so this is the thing my neuro and i haven’t figured out yet. total migraine days dropped from 14-15/mo to 8-9 since aimovig, three months in, i’ve posted about that plateau already. but i went back through my log specifically for “had to leave school / called out” days and that number hasn’t moved. still 4-5 a month, same as before the med.
when i actually split the 8-9 days by whether i got a prodrome warning first, the pattern showed up. the ones with an hour or two of prodrome (neck stiffness, yawning, word-finding getting worse than my baseline topiramate fog) i can usually push through a full day or text the office i might need coverage. the ones with zero warning, aura straight into pain in under 10 minutes, those are the ones where i’m literally walking out mid-lesson. aimovig cut my total attack count but it didn’t touch the no-warning subset at all, they’re just as frequent as before.
so now i think “migraine days per month” was never the number that mattered for the work problem. it’s “no-warning attacks per month” and that one’s flat. which makes me wonder if a preventive working on frequency and a preventive working on onset predictability are actually two separate things nobody talks about separately. has anyone tracked this split themselves, warned vs unwarned attacks, and found one med moved the ratio?
or is this just how CGRP preventives work, they reduce volume but leave the surprise ones alone? trying to figure out if this is worth bringing to my neuro as its own question or if i’m overthinking one column in a spreadsheet.