Thursday, 31 March 2011

Overcooked Physiotherapy

Part on of my journey into the world of physiotherapy can be found here http://anothermigraine.blogspot/physiotherapy-and-migraines.

There was a fair amount of trepidation as appointment two drew nearer.  The combination of the induced migraine and the neck pain from from my first appointment was still sharp in my mind.  To make me less inclined to attend, the physio told me that it would get worse before it got better.  I took a deep breath and began to ascend the staircase to the first floor.  We got straight down to business.  I undid the top few buttons of my shirt and lay face down on the bed.  The physio started to apply the pressure to my neck only this time she had a much better idea where the sweet spot what and it wasn't long before the pain meter was flickering in the red and I could see stars in front of my eyes.  The pain really was quite excruciating and only just bearable.  If the pain got any worse then I would have had to have stopped the treatment.  Apparently she was inflicting a 5.5 pain rating on me out of 6.  As the pain increased, the involuntary giggles started and my leg decided to get in on the act by flipping up in the air.  The more the pain, the higher my leg and the louder I laughed.  I am sure that the physio used this as an indicator as to when the pain subsided.  Leg touches down on the bed equals no more pain.  After some analysis and a glass of water, I was sent on my way for another week.   

The following week the combination of the pain and being face down for so long gave me a nose bleed.  A common problem that I have when I am run down and quite a problem when I am meant to lay face down for so long, so that week was cut a little short.  The following weeks came and went and so did the pain.  After six sessions we had come to the following conclusions:
1- I had a slippery C2.  Nobody had ever told me that before.  Apparently when applying pressure to one side of the C2 it slipped all the way to the other side rather than seating itself in the middle where it should be.
2- The treatment had not worked.  Not only that, but the frequency of my migraines had got worse which was quite a disaster.

Dr Dean Watson from Australia championed this trial and apparently it works for a lot of people.  So, as always, don't let my experience put you off if you want to try it for yourself!

But, this isn't the end of the story.  The physio (who shall remain nameless) took my increased migraines very seriously and personally and after a few weeks research and a number of conversations with Dr Watson, she offered me the chance for her to attempt to reverse the damage.  She had, in her own words, "over cooked it" and had applied too much pressure to my neck.  She was very upset about what she had done, but was confident that it was reversible.

So, should I risk it?  Would it get better, or could I end up with one long permanent migraine.  As I am the trusting type I decided to go for it, even though it meant more weeks of pain.  So I got six more weeks of free physio until we reached the point where no more progress was being made and I was pretty much back to where we started 5 long months ago with 1 to 2 migraines per week.

So was it worth it?  There are always risks when taking part in a trial.  That's why they are a trial!  I came out of it no better and no worse off which is a shame.  But I still think that it was worth it and I would love to hear from anyone who has had a success with this or any other physio treatment.

Wednesday, 16 March 2011

Physiotherapy and migraines

I now knew that I had migraines, which was a big plus, as I could now find some real help.  This lead me to discover the world of triptans which meant that most headaches lasted only an hour or so rather than up to 3 days.  But that wasn't enough for me.  I wanted more!  I was on a quest to discover a cure for my migraines.  There had got to be someone, somewhere, with a cure for migraines.  Feverish searching on-line and would you believe it? A new migraine research programme was being carried out just down the road from where I worked.  Perfect.

The research was based on physiotherapy to the upper neck.  The top of the neck is where your spine starts.  The disks in your spine, from the top down are called C1, C2, C3 etc (see diagram).  This research was based on applying specific pressure to one of the discs.  This pressure would induce the migraine and then remove it.  The idea was that it would reprogramme your body into not having migraines anymore.

I walked up the stairs behind an opticians to get to my appointment.  A nice lady introduced me to the concepts of the test and took down all of the details of my migraines.  Then we got down to business.  I lay face down on the bed looking at the floor through a nearly made to measure hole wondering why they couldn't put a picture on the floor for me to look at.  The physio started to size up my neck with her thumb and forefinger.  She pushed down with her thumb on my C1 and asked whether that hurt.  Nope, nothing.  A slight change in the direction of her thumb prompted the same lack of pain.

She then moved down to my C2 and as the pressure was applied, I felt some kind of pressure spread across my head.  "Is that your migraine" she asked eagerly.  It wasn't.  The pain was too dull and at the back of my head not the front right where I normally get them.  Her thumb moved slightly and the pain moved with it.  It was as if she was controlling the pain with a game controller (I was going to say joystick, but does that age me at all?).  This feeling was equally as unusual, but still not my migraine.  She took her thumb off to consider my neck in all of it's complexities and decided to change her angle of attack to the other side of the bed. 

YOW, that's the one!!!  That's my migraine.  "Good" she said and continued to apply the pressure.  "Tell me when the pain stops".  The pain didn't stop, but time did.  Not only had I a really bad migraine, but I had someone pushing with all of her might on the back of my neck.  The pain surged up from my neck, through my head, bounced around my eye socket, down my cheek and back down to my neck.  I got the pain induced giggles.  I couldn't help it, giggling away as she put me through this suffering.  The pain started to lesson after about 3 minutes and then a minute later it stopped and she removed her thumb and waved her hand around to get the blood to flow back into it.  Even though I lay there completely drained, I felt sorry for that thumb.  You try pushing down on somthing for 4 or 5 minutes and see how long it takes before your thumb starts to hurt.

As I lay there, face down and exhausted, the thought went through my head that I had another five weeks of this to go.  "That was just a preliminary check", the physio said.  "The pain might get worse next week, but it should then get harder and harder for me to find your migraine as the weeks progress until I can't find it anymore.  That means that the treatment has been a success and you shouldn't get migraines anymore."

I will tell you how it went and whether I coped in my next post.  Let me know if you have had a similar treatment, how it worked for you and whether you coped with it!

Thursday, 3 March 2011

The Magical World of Triptans

There are so many different types of alternative medicines that is can be difficult to decide which one to go for first.  It is also easy to forget that there is an alternative to the alternative.  Good old fashioned traditional doctors.  So I made an appointment and went along.  They confirmed that I was suffering from migraines.  It was nice to have it confirmed after so many years of suffering exactly what the pain was and that I wasn't going to collapse at any minute.  Their first piece of advise was that I take over the counter drugs as these quite often work.  I had already worked my way through all of these from paracetamol, to nurofen, to sinus cures and none of them touched the pain.

The docs then introduced me to the world of triptans.  There are about 8 or so different triptans on the market and no way of telling which one will work for you.  This came as a bit of a surprise to me.  Surely the doctors would know how the drugs work and which one would be best for me?  But, no.  It is a case of simple trial and error.  So off I went on an unknown adventure into the world of triptans.

Triptan 1 - I can't remember the name of this triptan as I only took a few of them.  There was no change to the pain and no side effects.  This wasn't the best start, but I persevered.

Triptan 2 - Zolmitriptan (Zomig).  I wasn't expecting much.  After all the first triptan hardly set my world alight.  But boy, was this triptan was different.  This triptan was evil (please note that this triptan does work for a lot of people so please don't let my experience put you off).  The effects were startling by their severity.  About 1/2 an hour after taking the tiny tinsy tablet my whole world ground to a halt.  My head started to spin, my vision was blurred, my movements were hampered like I was walking through treacle.  Somehow, I had just driven and parked outside of the Synagogue where I was learning that evening and luckily I was a bit early.  I lent my head back on my chair to try and clear the muggy feeling and half an hour later, woke up.  The worst of the pain had gone but my tongue felt furry and twice the size and the world was still slightly sluggish.  There was a stark similarity to a hangover.  There was even a slight sicky feeling.  Zomig had got rid of my migraine, so that's good.  But, the side effects were not overly desirable which was very bad.

3 - Rizatriptan (Maxalt).  Not perfect, but definitely the best yet.  You have to take a triptan as soon as the symptoms appear.  This is because a migraine will slow your metabolism so waiting too long means that the tablet would not be digested properly and thus might not be as effective.  It took me a while to get past the "it's just a small headache and the pain will go soon" stage.  Taking this route means missing the window of effectiveness for the triptan and it won't work.  But did Maxalt it work?  No and yes.  The no is because immediately after taking the tiny little tablet, the pain gets a lot worse as the stabbing pain in my head increases.  But within an hour, the pain has gone.

4- Sumatriptan.  I decided to dable a bit and try another triptan variant.  Luckily, my doctors are very open to trial and error.  If yours isn't, you must push them into letting you try as many triptans as you need (but just not all at once of course) until you find the one that works for you.  Sumatriptan was very similar to Maxalt expect the success rate was every so much slightly lower.  I still have a few tablets in my drawer at work as an emergency back-up in case I run out of Maxalt, which I sadly quite often do.  I really must get better at ordering a repeat prescription.

So I have found the miracle cure to my migraines.  Yay!  No longer will I have to suffer the pain and disruption in my life.  Sigh... If only it was a simple as that... More to come in my next blog entry.