Case Histories - February 1998 (3/18)

i'm 27 and have had migraines since i was ten. prior to puberty, they weren't terribly severe - i'd lose my peripheral vision for a while, and that would be it. i can't recall exactly when they did get full-blown (the so-called "aura", although i think that's an awfully kind name for the visual disturbances i get, numbness, dizziness, nausua, hypersensitivity to ALL of my senses), but now it seems that they've always been like that. i'm lucky in that the overall severity of my migraines has become less as i've gotten older, as has the overall frequency. just the same, when one DOES occur, it seems like "the worst one ever" (no matter how logically i insist to myself it's not). i've been prescribed the cafergot/fiorinal [or fioricet] combination, with limited success - although the cafergot seemed to do VERY little, and i eventually only had the pain med scrips refilled. recently, i was givin midrin (which was UTTERLY worthless) and then, after insisting on "something else", was given imitrex. that doesn't seem terribly effective, either. what frustrates me most is the unwillingness of my doctor to actually *listen* to me about any of this - after all, I'M the one who's had the condition for 17 years, i should know a little bit about how i'll react to certain things. the imitrex, for instance, seems to do more harm than good. in addition to not-really-helping, the side effects are awful: extreme muscular tension, nausea over and above the usual, along with a general "ditzyness" which makes my detail-intensive job all but impossible to do. and lets not forget the COST of the stuff... over $10 PER PILL. i digress. my doctor acts like she listens, but does whatever she wants anyway. the only effective cure i've ever found was chiropractic - at one time, i worked for a chiro and if i felt one coming on, she would adjust me and i'd immediately feel better. and regular adjustments seemed to keep them very effectively at bay for over a year. another point of interest to me is the fact that once i actually have one, it seems to take days for it to go away, even if the aura/initial headache was brief. the effects seem to last anywhere from 24-72 hours, which is frustrating in the extreme. i've never found a consistent pattern to them. avoiding the proper foods seems to have no effect. stress is definitely a factor, but there are times when i'm so stressed out that i'd think i should have one, but don't. hormonal changes also seem to contribute, but not in any reliable way... on another note, what i would like to see is an automatic referral to a specialist for migraines, since every GP i've been to seems relatively clueless - and since, even within that state, they don't want to listen to the clues the patient could offer. sorry if this is a generalized gripe, but that seems to be another of my symptoms: loss of all patience and extreme irritability (maybe has something to do with the overall hyper-sensitivity?)... and i'm still dealing with the backlash effects of imitrex... relief and luck to all... and i'll be checking out the chiro in portland that was mentioned!

---tessa <kauzhqa@earthlink.net>
portland, or USA -

I have had migraines since I was very young. I used to call them "eye aches" and my mother never knew what was wrong with me. I recently got on Doxepin which is supposed to help with the recurrent headaches I get every day. I also use Imitrex, which has been a godsend. Lately my migraines seem to be getting worse. I've been doing more research on them and watching what I eat and drink carefully, but I still seem to get whalloped. I get at least one a week, which is a blessing, because up until 2 months ago, I've been getting 4 or 5 a week for the past 3 years. I would welcome any ideas or medicines from other people who have a history like mine. Sometimes they come out of nowhere and they're driving me crazy and making me angry and irritable. I also feel guilty because my fiance has to put up with me. At times I feel as if I ruin our day because I get one and I have to be at home. Does anyone else experience this?

---Mary <scratch@ptdprolog.net>
PA USA -

I suffered a serious neck injury (compression of the cervical spine) in a skiing accident 20 years ago.This resulted in two separate surgeries involving discectomy and fusion (1990 and 1997). My most recent operation was, in part, necessitated by incapacitating, right-sided, migraine-like headaches (photosensitivity, severe nausea and vomiting, extreme throbbing pain) due to pressure caused by spasms and calcification at the occipital nerve root (C4). Although surgery brought complete relief for 4-5 months, the intensity and frequency of the migraines are returning. I am certain that these headaches are related to muscular-skeletal involvement. Though I am rarely free of neck pain and/or muscle spasm, the headaches only occur when neck pain and spasms are particularly acute. Most of the time, 50-100mg of Imitrex will resolve a headache to the point where I can function within 4-6 hours. Occasionally, I am laid up for two full days with only minimal relief from Imitrex and fioricet in combination with the meds that I am accustomed to taking in various combinations to manage the neck pain/spasms, e.g., valium, vicodin, ibuprofen (until my stomach reacts, usually within 24-48 hours). Lately, these "occipital migraines" have been occurring at a rate of 4-6 per month. Though I have been in the care of a wonderful neurosurgeon (Baylor College of Medicine/Houston) for 12 years, my new health plan does not cover his services, nor those of any neurosurgeon he is comfortable recommending. I honestly believe that the best - perhaps only - long-term, therapeutic solution to my problem lies in treating the head/neck symptoms with intense, carefully managed, physiotherapy (heat, cold, ultrasound, massage, and physical rehab). However, insurance will not pay for therapy at any of the Baylor institutions and I am highly distrustful of going to the for-profit (read:non-academic, less-experienced) physical therapists listed on my "health plan", particularly since anÊ MRI after my first surgery revealed a syringo myelia, e.g., herniation of the spinal cord, at C 6-7. In short, I barely escaped quadraplegia from my original injury; after two neck operations and several years of chronic tissue deterioration, one "mistake" by an inexperienced or overly-confident physical therapist could ruin me. Like most people, I cannot afford to pay "through the nose" for long-term treatment; and I know from previous experience that the physiotherapy regimen from which I have benefitted in the past is very costly. Any advice, suggestions, ideas, remedies, referrals, and commiserations are most welcome! Frankly, I would like to know if there is anyone out there who suffers from (or treats) trauma-induced migraines like mine, particularly from cervical spine injury. Contact Chris at: revcsteele@msn.com Thanks.

---Chris Steele <revcsteele@msn.com>
Houston, Tx USA -

I am a migraine sufferer for 20 years and counting. They are classified as menstral migraine. Instead of paying the high cost of emergency room care, find a family doctor that will allow you to come to his or her office when your migraine strikes, and receive the demerol/viseral at the office. Be sure to have a ride with you or they maybe wont allow it. I now go to my family doctor every month when I have an attack. They give me a shot (sometimes 2 or 3) and I go home. This is at my family doctors office! Alot more affordable, and you feel a little better knowing you are being cared for by your own doctor. Vicks vapor rub works great with an ice pack tucked in my eye sockets. Is there really a preventative drug that works? I guess I would rather suffer once or twice a month, then live every day with the side effects of dangerous drugs. Hair loss, muscle spasms, sleepiness, low pulse rate, fainting, dizziness, low sex drive, weight gain, weight loss, headaches, just to name a few. Doesnt make any sense. Headaches as a side effect for preventative meds. No thank you! Good luck.

---Tammy <tengstro.excel.net>
WI USA -

Hello, My name is VINCE RAMCHARRAN and I am a migraine suffer...I am 52 and have had migraines as far back as I can remember...I have read all of these messages and could relate to the treatment and pain...I dont know how I have not taken my life as yet...I get my headaches in bouts of three months and might go for a year without having any...I am at the moment in the middle of a bout with two to four attacks a day...I have surrendered myself to learn to live with the headaches...I find that vicks trigger my headaches and they seem to occur with some chemical imbalance in my body...my hands have a acidy smell and have to wash it with a sweet smelling soap...In the past I would throwup and want to stay in a quiet dark room...noise still bothers me but now I get some relief in a bright lit room...a few days ago, I went to the ER with a numbness on the left side of my face and nose..first time it ever happened...I dont think anyone know for sure what causes migraines...I have done EVERYTHING mentioned on this page...including a brain scan while the headache was occuring and an operation to "FREEZE" some arteries causing the headaches...I live my life normally an when the headache occur I deal with it THIS WAY...one of my headache occurs 60 to 80 minutes after I go to sleep...like clockwork...it wakes me up...I first take a 100mg IMITREX tablet..the needle and spray dont work fast enough...I then put two drops of XYLOCAINE in my left nostril...my headache occur on the left side of the head and behind the left eye..my temperature goes up quite a bit..so I next put a cold cloth over my left eye and even go outside in the cold to cool off...I would know if the headache would be serious and might take two Tylenol#3 with the Xylocaine instead of the IMITREX...I noticed that if I breath in heavily the headache gets worst so I breathe in slowly thru my mouth and exhale thru my mouth...I NEED TO CALM DOWN while this volcaneo erupts in my head...the method I use to calm down is to mediate on something far away...I grew up in South America and noticed a large bent nail on a coconut tree...at first I would mediate on the cracks at the back of the bent nail...I have focused on the sharp ridge of a large mountain and most recently I have been focusing on the tip of a needle..while I wait for the mediacation to work I need to calm down and lower my body temperature...I now get some relief from bright lights..I would go in the bath room and stare in the mirror..or I would put on a action movie that I have seen b4 ..and with the sound down I would stare at the screen...as the medication starts to work I would get intermittent SECONDS rrelief and I know that the headache is starting to go away...I would the make my self comfortable and start to mediate on the tip of the needle...I also have a tight headband on...before too long I would fall asleep...at times I would wake up with a "Migraine Hangover"other tablets will take that away..after almost 50 years of migraines I feel that they are started my some chemical imbalance in my body .. and when I get them I need to lower my body temperature and CALM down..with practice it can be done..it is important to find a medication that works for you...in Canada there are reports where IMITREX have been known to cause heart problems cause by an excessive dose...I find now I can get rid of a headache sometimes in FIVE MINUTES...the hyper state of my mind can cause the headache to go on for two hours...my Key is to lower the body temperature and mediate the mind to CALM DOWN...it seems as if different treatment works for different people...If anyone wants to chat more about my method please e-mail me...

---Vince Ramcharran <VINCE_RAMCHARRAN@bc.sympatico.ca>
Prince George, BC CANADA -

Has anyone ever used a anesthesiologist who specializes in pain management to try a series of nerve blocks?

---Ray <ryeager@monmouth.com>
Manasquan, NJ USA -

Just discovered this journal. interesting, but almost gives me a headache just reading everyone's histories. My headaches started 17 years ago, age 42, and were HORRIBLE! Diagnosed for years as "sinusitis" Even had surgery to correct a deviated septum, which drs. were sure was causing nerve pressure & brought on the headaches. Worked for a year. Finally saw a neurologist 3 years ago, and heard the "CLUSTER" headache diagnosis. Classic. Always starts with a hard to define "stirring" in left temple. Alcohol, bright sunlight, dropping barometer, stress and napping will bring them on. My smoking can't be a help either. Dr. put me on Procardia about 2 yrs. ago, with Fioracet w/codeine for the pain. As soon as I feel the "stirring trigger", I take the Fioracet. 90% of the time this stops it cold. If it doesn't, I use an ice bag and lie down in the dark. Often take a second Fioracet. The first cycle of treatment with Procardia yielded about a 5 month cluser, but with fewer and less severe headaches. They then STOPPED for 20 mos., but returned in November. Back to Procardia (proceeding from 30 mg to 60 then 90). Have now gone almost a month without one! Even when I sneak a beer or two, or a couple drinks. Seems Procardia is having a therapeutic effect. I pray so, and hope it helps some of you guys. When that "hot poker" - always thru the left eye, then entire head, comes on, the pain is really bad. Any comments? Should I be on some CLUSTER-specific site?

---Tom Sandusky <oriolesnut@msn.com>
Somerdale, nj USA -