I've suffered from migraines all my life. It worsened as I've gotten older. One day long attacks turned into three day long attacks. Then turned into five day long attacks. I've taken various preventatives and abortives over the years to varying success. It runs in my family so I never thought to see a neurologist for them. A couple years ago I had a bad string of them and my medicine wasn't really touching it, so I finally decided to see a headache specialist. The doctor very quickly got me started one of these anti-CGRP medications.
Almost immediately, I dropped to 0-1 attacks a month, and when they do happen they are both less painful and my other medicine knocks them out fast.
My mom had migraine headaches pretty much all her life. For many years she had been seeing the same doctor for her headaches.
Then she got old enough that she was on Medicaid, and she had to stop seeing that doctor because he didn’t accept Medicaid. So she found a different doctor. Different doctor prescribed a different treatment and lo and behold, her headaches pretty much went away after that.
My paternal grandmother was a migraineur, but back in the 1930s she was treated as a "hysterical" woman and given opiates. Her battles could not be overcome and she lived a short life. Thankfully the treatments have evolved.
I had them in my 20s on a weekly basis but since I could stave them off with massive water intake I thought they were something else. I didn't get optical symptoms, it was just a really bad headache, nausea and chills that felt like a bad hangover. It wasn't until my 40s when I started getting optical migraines (which are scary as hell since they mimic a stroke) that I went to a dr and he diagnosed me. Apparently it's common for migraine sufferers to transition to optical migraines when they're older.
Yep, I was exactly the same. It took me decades to get diagnosed, then several more years before I saw a neurologist. Now I'm on a CGRP blocker, I hardly get them at all.
In addition, my anxiety/depression is almost gone and my ADHD is about 50% improved (I'm not able to tolerate anti-ADHD meds). I love Nurtec. Expensive, but worth every penny. If my insurance didn't cover it, I'd pay out of pocket without a second thought. It's that good.
Same pattern for me. About a year ago migraines escalated to a few times a week. Debilitating. I started searching for a solution and discovered this book [1]. It basically recommends a low carb or even a keto diet. After three weeks migrants reduced to once every three to four months, and mostly because I'm cheating on the diet. Life changing.
This is what helped me as well, plus probiotics to turn my gut flora around.
I have a nagging feeling that "migraine" is actually not an actual single disease. It's rather a syndrome, i.e. a set of symptoms people have for various different reasons.
Through keto and the probiotics experimenting, I've learned much more about how the whole gut thing "works" (very much not an exact science!) for myself and that doctors in general are clueless about it themselves. Or ignorant. Or don't want to deal with anything they can't just diagnose with a 5 minute talk.
My migraines are food related. Without the probiotics I could somewhat control when I might get one by not slipping and eating something tasty but bad for me (like lasagna two days in a row - tomatoes bad). Add to this the fact that food in many cases takes two days to go through your system, eating a food and getting symptoms is delayed. Evacuating the food from your system would also cure the acute migraine headaches and other symptoms. With the right probiotics I can now eat all the lasagna I want and throw in blue cheese and red wine as well!
Low carb/keto also had dramatic effects on frequency of migraines/headaches for myself. CPAP however, has been even more life changing in that regard for myself. From headaches 4-7 days of the week to fewer than 1 per week.
Some confounding variables on diet/weight loss/sleep quality. But I don't care, things are better and I'm happier for it.
I've been on Qulipta (a CGRP drug) daily for about a year now. It started working pretty much immediately, and I cannot think of a single side-effect in use, other than that you will have a withdrawal period pretty much immediately if you miss a dose.
Before that I've used Rizatriptan to treat rather than prevent (works well, but can cause brain fog, mood swings and GI issues). In order to get approval for the CGRP I had to try lower-cost drugs like Verapamil (a calcium channel blocker) which had no effects at all, positive or negative, and Topiramate, which is the single worst medication I've ever used. Compared to all of those, the CGRP is a miracle and has been life-changing.
There a some small side-effects with Quilipta. I was a bit low energy for a couple a weeks until my body got used to it. Also, it is a mild appetite suppressant. I seem to be able to miss doses of a day or two just fine though. Nurtec also works well for me as an accute migrate treatment.
I'm on Emgality, and haven't noticed any side effects at all.
Honestly the worst part of it has been getting special approval from insurance; sometimes they don't cover much of it but right now the manufacturer provides a savings card that brings it down to $35/month.
Almost immediately, I dropped to 0-1 attacks a month, and when they do happen they are both less painful and my other medicine knocks them out fast.
Literally life changing.