Migraine

Is there a difference between chronic daily headache and transformed migraine? My neuro said I have CDH (getting 2nd opinion as everyone is well aware) but my symptoms much more closely resemble migraine, not tension headache.

Hi Melissa!

I'm so glad you're getting a second opinion because the best person to talk to is your doctor. Here are some articles about Chronic Daily Headaches and Transformed Migraine to help get you started:

Chronic Daily Headaches - Headaches that occur 15 or more days a month

Transformed Migraine - The Basics - Marked by increasingly frequent Migraine attacks, eventually becoming daily less severe headaches punctuated by debilitating Migraine attacks.

I hope this helps! Keep us posted, k? Good luck!

Hi sweetie,

I think the poor doctor just doesn't know where to turn. Laura gave you good information. After you read it, let us know what you think,ok?

I'm still not sure. Like you said Nancy, I think old Doc is reaching with CDH. Both of these diagnoses generally speaking seem to have medication overuse associated with them, and that is something I have consciously worked to avoid. I take abortives maybe two, three times a month at the most. I'll fill in with ibuprofen maybe once a week when I really can't take the pain. But almost every day on my headache calendar has a migraine penciled in.

I'm having a personal mental block about tension headaches. I normally do have quite a bit of muscle "cramping" I would call it in my scalp and neck during and after a migraine, but only on my right side. My head also tends to pull forward. I just can't relax. It's an involuntary spasm associated with the headache. My personal block with the tension headache is I feel like they would be my fault, like I'm doing it to myself.

I think I'm going to reserve any judgement for the end of July when I see Dr. Kaniecki. Its just too complicated.

Thanks for all the info.

Hey now, of course your not "doing it to yourself", that is just silly talk. I hight doubt you would want to walk around in pain with a Tension-Type headache or any other type because you were doing it to yourself.

I'll make you a deal. If you give yourself a break, I'll give myself one too.... does that sound good?

Nope nope nope, you are not doing it to yourself. With CDH, in about 80% of cases (according to my doc) MOH is an issue. That means in 20% of the cases there is no MOH issue. I'm one of those 20%. My CDH developed into daily migraines and now a continuous migraine - which my doc says is somewhere between transformed migraine and status migrainous - and no MOH issue. I am rigorous about not overusing my abortives. So DO NOT blame yourself, and DO NOT think that all cases of CDH or transformed migraine are the "fault" of the sufferer. Some of us are just programmed that way.

I often have neck stiffness with a migraine--a migraine, not a TTH. So those muscular neck pains can be migraine symptoms. I am really not prone to TTH at all. While I'm sure I've had one in my lifetime, I really can't remember when. And my doctor wants me to assume that all head pain I experience is migraine.

Interesting discussion-

My neurologist diagnosed all my pain as migraines, and my head specialist diagnosed me with CDH and Migraines.

Ugh - it's the same thing with Transformed Migraine - my doctor diagnosed me with Transformed Migraine in Jan.

After looking at my pattern - I get it, but I know I'm not in the 80% who overuse medication. I am very careful about that. So it took me awhile to fully accept the diagnosis.

My symptoms were migraines daily - lower on the pain scale. At the time, I described to my doctor possible TTH since I was not sure. I just said sometimes the migraine didn't feel unilateral in nature - he said they are probably tension headaches. I was having them so back to back - they would mix into each other - TTH triggering migraine - migraine right into TTH - it was a mess! I get why it's called Transformed Migraine!

The addition of Amitriptyline since January has really knocked down the TTH's to maybe 3 a month - as opposed to 2-3 a week on top of migraines. And the migraines are down to about 1 every 16 days or so.

So I have to say his diagnosis, and reading about it, I feel was on the money.

Have you or do you have muscle relaxers in your toolbox of medications that you use for the headaches that are not migraines? I find them helpful sometimes to knock down the pain and avoid having my TTH or regular headache (which I rarely get a regular headache) trigger a migraine for me.

Okay, Nancy, I'll give myself a break. I do think most of my pain is migraine-related, though I'm still not sure what overall condition my doctor in July is going to call it. I'll be sure to keep you posted.

For those of you who have CDH - how well do you function, day-to-day? I'm not getting a lot of "clean periods" right now. I have daily pain (hence the name, right? ). It really prevents me from doing anything.

Nut - What do you do to get relief from the neck stiffness? That seems to be part of my postdrome a lot of the time, and its tough to deal with.

Thanks again to everyone for all of the info.

Eileen,

We must have been posting at the same time. I don't have muscle relaxers. Just 200 mg Topamax daily as a preventive, Relpax as an abortive and Motrin as I see fit. Aleve did nothing for me, and my neuro was very disappointed. That is apparently the great new hope, imitrex and naproxen. It doesn't do much for me. But I'm getting off topic.

Anyway, my current neuro went as far as the topa and relpax in 3 visits and told me to see another doc. He couldn't help me with my headaches anymore. So I see a headache specialist here in Pittsburgh at the end of July. He is on the patient reccommended list, so good things are coming.

Melissa,

I know the question about neck pain was directed to Nut, but I'd like to chime in, if I may.

Have you looked into a TENS unit? I know they have them on Amazon and I believe you can also get them from your doctor. It's little patches you put on the area of pain or tension (like your neck) and then when you turn the unit on, it will help release some of the tension in that area....I don't think I'm explaining it that well, but I know both Teri and Jamie use them. They may chime in when they see this.

Or, I have one of those little hand held dealies that I got for christmas.....sometimes I can actually convince DH to use it on my neck for 2 seconds before he gets bored and gives up......typical huh? We have to give them like 10 min. back rubs, we get like 15 seconds.

Just something to think about....

I have a TENS unit, too, and while I don't use it for migraine, I do use it for fibro, and it would've probably been a lifesaver several years ago, when I was having severe muscle spasms, which let to tension/migraine combo headaches.

You do really need to go through your doctor to get a TENS. They have to be prescribed. I went through my neuro, who then sent me to the PT department to get the unit, learn how best to use it and where I could safely put the electrodes, etc. You can rent them temporarily and give them a test drive before you commit, to see if they help, too. Mine was roughly $700, and I was told that while there are some cheaper, you get what you pay for. I can adjust for all different kinds of modulations and frequencies with mine. If you get a cheapo with maybe two settings, my PT said you can "acclimate" to them quickly, and after a bit it won't help anymore.

quote:

Originally posted by Melissa Z:
For those of you who have CDH - how well do you function, day-to-day? I'm not getting a lot of "clean periods" right now. I have daily pain (hence the name, right? ). It really prevents me from doing anything.

On average, I have about five days a month without pain, which is an improvement over last year. I can relate to the daily challenge. Having four young children I have had to be very creative with how I deal with CDH and migraines.

The thing that helps me the most is I try to focus on what I can do, not what I can not. (Something I tell the kids too.) For example, I actively focus on being grateful for the milder days and the days I don't have nausea with the pain, instead of being frustrated (I've been there too).

On the really bad days, I give myself a break and surrender to the migraine. Somehow it makes things easier not to fight it.

I also don't lose hope that I will find the right preventative mix for my migraines. I've learned that knowing my body and learning as much as I can about migraine disease will help my HA specialist make the best choices for me.

Share your frustrations with your doctor and make suggestions that you believe might help you. Best of luck in July!

Since my neck stiffness is a symptom of the migraine, it goes away once a triptan has fully aborted the migraine. It doesn't linger around during postdrome. So I guess I can't help much with that question.