Describe a treatment dilemma you have experienced with #Migraine or #Headache and other comorbid health problems.


For comorbids I have:

  • Hypothyroidism
  • Asthma
  • Depression
  • Fibromyalgia
  • Peripheral neuropathy
  • Allodynia

The main complication I face, aside from the depression which I have discussed this month Here, is fibromyalgia. First of pain compounding pain, not awesome. My fibromyalgia itself is moderate, not severe. In itself, it doesn’t inhibit work of a desk nature.. it does for standing work or work of any sort of physical nature. However, add in migraines and it becomes quite a bit more strained on the coping strategies and pain scale.

One of the major issues is that fibromyalgia is not big on quality of sleep or quantity of sleep… just sleep is hard to come by period. And lack of sleep is a major migraine trigger. And then compounding pain leads to painsomnia, which leads to less sleep. And we have an endless lack of sleep pain cycle that is difficult to break. You have to manage pretty much both to manage the pain enough to handle the painsomnia First. And you have to handle the sleep issues with FM to handle the migraine trigger. I personally am on two medications for sleep; zopiclone and trazadone. One doesn’t cut it. Both do. None and I was severely sleep deprived, waking up with full blown migraines, distorting auras and frequently getting sleep paralysis at night which further disrupted my sleep. The zopiclone alone helps with all that, but only gives me about 4-5 hours of off and on sleep. Add in the trazadone and I am getting a solid 6-7 hours of sleep. Without any grogginess. Without waking up with a migraine. I may have daily migraines, but they are Not 24/7 migraines. I am not in the headache phase of a migraine until a few hours after waking… until recently with my more recent treatments and now it can even be later in the day. So my migraines are distinct entities. Not forever locked in pain, which at one time with sleep deprivation, I was. So that is a complication. Not to mention the sleep deprivation trigger my Alice in Wonderland auras in the early morning, making it difficult to function.

The complicate each other in other specific ways. Migraines are rather sensitive to treatment. You cannot take opiates regularly without rebounding. But my doctors have put me on slow release tramadol for fibromyalgia management. So far, given my treatment of migraines as been positive lately I have not seen any negative response and they certainly do not consider any other opiates an option. Neither do I. I have had a rescue med once of codeine and I could not even take that twice a day let alone two days in a row without a ‘after headache’… so there is a severe limit to FM treatment. Which means a limit to things like FM management with exercise, which is rather painful. It is fortunate I found the Oska Pulse which helps with FM pain, so I can exercise without pain… otherwise I have no idea how I would be expected to do the exercise with that amount of pain without further pain management. I am not exaggerating when I say the pain was pretty extreme and limited me to about ten extremely painful exercise minutes. So what good was That? But migraines simply do not allow for further medication in that department. So before I found alternative treatments for my pain, I had limitations to pain management which restricted activities and certainly other pain management strategies like exercise. I should note for FM there are specific medications to try but I cannot be on Cymbalta (suicidal ideation and actions) and Savella (again no antidepressants for me) and I was on Lyrica but it ran its course. They also took me off the Lyrica due to excessive fatigue and that side effect would limit my capacity to do the exercise aspect of my treatment.

The main thing I do for FM is exercise, the tramadol and my Oska Pulse. Which manages it quite effectively pain wise. Again, I have two medications working for sleep. I do pace myself. I take supplements for fatigue.

So it is certainly the compounding factor of symptoms like pain, fatigue and brain fog that are an issue and management of them. Definitely in the past the sleep issue and, certainly, the pain management issue. I will say this; I coped quite well with FM alone, which, as I say, is moderate with the coping strategies I developed when I was younger and the specific limitations I have. But when I added in the chronic migraines… well, that takes a lot more time to adjust to and it really hurt my capacity to cope. And to this day I hope to continue to work on better and more effective coping strategies and better treatments.


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