Well, after staying a week at Jefferson last April I had pretty good sucess in breaking a cycle that put me out of work most of March. A few weeks after the DHE treatment I returned to having episodic migraines which I treated with DHE injections (max twice a week) along with aleve, advil, compazine and zanaflex (max three days a week). For most of the summer and into the fall I was fine 4 days a week (did not need to take rescue meds) and was able to control pain well enough to participate in life the other days.
Occasionally I would be down on sunday because I had used up all my med days during the week. Slowly but surely I started adding an extra med day. It helped me maintain but eventually I was taking something for pain (in addition to the current preventatives) nearly every day. I also started drinking caffeine again on shot days (it was highly effective in knocking out the pain).
Eventually I was drinking caffeine more than I was supposed to as well. I started missing work again in December and the first couple weeks of 2010 I used 4 out of 9 sick days. My local doctor had me go back on prednisone for a taper to take a break from the rescues to eliminate any possible medication overuse headache. I've had nothing except prednisone (and zanagram when it was especially bad) for two weeks now. Stopped caffeine altogether again (soo hard for me).
Has anyone had success with avoiding rescue meds for longer than a two week period (say a month or more)?
I'm willing to endure another couple weeks without rescue meds if it might mean long term stability.
Any experience with how to handle episodes post-prednisone would be appreciated.
Thanks,
RRW
so sorry to hear that you are having a difficult time, i to have tried to limit my caffeine, with some success. what is the dose of your prednisone taper? i was put on a 10 day course last November, i was headache free for 12 days, but then the migraines resumed. let me know how you are doing,
God Bless,
cathie
From 80 mg down to 20 mg. Ended up missing work yesterday (my first day off). I'm going to try to stick to only 3 rescue med days a week a little more to insure I'm not rebounding. DHE injections were very effective yesterday, still pain free and at work right now.
glad to hear that you made it to work. are the DHE INJECTIONS given IM? Do you have to go the your doctor's office for these?
cathie
how are you doing, i just started another steriod taper on saturday,
cathie
Its been a little rough. I was OK on thursday and friday with IM DHE injections but once they wore off Saturday and Sunday I was back into a headache. Missed work Monday, drug myself in today. Very little head pain right now with no rescue meds so that is something but I feel drained. How is the prednisone working for you?
No, I was trained by the nurses at MHNI to give myself injections in the leg. They work better for me than triptans and tend to last about 36 hours.
sorry to hear about your pain, you are in my prayers today. i haven't really seen any improvement yet. i am nausaused from the steriods right now. i have never tried DHE injections, i've never had them offered to me. do you give them to yourself?
cathie
is DHE an IM injection?
cathie
yes, its IM. I use a 1 inch 25 gauge needle to draw the medication from the vial and inject 1 cc into the side of my leg in the meaty part of the thigh. It hurts a little after you inject (kind of like a charlie horse) but it goes away.
thanks for the info, do you get immediate relief or does it take awhile?
Faster than a pill but not quite as fast as an IV. It goes faster if I get the muscle moving, like walking up the stairs a few times. It can cause nausa so I tend to take aleve and compazine about 15-20 minutes before I give myself the shot. The combination usually completely knocks out the headache.
thank you again for the info. i will ask my neurologist about this. he is very cautious and will probably not offer it. i am a nurse and i can myself the injection(i think) but he will probably want to admit me. what meds were you given when you were admitted before for the whole week, did you work give you a hard time about missing work due to migraine treatment?
thank you again for the info. i will ask my neurologist about this. he is very cautious and will probably not offer it. i am a nurse and i can myself the injection(i think) but he will probably want to admit me. what meds were you given when you were admitted before for the whole week, did you work give you a hard time about missing work due to migraine treatment?
I'm a paralegal specialist at a law firm. They have been more than understanding about missing work, I've been lucky. They let me stay on part-time until I was stable for about 6 months (May-November 09) when they allowed me back on full time. Now I'm hoping I can get stable again without missing many more days.
I don't think you would need to be admitted to learn how to self-inject DHE. A nurse taught me, we started with an orange. I've been led to believe there aren't any critical nerves to hit in that area of your leg. My girlfriend is actually training to be a nurse and I've let her do it for practice.
As far as meds before the whole week, I tried a number of the first line preventatives - depakote, topamax, nortriptyline, keppra and others. Before my first hospital stay I was taking triptans frequently (4 days a week), tried prednisone a couple times. Before the second hospital stay I was taking triptans but less frequently (2x per week). I was not suffering from a medication overuse headache. Before the second hospital stay I did not use DHE aside from the nasal spray because I hated giving myself the shots. After the second hospital stay I switched to DHE from triptans and they work better for me. The only big drawback is they cost a lot more than triptans under my insurance. I pay something like $6 per shot AFTER insurance.
Catharine,
I don't mean to question the Michigan protocol, but when you talk with your doctor about DHE, be quite sure to ask him about injections. Everything I've ever read, including the prescirbing information, says it's to be injected subcutaneously (under the skin), not into the muscle. So, please don't inject into muscle unless your doctor specifically tells you to.
Teri