rampant in my family, and I have seen first hand its ravages.  Truthfully, I’d rather have migraine, even several attacks a month, than lose a foot, a finger, or a kidney.

I hope it won’t come to that, though.

August 14, 2007

All Quiet Here

Well, actually things are not quiet, exactly – we bought a house and moved all our stuff over the course of 36 hours, then I headed off to god-forsaken Orlando (yes, in August) for a conference that is a total waste of my company’s time and money to send me too.  Now it’s budget time at work, which is a huge pain in the ass, and I’m trying to paint, and … and … and …

But it’s quiet in the sense of, no migraines.  Hooray!  More than 60 days on inderal, and it still seems to be working.  I’m a little tired and weak in the heat, but hey, this is Boston – it was actually chilly this morning when I woke up.

I’m seeing the endocrinologist on Thursday; maybe I’ll have news to report then.

July 27, 2007

Inderal + Alcohol + Heat = Bad News

Yesterday I went out for drinks after work to send my coworker J. off on her way to graduate school (jealous!).  When I got there, someone was drinking a Rocket Pop, a layered drink with Chambord on the bottom, a mix of lemonade and pear vodka in the middle, and blue curacao on top.  It looks just like those red-white-and-blue popsicles my mother would never buy for me because they were more expensive than the plain grape ones.

That looks good, I thought, so I ordered one.  A few minutes later I noticed that this place also serves champagne cocktails.  You don’t see those very much any more, and although I had planned to only have one drink, I couldn’t leave the bar without having a champagne cocktail.  (It was very tasty, too.  I used to drink them a lot when I was younger, made with cheap Spanish cava instead of the real thing.)

I didn’t feel tipsy at all, probably due to the huge plate of French fries I’d been sharing.  When it was time to leave, I got up, walked through the air-conditioned bar, feeling fine, and then stepped out into the 90 degree street.

Suddenly I felt as though my spine was made of wet towels, limp and heavy at the same time.  I made it to the T, waited in the sweltering station hoping I wasn’t gonna pass out, and then got on the air-conditioned train.  Much better.

Then, of course, I had to walk the three blocks home from the T station.  I stopped at the air-conditioned drug store on my way home to take my blood pressure.  93 over 60, pulse 101.  Ugh.  I have certainly had BPs in that range before, but combined with the elevated pulse and the terrible weakness/tiredness, it suggested that I wasn’t getting enough blood to my brain.

When I got home, I drank lots of ice water, ate dinner, and went upstairs to pack up my air-conditioned study for the move.  Within an hour or two, I felt better.

The moral of the story seems to be, pick your drink wisely, because you only get to have one.

July 8, 2007

What Do We Gain From Illness?

Not much to report – 33 days of Endure-All, no migraines.  (In fact, my last migraine was June 4, a couple of days before I started the Endure-All.)  I am still finding that hot, humid days are even more draining than they used to be.  This is surely because low blood pressure is generally worse in hot weather, and Endure-All has been slightly lowering my already low blood pressure.  And I am having extremely vivid dreams, which I kind of enjoy, unless it’s a disturbing dream, which have so far been rare.

Today I was rather out of sorts because it was very humid and rather hot, and I was thinking that I sort of missed my migraines.  Not the pain, surely, not the aura, not the nausea, and not the aftermath where bending over causes my head to hurt.  And I don’t miss the lost days or the bad moods, either.  But I do kind of miss getting a sick day every month or so – my migraines are over in a matter of hours, and then I spend the rest of the day in bed, resting and reading - and I kind of miss the sympathy.

There, I said it.

I just finished reading Robertson Davies’ fine last novel, The Cunning Man.  It is about a doctor, Jonathan Hullah, with some unusual approaches to treatment, approaches that are not quite psychoanalytic but share something in common with psychoanalysis – the notion that an illness might fill a need for a patient.  It’s not his best novel, but I still recommend it for people facing chronic illness and wishing for a doctor who really listens.  I kept wishing for my own Dr. Hullah.  Instead, I’m being treated by a patchwork of specialists, including a shrink I’ve been seeing for much longer than I’ve been having migraines.  I wish they could all get in a room together and talk for an hour or two – maybe then they’d figure out what’s up in my head, literally and figuratively.

The Cunning Man also reminds me of something someone said (was it Freud?  it sounds like the sort of thing Freud would’ve said) about needing to know what role an illness fills for a patient – the notion being that illness, in its stealthy, twisted way, accomplishes something for a patient that the patient hasn’t learned to achieve in a more constructive way.  I’ve thought about this a lot, long before my migraines came back, because it seems true to me, and yet I don’t think it means simply that our illnesses are All In Our Heads.  (Well, OK, unless maybe it’s an illness of the head, like migraine.  (Ha ha, I’m so clever.))  But, given that the brain is not merely a physical organ, but the physical organ that both generates thought and in a large measure controls the other organs, it stands to reason that what goes on in our minds and what goes on in our bodies and brains is this one big feedback loop.  Research has shown how mental stress affects our bodies, and how our belief in a treatment can cause us to get better even if the treatment has no active ingredient (the placebo effect).  Why is it so strange to think that we can become ill because of what’s going on in our minds, or that our minds can adapt our illnesses to suit our needs?

I know it was that way for my mother – her many illnesses were how she got love and support from her family.  I don’t want migraine to be that for me, and after years of therapy I believe I am self-aware enough to get the things I need in a straightforward, positive way without resorting to guilt trips and manipulation.  Truly I’m glad to be rid of the pain, for however long it lasts.  And yet it was easy to get used to the extra sick days, the concern of my husband, and the sympathetic ear of friends and coworkers.  And so I think today I have more sympathy for my mother than I’ve had in many years.  I wonder how her life, and mine, would’ve been different if she’d been able to see a therapist.  Would she have been any less sick physically?  I don’t want to touch that question.  Would her life have been better, whether or not her physical condition improved?  I think it would have. 

June 30, 2007

Sensitivity

Filed under: headache, inderal, migraine, sensitivity, side effects, sleep, therapy, treatment, trigger — by psipsina @ 12:44 pm

So far, so good with the inderal – no migraines, and it’s been nearly a month since I started taking it. The side effects haven’t been too bad, either. But I still find myself very sensitive to environmental stimuli. Smells, bright lights, and loud or repetitive noises grate on my nerves, even though they don’t trigger migraines for me, at least at the moment.

I was, therefore, amused and sympathetic when I saw Kerrie Smyres’ latest post on The Daily Headache.

Something similar happened to me yesterday. I was waiting for a friend outside her office in a suburban office park, and the little shuttle bus that ferries people around the complex pulled in – and sat there idling its smelly diesel engine for 15 minutes. Between the sound and the smell, I was actually fantasizing about calling the police. (Aren’t there are laws about how long a vehicle can idle?) Instead I suffered until my friend came out, and I’m afraid the first thing I said was not, “How are you?” or “Nice to see you!” but “Does that damn thing always sit there idling for 15 minutes at a time?!” My poor friend. Like everyone in my life, she’s had to adjust to the recent resurgence in my migraines, and I’m sure she just did not see that outburst coming.

The starting construction work at 7:00 am thing that Kerrie describes has always bothered me, though, even before my migraine remission ended. It makes some sense in the winter, when daylight ends at 4:00 pm and the crews can barely get in a full day’s work. But the other 9 months of the year, why on earth can’t they work 8:00 to 5:00, like everyone else? I’ve heard people argue that it’s to avoid the heat of the day. But the hottest hours of the day are 2:00 to 4:00 pm, which they don’t avoid by starting at 7:00 am. (Oh, heaven forbid anybody gets the idea that construction crews should start at 5:00 am! Forget I brought it up!)

June 20, 2007

Endure-All, Day 15

Filed under: headache, health, hope, inderal, medication, migraine, side effects, stress, therapy, treatment — by psipsina @ 10:38 am

Today I go to get my blood pressure checked.  I’ve been following it in the drugstore (not accurate, I know), and it seems to be going down slightly.  Yesterday it was 96/53, probably the lowest I’ve ever seen it, but not out of keeping with 99/59, a fairly typical reading.

People with low blood pressure don’t do well in hot or humid weather, and I think the Inderal might be exacerbating this, but only slightly.  I have been getting tired a lot lately, but I’ve also been under stress.  So I am not sure whether it is a drug side effect or not.

Speaking of under stress, I was, in a way, pleased to learn that the adrenalin receptors in my brain have not been totally shut off by the Endure-All.  Yesterday was a day of great demands – lots of work demands, lots of stuff to do on the upcoming purchase of a house, and everything with a deadline - and I actually felt a little stressed.  This pleases me because for me the ideal drug will treat my condition but leave me feeling like me.  And the real me would definitely be stressed out by a day like yesterday.

June 18, 2007

No News, Good News

Filed under: headache, health, hope, inderal, medication, migraine, placebo, side effects, sleep, therapy, treatment, wellness — by psipsina @ 12:32 pm

I haven’t written much lately because there hasn’t been much news on the migraine front.  This is my 15th consecutive day without a migraine.  Considering the amount of stress I’ve been under, with our frantic househunt and the attendant loss of sleep and delayed or skipped meals, I’d say this is a #%@*!! miracle.

I have been migraine-free for more than 14 days before, but never under such conditions.  Either the Endure-All is helping, or I am the beneficiary of the Placebo Effect.  I hope it’s the drug, because in my experience, the Placebo Effect is temporary.

Thus far, the side effects seem to be manageable, too.  I felt kind of icky this weekend when the temperature rose, and in fact at one point my diastolic pressure was a slightly alarming 55, but hot weather always lowers my blood pressure and leaves me a little tired, weak, or faint.  I am still keeping an eye on myself, but so far, so good.

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