Mixed Messages

I suppose the fact that I'm not thinking of writing this as regularly as I used to means the misery really is less than it used to be. However immediately after writing "Better Times" I had less intense than normal but nevertheless unpleasant common migraine. Maybe the very act of focussing on the blog is triggering something! A horrible thought.

Yesterday I had to cancel a day out with a friend because I awoke with another common migraine and felt incapable of driving. It did not last past lunchtime but I began to think that the minor liberties I'm taking with the diet are likely to be causing these more frequent attacks. These liberties are mainly sating my craving for fruit by risking muffins with currants and dates and also an apple pie. I've also been trying a little potato salad and this afternoon had some blackcurrant jam for the first time since starting the diet. More sinfully perhaps I had a chicken baguette for lunch at a cafe on Tuesday and this turned out to be really nice - far spicier than anything tasted in the last few weeks. (Surprisingly this did not upset my stomach.) I could argue that rather than taking liberties, I'm adding back foods in a controlled fashion to see whether they have any effect. Unfortunately, everything I add back seems to have an adverse effect.

Looking back to April when I first came off amitriptyline, there is however no doubt whatsoever that I feel heaps better. Equally theres no doubt that the "heads" are less troublesome both in frequency and intensity. Sleep patterns continue to improve, and while I still get up between 5am and 6am most days, it is a pleasure to be up, often in the garden, on these still calm summer mornings.

For the last 3-4 days the gastro problem has been better so maybe the persistence with Zoton is paying off.

Better times

Shortly after writing last Thurdsay's post I had a classic migraine; the full aura and a few hours of subsequent headache and sickness, but as I've recorded previously, these are minor events compared with the common migraines which in recent times have been the main source of misery.

Since Friday its been a very good spell, with clear head and somewhat reduced stomach pain. I saw the doctor today, and while he had hoped for better results from the Zoton, he's asking me to stay on it for another six weeks prior to reducing the dose by half for a fortnight and then stopping.

Normal again?

It's a week since I last wrote and I'm trying to remember the details. Overall I'm now pretty convinced that the diet is the key to the reduced frequency of migraines. I've had one relatively minor migranous event in the last seven days, and this hangover-like incident followed a very nice three-course meal out at a good restaurant this Tuesday. I woke up with a bad head on Wednesday morning early, took 2 Solpadienes and by lunchtime it had faded. I also ate out on Saturday night and while there were no immediate ill-effects I feel this in some way contributed to "going over the top" with Tuesday's meal. In neither outing was it possible to avoid some of the no-no items in the migraine diet, and I feel while I can take the occasional risk*, two within the same few days leads to trouble. This was the case on the cruise, and once over the top I need a few days of careful eating to detox and get back to normal.

Looking back at the early days of coming off amitriptyline, I realise how everything seemed magnified in the first few weeks: all the little worries and concerns were amplified to the extent that I was really depressed and could not see the point of not starting to take it again. I seemed to be screaming silently all the time. It was a true addiction and one that I am now well rid of. Dare I say I feel normal again - mentally, and at the moment the migraine frequency and intensity is lower than it has been for ages.

Sleepwise, things are still disturbed. Some nights I get through without sleepers and others I don't even though I've taken some. I suppose I feel things are getting better but very gradually: either that or I'm less concerned about sleeping less.

One new issue - I hesitate to add - is a recurrence of the ulcer symptoms I suffered from about 15 years ago. The doctor has decided to put me back on Zoton for a month to see it this controls the unusual "ache" which is not burning and not ordinary indigestion. When I first had this someone said these symptoms were migraine related. Now I wonder if they're migraine-diet related.

* By "risk" I mean some gravy with the main course or a dessert with some summer fruits in. Alcohol, citrus fruits, chocolate, cheese and all the other common triggers never pass my lips.

Up and Down - again

Nothing developed on Monday and despite the cold and sore throat it was a good day. Monday night was the best night for weeks, sleeping right through until the 7am alarm without any chemical assistance. Once again on Tuesday evening I thought something was developing and took 10mg of Temazepam to get off to sleep. Unfortunately I woke at around 3am with a headache and couldn't get off again. Once again I took two Solpadeines and once again they worked quickly so that Wednesday was a clear day. These heads can't be migraines, so I must assume they're related to the cold symptoms and hence easily cured.

I woke early Thursday (4am) and decided to get up and do the ironing. Tired all day but once again free of migraine, the 12th consecutive clear day.

Catching Up

This is a compilation of several days, having taken a holiday and having been unable to keep the blog up to date.

Wednesday - 9th May

I'm feeling unbelievably tired because I'm still waking up between 3 and 4 am and failing to get off to sleep despite taking 10mg of Temazapan. When is it going to get better? I've been falling asleep during the day whenver I sit in a comfortable chair: should I be forcing myself to stay awake until bedtime in the hope of getting more rest at the right time? Can this still be amitriptylene withdrawal or is it the menopausal sleep problem I suffered from before starting amitriptyline for migraine and finding it made me sleep better? What will happen during my holiday which starts on Thursday with flight to Venice? My husband was dealing with the same questions at 9pm on the internet and had discovered that women suffering sleepless nights after withdrawal were taking the occasional 10mg of amitriptyline as a sleeping tablet with immediate good effect. We agreed that I would try this tonight and take the tablets with me to Venice.

Thursday 10th May

I had the best night for ages, amitriptyline-fuelled, and my husband had one of the worst. Apparently at about 3 am he was awakened by me chatting in my sleep and twitching regularly - Rapid Molly Movement sleep he called it - and this kept going for a couple of hours before I woke up and he finally drifted off to sleep again. I felt very groggy and spaced out for most of the morning, which was no bad thing because we flew to Venice. Here the hotel was so hot (air conditioner putting out more sound than cool) I doubt if either of us would have slept well under any circumstances. In the event, 10mg of Temazepam were useless.

Friday 11th May

We revisited St Marks Sq. in the morning, discovering it had lost a lot of its charm in the last 10 years, thanks to its increasing popularity and an attack of graffiti. Spent the afternoon touring around the city in a vaporetto and had a quiet dinner in a pleasant restaurant just north of the Rialto. The hotel room was a little cooler having kept the sun out all day and having complained about the noise at breakfast.

Saturday 12th May

Moved on to Dubrovnik, arriving Sunday am after another great nights sleep on 12.5mg amitriptyline. Once again very groggy and dopey during the morning. Must reduce the dose to around 6 mg to see if it still works without the "hangover" the next morning.

Sunday 13th

A day out in Dubrovnik and Cavtat. Slept well with 10mg temazepam.

Monday 14th

A day at sea - heading for Turkey. No medication, no headaches and a good night's sleep. What's going on here? I'm also eating a wider range of foods due to the inability to control my intake while eating only in restaurants.

Tuesday 15th.

Kusadasi, Turkey. I'd decided against taking the tour to Ephesus in view of the heat and difficult walking conditions. Just as well, a migraine started in the afternoon, but I managed to keep going until bedtime, taking a walk around the port area of Kusadasi. Needed a temazepam and woke up with a worse head in the morning.

Wednesday 16th

Santorini, Greece: Solpadienes taken to keep going - went ashore but the queue for the cable cars was about 2 hours long so I returned to the ship after an hour on the shore below Fira. Things improved in the afternoon and evening, but I decided to go to bed with an amitriptiline - about 8mgms this time.

Thursday 17th

Corfu, Greece: Feeling better so I had a look round Corfu town which was quite disappointing. Apparently the rest of the island is quite beautiful.

Friday 18th

A day at sea heading back to Venice. Feeling OK until the evening when another headache started.

Saturday 19th

I've often wondered what it would be like if I had to spend a day travelling with a migraine, not being able to collapse in a chair and try to chill. Today I found out. It was very grim, waking up with it, having to trudge round Padua - the last of the planned tours - taking it to the noisy airport, nursing it on the flight home, and finally taking it to bed when we got back home that night. 16 hours of continuous motion, boat, coach, trudge, coach, plane, bus and car while feeling like death. I really was very brave, and felt I really deserved my 12.5 mg of amitriptyline.

Sunday 20th

Woke up groggy but with a clear head, determined to get back onto the migraine diet.

Sunday 27th

As I write this in the evening of 27th May, but for one nocturnal headache (midweek) which responded to a couple of Solpadienes, I can say its been a good week back in the relative peace
of our Warwickshire village. I've been getting increasingly tired due to waking up early every day, and have to admit to taking about 6mg of amitriptyline on Tuesday night for some respite. Tonight I might do the same. For the last couple of days I've been fighting a sore-throat and a cold, which I guess is not helping. Nevertheless I am feeling a little migranous for the first time in a week.

Up and Down

Had a couple of good days, Saturday being great enough to make me think I was finally getting on top of things. On Saturday night I went out for a meal at a friends house in the village with the usual trepidation related to what I might have to eat. The meal seemed fine, excellent in fact, but I can never be sure that the homemade soup or sauce doesn't contain something I'm trying to avoid.

At 4 am Sunday I woke with the start of what I thought would be a day of nausea and headache, and things deteriorated until I took 2 Solpadeine at around 8 am. As with the last episode, the tablets dulled the headache considerably and whilst feeling drained and wobbly, I was able to get over to see the grandchildren and have an enjoyable afternoon but for the full aura of a classic migraine coming on at about 4pm. As in the old days of mainly classic migraines I could feel it coming before the aura started, but as with the other recent classics, they seem to follow a common migraine, and their post-aura headache is more manageable than it used to be. I guess my system is still a bit haywire after the drug withdrawal.

I digress

My husband has been treated over the last 10 months - on and off as the NHS schedules permit - for a suspected kidney stone. After his initial collapse in the small hours of a July Saturday, I took him to Warwick Hospital A&E where the initial diagnosis was either aneurism or kidney stone; later refined to kidney stone after X-rays and a urine analysis, the latter containing blood and signs of an infection. No stone had showed up on the X-rays, but as some stones only showed on an ultrasound scan, and as the ultrasound scanner had broken, he was told to see his GP and get referred to a urologist. This was done, and in October he had the first ultrasound scan which showed a 6.4mm (!) stone, probably uric acid based, in the left kidney. The consultant (November) recommended lithotripsy and this was done in January. In March a second ultrasound scan was due but postponed on the day of the appointment. He finally had the scan in early April, and no sign of a stone was found. Conclusion: the lithotripsy had been successful and the stone had been shattered and passed. However he was still suffering from fairly constant low-level pain in the bladder area, and having to pee much more often than was normal.

He went back to the GP who said that if the stone had been passed, the pain and frequency should be diminished, so he should really phone the Urology dept. and demand to see the Consultant, not the specialist Urology Nurse who had dealt with the case since the first 5 minute session with the Consultant back in November. Our GP was clearly unhappy with the Nurse Led Urology unit and argued that a nurse did not have the skills to deal with complex cases.

Phoning Warwick Hospital Urology Dept is a task best tackled on a full stomach and a free day because it often takes the best part of a morning to get as far as the answering machine. This milestone was reached and a message left by about 11am, and to everyones surprise the Nurse called back at about 4pm. Here the story takes a dramatic turn. Could he come in for X-rays tomorrow - say 11 am? Of course he could.

On arrival the Nurse greeted him before he had chance to sit down and a full one hour consultation later he had been given another Ultrasound scan, a prostate examination, a urine flow rate test, forms for an immediate X-ray, a blood test, a urine analysis, a prescription for a course of tablets to help increase the urine flow rate (Contiflo XL - 400 micrograms) and an appointment for a review of the results of the X-rays one week later.

From the US scans, urine flow and my husband mentioning that he had had Benign Prostate Hyperplasy (BPH) for about 15 years, she proposed that he could well have stone fragments blocking the urethra where it was being narrowed by the oversize prostate. Hence the urethra relaxing medication which might help the fragments to pass. She also recommended giving up strong coffee and drinking cranberry juice instead. If an infection showed in the urine sample, antibiotics might be needed later.

One week later at 11am sharp, he was back with the same Nurse comparing the X-rays from last week with those taken by A&E last July and concluding that there was very little difference. We still await the blood and urine test results and an appoinment with the consultant, but I have to say at this point that we seem to have had excellent service from the Nurse Led Urology unit. More later...

In the Monet again

Today dawned bright and clear and while I missed the sunrise by an hour or so, I'd left yesterday's Heironymous Bosch behind and emerged in a Claude Monet landscape.

This afternoon however, on the way home from a nice outing to Stratford-on-Avon I had the full aura of a classic migraine for half and hour followed by the usual headache, which in comparison to the common migraine "killer" is gentle and managable. This common-classic one-two has happened on several occasions, and while the classic migraine headache continues this evening, if I wasn't writing this blog it would hardly be worth mentioning.

A medication-free day, however for lunch in Stratford I could do no better than an egg mayonnaise sandwich from Marks and Spencer: the mayonnaise being a no-no for the migraine diet. Swift retribution in the shape of a classic? I doubt it.

Another Migraine Day

This one came out of the blue. None of the usual precursors, other than feeling murderous yesterday afternoon after being stressed-out for no apparent reason all morning. I suppose there's a continuous low-level of stress associated with keeping house, husband and Village Hall under control and tidy, and this level is sometimes increased by other pressures arising in the family.

Dietwise, there's almost nothing I can blame other than feeling guilty about yesterday's consumption of biscuits (two) and that wonderfully wicked dessert of meringue and dulce de leche. Maybe I should try doing without the latter for a while to avoid raising the blood sugar too suddenly.

The headache and nausea woke me up at about 3 am but I managed to get off for an hour or so before it woke me again, this time so bad that I just had to take something even though I knew it would do no good. This need to do "something" at moments like this is an irresistable compulsion, (much like the need for a blast of sweetness at some point during the day) and the "something" was taking two paracetamol and a Nurofen. At this stage it's worse lying down than sitting up so I got up and made breakfast (porridge - at 6am) and sat quietly as the tablets did no good and the migraine took over. I get overwhelmingly depressed by the whole pattern of events at this stage. Nothing is right, everything is wrong. The pain is like nothing else I experience and I know I just have to sit still and bear it.

By lunchtime (bran flakes and toast) it was no better and when my husband came back at about 2:30pm he insisted that I tried to ease the pain with two Solpadiene. These sometimes help and this time they did. The headache dulled, and while the nausea continued unabated, I was able to move into the conservatory and watch Charlie the pheasant destroying a parched molehill to create a dustbath. It's the little things in life that keep you going...

The Diet so Far

All the common migraine triggers (cheese, chocolate, caffeine, alcohol, citrus fruits) are "out". Also excluded are other fruits, leeks, celery, garlic, mushrooms, baked beans, tinned fish, any seafood, any processed food, any preserves, ice creams, anything with monosodium glutamate, nitrites or vinegar. So most dressings, sauces and gravies are verboten and I'm suspicious of anything in a packet with an E number on the ingredient list.

Breakfasts are now Bran Flakes mixed with Oat Crisps with milk and sugar, or, porridge with toast and butter and a cup of decaf tea. I'm restricting myself to 3 (max) decaf teas a day and apart from that, water is the only other drink. For the last couple of days the bread has been soda bread, rather than the home made wholemeal/ciabatta mixture.

Lunches at home are usually chicken slices with bread, butter and tomatoes and or salad. No dressings.

Dinners vary. Today we had roast chicken with roast carrots, parsnips, potatoes and blanched spinach. Last night it was a jacket potato with sliced chicken, lettuce, tomato, cauliflower (raw), and water cress. On Friday night I had a rare treat - fish and chips with my daughter while my husband went out to a barbecue.

For dessert? So far I've restricted myself to meringue with dulche de leche, but I also eat the occasional shortbread biscuit.

What would I add back once I'm sure this diet is migraine-free? Apples

Settling down?

But for the sleep difficulties and dizziness whenever I move my head quickly I've had a couple of good days. I've stuck to the migraine diet and avoided any medication but for half a Temazapan two nights ago when I woke at 4 am and a whole one last night when I woke at 1 am. The half failed to get me back to sleep so I got up and did the ironing at 5am. Last night the whole one worked and I slept until 0530 - the best night for ages especially considering I went to bed at 1030pm (an hour earlier than usual) due to extreme tiredness.

Looking back over time since I started this blog and went on the diet, I don't think I've had a full blown migraine since April 11th - that is if I assume the "event" of April 13th was due to the Ciprofloxacin - more a collection of headaches and nausea which may well be associated with the rapid withdrawal from amitriptyline.

Second thoughts about amitriptyline

Is a pattern emerging? Tuesday I woke with a bad head that disappeared by lunchtime.

Yesterday I was clear in the morning but felt increasingly bad-tempered during the day getting cross about all sorts of things. We went out for lunch and I had a beefburger at Bistro Pierre's: very wholesome and free from additives but my husband reminded me that during the previous attempts to control headaches with diet, we had been suspicious of beef. By evening I was beginning to feel migranous. Today I woke with a bad head and feeling sick, but once again it did not develop into a migraine and after lunch I had a pleasant spell in the garden planting out.

Since coming off amitriptyline, I've been sleeping badly and waking early - usually around 5am, getting up around 0530. My husband looked at amitriptyline withdrawal again and was struck by the prolonged periods of tapering off which others seem to have used to avoid this and the other withdrawal symtoms of nausea, headaches and dizziness. Some people spent 6 months tapering away from 60mg down to 2.5 before dropping it completely, and most seem to take weeks over this. The overall wisdom seemed to be to reduce the dose by 5mg and stay on hte new level for 5 days before knocking off another 5 mg. There were also comments about going back up for a day or two if the withdrawal symptoms become intolerable, and then recommencing the taper.

I came off it (50mg to 25 to 12.5 and then none) in about a week, so maybe I'm paying for it.

An important day

I think the dizziness caused by the Lisinopril is gradually fading, and while I've had a dull headache all day, its been tolerable without analgesics.

It's been an important day in other ways too. I'd like to think a whole new attitude is starting following my daughter yesterday doing some other intenet searches on drug effects and other migraine causes. She says long term drug use has been shown to cause chronic daily headaches and working too hard, and getting overtired is a known migraine trigger. I always have a list of jobs I have to do before I can relax and probably drive myself too hard even when I'm doing things I enjoy like gardening. So, I want to make a determined effort to "stop before I drop" and take out more time to relax, especially to play the piano more.

No More Lisinopril

By Friday I was pretty sure the morning headaches of the last week (not migraines), the light headedness, and the dizziness especially when moving my head quickly were lisinopril side-effects. I was also beginning to think the new diet was helping, so decided to miss Friday night's tablet. Saturday morning I felt much better - no headache and generally livelier. So we'll continue without it and hope the diet is helping as much as I think it is.

However later in the day I felt migrainous and a headache developed through the evening. I woke up with it at 3:30am and this time took some Solpadeine - which in the past have dulled the headache but tend (I think) to be addictive. I also took 5mg of Temazepam, which I use occasionally to get off to sleep and woke the next morning with a much reduced headache. This does not happen often, so something is changing. How do doctors distinguish between migraine and other headaches? Does lisinopril have withdrawal symptoms?

Migraine Milestones

I was 12 when I had the first migraine and for the next 25 years they were all the "classic" migraines with visual disturbance starting with a small sparkly translucent crystal which grew into a semi-circular flashing zig-zag obscuring about half the visual field for about half an hour. This shrinks back to the side of the field of view and the headache and nausea begin. Occasionally numbness in the left arm and down the left side and an inability to speak accompany the headache. These symptoms generally lasted about half a day, and were relatively easy to cope with compared with today's attacks without aura ("common" migraine) which started when I was about 35.

These "classic" attacks occurred about once a month but not with any regularity that might have been linked to the menstrual cycle. At age 22 they were affecting my work sufficiently for my boss to insist that I visited The Migraine Clinic in Russell Square, London. Phenobarbitone was prescribed for a month and this helped but I was not allowed to stay on it. When I got married and went on the pill, the frequency increased to 1 or 2 a week, but some were "aura only" with very little headache. My husband read something about taking the pill being inadvisable if these symptoms occurred so I stopped taking it, the migraine frequency dropped, and I had my first child at age 25.

Being pregnant increased migraine intensity and frequency dramatically, but they returned to normal after the birth. The same sequence occurred with my second child, and the pregnancy migraine misery was a contributory factor in deciding to get sterilised immediately after the birth (at age 28).

Classic migraine returned to the approximately 1 a month level and continued unremarkably and manageably for the next 10-15 years. During this time I was unaware of migraine triggers and while never drinking red wine, I was fond of cheese, chocolate and citrus fruits.

When my mother died (I was 45) I developed stomach "erosions" and the specialist said these were is some way related to migraines. He put me on Sanomigran and suggested giving up cheese. chocolate and citrus fruits, a regime which worked quite well for about 5 years. Things get a bit hazy here, so I'll record the milestones and fill in the details as I remember them:

• Sanomigran stopped working and I came off it, but can't remember what came next.
• I had a spell with no regular medicine but used Migraleve and Maxalt whenever I had an attack.
• These (especially Maxalt) worked when I could take them right at the start of a headache, but they seemed to delay the onset rather than preventing it. I'd have a day or two clear, and then it would start again, another Maxalt would "cure" it, but it would return yet again. Being allowed only 2 Maxalts per week, I then had to let it come, and after a couple of days of misery, I'd be in the clear for another week or two.
• The best period was, as I said earlier, the year or two I spent oh the special diet which avoided all known triggers. This caused a not unacceptable weight loss, but was eventually abandoned simply because it was hard to enjoy life with such a restricted diet.
• The migraines returned as the diet returned to normal, but it was impossible to tell which if any of the foods added back were responsible.
• The doctor now recommended propranolol which I used for a year or two. I suppose this lessened the frequency but not to a manageable level
• The doctor referred me to a specialist who prescribed amitriptylene - which was great to start with, but the dosage had to be increased every 6 months to maintain the effect and with each dose increase came weight gain.
• Coming right up to date, having gone from 10mg to 50 mg of amitriptylene over 2-3 years and found the last increase seemed to have no effect, the doctor recommended coming off it and moving to lisinopril.

Wednesday again

After waking up feeling like yesterday, the head cleared by 9am and a much better day resulted. Maybe the Lisinopril has successfully kept an attack in the background through yesterday and last night. However I've been established on the migraine diet since Sunday and the resulting detoxification might be helping too.

Yesterday I had a breakfast of Branflakes with semi-skimmed milk, homemade bread and butter, and a cup of tea. Lunch comprised a tomato sandwich and water, and I had a jacket pototo with spinach, omelette and water for dinner. Supper: half a brown bread roll and butter. This morning I had porridge, tea and water for breakfast, tomato and basil soup with water for lunch (additive free), and poached white fish with jacket pototo, butter and stir-fried (veg.oil) broccoli, onion and red pepper for dinner - with water.

Tuesday

I've been feeling dizzy, tired, and as if I'm about to get a migraine all day. Sickly, dull headache across the forehead with mild jabbing pains in the right temple and a mildly upset stomach.

Could this be a migraine day where the attack is being kept manageable by the lisinopril, or is it a normal day with a lisinopril side-effect headache?

An incredible coincidence?

I was lucky enough to get an appointment with the GP this morning, wanting to discuss Friday 13th and get some antibiotic ear drops. His comments were as follows:

• My records showed I'd tolerated the Ciprofloxacin tablets on two occasions in the past so the problems were not caused by their side-effects.
• Antibiotics do not cause elevated temperatures. There was a gastro-bug going round which would account for the flu-like symptoms I'd suffered - even though they only lasted 5-6 hours at most, and despite "flu-like symptoms" being a noted side-effect of the antibiotic.
  
• The migraine symptoms were due to another migraine and were unrelated to the "severe headache" side-effect of the medication.

However he did not recommend I continued with the Ciprofloxacin. As with last year's earache, he took a swab of the fluid in the offending ear and sent it for tests so that any antibiotic could be tailored to the organism. I should check back in a week.

Friday 13th

Migraine-free and feeling well but for a slight earache which reminded me that I was supposed to use antibiotic eardrops on the rare occasions this developed. The doctor had provided me with an extra prescription for these after the last episode during which swabs were taken and tested to identify the culprit organism and select the most effective lethal agent. Sainsbury's pharmacy made up the script at lunchtime and on returning home I opened the packet to use the drops.

Drops? This time the Ciprofloxacin was in tablet form - a course of seven 500mg tablets to be taken one a day. Had Dr Watt changed the prescription or had Sainsbury's made it up wrongly I wondered, but took the first tablet at about 3pm. By 730pm a headache started and by 830pm I felt as if I had flu with aching joints and an elevated temperature. The headache got worse, my skin started aching, and then I started shaking uncontrollably before the first of many urgent visits to the loo. Breathing was becoming difficult and my top lip was swelling. My husband decided to check the Ciprofloxacin literature for side-effects which after the usual "these are generally well tolerated" comment mentioned all of the above as a reason to seek medical advice. So, he phoned NHS Direct (930pm) who asked to speak to me and took all the details before telling us to stand by for a call-back. The call back was another nurse who took the same details and told us to stand by for a call from a doctor "within 2 hours". When this came, around midnight, the advice was to go to the nearest A&E hospital for unspecified treatment.

Driving 30 minutes to A&E, in my condition, in the early hours of a Saturday morning did not seem like a good idea, and as by now my breathing was getting easier and the shaking had slowed down, we decided to stay at home, go to bed and review the situation in the morning.

The Ciprofloxacin side effects list included "increased pressure in the head" and "very severe headache with visual disturbance" and by 2 am, visual disturbance excepted, these had arrived. My temperature at this point was just over 100, I vomited a small amount into the bowl usually kept at the bedside during migraines, but breathing was no more difficult and the shaking had stopped. We got a few hours sleep and during Saturday the symptoms gradually subsided. For the record the headache was significantly more intense than Wednesday's.

Had it not been for the shaking, the high temperature and the swollen lip, this could have been just another migraine and I began to wonder if antibiotics, maybe traces remaining in intensively farmed meats could be a trigger factor.

The relationship between diet and migraine had impressed me since July 2000 when an article in the Daily Telegraph caught my eye. At the time I was worried that migraine would ruin my daughter's wedding which was planned for August 2001, so, clutching at straws, I adopted the diet with enthusiasm. In retrospect, the year on this diet was the most migraine free period I'd had, but the least gastronomically satisfying. After the wedding I gradually returned to a normal diet and when the migraines returned I was advised to go on to amitriptyline which seemed to work well - for a while. More of this in a later posting, but I now resolved to give the diet another go.

Wednesday's Attack

Whenever I get an attack I think of Beethoven. Not that he suffered from migraine; simply that it helps to regard my problem is trivial compared with deafness to a composer. Wednesday's attack (11th April) started at about 2am although my husband later reminded me that I'd been complaining about how bright the light was all Tuesday, sensitivity to light being one of the usual precursors. I also felt particularly good that day; another sign that something's brewing. The headache woke me up, as it usually does, announcing that Wednesday would be very different. I got back to sleep but woke up at 6am with a migraine which would steadily increase in intensity until lunchtime.

This was the first migraine since coming off Amitriptyline (50mg at bedtime), which had reduced the frequency of the attacks and lessened their intensity for a couple of years, and the first since starting a course of Lisinopril (2.5 mg at bedtime) a week ago. I'd also been in the habit of taking 400mg Nurofen and 2 x 500mg Paracetamol's when the headache got bad. These sometimes numb the pain slightly at best, and if they do I sometimes repeat the dose 4 hours later. This is a funny thing really. Even though I know the tablets don't do very much they are a prop which psychologically seems important. Sometimes I take Solpadeine for the same reason and while this sometimes works better, the addictive nature of the codeine content bothers me. If I'm honest, nothing works during an attack, but taking nothing takes more courage than I usually have.

Having had two bad migraine days the week before, and worrying that regular consumption of the Nurofen/Paracetamol mixture to lessen the pain might be causing withdrawal symptoms, I bravely decided to let this one run its course without additional medication. I was immobilised for the rest of the day with one of the worst attacks of headache, nausea and diarrohea for a long time, covered in fleeces and sitting next to a hot radiator on a hot day but still feeling cold and finally going to bed with pain only slightly less intense than on getting up. Why get up? Because it's worse lying down. Why was it so bad? Was it due to the absence of Amitriptylene or the Nurofen/Paracetamol mixture or both?

Wednesday night was disturbed to say the least, but the pain was less by dawn and lessened all day. Thursday night was normal and I woke Friday feeling well. Maybe having had a bad one I could now enjoy a few extra days of normality. But I was forgetting this was Friday 13th.

Just starting

Hello, this is Molly speaking. I'm new to the world of blogging but a very experienced migraine sufferer. I've had a bad week and this is one way to vent some of the frustration and to share some experiences with other sufferers.

I'll recount last Wednesday's attack first and then the rather extraordinary story of Friday 13th - which was really all about earache - to start with. More later...