Migraine

Hi Terry,
I just wanna give you a bit of background, and get your opinion, I know you cant give me medical advice..

I have hemiplegic migraines. Since the day before thanksgiving I have been on the same migraine. It wasnt too bad untill Monday the 26th. By wed. I was getting worse and worse despite my varapamil and midrin. My neuro upped the varapamil, and put me on a 4 day steriod dose. Thursday night was horrible I kenw i was in status migranus by then, so went to the urgent care. My neuro had orders for drs to follow. So I got oxyge, dose of lasix, toridal and compazine. I had a reaction to the compazine, so they gave me ativan to contridict that.

On sunday night i started having small seizures.(not grand mal but something..) Called neuro, she sent me to the day nurse clinic for more lasix and toridol. (Lasix dropped my bp so low before docs didnt wanna give again!) Then just before getting the treatment I had a seizure, totaly unresponsive. They took me to their hospital by ambulance. Spent all day there, gave me more toridol(duh its not working peeps!) and a steriod starts with a D..cant remember name. They did a CT, which was fine. Then ER dr said both him AND my "migraine specialest neuro" had no more ideas! and sent me home!

By this friday still awful, I had asked for an outside referral to The Oregon Headache Clinic. They could get me in Thursday the 13. My neuro had me come in friday for a nerve block. All that did was make my nerves mad! Made migraine worse! Then we come home and find out insurance(kaiser permenente) denied my referral but would send me to one of theier"contracted outside Drs" He is 2 months out.

Well Sat. I went back to urgent care. FINALLY saw a dr that was concerned that I was in this same migraine for SO long! Talked to him about being admited for Iv refractory(sp?) treatment. He said I should be admitted, and sent me down to the local ER hospital with a letter from him. Well the ER dr was very flippant, doubt he even read the letter from the urgent care dr, and said well what do you want me to try? I told him my neuro was out of ideas but we needed to do something. He gave me...Ativan and dilouded and sent me home.
He acted like I was just anxious! Um little nervous about a 2 week status migranus that wont break maybe, but I know when I need help for petes sake! He sent my hubby home with a 5 day prescription of Ativan too. told him they use it as a migraine breaker sometimes. My migraine is STILL there, once i woke up from a drug induced sleep yet again.

Have you heard of ativan used as a migraine breaker? Should I push further? should I take the ativan he prescribed! (I will be calling my dr about this one) I am not having anxiety, or depression, just getting VERY frustrated with dumb drs! Any Ideas where I can turn now is greatly appreciated. Feel though my nuro is no more help to me, but cant afford to pay out of pocket forthe headache clinic, and feel 2 months is WAY to long to wait this one out(perhaps if it would break then I dont mind waiting 2 months for new neuro...)

Yikes! That's a real predicament. The steroid starting with a D was probably Decadron.

In your place, I'd be concerned about letting that Migraine go two months too.

I've heard of Ativan given as part of a combination of med (IV) to break a Migraine, but never oral Ativan taken at home to break a Migraine. I don't think Ativan alone CAN break a Migraine.

Doesn't your neuro have hospital privileges? I'd think that if he can't do IV infusion in his office, he'd admit you for IV therapy. I've seen, and people here have had success with, IV magnesium sulfate breaking a Migraine. Simple, easy, and safe. If that doesn't work, there are still many things to try. You may have already seen this article, but I'll give it to you anyway because it has a list of meds that work well for IV infusion, V Treatment of Refractory Migraines.

Darn. I wish I knew more to suggest.Is this particular Migraine a hemiplegic Migraine? I think those would worry me more, but I'd be concerned about any Migraine going this long.

Please keep us posted?

Hi Terry TY for replying.

I am having a hemiplegic, though no total paralysis this time. Its ranging from numb and tingly(do that with NON hemi ones too) to true motor weakness. Somedays I have more neuro problems..talking, spastic eyes, etc. So I feel it is hemiplegic, but nnot constantly does that make any sense? I have lost consousness though several times, with seizures.

The ER I went to a week ago was my Neuros Hospital, thats why the ambulance took me to that one. I truly do NOT know what this lady is thinking!

NEW TWIST: She had all over in my chart that im contraindicated for DHE and Imtrex, and other triptans. Get this. She called yesterday saying she wants me to go to nurse treatment 2X a day for IV treatment of: IV DHE! She actually REMOVED her warnings just so the nurse could do the first treatment. I asked about magnesium IV instead. TOld her I was hesitant to do the DHE. She says the IV is less of a risk than the injection form for me. So I did one treatment yesterday and felt HORRIBLE, NOT doing any more until I get a 2nd opinion.

While I was there I got a message from the Oregon Headache Clinic. We had gotten as far as sending my charts to them before our insurance dnied us. Their dr had actually looked through my file, saw that the DR was gonna treat me with DHE and called JUST to warn me to NOT do it and see a different dr immediatly! I had already cancled my appt. with this wonderful lady, as my insurance wont cover the visit to her and she STILL looked through my file and warned me! Now im even more worried about doing further DHE treatments, OR listening to ANYTHING else my neuro says! What do you think??

Oh, boy.

Thanks for clarifying that this Migraine IS hemiplegic. Wanted to be sure since most people with HM also have Migraine with aura, Migraine without aura, or both.

Triptans and HM and basilar-type Migraine are a topic of some debate. I don't know of any studies of triptans in HM, but there was one with BTM that showed triptans to be safe and successful. Dr. Krusz mention that in this week's Ask the Clinician, HERE.

In your place, I'd be concerned about DHE and triptans. I find it concerning that your current doctor removed the warning from your chart and ordered the treatment.

I really feel for you. Our insurance stopped paying for my specialist treatment when my husband retired, and we had both travel and the doctor's bill to pay every time I went after that.

Darn. Wish there were some kind of concrete information I could come up with you. There just isn't though. I'm sorry.

Please, even though this is a tough situation where we don't have solid info to share, please keep talking to us about your concerns and keep us posted on this?

with a gentle hug,

quote:

Originally posted by momsbreak9:
Hi Terry TY for replying.

I am having a hemiplegic, though no total paralysis this time. Its ranging from numb and tingly(do that with NON hemi ones too) to true motor weakness. Somedays I have more neuro problems..talking, spastic eyes, etc. So I feel it is hemiplegic, but nnot constantly does that make any sense? I have lost consousness though several times, with seizures.

The ER I went to a week ago was my Neuros Hospital, thats why the ambulance took me to that one. I truly do NOT know what this lady is thinking!

NEW TWIST: She had all over in my chart that im contraindicated for DHE and Imtrex, and other triptans. Get this. She called yesterday saying she wants me to go to nurse treatment 2X a day for IV treatment of: IV DHE! She actually REMOVED her warnings just so the nurse could do the first treatment. I asked about magnesium IV instead. TOld her I was hesitant to do the DHE. She says the IV is less of a risk than the injection form for me. So I did one treatment yesterday and felt HORRIBLE, NOT doing any more until I get a 2nd opinion.

While I was there I got a message from the Oregon Headache Clinic. We had gotten as far as sending my charts to them before our insurance dnied us. Their dr had actually looked through my file, saw that the DR was gonna treat me with DHE and called JUST to warn me to NOT do it and see a different dr immediatly! I had already cancled my appt. with this wonderful lady, as my insurance wont cover the visit to her and she STILL looked through my file and warned me! Now im even more worried about doing further DHE treatments, OR listening to ANYTHING else my neuro says! What do you think??

Thanks for the support Terry!

I also have Migraines with Aura, those are most common for me. This particular ongong migraine seems to be a mix of BOTH aura and hemiplegic.

My neuro messaged the new neuro that my insurance will refer me to: Dr Hubert Leonard from Legacy Good Sam hospital. Suddeny my neuro wants to FINALLY admit me into the hospital. I go in a few hours as soon as she gets the admit papers done.

I am a little nervous to be under her care, as I dont think she has handled anything right so far, And Im particularly concerned all she wants to do is DHE, which makes me feel WAY worse. BUT I am glad to finally be admited, and hope and pray that when I get out I will be Done with this 3+ week migraine!!

She hasnt tried Triptans on me, she has been really cautious about that, just DHE, whci she origionally said was a NO NO for me. We shall see!

Sorry the darn insurance stopped paying for your appointments. The added stress of having to pay for the DR Im sure doesnt help!

I will update ya when I get back from the hospital.

THanks again for the info and support!

Tawsha

Tawasha,

Honey, I'm glad you're finally going to get some help. Maybe they'll do soma magnesium sulfate, antinausea meds, or some of the other infusion options other than DHE.

I'll watch for an update from you. REALLY want to see you feeling better before Christmas.

sending hugs,

quote:

Originally posted by momsbreak9:
Thanks for the support Terry!

I also have Migraines with Aura, those are most common for me. This particular ongong migraine seems to be a mix of BOTH aura and hemiplegic.

My neuro messaged the new neuro that my insurance will refer me to: Dr Hubert Leonard from Legacy Good Sam hospital. Suddeny my neuro wants to FINALLY admit me into the hospital. I go in a few hours as soon as she gets the admit papers done.

I am a little nervous to be under her care, as I dont think she has handled anything right so far, And Im particularly concerned all she wants to do is DHE, which makes me feel WAY worse. BUT I am glad to finally be admited, and hope and pray that when I get out I will be Done with this 3+ week migraine!!

She hasnt tried Triptans on me, she has been really cautious about that, just DHE, whci she origionally said was a NO NO for me. We shall see!

Sorry the darn insurance stopped paying for your appointments. The added stress of having to pay for the DR Im sure doesnt help!

I will update ya when I get back from the hospital.

THanks again for the info and support!

Tawsha