Consider yourself fortunate if you have never suffered a migraine headache. I haven't had them on a consistent basis like some people I know, but I have had a few bouts of what are called "cluster migraines". Cluster migraines are migraines that come in a cluster over some period of time. In my case, each night for about two weeks.
I had my first cluster around 1996. One night, I woke up with a developing spike-like pain behind one eye. Within 10 minutes, it had developed into the most acute pain I had ever had. None of my over the counter analgesics made a dent in reducing the pain. I recall spending at least an hour sitting on the edge of the bed, on the living room couch holding my head in my hands and wishing away the pain. It lasted about an hour or so and when it subsided, I was exhausted. The next night, I woke at approximately the same time, with roughly the same symptoms. This "cluster" lasted about two weeks.
About two weeks ago, while I returned on the red eye from Oakland to DC, about an hour or two after going to sleep, I woke up with that same developing sensation. It didn't start with pain, just a sense of something not quite right (an "aura"). That sensation quickly turned into first a light but persistent pain and then a full blown migraine. While this is in full flight, I'm sure that I couldn't tell the difference between the migraine and an axe embedded in my head. An axe, and then when it starts to subside again, just an ice pick. Wicked, nasty soul searching pain.
After three nights of this, I saw a doctor. He prescribed three medications:
My doctor instructed me to take the Zomig at the first hint of a migraine, to "intercept it". He also instructed me to take an Indomethacin pill in conjunction with Zomig. If it was bad enough, I was to take the Butorphanol. Frankly, the Butorphanol was the best as at least the pain was transmogrified into something that Alice would appreciate.
This went on for several days, and I again traveled to California for a business meeting. My return red eye was the migraine from hell. I dreaded that flight even before I set foot on the plane. Again, an hour or so after taking off and trying to sleep, came the first sensations of impending pain. I went to the restroom with my collection of medications. I took the Zomig. Nothing. I took the Indomethacin, nothing. I tried to take a squirt of Butorphanol, but the vial was at it's end and it meekly ejected a fractional dose. I squirted it again, another partial dose, again, again, I was desperate for relief! Apparently, I got several full doses of Butorphanol up my nose. It felt very nice, even though the pain was still actively deployed behind my eye (is this due to air pressure at altitude?).
Back in my seat, after about 15 or 30 minutes I started to wonder if I would stop breathing if I didn't concentrate on actively breathing. I started to become aware of the possibility that I had really dosed myself into a bad state with the Butorphanol. I blew my nose on a cocktail napktin (I had a single glass of red wine when I boarded). Man, I didd not feel so safe and secure up there in my upgraded first class seat. I thought it was possible that I could die before we landed. Surely the Butorphanol combined with the persisting pain would do me in. I pinched my finger to stay awake until the effects wore off, it took awhile and I lost sensation of my pinching several times. Finally, I became comfortable in my breathing and I subcumed to sleep... I awoke 30 minutes outside DC, having had at least a few hours of restful sleep.
I got home just after 6AM to a chilly and slightly snowy DC. I walked the dog before most of the neighbors woke up. A few hours of napping and off to a meeting in the city. That night I had another migraine, but the next night was the worst of my life. I fell asleap on the couch and woke to a killer migraine. I spent the next hour upstairs on the bedroom floor with tears coming out of both eyes. It was so bad that it seemed a visit to the ER was in order. I went, it was horrible. When the pain subsidded, my hands and lips were cold from shock/pain. Eventually, I was seen by a very adeept Dr. He consulted and ordered a CT scan which showed nothing amiss. After a second lengthly consult, he prescribed the following:
I had another migraine the following day, but by evening my head felt very different. I felt very confident that something had changed (or lifted). Since then, I have had several vague migraine likee sensations, but nothing that lifts into the actual realm of pain.