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Chronic Migraine; Is there in-patient treatment?
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Chronic Migraine; Is there in-patient treatment?

I have had a migraine for the past 11.  The onset was the birth of my second child on 12/5/05.  The delivery was uneventful, with exception to having postpartum elevated blood pressure and unilateral success of the epidural (left side numb, right side no affect).  The conclusion from the professionals I have seen is that I have a history of migraine headaches and the delivery was just a trigger.  
I tried BP meds and narcotics the first two months and then moved on to migraine and anti-seizure medications.  I have had a MRI, CT scan, spinal tap, a sleep study(all within normal limits).  Cleveland Clinic on 5/10/06 and saw Dr. Kriegler and had a 5 hour infusion; by that time I had gotten myself addicted to ibuprofen to assist with pain management.  After I left the Clinic I had a DHE pain pack for 9 days; at the end of which I had about 6 hours pain free. That was the first and last time I have been pain free in the last 11 months.  I am currently on 200 mg of Topamax and 120 mg of Cymbalta.   I recently weaned off Lyrica which helped manage my pain due to the adverse event of weight gain.  On 11/20/06 I had Botox for the first time which appears to have decreased the pain somewhat but did not eliminate it totally.  
My question: Is there an in-patient treatment for migraine?  A sort of in-patient protocol to utilize steroids and/or pain meds to shut down the brain and then restart it again?  This has been going on for so long and the pain has been so constant; at times I feel I am going crazy and there doesn
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Avatar_n_tn
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
   There is a "In-patient" protocol for IV infusion in severe migraine (also called 'status migranosus').  This in-patient protocol these days is more often administered in outpatient IV infusion suites (same medications given for the same amount of time, usually 3-5 days of IV infusions).  The protocol can vary based on your headache type, but generally consists of DHE, magnesium, depakote, kytril, benadryl given daily.  Sometimes medications such as solumedrol and zyprexa or seroquel are also added.  Unfortunately if your are taking the ibprofen or other pain medication twice per week they can cause rebound headaches, that cannot be cured by cocktails-only by stopping the medications.  Some patients need 3-5 days of infusions allow them to get off their pain medication.  Dr. Kriegler is an excellent doctor, and will be able to arrange the best IV infusions for you (there is an IV infusion suite in the CCF headache center).
I hope this has been helpful.
11 Comments
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Avatar_n_tn
I have been going to Lisa Mannix since October 2006, who was recommended by the Cleveland Clinic.  It is just such a slow process after a year of constant pain.
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Avatar_n_tn
I have had a nerve block, Dr. Mannix did it but it only affect the back of the head and it doesn't last very long.  I have a LOT of tension in my head and shoulders.  I can't even tell I had the botox in my shoulders.  The pain is worse on the right but at this point is bilateral.
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Avatar_n_tn
Diamond Headache Clinic is the greatest.  I have been going there for many years and they start by having you inpatient if you are seriously in pain.  You do not have to be in-patient.  It depends on the amount of medication you are taking, or if you require IV medication, or how decide what you need I am sure.

I am just saying they do inpatient in St James Hospital in Chicago also.
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Avatar_n_tn
Thanks you SO much for this valuable information; I just looked up the Diamond Clinic and have already learned so much.  Thank you, thank you!!!!  I actually have relatives in Chicago so I will have them check it out in person, thanks again.
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Avatar_n_tn
I have gotten migranes (migraines) since I was in 7th grade.  I had tried many different types of migranes (migraines) meds with no povail until after the birth of my first child.  I had pre-eclampsia with him and afterwards the high bp stayed the dr put me on lopressor.  Low and behold I no longer had migranes (migraines).  If I don't take my medicine on a regular bases I will get a migrane (migraine) and they are horrible for me.  I get dizzy, vomit, very sensitive to noise, sound and light, I slur my speech and just can't think.  I now take atenolol which just like lopressor but as my Dr said on of the side effects of these drugs are that they suppress migranes (migraines) now who wouldn't want a side effect like that?
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Avatar_n_tn
Diamond Headache Clinic

I noticed you were talking about Botox

They do Botox for Headaches also.

They inject botox in your neck muscles and in your forehead.

They have all different kinds of migraine medications though that they specialize in... and they have trials too that you can sign up for.

I was in a trial.

I also had Botox 3X.

Good Luck!
Nancee
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Avatar_n_tn
Do you know how to post a question?

I had a brain and spinal MRI and have a choroid plexus cyst within my right temporal horn.  It is small.  I was wondering if this might be causing my headaches, naseau, vomiting etc.  I also have a syrinx in my central canal that is small, but I understand that should be inopperable as it is in the central canal, and would probably cause more damage to repair.  Both of these should be monitored?

I wanted to ask about these two things?

Thanks!  Nancee
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Avatar_n_tn
Thanks for the info.  I live in Cincinnati so I was looking for an in-patient treatment facility here but I will go to Chicago.

To post a question, you have to keep clicking on "post a question" they only allow one or two questions a day and the time you can post changes every day.  It took me a couple weeks of attempting pretty frequently at various times to get my question posted.  Good luck.
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Avatar_n_tn
My past medical history is positive for rosacea and raynoids, the migraine meds don't seem to be having an affect; could this be some other kind of vascular issue?

Thanks,
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Avatar_n_tn
This is meant to shared as I am doing some research on migrain and have come to this site.

my sister, me and my brother all have migrain and lately, my sis was hit badly and was send to the hospital due to blur visions and half body numbless. She stayed there for 8 days and nothing much the doctor can do as the pain still there thru out her stayed.
I am so afraid that she will have mild stroke. And the doc diagnosed that she have chronic migrain. And she have been taking pain killer cafergot for many years and this time is the rebound migrain or overused of the drug.

I have did some research on migrain as I personally have migrain attacked, I have it lesser now compare to last time. I realized that fish oil did help me and after consuming for months I don't get attacked so often.

I also take essence of chicken once or twice a month and it also stop the pain I have as after my menstrual I have really bad migrain and I use to take pain killer and I noticed that I have been relying too much on drug and is not going to help me in the long run. So I have tried many ways and essence of chicken really work wonders for me. Now my pain killer are kept for only emergency and this is termed as menstrual migrain by doctor.

I hope people who write to this site can considered taking fish oil capsule or essence of  chicken (anyway is good for health too, you never know if is works on you) and lastly, sleep is also important. I am in the field of design and my time is not so flexible as I work more than 10 hours a day.

cheers...
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A related discussion, Migraines in KY from losing hope was started.
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