'Always look on the bright side of life.' – Eric Idle (Monty Python)

Yesterday I had a migraine. It was one of those low-level ones where I spend all day feeling horrible and wondering if I should leave work and go back to bed. It's not strong enough to make the decision clear; it just hangs around despite taking medication.

This morning I woke up feeling human again. In contrast to yesterday, I feel wonderful. I realised that this is, perhaps, the only good thing about having a migraine (and maybe many other health issues): you feel great when it's over; you appreciate your health and normal functioning.

I hope today sees you migraine-free so that you can enjoy it. If it doesn't, then know that things will improve – that's something I need to remember myself when I'm mid-migraine.

'Time has no divisions to mark its passage.' – Thomas Mann

It's been about a month since I got Botox. In some senses it feels longer than that - particularly when I have a migraine and am impatient for the next treatment. On the plus side, I've had fewer migraine days than the month before Botox, and the ones I've had were generally milder. After those initial days of swelling and soreness, there's now only intermittent muscle spasms. In the last few days I've felt a gentle burning, tugging in some of the sites where the Botox was injected. When it's in my forehead, it looks like one side is trying, semi-successfully, to frown. It's a disconcerting, uncomfortable feeling, but it doesn't usually last very long. I don't think this is cause for concern given that some patients in the clinical trials reported pain in the injection site as a side effect. (Apparently some also reported headache and migraine as a side effect, but I don't know how they could tell it was a side effect and not caused by their condition.)

For more information about Botox, visit the Migraine Trust or www.botoxchronicmigraine.com. 

'Desperate times call for Botox.' – not-so-ancient proverb

I've said before that I wouldn't use Botox for my migraines because I didn't like the idea of putting a neurotoxic protein into my body. Botulism is a horrible infection and it seemed ill-advised to tempt fate by introducing it deliberately.

However, that was before my current daily medication stopped working. I realised that I put a lot of literally mind-altering medications into my body. I also started getting a couple of migraines a week again so I got desperate. My neurologist suggested trying Botox injections because I had tried a lot of pharmaceutical medications and many hadn't worked for long.

I got 33 infections around my head, face and neck this week. The neurologist was excellent. Some of the sites hurt a lot, but she was very quick. For about 24 hours afterwards my head and forehead felt lumpy and tender. Three days later, that's all gone down now except one bump above my left eye, which I think is only noticeable by me.

It should take about a week to start to feel the effects of the Botox in terms of muscle relaxation and paralysis, and in term of migraine reduction. Often people need two rounds before seeing good results. That means it's about a four month process because you can't get a second set of injections for at least three months (those are the Medicare rules in Australia). 

As I write this, I'm (hopefully) recovering from this weekend's migraine and looking forward to this treatment having some effect. I'm also very grateful that I live in a country that approves and subsidises these kinds of treatments.

Image from: http://sd.keepcalm-o-matic.co.uk/i/keep-calm-and-let-botox-help-you.png

'Necessity is the mother of invention.' – Plato

This morning I created this migraine diary:

I probably could have downloaded one or found an app, but this one is tailored to my particular symptoms and treatments. It also has my favourite colour for the highlighted rows.

In the past when I've tried to use an app, I often forgot to log in everyday to track what was going on. Over the past few months I've been recording migraine occurrences on a paper calendar. I've got pretty good at remembering to make a note each day. Then for the past week I've been also using a form similar to the one I made that my new neurologist sent me. This is to give her an idea as to whether I qualify for botox injections or not.

Now that I'm in the habit and have a chart that I like, hopefully I'll keep using it. 

Let me know if you want a working copy of the migraine diary for yourself.

'Find a place inside where there's joy, and the joy will burn out the pain.' – Joseph Campbell

Part of any chronic illness is adjusting your self-image to the new normal. I've finally come to terms with being someone who needs to monitor their diet, sleep and stress; who will need to take medication for life; and who will have to adjust work and social commitments at the whim of the migraines.

Now I've been told by my physio that I need to accept that I'm unlikely to ever be completely pain-free (in my hip). This is devastating. That's meant that this weekend I've been adjusting my self-concept to someone who has health problemS [plural!]. I keep saying to myself in the back of my mind: I'm sickly (the opposite of healthy).

Couch Potato by Graela (Flikr)

This prognosis means that I won't be able to be as active as I want to be. I'll have to let my tennis membership lapse. I won't get into running, regardless of how perfect our local park is for running. I'll have to find low impact exercise to do: weekend hikes will be weekend walks, tennis will be tai chi, and kickboxing will be kayaking. It's easier to accept the activities that will be curtailed if I think about other things that I can do. That way I don't believe the pessimistic little voice in my head that says that I'll be a fat lump of a couch potato because I can't exercise. I'll prove it wrong!

The mother of excess is not joy but joylessness. – Friedrich Nietzsche

How much is too much? I've been wondering this for a few weeks now, particularly every time I get a migraine, which is about once a week at the moment. When I don't have one I tell myself I'll keep a really diligent migraine diary for another month (making a total of two months reliably recorded) then go back to my neurologist to adjust my medication. At other times, when I'm feeling plagued by the latest migraine, I'm tempted to call him right then and book in.

Image from: http://erviluca.com/2014/03/05/

I'm also struggling with whether I want to continue on the current medication or not, which I need to decide before I see the neurologist. On one hand, I have very few side effects from it, and virtually none on the current dose. On the other hand, it doesn't seem to be working very effectively if I'm getting a migraine a week and taking 2-3 days off every fortnightly pay cycle. If I raise the dose again, I'm worried I'll start gaining weight again (woo-hoo for big, fat side-effects!). However, if I go off it, then who knows how long it'll take to find another medication that controls them even a little and has manageable side-effects.

I'm also starting to contemplate treatments I'd never considered before: botox and ECT (electroconvulsive therapy). I'm feeling the emotional toll as well and wondering about support groups or seeing a counsellor again to help manage the despair, frustration and hopelessness that's creeping in.

Does anyone have any suggestions? 
(Please post in the comments below.)

Migraine To Do List

My Migraine To Do (and not to do) List