Migraine

I was never officially diagnosed with Migraines but I've had them since I was 15 or so. They have recently changed and have become more intense and linger for weeks. My rescue meds only work for a period of two hours. The first time I had one this bad was back in March it lasted weeks, a steroid pack finally broke it. My second one started a several weeks ago, I finished the steriod pack on Friday. I had a day of relief on Saturday and Sunday I woke up and there it was again. Today the pain was intense. I want my neuro to run tests and find out why I'm having these that are so different than the ones I used to have. I go to see my general dr on Thursday, she's normally very supportive of whatever I need done. I am hoping she'll be able to convince the neuro. Am I being unrealistic to want tests to find out why this are so different? Are these tests viewed as unnecessary because I've had migraines for so long (13 years)?

My parents are frustrated that no one has figured out why all of a sudden they are so intense. I haven't pushed it but now I feel like maybe it's necessary especially since I'm unable to get rid of this. I've tried doing research on my own to figure things out based on my symptoms but I'm not getting anywhere.

Any advice would be greatly appreciated. If the pain is bad tomorrow I anticipate going and sitting at the neuro's office and not leaving until someone helps me.

Rachel I'm not sure they can really test to find out why the migraines have gotten worse. What they can do is listen very carefully to what your new pattern is like and adjust and improve your treatment to address where you are now rather than where you were. do you keep a migraine diary? It might help to identify triggers and other factors that may have changed, and that you might be able to avoid.

Migraine patterns change and we often can't really identify why - could be age, changing hormones, changing stress patterns in your life, so many factors. What's important is getting a treatment plan that works for you!

- Megs

I think nutmegan is right that tests are unlikely to show why there's been a change in the migraine pattern. Migraines are called "primary" disorders precisely because they are not "secondary," or caused by, some other problem, although of course there are triggers for migraines.

Your doctors may run tests to rule out conditions other than migraines which might be causing your pain. You should ask the doctor whether tests are advisable for that purpose.

If your pain is migraine pain, then unfortunately, you will need to start a trial and error process to find a good treatment plan. If your migraines are lasting that long, it is time for a migraine specialist. See this list:

Patient Recommended Migraine and Headache Specialists

I'm just going to be repeating what Nutmegan and Nutcracker already said.

There really isn't any test they can run to find out why your pattern changed.

You're about 28 or so right? (15 at start + 13 years having) I can tell you for me, right after I turned 28 my migraines went from 1 every 2-3 months to 3-5 a week. It turned on a dime.

You can look into what has changed in your life, but even that is necessarily going to be a cause. I thought mine changed b/c I went back to school at night, but I dropped out a month ago, and I'm still getting clobbered.

Right now, I'm chalking it up to a late 20's hormonal shift.

Nutmegan has the right idea

quote:

What they can do is listen very carefully to what your new pattern is like and adjust and improve your treatment to address where you are now rather than where you were

Sorry we can't give you a better answer.... Good luck and keep us posted.

Everybody is right when they say that there are no tests to determine actual migraine causes, but if I were you, I would ask my doctor to do a very complete blood panel, including full testing for thyroid (all aspects, not just T4), and everything else endocrine he can think of. My headache specialists have always done that right up front. But a good internal medicine doc has a clue what to order. Anything a bit out of range would be good to know.

IMO, your best step would be to go to a headache specialist. They know what to look for and rule out. And, the good ones especially, will be able to get you started on experimenting around on meds that will help you. The best ones don't just throw a bunch of drugs at you and hope you get well. At least that's been my experience with the 3 good h.a. guys I've been fortunate to go to. We won't talk about the other 2, who were total turkeys.

Tracie

Thanks everyone for your replies. I guess my main way of thinking has been that these are being caused by something else and are not just migraines with no cause- that would be thanks some of my friends and family. My dad has suffered from migraines for most of his life although his aren't/weren't anywhere near as frequent as mine have been or as intense. I have a migraine specialist that runs a headache clinic here. I have pretty much decided to change to a new one. I found one in this area from the link provided by nutcracker- Thank you! I hope he is better than the current one. The nurse at the current one told me to go home yesterday and take a phenegran. While it did reduce the pain and knock me out for five hours it did not get rid of it completely. I realize now my preventative isn't working either which is frustrating but I've recently added an anti-depressant to my dailies so I had to change the preventative from one that was working to the one now.

Nutmegan- I don't officially keep a migraine diary. I am horrible about remembering to write things down and then i'm even worse keeping up with it. I have, however, noted the warning signs of when these come on. I'm hoping that will help once I get an abortive/rescue that actually works. I thought for a while nitrates/nitrites were my trigger but since i've avoided all those foods for weeks now I realize that was wrong.

Kaitlinthecorner- thank you for telling me that. It makes more sense now. I haven't yet turned 28 but my body has changed in several other area. I just never thought or imagined my migraine pattern would change as well and not to something this severe!

Thanks again for your replies. I hope it doesn't take too long to get on the right meds.

Rachel--

Remember there are lots of possible triggers and these can stack. Do you maintain a daily planner? The only way I can keep a decent diary is I write it in my planner (I used to use a palm pilot and kept it there but really like paper better (what can I say--I'm Old). I just remember to jot down possible triggers, time started, treatment and effectiveness. Until it became a habit, I had what to remember to log written down in the front of the planner. I move it to my paper log when I'm going to the doctor. You might find that easier to maintain, it only takes a minute to jot things down there. I'm NEVER without my planner.

Tracie

Rachel - Some of us have even used this site to aid our diaries - if you post every day, like come in the tea room and say how you are, then voila - there's a record of how you were on which day, what was going on, etc. Just a thought...

- Megs

Hi Rachel!

My migraines increased when I hit my mid-thirties and got so out of control that by the time I was 38, I had to quit my full time job because I spent more time in bed than I did at work. Nothing in my life had changed that would trigger the increase, it just happened. I began seeing a migraine specialist from the list that Nut gave you and now I'm seeing a dramatic improvement in my migraine pattern.

I also keep a detailed Migraine Diary in Excel and print it out for each doctor's visit.

Good luck and please keep us posted, k?

Hi there,

In addition to whateveryone else has said, I'd like to add a few things if I may.

It never hurts to have tests to rule out other conditions when head pain changes or "become more intense and linger for weeks" as you said in your post. Any change in our Migraine pattern should be discussed with our doctor.

Migraine patterns can and sometimes do change over time. Migraines and headache disorders can also be primary or secondary disorders. For more on What is Migraine? Click HERE.

Piggybacking on what everyone else has already said, I was around your age when my migraines "changed." I have experienced migraines since I was a child but around when I turned 28 or 29 my migraines changed in both frequency and intensity. Up until that time I would experience a migraine once every 1 or 2 months at the most. From age 28 or 29 they just steadily increased.

Like you I had a hard time keeping a migraine diary but I did find that once I did it helped track any triggers. I have to admit I didn't keep the diary as long as I should have but it did help rule out a lot things I thought were triggers, like caffeine for example.

Hang in there with trying to find the right meds. It's frustrating at times but if you have a good neurologist that will make it easier.

I have found that when I'm the most frustrated with my migraines, treatment, etc., it helps to come on here and talk about it or at the very least look at other member's posts.

Rachel,

I'm going to stray from the path of what most of the replies have said.

It's true that there are no tests to confirm a diagnosis of Migraine, but there are some things to consider...

• If you haven't had an MRI, if nothing else, it would relieve you to have one run to rule out organic brain issue.
  
• Is there any history of thyroid issues in your family? Have you ever had your thyroid checked? It's worth a try because thyroid issues can make you more susceptible to triggers. If they check your thyroid, don't let them get away with running just a TSH level. Make sure they run a TSH, Free T3, and Free T4 -- first thing in the morning. TSH controls he ammunt of Free T3 and T4. Without checking those, you really don't know what your TSH numer means.
  
• It can't hurt to have your vitamin D level checked. Dr. Krusz is finding low Vitamin D levels in many of his patients, and taking care of that can be helpful.

Even if you're bad at keeping a diary, please try again. It can be so VERY helpful. We have a free downloadable diary workbook that gives you several formats to choose from HERE.

All of that said, sometimes patterns change for no reason that we ever find. In your place, I'd really work on the diary to see if there are any avoidable triggers to be discovered and consider some simple lab work to rule out thyroid issues and Vitamin D deficiency, and maybe the MRI.

Hope this gives you some points to discuss with your doctor.

I'm with Teri on this one.

Granted, there are no test to say why your migraines are increasing or getting worse, the MRI is always a good idea - just to have a baseline even.

And - even if it seems redunent or overly analizing - tell your doctor EVERYTHING!

The first time I went to my new neurologist, I had a sheet long of things, symptoms, what my aura was like, what my triggers were, anything you can give them to have a better picture of you - the better.

I have had migraines since about 13 - my pattern changed at about 25ish as well. I think it may have to do a lot with how our lives are at this time, at this age.

Think about it: we are (or most of us) done with college and have a stable job (adding stress, and potiential triggers here if stress tends to get you tightened up in your shoulders and give you tension headaches)

We are being pressured into the "when are you going to get married?" or if you are married the "when are you going to have a baby?" or if you have a baby "when are you going to have another baby?" Being a woman is much more of a pain in the butt socially then being a man, in my opinion. I think it adds so much pressure to us during that 25-40 age bracket - it would make a lot of sense to me at least that our migraines would increase during this time....then we have menopause...husbands....money...ugh!!!!

Just wanted to give everyone an update-

My neuro was hesitant about running the tests back in March when I mentioned it so I went to my general doctor to do the blood work and get the MRI requested. I can understand why he was hesitant but I'm the type of person that needs to know the other options are ruled out. I had my dr run the thyroid tests Terri recommended they all came back normal. I have a MRI scheduled for Monday- insurance company needed some convincing.

Meanwhile the pain increased over this past weekend so the neuro gave me an imitrex injection on Monday because I can't miss anymore work and all the rescue meds he's been having me try have failed. He gave me an injector and several samples for the week. The neuro's office is working with my insurance to get it approved to get me admitted for either a DHE or an IV treatment.

My Dr put me on Topamax. I fought this at first with the neuro back in March but when I went in to see my general Dr. a week ago, I looked so horrible and just need this solved I stated whatever it takes. I'll do it. So Topamax. and Imitrex Injections for now. Here's hoping the topamax is my miracle drug.

Rachel good for you getting test done to rule out other problems. it sounds like you're being a real advocate for yourself. I hope the Topomax helps you, and that the other treatments break the cycle. Once you knock this one out, triptans taken early in the migraine can make a huge difference.

- Megs