Monday, July 4, 2016

Headache, anyone?

The vial inside the Imitrex self-injector
Bill Underwood

There are two kinds of people in the world: Well, of course that isn’t true, there are 7 billion kinds of people in the world. But that discussion would be about stereotyping and prejudice, and that is not what this piece is about. If you don’t like it, write your own story.

As I was saying, there are two kinds of people: those who get headaches, and those who do not. I am one of the former. I would even venture to say that of the former I am preeminent. I honestly feel that I have single-handedly raised the value of Bristol-Meyers stock. When the subject of headaches comes up, I occasionally encounter someone who tells me, “I never get headaches”, and I stare at that person as if they had casually mentioned that they just arrived from Neptune. There is just something unnerving about anyone who is that pain-free.

I have had a headache or two every week for about the last 40 years. I get sinus headaches, presumably from an allergic reaction to the splendid potpourri of pollen and pollution here in the Valley of the Sun. I get tension headaches, which start as a pain in the neck and migrate up both sides of the head to the temples. I get eye-strain headaches, felt behind the eyes or at the base of the skull. I get hypoglycemic headaches if I don’t eat on time, an all-over pain and muzzy-headedness that feels like I am trying to assemble my thoughts through a thick, wet blanket. Many of these are of the take-two-aspirin-and-work-through-it variety; a minor annoyance for an hour or two. And then there are migraines.
A migraine is a different beast altogether. Calling a migraine a headache is like calling the Titanic a boat. I laughed when Excedrin came out with a product called Excedrin Migraine. It’s simply aspirin with caffeine in it; it can’t touch a real migraine.

A migraine, by definition, is typically experienced on one side of the head only. It is accompanied by tears from one or both eyes, sensitivity to light and noise, nausea, and copious perspiration. But the key symptom is the pain. In my case, it feels like someone has inserted a knife into my left temple, and just so I don’t forget its there, they’ve attached an electric cord to it.

I have a routine for dealing with a migraine. At the first symptom, I take a drug called Imitrex. I then take an ice-pack out of the freezer and wrap it around my head, and retire to a dark, quiet bedroom where I lie very still, breathe deeply and slowly, and try to distract myself from the pain. I count my breaths. I repeat an affirmation given me by my chiropractor. Frequently I play a piece of music in my head, something slow like Pachelbel’s Canon.
The problem with this regime is this: Imitrex pills can take up to an hour to begin to work. But a migraine flares up very quickly, frequently in five to ten minutes. Additionally, the accompanying nausea must be fought, or the pill won’t get a chance to do its job. So I lie there in a puddle of sweat playing variations on Pachelbel’s Canon and trying not to hurl. 

Thankfully, there is an alternative… you can get a self-injector of Imitrex shots that might begin to work in 10 to 15 minutes, depending on the headache.

When the Imitrex finally kicks in I usually drift off to sleep. When I awake a few hours later, congratulating myself on still being alive, I’m exhausted and dehydrated, the side of my head feels like Mike Tyson has been using it for a heavy bag, and I attempt to navigate the remainder of my day through an Imitrex-induced fog.

I have friends, particularly women, who get a migraine once or twice a month, and they have my utmost sympathy. I’m fortunate in that respect. I have a disease called “Cluster Headache,” “Cluster Migraine,” or sometimes just “Cluster.” What that means is I can go a year or more without a migraine, but when I get one, I know I’m in for a meaningful experience for the next 3 to 6 weeks or so. I’m currently engaged in a cluster that began two weeks ago. I’ve had 14 migraines since then. And yes, I'm counting.

Now, this makes it fun: The good people at my HMO can’t imagine anyone needing more than 4 shots of Imitrex in a month, so they refused to fill the prescription the Doctor wrote. I could buy more on my own dime, but the shots are $180 for a two-pack. (Did someone mention something about HealthcareReform?)

So here’s my routine: I take the injector apart and pull out the little glass vial inside; I use my pocket knife to scrape the paper label off the side of the vial so I can see the 6 mils of liquid inside; I eyeball the contents and guesstimate how much of it is about one third; then I jab it in my leg and use a q-tip to carefully push the rubber stopper down just one third of the way. (Needless to say, I'm not a doctor. Don't take anything I say as medical advice. I read about this trick on an Imitrex blog several years ago.)

Waiting for the Imitrex to kick it seems like an eternity, and sometimes it never does. At those times, I stand under a cold shower reciting my affirmation and counting breaths until the migraine stops. Last night I made it to 450, about an hour. This morning it went away in about 20 minutes.

So, okay, I guess there are three kinds of people in the world: those who get headaches, those who don’t, and those who think they know what I’m talking about when I say, “I have a headache.”

Not that I want to take a poll… I can feel another one coming on.

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