Migraine

One of the things I'm concerned about after reading some of the posts is my Dr. hasn't really been that good with giving me abortive or rescue medications. I had to twist his arm to get him to give me Vicodin to try, He made me take a drug test and sign a narcotics agreement before he would give me the scrip.. He has had me try most of the Triptans but they only work a small percentage of the time and when he found out that they didn't work for me he didn't make any other suggestions.

He really gave me a hard time about the Vicodin and they don't work to well. I can understand that he doesn't like to give out narcotics and I don't mind doing the drug test every 3 weeks but he expects me to only take drugs for my very worse headache. I have had the Vicodin for about a month and only taken it twice when I had # 7 headaches but when I get # 5 or # 6 headaches I'm in bed and in really bad pain and I get headaches this bad 3 or 4 days a week.

One of the problems is that I wake up with them so they are full blown and the Triptans don't work at that point. I'm at a loss I don't know what to ask for.

If anyone has any suggestions that I should talk to the Dr. about please let me know .

Thanks in advance...

Jim

Jim--

Have you discussed DHE-45 with your doctor? If you are a candidate for it, it could be a good abortive for you. I have always had a dreadful problem with rebound to the triptans, and for many years found DHE to be my best choice. I used both the IM injection (for the bad headaches) and the nasal spray for the lesser ones. I cannot take it any longer however and have had to learn to deal with the almost immediate MOH from the triptans.

Tracie

Hi Jim,

Have you tried trigger identification and management with a Migraine diary? This may give you an idea when a Migraine attack occurs, what may be triggering it and what medications help, or don't help it. After you complete the diary for a few months you can bring it into your doctors visit and discuss it. You can find that information HERE.

The other important part of treatment is a good preventive medication. If you are getting 3-4 Migraines a week, your preventive medication is not working properly. Have you seen this: Migraine Preventive Medications - Too Many Options To Give Up!

Seeing a Migraine specialist may be the best thing you can do for yourself. We have a list of patient recommended doctors you can see by clicking HERE. We currently don't have a Migraine specialist in MA, but do have excellent ones in CT. That's not too far from you.

Hi and Thanks for responding.

I am going to talk to my Dr. about DHE-45 and see what he has to say.
Nancy I have been keeping a headache diary for about a year and a half and update it every day I bring it in to the Dr. ever 3 weeks when I see him, So really I start a new one every 3 weeks or so.

The Dr. I'm seeing is in a pain clinic, He's a Neuro. that deals with a lot of migraineurs, I have tried quite a few of the preventive medications and now he has me on 5 of them at the same time and he said he is going to load me up because no one of them has worked for me on its own.

As far as triggers go I normally wake up with a migraine just about every day on the rare occasion that don't have one when I wake up a loud noise such as a car with a loud muffler or a car with a loud booming stereos going by the house will set it off.

I haven't found any food triggers other than alcohol and MSG so I stay far away from them and some smells, So come to thing about it I do have a lot of triggers that I automatically avoid as much as I can. So you gave me something to think about.

Jim

Hi Jim,

I wake up with most of my migraines too. Nancy's suggestion about keeping a migraine diary is a great one. I use mine to track my triggers and also my medicine intake. I print mine out and bring it to each doctor's visit.

Here is an Ask the Clinician question about waking up with migraines. I hope it helps

Hi, Jim,

Has your doctor ever asked you about your sleep? I assume you've mentioned to him that you wake with Migraines. If he hasn't asked you about your sleep patterns and quality of sleep, run - don't walk - to another doctor. Waking with a Migraine is a huge sign that sleep issues may well be a Migraine trigger, and any doctor who understands much about Migraine knows that and should follow up on it. Too much, too little, disrupted, or poor quality sleep can all be horrid Migraine triggers.

I don't really understand why you're starting a new Migraine diary every three weeks. Certainly take him a COPY of your diary, but it can be very important to keep an ongoing diary. If you haven't seen it already, take a look at the free downloadable diary work book in our article Your Migraine and Headache Diary.

Something else that doesn't make sense is taking five preventive medications at the same time and "loading you up" on them. Do any of them help? Did you start taking them at the same time? If a preventive helps, but your Migraines are still to frequent and/or severe, then adding another med makes sense. If they're not working, then there's no reason to keep taking them. Many of us have found that a combination of meds works better than a single one, but it takes time to develop a regimen. It can take up to three months to know if a med is going to work, but if you start more than one at a time, and something helps, then you don't know which one is working.

quote:

Originally posted by JimFallRiver:
Hi and Thanks for responding.

I am going to talk to my Dr. about DHE-45 and see what he has to say.
Nancy I have been keeping a headache diary for about a year and a half and update it every day I bring it in to the Dr. ever 3 weeks when I see him, So really I start a new one every 3 weeks or so.

The Dr. I'm seeing is in a pain clinic, He's a Neuro. that deals with a lot of migraineurs, I have tried quite a few of the preventive medications and now he has me on 5 of them at the same time and he said he is going to load me up because no one of them has worked for me on its own.

As far as triggers go I normally wake up with a migraine just about every day on the rare occasion that don't have one when I wake up a loud noise such as a car with a loud muffler or a car with a loud booming stereos going by the house will set it off.

I haven't found any food triggers other than alcohol and MSG so I stay far away from them and some smells, So come to thing about it I do have a lot of triggers that I automatically avoid as much as I can. So you gave me something to think about.

Jim

Hi Teri.
I start a new diary after I see hi so that I'm not giving him the same pages over and over. I do my log on Excel so I have about 20 pages over the last year and a half. I do keep all my logs and can re print them for a new Dr.

He asks me about my sleep every time I see him. He started me on Trazodone a couple moths ago to help me sleep, I have insomnia and have been taking Lunesta for a year and a half so its not as affective as it used to be. I have talked to him about doing a sleep study but we haven't made any firm plans.

As far as the preventive med's he started me on them one at a time. I think his reasoning is to get me up to full dose on the med's and see if that works. He said if it doesn't work within the next few months we will try a different combination.

I hope this helps clear some of this up, If you have any other questions or comments please let me know.

Jim

Jim--

With your migraines beginning while you're asleep, you may be having problems with sleep apnea or other sleep disturbances. Have you had a sleep study? This test can be a very important diagnostic aid in the kinds of migraines you're describing.

Tracie

Hi Tracie,
I had a sleep apnea test done about 5 years ago before I started getting the headaches and at that time I had apnea but sense then I have lost 60 pounds and the apnea has gone away. But I'm going to talk to my Dr. about take another sleep test just to be on the safe side. I don't know if there are different types of sleep tests but I will talk to him about that. I know that one of the problems is that I wake up often during the night even with all the med's I'm on for sleep so it could be apnea again, I just hate to think it is I had so much trouble sleeping with the mask on. But again I will check into it and post it here.

Thanks for responding to my post.

Jim

Jim--

I understand where you're coming from on the apnea and mask. My test does show apnea, but I have been absolutely unable to adapt to ANY form of C-Pap so far, much to Dr.T's disappointment. I have very severe claustrophobia and special fear of masks due to surgery as a child and even hypnosis couldn't completely cure it. I wake up the second the machine trips, unable to breathe with a gigantic panic attack which immediately triggers a major migraine. So now I sleep with Oxygen using a simple nasal cannula, and that has helped a lot. (Using Oxygen at the beginning of a migraine can reduce and even abort one sometimes).

Anyway, even if you do have apnea, obviously C-Pap is not your only option! I just wanted you to know that--otherwise it could just feel too hopeless (I know that's how I felt while Dr.T and I were arguing it out!)

Tracie