need advice (this is really long)
Question:
– Hide quoted text — Show quoted text – Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches (about once a year) that weren’t that painfully, but caused me to lose my vision. In August, I began to have daily headaches. In October, they became less frequent but more painful and I caused me to shake, sweat, throw up, and have some vision loss. Finally, after another painful attack in February, I went to see a doctor. After testing me for several things and an MRI, she said that I just developed migraines. First, we tried propranolol, which reduced the frequency, but made the few I had more painful. Now I’m on amitriptyline, which doesn’t seem to help too much. My doctor plans to send me to a nerologist in San Diego, but what can a nerologist tell me that isn’t in my MRI? These headaches make my life in the military miserable. I have no food triggers, so could anyone provide me insight into ways I can deal with these headaches or any other information that can help. Thanks
The neurologist will have seen more patients with migraine and may know of some possible prophylactics and treatments that are not familiar to an internist of family pysician. You might try adding a dietary magnesium supplement while waiting; magnesium is not on average as effective a prophylactic as the prescription medicines, but it has a huge safety margin. The dose would be up to 325 mg of magnesium twice a day. Someone here mentioned Vioxx 25 mg per day plus Singulair 10 mg/day as a more effective prophylactic than most. I’ve tried it with a few people and have been impressed; you might mention that to one of your physicians somewhere along the way.
Response:
Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches (about once a year) that weren’t that painfully, but caused me to lose my vision. In August, I began to have daily headaches. In October, they became less frequent but more painful and I caused me to shake, sweat, throw up, and have some vision loss. Finally, after another painful attack in February, I went to see a doctor. After testing me for several things and an MRI, she said that I just developed migraines. First, we tried propranolol, which reduced the frequency, but made the few I had more painful. Now I’m on amitriptyline, which doesn’t seem to help too much. My doctor plans to send me to a nerologist in San Diego, but what can a nerologist tell me that isn’t in my MRI? These headaches make my life in the military miserable. I have no food triggers, so could anyone provide me insight into ways I can deal with these headaches or any other information that can help. Thanks
Response:
Hi. I’m assuming you’re a guy, although I guess a woman might be in the military too. Anyway, I just wanted to make a couple of comments re your questions. Many folks (I am one) find that the combination of amitriptyline and propranalol help reduce migraine severity &/or frequency, while one at a time may do little. There are other drugs in those classes (antidepressants & blood pressure meds), & some might work for you while others don’t. Other possible preventives include antispasmodics. Then, of course, there are a myriad of non chemical treatments including dental devices, acupuncture, massage, etc etc … Management also consists of keeping track of what your triggers may be & avoiding those things. Tyramine containing foods, alcohol, changes in sleep patterns, stress, & for women, hormonal surges are some common triggers. Odors, bright sunlight, & changes in weather are some others.. To treat attacks, abortive drugs used successfully include ergots & the newer triptan drugs. Sometimes one of these works & another doesn’t. Some people respond well to one of these in a particular form (such as nasal spray or injection) & won’t respond well to the same medication in another form (such as by mouth). In short, a lot of diddling around might be required to find what works best for you. It can be a long hard road, & you’ll want a health care provider who will work with you. Good luck in this nasty venture, & welcome to ASHM ! The thing about referring to a neurologist is something that has puzzled me as well. I’m guessing that they just want to rule out any other cause thus confirming the migraine diagnosis. In fact, any doc with an interest in migraine (a lot of docs don’t like to treat migraine pts because they can’t "cure" it, & that frustrates them) can be a competent migraine doc.
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Hi, Since I don’t know if you’re male or female, I won’t speculate on any of that. Sometimes, as others have already said, it’s a matter of trying different meds and combinations. I’ve experienced the situation you describe when headaches are less frequent, but are more intense. It’s almost a question of which is worse. Working with your doctors is the best way to work on it and watch the posts on this group. I can’t believe the diversity on here–so many different people and their solutions or ways of coping are just as varied. I would suggest a headache journal, however. I had my best personal luck when I used my journal. I’d be sure to write down every day what meds you took, migraines, any treatments you tried that seemed successful, etc. That was how I discovered that sometimes I can knock out my migraine with 2 Excedrin rather than take my Zomig. I’ve learned a lot from my journal and have been able to successfully back up my claims with my doctor when he doesn’t believe I followed his directions. Good luck and don’t be shy about sharing how you are approaching this or what results you might have. People are more than willing to offer other ideas. Blessings, Michelle
– Hide quoted text — Show quoted text – Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches (about once a year) that weren’t that painfully, but caused me to lose my vision. In August, I began to have daily headaches. In October, they became less frequent but more painful and I caused me to shake, sweat, throw up, and have some vision loss. Finally, after another painful attack in February, I went to see a doctor. After testing me for several things and an MRI, she said that I just developed migraines. First, we tried propranolol, which reduced the frequency, but made the few I had more painful. Now I’m on amitriptyline, which doesn’t seem to help too much. My doctor plans to send me to a nerologist in San Diego, but what can a nerologist tell me that isn’t in my MRI? These headaches make my life in the military miserable. I have no food triggers, so could anyone provide me insight into ways I can deal with these headaches or any other information that can help. Thanks
Response:
Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches (about once a year) that weren’t that painfully, but caused me to lose my vision. In August, I began to have daily headaches. In October, they became less frequent but more painful and I caused me to shake, sweat, throw up, and have some vision loss. Finally, after another painful attack in February, I went to see a doctor. After testing me for several things and an MRI, she said that I just developed migraines. First, we tried propranolol, which reduced the frequency, but made the few I had more painful. Now I’m on amitriptyline, which doesn’t seem to help too much.
How long have you been on it? "They" say it takes 6 to 8 weeks to work up to it’s full effect. My doctor plans to send me to a nerologist in San Diego, but what can a nerologist tell me that isn’t in my MRI?
Neurologists have a lot more experience with treating migraines than family docs-and I think may have access to better research and literature too. These headaches make my life in the military miserable.
Well, I think we all sympathize with that. You’ve definately come to the right place, for information and for support. We’ve all been there, done that. I have no food triggers, so could anyone provide me insight into ways I can deal with these headaches or any other information that can help.
One good place to look for information is: http://www.meldrum.demon.co.uk/migraine/ But there are lots of good sites that people will point you too. Best of luck to you.. Dana
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Hi, The others who posted made good points. Something you should know about Migraine and MRI’s. An MRI canNOT diagnose Migraine. It’s used to rule out other causes of the symptoms. Unfortunately, there is no diagnostic test to confirm Migraine. Doctors make the diagnosis based on your symptoms and ruling out other possible causes. Michelle’s advice about the Migraine diary is excellent. Your neurologist can sometimes get a great deal of info from it. If you don’t know how to do one, you can print or download one at http://headaches.about.com/bl-diary.htm Good luck, — Teri Robert, Ph.D. your About Guide to Headaches/Migraine http://headaches.about.com Visit our forums at http://headaches.about.com/mpboards.htm MAGNUM Staff www.migraines.org **Whatever the question is, compromising patient needs and rights is not the answer.**
Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent
headaches
Response:
Singular for migraine prevention? Any thoughts on possible mechanism.? Murray Grossan, M.D. http://www.ent-consult.com http://www.TinnitusRelief.net http://www.emedicine.com/ent/topic516.htm
Nothing beyond the most simplistic, unfortunately. Singulair and Accolate block leukotriene receptors. We don’t fully understand the mechanisms of migraine, but similar humoral factors seem to play a prominent role. The observation that some patient on Singulair (montelukast) led Sheftell et al. to try using it for that purpose (see below). Leukotrienes are produced from eicosenoic or arachidonic acid, like prostaglandins. Someone else (I can’t find the reference) apparently decided to try blocking both pathways, with good effect. I shall hope some other respondent knows more. Sanford S. Leffingwell, M.D., M.P.H. Montelukast in the prophylaxis of migraine: a potential role for leukotriene modifiers. Sheftell F, Rapoport A, Weeks R, Walker B, Gammerman I, Baskin S. Headache. 2000 Feb;40(2):158-63. New England Center for Headache, Stamford, CT 06902, USA. OBJECTIVE: Clinical observation of a decrease in migraine frequency in patients with comorbid asthma taking montelukast, a specific D4 leukotriene receptor antagonist, or zafirlukast, another leukotriene receptor antagonist, prompted us to explore a possible role for leukotriene modifiers in the treatment of migraine. (A further prompt was a pharmacist colleague’s observation that a number of patients on these agents reported a decreased sensitivity to perfume triggers and improvement in migraine.) BACKGROUND: Nonsteroidal anti-inflammatory agents have been used widely in the treatment of migraine. Another class of anti-inflammatory agents, known as leukotriene modifiers, have not been studied to date with regard to their possible role in the treatment of migraine. The name "leukotriene is derived both from the parent molecule, which was originally isolated from leukocytes, and from its three double-bond carbon backbone or triene structure. Both prostaglandins and leukotrienes are derived from the metabolism of arachidonic acid, with prostaglandins coming off the cyclooxygenase pathway and leukotrienes derived via the enzyme 5-lipoxygenase. Both prostaglandins and leukotrienes mediate inflammatory responses. The latter have been studied with regard to their role in the pathophysiology of asthma. METHODS: A prospective, open-label study evaluating the efficacy of montelukast, 10 mg or 20 mg, in the prophylaxis of migraine in 17 patients is presented in this paper. All 17 patients completed the study that consisted of a 2-month baseline run-in period and a 3-month treatment phase. RESULTS: Montelukast was extremely well tolerated, and no adverse events were reported by any of the patients. Fifty-three percent showed a reduction of greater than 50% (P<.025) in the frequency of severe attacks, with 41% showing a reduction of greater than 60%. Responders, including modest responders, rated the drug as excellent. CONCLUSIONS: We conclude, given the limitations of an open-label study design and the small sample size, that montelukast shows potential as an effective, well-tolerated prophylactic agent in migraine. Double-blinded, placebo-controlled studies are warranted. In addition, the leukotrienes, as suggested previously in the literature, may play a role in the pathogenesis of migraine. Publication Types: Clinical Trial, Journal Article MeSH Terms: Acetates/*therapeutic use; Adolescence; Adult; Female; Human; Leukotriene Antagonists/*therapeutic use; Male; Middle Age; Migraine/*drug therapy; Migraine/*prevention & control; Prospective Studies; Quinolines/*therapeutic use Substances: 0 (Acetates); 0 (Leukotriene Antagonists); 0 (Quinolines); 158966-92-8 (montelukast) PMID: 10759916 [PubMed - indexed for MEDLINE] From PubMed
Response:
Singular for migraine prevention? Any thoughts on possible mechanism.? Murray Grossan, M.D. http://www.ent-consult.com http://www.TinnitusRelief.net http://www.emedicine.com/ent/topic516.htm
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I don’t really have anything to add (you’ve gotten great advice so far from this group).. Stay with us and keep posting.. we really understand how awful it is to live with these monsters. Liz
– Hide quoted text — Show quoted text – Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches (about once a year) that weren’t that painfully, but caused me to lose my vision. In August, I began to have daily headaches. In October, they became less frequent but more painful and I caused me to shake, sweat, throw up, and have some vision loss. Finally, after another painful attack in February, I went to see a doctor. After testing me for several things and an MRI, she said that I just developed migraines. First, we tried propranolol, which reduced the frequency, but made the few I had more painful. Now I’m on amitriptyline, which doesn’t seem to help too much. My doctor plans to send me to a nerologist in San Diego, but what can a nerologist tell me that isn’t in my MRI? These headaches make my life in the military miserable. I have no food triggers, so could anyone provide me insight into ways I can deal with these headaches or any other information that can help. Thanks
Response:
I can get migraine from coffee or chocolate (caffiene like). Gensing helps to cure these. I use gensing pills from a vitamin store or any store or catalogue. Also those little bottles of gensing that I get from Chinatown are very fast and very effective. I find that I can now drink coffee and eat chocolate without gettng migraines-I don’t need gensing so much or as much. – Hide quoted text — Show quoted text – Hi, The others who posted made good points. Something you should know about Migraine and MRI’s. An MRI canNOT diagnose Migraine. It’s used to rule out other causes of the symptoms. Unfortunately, there is no diagnostic test to confirm Migraine. Doctors make the diagnosis based on your symptoms and ruling out other possible causes. Michelle’s advice about the Migraine diary is excellent. Your neurologist can sometimes get a great deal of info from it. If you don’t know how to do one, you can print or download one at http://headaches.about.com/bl-diary.htm Good luck, — Teri Robert, Ph.D. your About Guide to Headaches/Migraine http://headaches.about.com Visit our forums at http://headaches.about.com/mpboards.htm MAGNUM Staff www.migraines.org **Whatever the question is, compromising patient needs and rights is not the answer.** Hi everyone, This is my first visit to this site and I thought that maybe some of you could help me out. First, I’m 24-years-old and serve in the military, so I don’t have very many treatment options. As a child, I would have very infrequent headaches
Response:
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