Sunday, May 19, 2019

Chronic Headache Pain

Not actually Erin.
& is used with permission.
As I write this, I am in pain.

It's not big, bold pain, the kind that gets me in the hospital on the good drugs. It's about a 4 on the pain scale listed below -- I'm constantly aware of it, and I can't ignore it, but I can function with it so long as you don't ask me to do something super-physical or mentally intensive, and I can probably fall asleep tonight even with it hurting. After a lifetime of chronic sinus and migraine headaches, I've found that the best anesthetic is unconsciousness, and so I've learned to sleep through pain up to a level 7 or 8.


I remember what a shock it was when I realized in high school that people didn't carry painkillers with them because -- surprise! -- they didn't get headaches on a weekly basis. I marveled at what it must be like to go weeks, maybe even months, without their head hurting.

I have never had level 10 pain. I've had level 9 pain, but that was from kidney stones. The worst migraine I've ever had was an 8, and many of my sinus headaches are in the 5-6 range.

What a lot of people don't realize, however, is that a low but constant pain can wear you down over time. Sure, it may only be a 3 or a 4 when it starts, but after 8-12 hours of it, my pain tolerance recedes and takes with it my patience, good humor and willpower. Eventually that 3-4 feels like a 5-6, and not only do I hurt but I also feel like a wimp because something that shouldn't be able to take me down has done so.

Here's how I cope with chronic headache pain. I make no guarantees that these will work for you.

Sleep
Anesthesia works by putting the body into a sleep so deep that the body can't feel pain, and so as far as I'm concerned sleep is the best way to get rid of pain.

When possible, a nap in a quiet, dark room (possibly with a cold compress over my eyes or forehead) will work wonders. However, it's often not possible to take a 4+ hour nap because of where I am or what I must get done.

Painkillers
Good old NSAIDs, Nonsteroidal Anti-inflammatory Drugs. They usually work, but I've taken so many of them over my lifetime (I was getting migraines before I was 10) that I've built up a tolerance to them. In a very real way, I suffer from the Ramp Effect, whereby I've developed a resistance to painkillers and therefore require and increasingly larger dose to achieve the same effect.

To prevent this, I frequently switch between types of painkillers (ibuprofen, acetaminophen, naproxen, etc) in the hopes that my tolerance to a particular type will decline as I take the others.

Alcohol
Let me be very clear on this:  I am not suggesting that someone drink alcohol until they are unconscious.

I am simply stating that, based on my observations, a drink of liquor (in my case, a shot of rum) helps take the edge off a lot of vascular headaches. It also helps increase the efficacy of painkillers. Yes, I know, medicine says not to mix painkillers and alcohol; I don't do this if I plan to drive or use machinery (mainly because if I'm hurting this much it's not safe for me to drive anyway) and I never consume so much that I become inebriated.

It works for me. It might work for you. Use caution and common sense.

Scalp Stimulation
Despite how weird this sounds,  having the top of my head scratched for 20-30 minutes is practically guaranteed to make me feel better. While it won't completely cure a headache, it will grant me enough relief that it knocks the pain down by 1-2 levels and makes other treatments more effective.

I don't know why it works. Maybe because there are nerve clusters on the top of my head and being scratched stimulates them to produce endorphins (pain-killing hormones). Maybe it just feels good and the pleasure creates dopamine within my body, overwriting some of the pain. All I know is that it works, and if I ever get married that person has to be willing to scratch my head whenever my head hurts.


These are what work for me. What works for you?

2 comments:

  1. I am a chronic migraine patient, on disability due to the severity and frequency of them. I usually have 5 or 6 good days a month, where I don't really have a bad headache.
    I used to use opioid medications for breakthrough headaches, but with things the way they are now, that is pretty much a no go around here.
    I also used to go to the medi center or the ER for a shot if I had a really bad one that would not go away, and they will last for days at times. But the medi centers no longer stock anything but toradol, which I cannot take, as I am allergic to it. And the Emergency Rooms are pretty much all under the same umbrella now, and there are very few doctors who are willing to stick their neck out and give a narcotic for a migraine headache, no matter how severe the pain level. It was always hit and miss, with different doctors anyway, but now, they have the government on their back.
    An NP was just hauled in for giving too many pain meds to patients. I don't know what the final decision will be, but they were talking about taking her license. The thing is, now that the government has come out so strongly against pain meds, they have seen how much they are harming legitimate pain patients, and tried to change their instructions, sort of. Like, well yes, we gave you a list of how you should prescribe pain meds, but we really didn't mean that you had to follow it.
    Chronic pain can indeed weigh on you. I have had pain levels as high as 9 with migraines, since I never say 10, because unless you have someone rip your arms off, the pain can always get worse. I passed a 6 mm kidney stone awhile back, and the pain level with that was also a 9. I have had 10 on the pain scale with some kidney stones in the past. They nearly made me pass out, and I could not imagine anything hurting any worse. In fact, I think having an arm torn off would be preferable to kidney stones, at times.
    A hot shower, beating on the top of my head, can at times, help with the pain of a mid level migraine, until I get out of the shower,then the pain returns. I am currently working with a new neurologist and trying the new drug Aimovig. I have not seen any relief yet, but I am hopeful as always that it will work. It is VERY expensive though, and there are programs to get help paying for the med.

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  2. I have a couple of tactics. One is 400 mg each of magnesium, B2, and CoQ10. My son actually takes that daily because his migraines became 24/7.
    I've also used ice packs. The occasional pain cream on my temples. And sleep. In bad outbreaks for me that just won't break, I use Solgar or Longvida formulation of Curcumin. I tend to end up with those rarely but when they hit they are bad because I typically wait for other solutions to work first.

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