My Experience with DHE Migraine Treatment

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Background(Why I needed the migraine treatment)

So, to give a bit of background, I had a neurology appointment on January 2nd. Prior to this appointment, I’d had a constant migraine for about two months. Now, I’ve suffered from chronic migraines for years. I honestly can’t remember when I didn’t have them. For a very long time I thought that what I was experiencing was what everyone felt when they got a headache. However, this was the first time I’d had a migraine last for more than a few days. About two years ago my doctors and I began to look for a preventative medication to lessen my migraines and abortive medications for when a migraine came on. I’ve cycled through several medications with no success. I am currently am taking Gabapentin ( a seizure medication) as a preventative and using Excedrine Migraine as my abortive because it’s the only thing I’ve found to actually lessen my migraine. Any other abortive med has just put me to sleep and while I appreciate the rest, that’s not what I’m looking for. As for the Gabapentin, I was convinced it was yet another failure because it seemed like my migraines were increasing in frequency, and intensity, as if they were leading up to some big event.

In a way, I guess they were because I got a migraine in November that moved in without signing a lease, paying rent, or even being courteous enough to keep the noise to a minimum, a truly unwanted roommate. After about three days I realized my migraine had no intention of leaving. Every day I would wake up and just wait to see how intense it was going to be. Now, my partner can attest, I can get more done with a migraine than most. When you’re constantly in some type of pain, you learn to get things done, despite the pain. But this thing was taking me out every few days. I’m talking, under the covers, curtains drawn, not eating or drinking or anything, all day long. So, I guess it’s no surprise I was beyond ready for this neuro appointment.

At the Appointment

My appointment day arrives and my migraine is at about mid-level. However, the lights in the rooms are way too bright for me to handle. So, Mychal and I go into the room to wait on the doctor and immediately cut off all of the lights(this is not the first time I’ve forced a doctor to work in darkness, sorry but you do what you have to do. LOL!. I think it’s important to note that this appointment was actually to assess my progress with my B12 treatment( more on that later) and my suspected autonomic problems. But, when the doctor came in and saw the lights off he was obviously concerned. When I informed him that this migraine had been tagging along for two months now, he put everything else on hold. He immediately told me he wanted to try a DHE migraine treatment as soon as the next day. After dealing with this thing for as long as I had, he could’ve told me I needed to drink a bottle of mustard and I would’ve done it. He is also possibly the sweetest person on the planet and wears sweaters and bow ties so, like, yeah. I left that appointment with him seeking approval from my insurance. I was told to go home and wait for a call telling me I could be admitted as soon as tomorrow.

Going to the Hospital

That night, I received a call telling me they had no beds but they were going to work on it. I packed my bag anyway just to be sure. The next morning, around 9 A.M. I received a call from the same woman from the previous night. She informed me that I sounded so horrible on the phone( I audibly laughed), that she’s found me a bed on the neurology surgery unit versus the non-surgical unit where this usually takes place. She told me to head in whenever I could. So Mychal and I gathered my bags and headed out. A lot of paperwork and admitting crap happened per usual and then the nurses put in my room. My main nurse also performed the admitting standard tests and vitals. The nurses learned I was going to be a hard stick, we finally got an IV set up and then the actual doctor overseeing my treatment came in to explain the treatment to me.

Now, as it was explained to me DHE is simply meant to break up an ongoing migraine. It does not prevent migraines or treat future migraines. He did suggest that it could possibly aid in my current regime but he didn’t have his expectations. He also explained that it would be a series of injections through my IV several hours apart. With that, we were set. It should be fairly straight forward.

DHE Treatment

and an occipital nerve block

Okay, finally, the actual treatment. So, firstly, the treatment is done in the hospital because it can affect the heart and cause severe nausea so they need to monitor you. So, when the first round came, they told me to let them know how I was feeling afterward then proceeded. They pushed saline then slowly pushed the DHE medication over several minutes, then another round of saline. That was it. I wasn’t constantly connected to an IV and I was allowed to move because I had my cane. I simply watched TV or read or ordered food and waited around. There was A LOT of vitals taking. They took my vitals what felt like every one to two hours. They took them in the middle of the night even. My nurses were the absolute sweetest throughout the entire process which made it much more bearable. I even sent them homemade cake and pastries later, they were that good. Now, as far as the treatment, there wasn’t much of an immediate reaction except I got extremely nauseous. They offered me meds for nausea if I needed but I basically live my life nauseous so I said I was okay. There was no pain from the actual medication. My heart rate stayed within an acceptable range and the nausea eventually faded, so we proceeded with the next round. I think in total I had four or five rounds, spaced with several hours in between. Unfortunately, some of these rounds were at like 3 and 4 AM. There was no need for fluids so I was able to move around. The only ‘pain’ I experienced was from blowing several veins and my IV had to be placed in a fairly uncomfortable spot so my saline pushes hurt a bit.

Around mid-day on the second day, I started to feel some relief. Slowly, my migraine began to fade into a headache. By the end of the night, it was a dull headache. I cannot begin to explain the relief it provided. Now, to be fair I also had an additional treatment. My doctors noticed that I kept stretching my neck. Something I do so often I don’t even notice it anymore. My neck and lower head area are in constant pain, possibly because if the migraines. So, they suggested an occipital nerve block on both sides of my head, right at the base of my skull. The process was fairly simple. They mixed the drugs and because my hospital is a teaching hospital I gave the authorization to have students perform the procedure( bold, right? LOL). So one student stuck the syringe right at the base of my skull and pushed the amount they’d agreed on for that side and then another student did the other side. There was a feeling of immense pressure and a slight burning sensation but those faded over the next few minutes. Almost immediately the base of my skull and the top of my neck felt numb but not numb to where I didn’t feel like I had control. I was extremely appreciative of this. The nerve block in conjunction with the DHE had me feeling like a somewhat normal human. It felt like I had a mild headache. I hadn’t felt that in soooooo long.

Aftermath

After the treatment, I had a mild headache for the rest of the next day and part of the fourth day after starting treatment. The fifth day I woke up completely headache and migraine free! On the seventh day after the treatment, I woke up and could feel a migraine beginning so I took my abortive and it worked, imagine that! It’s been a couple of weeks and I’ve had probably 60% fewer headaches and migraines than I had last month. Now, they tell you DHE is only to break up an existing migraine and not treat further migraines. I personally believe the treatments allowed my preventative meds to actually work for once.

If someone asked me whether they should consider the DHE treatment I would not hesitate to tell them yes, not one bit. I was so grateful for my neurologist’s quick actions. If you’re lucky enough to not have migraines, appreciate it. They can be so debilitating and people often can’t understand why; they think isn’t is just a bad headache? But it’s not. Migraines can cause nausea, vomiting, dizziness, tunnel vision, double vision and more. Imaging pushing through that for two months straight. I’m thankful for my entire team and the DHE/nerve block treatments. 10/10 would do again. Okay, 9/10… hospital life sucks LOL.