chemotherapy and migraines

messy art journal page

So yesterday morning I saw my family doctor, to try and figure out how to address my recent migraines.

To give you some back story, I’ve been getting migraine headaches since I was about 10 years old, although they went undiagnosed until I was in my late 20s.

Even then, I wasn’t seeking medical help for my frequent headaches, and basically tried to self-medicate with over-the-counter NSAIDS until a couple of years ago, when I asked my family doctor to refer me to a neurologist who specialized in migraines so that I could get the most up-to-date medical solution(s).

At that point in my life I was having migraines two out of every three days.

Yeah. Not good.

With some lifestyle changes and one particular migraine medication that I used strategically for the worst headaches, I got the frequency of my headaches down to about two or three days of pain per month. I was pretty happy with that.

I should probably also mention that all my headaches come with nausea – sometimes bad enough to make me vomit (maybe twice a year), but always uncomfortable.

Going into my first chemo, I had a bad migraine that I didn’t treat with meds, and that night I had one of the worst migraines of my life, compounded with horrific nausea from the chemo.

My second chemo was great – they gave me different meds for the nausea, and I sailed through without a headache or nausea at all.

The last chemo, again I had a bad migraine that morning, which I didn’t take anything for. Once again the nausea meds for the chemo really controlled my nausea, and I felt not too badly after the chemo.

In the days afterwards I had severe, daily migraine auras (a visual disturbance where you see flashing lights or get a temporary blind spot in your vision) without any subsequent headache. (Normally I don’t get auras with my migraines – prior to my chemo, I’d had maybe half a dozen migraine auras in my entire life.)

The auras were kind of annoying, but I wasn’t getting any migraines, so I didn’t think too much of it.

Then I had another one of the worst migraines of my life on Sunday night, when I vomited multiple times all night long, and another one Tuesday night. Some of the worst pain I’ve ever had, and I didn’t take any migraine medication for them either time, because I was worried about fever suppression (I need to know when I have a fever, because any infection I get right now could be life threatening for me, with my lowered white blood cell counts from the chemo). I later found out from a cancer clinic triage nurse that I actually can take fever suppressing meds, I just have to take my temperature first to make sure I don’t already have a fever.

Anyhow… (sorry this is so long)… I went in to see my family doctor and we had a really great talk about migraine medication strategy, and how to try to manage really bad headaches like the ones I’ve just had, as well as strategize for the possibility that my headaches may get more frequent now that my hormones are going all wonky from the chemo.

The end result is I have a new med to try as a supplement to my favorite migraine med, and a backup med to use if the migraines do become more frequent again (because I can only use my favorite med a maximum of twice every seven days).

I’m pretty happy, because my doctor really spent some time strategizing this with me, and is also going to reach out to the neurologist for a consult to see if there’s anything else the neurologist would recommend, given my current circumstances (the breast cancer, chemo, and looming chemical menopause). All good.

I hadn’t seen my doc since before my cancer diagnosis (he shares the practice with another doctor, and she’s the one who’s happened to have been on whenever I’ve gone in since I first found the lump), and it was nice to catch up with him about the whole cancer experience. Both he and the other doctor have been so good about responding quickly to my needs during this journey – I really have only good things to say about their support.

(I remember my father had a very different experience, trying to coordinate care during his cancer treatment – it was very hard to get in to see his family doctor for urgent matters, and at the time I remember despairing for my dad’s mental health, the waits and delays for care were so inhumane.)

So, happy ending for this chapter, all going well.

photo: untitled art journal spread, wax crayon on paper, September 2005