My headaches have been getting more severe and more frequent. I had to do something. I called Dr. Liao's office yesterday, hoping for an appointment sometime next week or the week after, but the nice receptionist suggested 8:30 this morning. Who knew?
I described the symptoms - sharp pain in and behind the right eye, diffusing to a dull ache after Imitrex and/or Advil, occurring 5 or 6 days a week. We also went over my blood pressure, which the nurse put down as 130/80. I'd stopped taking Hyzaar a couple of months ago after a particularly bad stretch of headaches, and things got better for a week or so, but the headaches came back. Since then, I've been in the 130-140/85-95 range when they check my BP at apheresis.
She spent quite a lot of time with me, going over my medical history in some depth, asking lifestyle questions, and describing possible courses of treatment. We decided on a couple of initial steps: a) moving to 100mg Imitrex, instead of the 25mg I've been taking for years; b) changing from Hyzaar to Toprol-XL.
According to WebMD, Hyzaar is a combination diuretic and angiotensin II receptor antagonist (and yes I did seem to spend half my day walking to the restroom). Toprol is a beta-blocker, specifically metoprolol tartrate, which helps relax blood vessels, which in turn lowers blood pressure, and helps to reduce the frequency and severity of migraines. Two for the price of one - what's not to like? The possible side-effects don't thrill me, but you have the play the hand you're dealt sometimes.
Dr. Liao started me on a low dose of Toprol-XL - 25mg, the lowest they make. I go back in three weeks to go over everything. I have a month of Toprol samples, and four 100mg Imitrex samples. I can burn my stash of 25mg Imitrex by taking four at a time. There's a strict limit of 200mg of Imitrex per day - after that, Dr. Liao says to hit the OTC pain meds, up to their daily limits.
I wouldn't know what to do with myself if I went a week without a headache.