Is this really a migraine?

[MissMc528]

This may be long. There's a little too much weirdness going on.

I'm 23 years old, female, and I was diagnosed with a migraine for the first time in mid-August of this year. I was quitting smoking at the time so my doctor had reason to believe that it was triggered by the physical stress of going nicotine-less after seven years of smoking. She was hesitant to prescribe Imitrex or any other kind of medication and encouraged me to try to find relief in other ways. I've tried any and everything I can think of. Nothing works. Ever since, I got a few migraines, then a few more, and now two months later, I'm getting a migraine (perhaps a "migraine") every day. There doesn't seem to be a link to my cycle or to any medications I take or food or anything like that. However, my doctor has been very, very wrong more than once before, so I'm unsure on whether or not it's a real migraine.

Everything I read about auras corresponds with what I feel. I'm irritable as hell about an hour before the pain sets in, I feel like I'm going to pass out or throw up (or both), my vision goes blurry and swirly. When the pain comes, it feels like my head was shoved in a vise. But lately I've been noticing that anything that anyone says during the aura isn't processed. I hear it, but I can't recall what was said at all. I've been having some tinnitus issues that have been getting worse at almost the same rate as the migraines. I'll hear a clicking sound or buzzing or something strange. I'm a little afraid that what I hear isn't always what the noise was. My new stepfather plays first-person shooter games on his computer and when I think I hear him playing it, it turns out he wasn't. I've been having a lot of memory loss lately, which I chalked up to a lack of variety in my life - not a lot to remember when nothing is eventful, right? But even with my mother's wedding (which was two weeks ago and stressed everyone in the house out), I can barely remember the events. I had to actually sit down the next day and try to recall what happened so I could report in to my grandma, who did not attend. And in the most general way, I truly do feel that my personality has done a 180 since all this started. And I'm not the only one to notice.

Are these things typical of migraines? Or even semi-typical? Or some kind of post-migraine thing? The irritability, vision problems, vertigo and nausea seem to be textbook from what I'm finding, but the rest seems strange. I feel like because they've been going on all at the same time, it's all connected. If someone can just take away the aura and the anomalies, I can live with the pain. I've had two abdominal surgeries, one oral surgery and severe trauma to my left knee courtesy of my ex-boyfriend being abusive. I can handle the pain... the other stuff, not so much.

(Family history of cluster headaches on dad's side, brain tumors on both sides. These are the only two neurological issues I'm aware of)

[marileew]

Hi MissMc528,

First off I want to say that if your doctor diagnosed you with migraine and wouldn't prescribe you a triptan OR an alternate medication for pain relief if a triptan was not an option for some specific health reason then that is just utterly ridiculous and horrible and I personally consider your doctors refusal to treat your migraines properly to be sick, twisted and disgusting, and if your doctor has ANY understanding of migraines what-so-ever then your doctor should be absolutely ashamed of with-holding proper treatment... if your doctor doesn't understand migraines, well, then you should forgive your doctor because doctors are just human and make mistakes too but regardless of your doctors reasons for mistreating you, you NEED to get a new doctor ASAP.

By not prescribing you a triptan OR an alternative... your doctor is putting you at risk of getting into a situation where your migraines WILL get worse... and that is what it looks like is happening. Every time a migraine patient doesn't treat a migraine and lets the pain go on for a prolonged period of time, you put yourself at risk of getting into a chronic pain cycle and developing chronic migraines... which are extremely difficult to treat. Early intervention in pain is extremely important. Migraine is a disease that we are born with that can't be cured, it is like Type 1 Diabetes or Epilepsy in that way... but, just like with Type 1 Diabetes and Epilepsy, we can avoid triggers and control the disease with medication. In some cases, we can completely avoid the headaches entirely through trigger avoidance, but when that is not possible, it is important to intervene with treatment. A doctor would not tell a patient with Type 1 Diabetes who had high blood sugar that they could not use insulin, nor would a doctor tell a person with Epilepsy who was having a seizure that they could not use seizure medication... in fact, a sane doctor would give insulin to a patient who was having a hyperglycemic attack and would give seizure medication to a patient who was having a seizure... because, otherwise, their condition could deteriorate.... just as your condition is getting worse without treatment.

The best kind of doctor to see in your situation is a neurologist. That is the type of doctor to see if you have migraines. A neurologist will be able to assess you to make sure that you are in fact suffering from migraines and not something else. If you do have migraines, a neurologist will be able to prescribe you Imitrex, or another triptan, or, if you cannot take triptans for a specific reason, then a suitable medication to use for the acute treatment of migraines.

Now, as for some of the symptoms you have mentioned... no, those are not typical migraine symptoms. I cannot tell you what those are typical symptoms of because I am not a doctor nor a medical professional of any kind. That is why I think it is SO important for you to see a neurologist. I am SURE that a neurologist would be able to assess your symptoms and let you know what is going on. Now, just because I say that they are not typical symptoms of a migraine doesn't mean that they can't be symptoms of a migraine... there are lots of "atypical" symptoms of migraines that some people get, and, I have heard it cited that memory loss, auditory pseudo-hallucinations, and personality changes can all be migraine symptoms, but they aren't the classic symptoms that most migraine patients get. So, a neurologist would have to rule out other, more common, causes of these symptoms before saying that they were related to your migraines for sure.

Now, also, if you're having these symptoms and they turn out to be non-migraine related, that doesn't mean for sure that you're not having migraines either. You can have migraines at the same time as something else. That is why it is important to go to a neurologist to get a neurological exam as well as a CT scan if needed and an EEG if needed as well.

You need a referral in order to see a neurologist in most areas. If you can't get a referral from your family doctor, go to a walk-in clinic to ask for a referral, or as a last-resort go to an Urgent Care Centre or a Hospital to get a referral if you cannot get one from a walk-in clinic. But I hope that your family doctor would at least give you a referral to a neurologist even if your family doctor won't prescribe you the proper medication used to treat migraines.

Good luck! Let me know how it goes!

[dame_wilbur]

I don't really think there's anything for me to say that  marileew hasn't already said. You REALLY need to go see a neurologist. It's absurd that, after continued suffering, your doc won't give you a prescription to help break the cycle. And you really need to break the cycle as soon as possible.

Good luck!

~dame

[MissMc528]

Thanks for the reply! Lots of information to absorb there...

Thing is, I have two doctors. The one who diagnosed the migraine is the one I could get into the fastest when, quite frankly, I felt like I was dying the first time I got the dizziness and pain and nausea. She told me to try to sleep it off. This is also a doctor who ignored my daily heartburn for years, prescribed antibiotics for viral tonsillitis and insisted I keep taking Levaquin for what she decided was an asthma attack, even though it acted absolutely NOTHING like an asthma attack. I go to her because A) she can usually get me in the office on the same day I call and B) if I want medication, she'll typically give it to me, and if I want a referral, she lets me pick the doctor I want to be referred to. She knows I have another doctor, one she used to be in practice with, and she seems fine with it, even after I told her I went to Doctor #2 for the heartburn Doctor #1 ignored for years.

From what I just read about triptans, there doesn't seem to be any reason she wouldn't give me a prescription. Especially when she'll write me a prescription for anything under the sun I want. I do run out of health insurance, or at least my mom's, at the end of this year, and they're apparently quite expensive without insurance, but so are my GERD pills and my birth control. So I have a hard time believing that cost is a factor. She recommended riboflavin and magnesium but that's done nothing.

I'm going to do some research into the neurologists on my insurance in my area, then call my doctor and ask if she can write me a referral to the one I like the best.

Thanks again!!

[marileew]

Hi MissMc528,

I am glad to hear you are going to start working on getting to a neurologist! It is good you do research first! Let us know the neurologist appointment goes.

As for the riboflavin and magnesium that your family doctor suggested, these are good suggestions but for preventative measures only. They won't do much to help stop an acute attack.

Magnesium sulfate at a high dose (around 1g, that's equal to 1000mg)  given intravenously (by IV directly into your blood stream) in a hospital setting has been shown to stop acute migraine attacks... but oral magnesium has not been shown to stop acute migraine attacks and giving someone an equivalent oral dose of magnesium is extremely dangerous and causes horrible stomach upset and diarrhea. So, bottom line, oral magnesium (on it's own) is not a suitable acute migraine medication.

As a preventative though, as little as 400mg of Magnesium daily can reduce the frequency and severity of migraine attacks. Although, that doesn't mean it will completely stop your migraine attacks. That is why you need a back-up acute medication for when you get a migraine attack.

Basically, every migraine patient should have a two-fold plan to controlling migraines: 1. Prevention and 2. Acute Treatment.

Prevention methods might include daily supplements like the magnesium and B2 your doctor suggested and also another supplement called CoQ10. But all of these supplements will only reduce the amount of attacks you get and maybe the severity of the attacks, but preventative measures must always be used in combination with acute treatment measures because you'll still probably get acute attacks even if the number of attacks are reduced and the severity of the symptoms are reduced.

Another really helpful prevention method includes tracking headaches in order to find patterns and triggers, the neurologist you see will probably suggest that you start tracking your headaches... so, you might as well start now if you haven't already, it will be useful information to bring to your neurologist appointment. Medhelp as a headache tracker that you can use if you like.

But, like you have said... the preventative methods your doctor already suggested have done nothing for your current acute symptoms. That totally makes sense because only an acute medication can stop an acute attack. So it's really good you're going to see a neurologist who will be able to prescribe you an acute medication to treat the acute attacks.

Although even though some of the preventative measures can't help the acute symptoms, it can still be worth it to do them because they can reduce the amount of migraines you get and the severity of the migraines. If after 3 months you have not noticed any reduction in either the number of migraines you get or the severity of the migraines you get after taking the magnesium or the B2, then yeah, unfortunately the supplements haven't worked to prevent your migraines at all and you can probably stop taking them. But, I think at the moment, they're probably still worth trying for a bit as long as you're taking them at 400mg each every day.

Anyway... I hope you find an awesome neurologist!!! Let us know how it goes! :)