January 9th 2020 archive

My experiences with migraines.

Although I began having migraines after the birth of my second son (and in no way attribute them to my pregnancy with him or his birth in that I do not “blame him” for their advent… that just happened to be the period of my life that coincided with me starting to have them), I didn’t know that they were migraines for the longest time because I attempted to brush them off for as long as I could, medicating them with Ibuprofen at the maximal safe dose because that could be taken while I breastfed, and then aspirin and Ibuprofen in alternating doses when I was no longer breastfeeding until I came to the realization that NSAIDs lowered my spirometry because my asthma responded unfavorably to them. It was around that point that I finally brought up my concerns to my new primary care doctor, having had to find a new one because the one that I had been seeing for as long as I had been an adult no longer took my insurance. Since my migraine care was a bit tetchy with me also being an asthmatic, meaning that I could not safely take NSAIDs as evidenced by their alterations to my spirometry long being in my medical file and beta-blockers not being a choice for me due to the fact that my asthma was markedly more than “mild intermittent”, I was referred to a neurologist to take on and then oversee my migraine care, which I was completely fine with.

Although I would eventually start seeing another neurologist in the same practice once she went on maternity leave and then decided not to come back from it, we came to the determination that I had been — as I tended to do — understating both the frequency of my migraines and the severity of them, so we figured out how much I was actually in pain so that we could start to work to reduce my pain as much as was possible. Along the way with the first neurologist, an MRI was done so that we had a head scan of me on file, and although we “didn’t expect any surprises”, one came about in the form of a nearly one centimeter pituitary macroadenoma. Because of the frequency at which I need prednisone for my asthma, we’re currently “waiting and watching” my pituitary tumor (since that’s what it is, although more than 95% of these are benign), hoping that it doesn’t cause any unnecessary problems other than the fact that it’s a bit uncomfortably large in such an enclosed space. Discussions about whether or not I should apply for disability due to the frequency and severity at which I had migraines were had with my second neurologist, and he believed — and still believes — that I should apply for disability until I actually get it, acknowledging that it might be a bit of an uphill battle if Social Security wants to arbitrarily deny me with every flimsy excuse they can come up with. But he is, and has been, extremely supportive of me applying for disability, and he does acknowledge that my migraines — chronic and intractable — are a severe, disabling condition.

If my pituitary tumor is in any way influencing my migraines, conceding that me being as steroid-dependent as I am might make removal of it difficult, I may inquire at some point about radiation therapy, having seen my own mother go through whole-brain radiation therapy when she was alive and being treated for cancer. In my case, it would be localized to a much smaller area, the side effect profile would be slimmer, and it might be an alternative to removal that would reduce the frequency and severity of my migraine pain if this is in any way contributing. It might be something worth looking into as a possible palatable middle ground.