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Daily Migraines with no avail
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Daily Migraines with no avail

Hi, I am a 25 year old female with many medical conditions.  Currently I have fibromyalgia, hypermobility syndrome, myoclonus, neuropathy, kyphosis, scoliosis, osteopenia, mild spinal stenosis, mild disc degenerative disease, mild disc dessication (desiccation), b-12/iron deficiency, anemia and possible Multiple Sclerosis.  I have been prescribed Pamelor for headache prevention by my very first Neuro.  At my first appointment with my Rheumy he prescribed Cymbalta to help with the burning sensations...So I was on two different anti-depressants for a while, and the entire time had major difficulty dealing with depression...After noticing this, my GP, told me to wean myself off both anti-depressants.  Now the headaches (migraines) are ten times more severe than they were before...On a good day I have to take about 2000 mg of Naprosyn and the migraines are still there...What kind of medicine have you found that really helps with Migraines?
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Unfortunately, there is no single drug that is effective for all migraine headaches and effectiveness of treatment usually varies in different people. People with migraine usually need to take a cocktail of drugs if the symptoms are severe enough.

For prevention, aside from nortryptiline (Pamelor) and duloxetine (Cymbalta), another anti-depressant that can be used for migraines is protriptyline (Vivactil).

As an alternative to anti-depressants, some anti-seizure medications have proven beneficial in treating the symptoms of migraines including divalproex sodium (Depakote) and topiramate (Topamax). A second-line drug is gabapentin (Neurontin).

You could also begin taking supplements of vitamin B2 and magnesium, both of which have been reported to help in preventing migraines.

As an important adjunct for prevention, you need to learn trigger management. This would entail you to identify what triggers your migraines and avoiding these triggers.

If attacks are already under way, the drugs that have been used include ergots and triptans, as well as butorphanol tartrate. You should ask your physician about the safety of taking these medications and if they are applicable to you.

Finally, pain can be managed initially by non-opioid analgesics, and if severe, with opioid analgesics.

You should talk to your physician about the treatment options which would be available to you.

Good luck.
You are so young to be dealing with all of this.  I looked at your profile and you are such a beutiful young girl.  Now, yes you have some tough illnesses but a lot of this could be related.  I am not a doctor - just my two cents here.  You have fibromyalgia, did you Rhuemy do the full blood work (did you have positive for RH factor or positive for ANA).  The disc degeneration issues could be from arthritic conditions or did you play major sports etc....   Here's the question, when you were on both anit-depressents it was obviously helping since the headaches got a lot worse after you stopped taking them.  Was it not helping alot?  These two meds work on differnet neurotransmitters so the fact that you were taking both is not a red flag off the bat - is that what the GP thought?

1.)  You obviously have inflammation issues, so you can take one of the long acting anti-inflammatories everyday.  That will help with some of the pain but will help keep secondary issues under control.  But I am very disappointed with your GP for taking you off anti-depressants, she didn't make a joint decision with the prescribing doc and she didn't give you another treatment..
2.)  A lot of people with arthritis, Lupus, fibro, get MIgraines.  I have read a lot about this and they don't know exactly why.  I would definitely stay in the anti-depressent area because of its action on pain and you have depression.  Frankly, if you have good health insurance, I would get a referral to a psychiatrist for medical management of the anti-depressents.  THEY KNOW SO MUCH MORE THAN ALL THESE OTHER DOCS ON THIS SUBJECT -it is their specialty.  Now some neuros are board certified in Psychiatry so you can check there.  Elevil, is a tricyclic like Pamelor but is a little more sedating.  It would knock you out at night which is good because restorative sleep is so important with your muscle involvement and spine involvement.  It is really good for pain - if you didn't gain weight on Pamelor I doubt if you would on Elevil - you can take quite a bit.  Psychiatrist who use it give much higher doses of it than maybe a Rhuemetologist would.
3.) Who is saying potential MS, is it the neuro - did they see indicators on an actual MRI or just from your symptoms.  You have illnesses that would give some MS symptoms.
4) The anemia is important - are you taking extra iron everyday and who is managing this.  This too can be seen in Rheumy issues.  It too could contribute to headaches.\\
5.) Again, is FMS the only diagnosis from RHeumy standpoint, do you ever get chest pain, I would stay away from IMITREX (tryptans) for Migraine rescue because it works on your heart as well as head and can cause or further increase chest pain (dangerous to some).
6) I don't want to push narcotic medication but with your diagnosis's, you should have your neurologist prescribe something.  Your history definitely warrants it.  But remember, you are only 25 so you only want to take it when you are in moderate to severe pain.
7.)  Heavy doses of B-Complex (I think it includes B2), obviously B2, Calcium, Big Magnesium (won't work right way give it time), Iron, and Omega 3 fish oil is really important.  Get this totally approved by your physician.  The B complex will turn your urine bright yellow so don't freak.  It will give you a calming feeling after only a few doses.
8) Always know that if the headaches get too bad go to the ER for treatment.
9) Finally, I know you have heard this before but keep a journal of all health, foods, symptoms, etc... You have illness's that over lap doctor specialties and that can get you into real trouble because very few docs take all your illness into consideration.  Sorry Docs, I appreciate you all but it is an area that needs to be worked on.  Have a Merry Christmas or Happy Holiday!  
Hi, I have been seeing so many different doctors at this point.  I noticed while treatment with the Cymbalta and Pamelor that the headaches were present but were only intensified by the discontinued use of the medicines.  I have bloodwork done by my Rheumy, one diagnosed me with hypermobility syndrome, myoclonus, neuropathy and fibro.  He prescribed the Cymbalta and the Lamictal for the Neuropathy & Fibromyalgia, and the Requip for the Myoclonus & RLS....He was more concerned with my Neurological conditionm, says the burning and tingling is a neurological condition....This sent me back to my second Neuro, because my first Neuro was a complete nutcase with the GOD syndrome....I have gained a lot of weight since I began using the anti-depressants, around 20 or 25 pounds in almost the last year, and I hardly eat...My Neuro after seeing that I barely have any reflexes in my extremeties, and no feeling in them either...also that I had the babinski reflex (he is afraid of degenerative disease).  He was afraid however to tell me this, he and his NP wrote letters stating their fears that it is MS.  My first Rheumy had put me on a month of Repliva for an Iron Supplement, and afterwards nothing, I really do not know how my Iron stands now.  Because I live in a small rural area, specialists are few and far between, so I had to wait 6 months for my appt with my second Rheumy....He agreed with all of the diagnoses from the first Rheumy, and also noticed that the skin on my right side was thickening.  So he scheduled tests and a followup appointment within a month.  At my followup appt he noticed the skin had thickened dramastically since the first appointment and that my muscles had become even more rigid...I do know he is questioning an underlying case of Scleroderma as well.  I have major chest pains, it feels like my chest muscles are on fire after the slightest movement.  I also have a lot of difficulty swallowing so I keep indigestion...I take b-12 intravenously every month.  I also take calcium (1500 mg) everyday because of osteopenia....I am now awaiting results from my Neuro for my Spinal Tap.
If I were you I would get the ferritin and a cbc checked again at your next doc visit. I also have iron deficient anemia and it is managed by my hematologist and treated with iv iron treatment whenever my ferritin falls too low.

according to him my hemaglobin needs to be above 12 at all times at a minimum and he wants my ferritin to remain above 20. my hemaglobin dropped from 14 to a smidge over 12 in 6 months and my ferritin dropped from over 50 to just under 30 in the same period. that just gives you an example of how rapidly the test results can change, and i had the longer lasting treatment than just oral additions. you should be on a multivitamin at minimum that has iron in it for overall health expecially with all of the other medical problems you have.

some of your muscle problems may be improved if your anemia is managed properly. no promises but it couldnt hurt.

A lot of symptoms.Now try these exercises everyday and increase the timing gradually upto the maximum.You will find the headache going down gradually and the body will be better able to deal with the other symptoms as well.
Anulom Vilom –
Close your right nostril with thumb and deep breath-in through left nostril  
then – close left nostril with two fingers and breath-out through right nostril  
then -keeping the left nostril closed  deep breath-in through right nostril
then - close your right nostril with thumb and breath-out through left nostril.
This is one cycle of anulom vilom.
Repeat this cycle for 20 to 30  minutes twice a day(maximum 60 minutes in one day).
You can do this before breakfast/lunch/dinner or before bedtime or in bed.Remember to take deep long breaths into the lungs.You can do this while sitting on floor or chair or lying in bed.

Kapalbhati -(Do it before eating) Push air forcefully out through the nose about once per second. Stomach will itself go in(contract in). The breathing in(through the nose) will happen automatically. Establish a rhythm and do for 20 to 30 minutes twice a day.(Max 60 min/day) Not for pregnant women. Seriously ill people do it gently.
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