After the baby was born, my migraines really picked up and I was up to two a week - on top of the ever-present underlying headache - by the time I saw my doctor. She gave me an abortive therapy (a powdered NSAID) and put me on a medication commonly used to prevent migraines.
Since the cold weather hit, I've had my usual uptick in asthma flares. This happens every year since my asthma is cold-triggered (well, it's everything-triggered. My lungs suck) but it's been extra sensitive this year. I commented to my husband recently that it seemed like I was using a lot of my rescue inhaler and it just wasn't relieving the tightness very well.
Now, if you are not a medical person, it likely won't occur to you why my asthma and my migraines are related. They aren't. But the drugs are.
The most common migraine prophylactics are beta blockers. That is, drugs that inactivate the beta adrenergic receptor by blocking the binding site. They're mostly used for blood pressure, so there are cardioselective ones (ones that work primarily on the types of beta receptors found in the heart.) I wasn't prescribed one of those. I was prescribed a first generation, non-selective one.
This matters because the drug that is used as a rescue bronchodilator acts on... (I'm sure you can guess) BETA RECEPTORS!
It's a beta agonist - the exact opposite of a beta blocker. So is the long-acting drug (a LABA - long-acting beta agonist) in my maintenance medication.
This is why you don't give nonselective beta blockers to asthmatics (or patients with COPD.) I know this. I am entirely aware of this fact. If I saw these meds together on a patient's list I'd ask my staff about it because of this. It is something I know and would clue into in a clinical setting.
But for weeks I've been lamenting my crappy lungs while taking a medication that blocks my lung medications.
Now, my family doctor - who is aware of the severity of my asthma - should have clued into this too, obviously. Most patients wouldn't be aware of this and would probably be worrying quite a lot in my position given how much it sucks to not be able to breathe. But I really, really should have picked up on it earlier.
I probably would not have realized this for a while longer until a med student friend asked me a question (a helpful learning activity) about beta blockers and asthmatics and I had a face palm moment.
I feel like a complete idiot, really I do, because this is something I absolutely should know as both a severe asthmatic and a medical trainee. Guess I'm just so used to blaming my awful lungs for things that it didn't even occur to me that my worse-than-usual symptoms are essentially a drug interaction.
So a phone call is in order, obviously.
Hopefully I've bought enough time for the pregnancy hormones to peter out and my headaches and migraines don't come back. The beta blocker was actually quite effective for that in my case.
This is why you don't treat yourself. It's possible to completely miss very obvious things. And obviously I can't be relied on to remember the most significant aspect of my medical history.