By Katie Golden
A Half Ironman, also known as an Ironman 70.3, consists of a 1.2 mile swim, 56 mile bike ride and 13.1 mile run – 70.3 miles in total. On the morning of a grueling competition such as this, the last thing anyone would want is to have a migraine attack. Dr. Susan Hutchinson was faced with this reality as she prepared for the Ironman 70.3. As a migraine sufferer and a certified headache specialist, she knew this could ruin her chance to compete. So Dr. Hutchinson took a medicine that stops her migraine symptoms, and within 30 minutes all signs of the migraine attack disappeared. She not only knocked out her migraine, she knocked out her competition, placing first in her age group!
The road to get here has not been easy. Dr. Hutchinson had her own practice in general medicine when she started experiencing what she thought were sinus headaches or just “bad” headaches in her mid-30s. After years of not treating her headaches, she decided to start carrying a migraine medication in her purse to try if an episode occurred again. When she started getting nauseous, feeling sensitive to light and sound during a conference, she decided to see what this migraine medication would do. Surprising to her, it helped to reduce her headache. That’s when she realized she had finally diagnosed herself as a migraine patient.
In medical school, students average only four hours of training in headache and migraine medicine. There are roughly 520 practitioners who specialize in this field, or one doctor for every 69,000 of the 36 million migraine sufferers in the U.S. Due to lack of training, it’s no wonder that Dr. Hutchinson, a family doctor, did not recognize the symptoms she had for years as being part of a migraine attack.
Dr. Hutchinson’s new revelation that she was a migraine patient sent her on a new path in her medical and personal life. She decided to take on extra training in headache and migraine medicine and became a certified headache specialist. Soon after, she opened the Orange County Migraine & Headache Center in Irvine, CA. Her practice specializes in hormonal or menstrual migraines. Dr. Hutchinson has even written two books on the subject.
On her long migraine journey, Dr. Hutchinson has realized that exercise is an important factor in controlling her migraine symptoms. She started slow and cautious because exercise can sometimes spark migraine attacks. Over the years of training she gained strength in swimming and cycling. This year her goal was to complete an Ironman 70.3 for her 60th birthday. Quite a feat for someone who had a migraine as she prepared that morning for the competition.
When I asked her how she got through a migraine attack before the Half Ironman, she said “Treximet.” Treximet is a drug taken at the onset of a migraine and is referred to as an abortive medication. Treximet is the only fixed-dose combination of sumatriptan and naproxen sodium indicated to treat acute migraine attacks with or without aura. (Dr. Hutchinson works with the manufacturer of Treximet to build awareness, but she is not a paid spokesperson for the medicine.)
In a study of the efficacy rates of different abortive migraine drugs that contain sumatriptan (such as Imitrex, Maxalt and Zomig), it was found that due to the additional pain relieving properties present in Treximet, it is superior to competitors “in terms of resulting in more patients being pain-free at 2 hours, having sustained freedom from pain at 24 hours, and improving normal functioning, overall productivity, and patient satisfaction.” (Dean, Laura. “Comparing Triptans.” National Center for Biotechnology Information. U.S. National Library of Medicine, 01 Oct. 2010. Web. 30 Nov. 2016.)
While the class of triptan medicines is an effective abortive treatment for many migraine sufferers, there are some patients that experience no relief from any of the many triptan versions. This is why it is important for patients to work with their physicians to properly diagnose migraines and explore diverse treatment options to find what will work best for them as individuals.
Beyond medicines, Dr. Hutchinson believes that every migraine patient should incorporate some form of exercise into their daily routine. Take baby steps. Tell others about your new fitness goals so you have accountability. Break down exercise into three or four separate intervals of 10 minutes of activity done throughout the day. For example, take a walk in the morning, do squats at your desk after lunch, practice yoga before going to bed. Dr. Hutchinson says, “I leave my stress at the bottom of the swimming pool.”
As a patient and a headache specialist, Dr. Hutchinson knows how powerful medicines, exercise and other treatment options are to help migraineurs. With so few headache specialists for the vast numbers of migraine sufferers, it is vital that migraine patients take the lead in discussing treatment options with their providers to find what allows them to be Iron Men and Women.
Katie Golden lives in Southern California. She is a member of the American Headache and Migraine Alliance (AHMA), the National Headache Foundation and the US Pain Foundation and community moderator for Migraine.com.