Case Histories - June 1997 (1/5)

Hi Ronda,

Exciting news for migraine sufferers. I have a letter already in your March 1997 file, but I had to share my experience!

On Saturday, I developed a migraine (aura and all). I had so much to do that day that I was quite discouraged and envisioned myself spending the day lying down and suffering as I usually do. I have taken Imitrex, etc. but find these migraine specialty drugs only trigger more attacks.

Well, on Saturday I decided to try an over-the-counter headache, muscle ache, fever reducer, etc., etc., pill called "Aleve". A half hour later, my migraine was there but very manageable to the point where I was able to function and go about my business. I could not believe it.

Please pass this on to your readers, I'm sure they would appreciate it!!

Best Regards,

---Dolores Lleida DBL@mail.BatelNET.bs

I'm 23 and I got my first attack of migraine when I was 18. It was during a university activity in which I had to be under direct sunlight for a period of about 4 hours. I felt the headache starting after I've gone inside a cooler room and I thought that it was normal because I was tired and I thought I just needed to rest. I went home, took a pain reliever and tried to get some sleep but it took a long time before I actually fell asleep. The headache disappeared but I still felt a bit dizzy. I didn't really think much about it until the headaches came again, increasing in intensity each time, and in one instance, I decided to go to the ER because the pain suddenly became excruciating, like I thought my head is about to explode, and I started throwing up. That's how I found out that I was actually having migraine headaches. The doctor gave me a shot of a pain reliever, the name of which I don't remember anymore, and made me rest until the headache was gone. Then he gave me a prescription for Avamigran. This drug was effective for me, as long as I take it as soon as I feel that the migraine is about to start. But when that happens and I unfortunately run out of Avamigran, it's back to the ER for me.

The thing is, I didn't use to get attacks frequently, that I didn't much bother to educate myself about this. I treated it as an occasional inconvenience that I had to live with and as long as I had Avamigran with me all the time, I felt reassured. But then Avamigran was reformulated and I don't know why but the new formula didn't work for me anymore. This came at a time when the headaches came more frequently. It's intense heat that triggers my attacks and that is really a problem where I live. You see, I live in the Philippines, where the summers are really hot and humid. On my last visit to a neurologist, the doctor told me that I should consider migrating to a cooler place, which of course is not a welcome alternative. He also told me that the drug I used to take sometimes actually triggers the headache itself. Now, I'm really baffled! He mentioned Imitrex and said that it appears to be the best solution to migraine headaches. BUT the bad news is -- IT'S NOT YET AVAILABLE IN THE PHILIPPINES!!! Tough luck for me! He then suggested that I try taking mefenamic acid first and to be sure to take it as soon as I feel the very first symptoms of an attack.

I followed that advice, of course. I guess it's working for me in the meantime, only, it takes longer for the headache to disappear than it used to when Avamigran was still working for me. Also, I need an icepack, a head/neck/shoulder massage and complete rest. What I really fear is that, one day, I might find mefenamic acid ineffective already.

P.S. Thanks to you, and to all your journal contributors, I somehow feel reassured that there'll be someone to turn to who will really understand what a fellow-migraineur feels. BTW, my e-mail address is rayerv@mnl.sequel.net

I am a 26 year old woman who has suffered from Migraine Headaches for about three years. I have been to a variety of doctors, and have taken a variety of drugs, and still, continue to have these headaches. Recently, my headaches have increased in frequency as well as in intensity. My headaches wake me up from a sound sleep, and are only temporarily subsided by prescription drugs like Imitrex and Fironal.

Due to having an HMO, my primary-care physician wants to try to treat me herself, (like many others before her), instead of sending me to a specialist, who deals in only headaches. I am tired of taking prescriptions that don't really give me any lasting relief, and I am tired of doctors telling me "Oh, you just have Migraines, here, take this and they will go away within an hour." If only it was that easy.

I feel so bad for my husband who now asks me daily, "Do you have a headache?" and then tries so hard to stay quiet when I do, so as not to aggravate it. I am at wits end about now, I have had a Migraine all weekend, with only a few hours of relief, and desperately want some feedback from people who have been where I am, and can give me some hope, advice or anything useful.

Thanks.

---Kim KLPowell@concentric.net

Thank you for this valuable service. I am a 44 year old physician who experienced a classical migraine prodrome around age 10. This was a progressive scotoma becoming a bilateral hemianopsia lasting about twenty minutes with no headache. In highschool I began suffering from Classical migraines, that seemed to reach their peak in frequency during college of once/ two or three months. Never had any nausea or vomiting and the headache would subside after 4-6 hrs. I was on a low dose of propranolol during med school for hypertension and this seemed to decrease the attacks to once or twice a year. After residency, I lost weight, no longer required propranolol for blood pressure and substituted Vitamin E 200 to 400 mg./day and a quarter of an aspirin tablet daily. I eventually stopped the aspirin also. Blood coagulation research published years ago in the journal "BLOOD" showed that Vitamin E decreases the "stickiness" and reativity of platelet membranes. Since platelet hyperactivity is a component of migraine I pursued this avenue. I believe it was effective because at one point I went 7 years without an attack, even though I was involved in a very stressful occupational setting. However, over the last few years I have had some unusual visual phenomena, and would appreciate it if any of your other migraine patients have had similar symptoms. Approximately 5 years ago I began exercising witha Nordic Track and after every 2nd or third 20 minute session suddenly have two large kidney shaped glowing blue objects appear in both temporal visual fields. They spared the central areas of vision. I couls see through the objects like they were blue glass or plastic. If, I closed my eyes nothing seemed amiss. The objects were "enhanced" or "refreshed" by blinking the eyes or waving a hand in front of the eyes. They acted and appeared much like a flahbulb afterimage from a camera. They would fade away after 10 or 15 minutes if i laid down and no headach resulted. After this occurred a dozen or so times a neurologist friend encouraged an MRI angiogram and all was normal. Several times I would also develope a small unilateral "spot" in one eye. One of these persisted for five days. If I stared at a visual scene it would disappear, but If I would blink or look around it would be "enhanced" and reappear About this time I learned of possible side effects of aspartame(Nutrasweet). I had been consuming large amounts of it to maintain proper weight. As soon as I stopped using it altogether, these symptoms almost disappeared completely, occuring only once every several months at most. I can usually correlate a recurrence with accidentally or foolishly taking aspartame in a pop or a dessert. The final and latest visual episode occurred recently. I was touring a prospective college campus with my son on a very sunny day with alot of glare. Everything was normal until I walked into a buliding. In the more subdued light I suddenly had large numbers of branching treelike black and blue lines superimposed on otherwise clear and complete visual fields. If I stared at a bulletin board they would fade in a fraction of a second. However, simply walking down hallways, the everchanging background passing light and windows would "refresh" the very annoying images. It was as if one had been exposed to a very bright point sources of light with shimmering afterimages that would not go away unless you closed your eyes or maintained a fixed gaze at an unchanging scene. At one point looking out a window and blinking my eyes rapidly, I saw large asterisk shaped bodies, centered in both visual fields composed of many irregularly shaped polygonal geometric figures. This all ceased upon going out into bright sunlight, but would be there when re-entering a building. This lasted about a half hour and was followed my a mild generalized headache. Have any other migraine sufferers experienced an evolution or changing of their visual symptoms over long periods of time? I am concerned because my previous personal experience and medical literature indicate that migraine visual alterations cause a loss of visual field or an obscuring zig-zag image. These "new" symptoms are superimposed on intact vision, have this strange come and go quality like a camera flash afterimage, and are usually unaccompanied by headache. Do they sound familiar to anyone? Please let me know at ilovevettes@msn.com If you try the Vitamin E remember it takes several months for the blood platelets to incorporate the changed lipids into their cell membranes, so don't expect instant results. Of course, it has no effect on an acute attack. Thanks for your time RR.

---ilovevettes@msn.com

I was so ecstatic to find your migraine page. At least I know I'm not alone in my migraine pain. I was previously migraine-free, but now it has been almost two months since I had my first attack, and I've had chronic, daily headache, (or head pain as I like to call it, because I could deal with a little "ache" but the pain is much more sever than that!!) ever since. I had the headache for about a week when I went to see a doctor in the walk-in clinic. He told me it was just anxiety, and told me the only thing he could prescribe me was tylenol with codeine to help me sleep! I told him I didn't want to sleep, that I wanted something to take the pain away. He said I should just tough it out. I cried the entire drive home, and that's when my husband and I decided that I would not be returning to that clinic/hospital anymore.

Well, the pain persisted for another week, when I saw a doctor in the urgent care clinic of another hospital. They first put me on Esgic, which did absolutely nothing for me. I returned the next day whereupon the doctor switched me to Ultram. Again, that did nothing to ease the pain. By the time the next night rolled around, I was in so much pain I honestly thought I was going to die. My mom drove me back up to the urgent care clinic, where the doctor said I didn't really have a "typical" migraine, but that "typical" is what you only read in some medical book. So she gave me a shot of Immitrex, which took the pain away in less than fifteen minutes. It was wonderful! Unfortunately, the effects wore off in about 24 hours, and my headache returned, although not so severe. However, three days later, I was in the clinic again to receive another shot of Immitrex. This doctor was very sympathetic, and told me over and over again how sorry he was that I had to go through this. He prescribed me some Immitrex pills which I could take at home (at $14 a pill!). My headache persisted though, and my family physician did some blood work and a CAT scan. Everything came back normal. He then prescribed me some Midrin, which sometimes worked, but sometimes didn't. The only thing I can do to feel a little better is to stand in a hot shower, or lie down with 3 ice paks on my head. The only time I'm certain not to be in pain is when I'm sleeping. When I saw my dr. last week , he prescribed some amitriptyline, and told me that it would take a few weeks to start feeling the benefits, but in the meantime I could still take Aleeve for my head if the pain got bad.

This past weekend I was in a wedding and I just had this feeling that I was going to get a bad one, and sure enough, on rehearsal night it started, and continued all day on Saturday too, throughout the wedding and reception. I layed down for awhile between the reception and the dance, and finally one of my friends dragged me out on the dance floor, and what a relief! I danced non-stop for four hours, because that was the only thing I could do to keep the pain away. Pain-free for four hours! I was exhilirated!! And keep in mind, I didn't have any alcohol the entire wedding either! I was confused though, because the following day I went for a brisk walk with my mother and the pain got worse as we walked. Sometimes physical activity can make it better, and sometimes it can make the pain worse. Weird. Finally on Monday I made an appointment to see a neurologist, and they got me in on Tuesday. The neuro looked at my head CAT scan films, and said my brain looked normal. I asked him why he had to look at them, when the notes were in my file and he explained that sometimes they can see things that other dr.s and radiologists don't see. I was relieved to hear him say that in his opinion, it was fine. He then performed a lot of neuro tests and then sat me down to talk with me like I was a real human being! He told me that because my mother has migraines, and because my head pain got extremely worse around the time of my menstrual cycle, he could almost certainly diagnose me with migraines. He told me that sometimes some lucky people, just have chronic ones, day after day, and that I was supposed to continue with my amitriptyline for another two weeks, and if it wasn't helping by then, he would increase my dosage up to 50 mg, and we'd start doing some biofeedback techniques. He then had his nurse hook me up to an IV for an hour and give me DHE eglan. I didn't care for that much at all, although it did lessen my headache. I got very nauseaous, and for the rest of the day I had chest pain (which is a normal side effect of the DHE). But I have to say, I went all afternoon with just a slight headache!! The nurse told me that I can also continue to use my Immitrex pills while I'm on the amitriptyline. I didn't know that, see what other doctors forget to tell you? She also said that the next time I got a really bad one, to call her in neurology and I could get in to get my immitrex shot there, and then she'd show me how to do my own injections at home, and the dr. would write me a prescription.

I would never have thought that headache pain could alter my life so much, or that it could cause so much pain! I get sharp, almost lightning bolt like pain that usually strikes the top of my head, and goes straight down the middle, or down the right side of my head. I also get pressure pain in my temples and behind my ears. I've also started taking Feverfew herbal liquid extract every day, to see if that will help. I am also considering going to a headache clinic, to see if they can help me. I'd be interested in hearing from anyone who suffers from this "head pain" on a daily basis also! You can e-mail me at mikki@mwt.net. Hope your day is pain-free!!!

I am 28 yr. old migraine and cluster headache sufferer. Since my first pregnancy (6 years ago). The last few years have been hell, except during my second pregnancy where I relatively headache-free (I had 4 headaches in the entire 9 months!).

I am on depakote right now, and they are upping my dose. I am already sleepy and lethargic (with two kids this is almost worse than the headaches!). Even worse, the depokote has not even slowed them down. I have tried Stadol (I feel like a rock, and pretty much act like one too), demerol (ditto, but with the added bonus of being able to sit under fluorescent lights in an ER for 3 hours and being looked at like a druggie waiting for a fix - can't find a better way to spend a Saturday).

My problem is this. I have taken so many drugs, both abortive and preventive, and none (SO FAR) have worked (Imitrix has very little effect). At this point I would rather wait for the migraine and take a pain pill. At least I am in control of the relief I need for my pain. With all the others (depokote included) I have no idea what they are doing to my body. If there are any beneficial effects, I don't know of them.

Additionally, any women out there who have been told they have migraine and cluster (I thought cluster headaches mostly happened in men??) and what meds/therapies have been useful?

I live in the Los Angeles area and would welcome any suggestions on where to go, who to see. I need to find either a cure (I am ALWAYS hopeful) or find a way to manage the pain with medication with a doctor who is willing, compassionate and knowledgeable.

P.S. I don't think being relatively headache-free is a good enough reason to more children... Though I do see it as an option...

---Heidy_Crow@MCKINSEY.COM

I am a 28 year old male suffering with migraines for nine years. During those years I have literally been through every test and medication and have found nothing that works except the opiates (percodan/Staydol/etc.). Other medications, indomethacin or the like, have seem to have rebound effects and some antidepressants such as Zoloft/Prozac actually seem to increase the frequency and intesity of the headaches.

My suggestion? Find a DR or pain clinic that will prescribe the opiate you need and take it without abusing it if possible. If your head hurts everyday, take it everyday. But explain to whomever that yes, in fact, your head hurts everyday/week/month and you need one/two/three pills or sprays a day to GET THROUGH LIFE!!!

Addiction is a real possibility, but it hurts a helluva lot less. Cure the pain, then work on the addiction.

Just some thoughts.

---cdillard@nashville.org