Rebounding

I have never been a directions-reading kind of person.

One of my dear readers asked about headaches from over the counter medicines. Yes, constantly taking painkillers can lead to more often and more intense headaches. This makes no sense. Really. You're in pain. What do you do? You take a pain killer.

Duh.

But according to Mayo Clinic, "Rebound headaches (medication-overuse headaches) are caused by frequent use of headache medication. Pain relievers offer relief for occasional headaches, but if you take them more than a couple of days a week, you may trigger rebound headaches."

And according to the bottle of Tylenol in my lap (that I currently cannot take, even though I'm hurting tonight), "Stop use and ask a doctor if ... pain gets worse or lasts for more than 10 days."

Ugh. Who knew they printed that out for a reason?

I'm sure there is an overly-complicated chemical reason for this nonsense, but you don't read this blog for that kind of stuff. The specific question was to let you know about my headaches in the hopes that you can compare and learn from my
mistakesexperience. So here we go.

My head has hurt almost every day for about a year. At first I thought it was sinus problems because sometimes the pain was in my forehead. X-rays came back clear and good. My sinus doctor thought it was TMJ, so he sent me to my dentist, who fitted me with a foxy mouth guard to make me stop grinding my teeth in my sleep. That didn't help either. Finally a neurologist diagnosed my pain as migraine with drug rebound. Every day. At least 6 days a week.

I don't know what started the headaches - there are all sorts of triggers - but it's safe to say that I have taken WAY OVER the recommended limit on the Tylenol bottle. I've gone through NSAIDS (Non-Steroid Anti-Inflammatory Drugs, aka Over the Counter or OTC) like they were popcorn. Advil, Tylenol, Aleve, Advil PM, Tylenol PM, BC, Goody's, you name it. I've even downed a Goody's or two without water because I was so desperate for the pain to stop.

I know. Hardcore.

Only often it didn't stop. Sometimes the pain worsened; many a night I have curled up in a ball and had to fall asleep in pulsing pain. There's a good chance I was addicted to Tylenol PM for a few months; when I realized I couldn't sleep without it, I weaned myself off. I would wake up feeling OK the next morning - maybe a little sore all over - but usually the next afternoon my pain would escalate to the point of incapacitation.

Only then I wouldn't stop. I refused to let the pain "win," stubbornly keeping up with my normal routine and tasks, living in pain. I've actually lost about 8 pounds because of the nausea that sometimes accompanies migraine. Until one day a few weeks ago, I passed out alone in the yard. I wasn't out for long, but it scared me. Dante was worried. Thank heavens I already had an appointment coming up.

Seeing a neurologist was both really encouraging and discouraging. The encouragement: there is a reason and a trigger for the pain; we just need to figure out what it is for me. There are treatments available that are better than OTC medicines. The discouragement: migraines are chronic, and preventative medications often make the takers completely looped out. Dr. P. prescribed Topamax, a daily medication to prevent migraines, but after reading the side effects, I'm not sure if I'll even have it filled.

So the next part of the question: how to ease rebound headaches from OTC NSAIDS.

You're not going to like this.

First, call your regular doctor. If you don't have one, find a general practitioner in your area. If you need one, most neurologists require a referral, and it took me three months to finally win an appointment with one. The whole time I kept thinking, "This is crazy. Nobody cares about a little headache. I'm whining over nothing when there are people out there with real problems."

The reality? If something in your body hurts for more than 10 days, it's an indication that something is not as right as it could be. I'll go with you and hold your hand. Headaches are a big deal and are becoming more common, keeping neurologists busy. It may take a few months to get in, but be persistent and have a professional check you out. I've stubbornly self-medicated for over a year and been in a lot of pain for no reason. Actually, you DON'T have a PhD in neurology.

Don't put your health on the backburner until you wake up in the yard with a concerned mutt licking your face.

The process of recovering from OTC NSAIDS is somewhat like an addiction: you have to wean yourself off of them until you're not taking them anymore. Same thing with caffeine, which I fortunately kicked back in January. I was down to one painkiller dose a day, so I have completely stopped taking anything as of Friday, April 9th. It hasn't been too bad. Easier than heroin anyway.

I'm still in pain about half the time and had one really bad afternoon on Monday, but you know what I did? I tried something new. With a hunch that the headache was triggered by stress, I took it easy until I could go home. Then I stretched out on the couch, grasped the reality that I had a migraine, and let my body heal. Forty-five minutes later I slowly sat up, stood up, and was able to take on the rest of the day.

Perhaps a mark of maturity is the realization that medicine labels have warnings for a reason. I really should pay more attention to them.

Photo courtesy of icanhascheesburger.