Migraines and cervical herniation

[mamatwoboys]

Well, I have had migraines most of my life, but never like this.  I take 120 Inderal LA for them and that made a big difference in years past.  However, I was in a car accident three years ago and herniated a disc straight out the back of my neck tearing the dura and I think it's number 5 or 6 disc, not really sure, I don't have the MRI report.  The pain has been getting worse, but no neck pain to speak of, just head pain.  All i have to do is sneeze wrong or sleep in any position, and i wake up with a migraine even if i didn't have one when i went to bed.  I am distraught now since i have two young children who need their mama.  One ortho wants to operate, another is offering an injection under fluroscope.  Neuro wants to try neorontin but I am scared of that.  I had a rare reaction to Zoloft years ago, where I vomited profusely and wanted to get out of my own skin and became panicked.  Will I have the same reaction to the neorontin.  I want to try it.  What should I do?  I am miserable and so is my family because of me.

[BabsGardens]

I am really curious about how you are doing now and about what you found to be the problem.  I have had wake up headaches for years now.  Tried almost everything.  Nothing has worked.  I also have a problem with my neck..  I am wondering if that is what is causing my headaches.  Let me know.  Barb

[Dr Santos]

Hi,
If the symptoms are coming back, it is best to see your attending for a follow-up check-up. It is good though that the shots provided positive results, even if only two months have just passed. Take care and hope to hear from you soon.

[mamatwoboys]

MRV was fine.  Had all three of my shots in the series and was amazed at how I felt!!!!  But now they are coming back.  Very disappointed.  What now?

[Dr Santos]

Hi,
Try to be strong about both the physical and emotional pain at this time.  I know how hard it is to feel that way- being absent from family affairs,  but as I have said, think positive always.  The MRV is just a week away and after this, we will be one step closer to the  management plan. Take care always.

[mamatwoboys]

MRV is scheduled for the 21st.  Definately NOT soon enough for me.  Good day most of yesterday, but today is awful.  I have medicated myself to the hilt and very little response.  I can't wait to see if it's a clot causing this so I can get the heprin to get rid of it.  The Neuro says once the clot is dissolved, the pain in gone.  If it's not that, I have decided to have the neck surgery to repair my disc.  I owe it to myself and my family to get this resolved as soon as possible.  I just had to sit and watch my husband take my two babies to dinner for their grandmother's birthday without me.  I am devastated and can't stop crying.  This pain has to end soon.

[Dr Santos]

Hi,
I agree with you that it is better to be safe than sorry. Magnetic Resonance Venograpy or MRVs are used to assess abnormalities in the blood vessels of patients with a history of stroke, aneurysm, heart disease, and atherosclerotic vascular disease. This would indeed help rule out any doubts on the white spot found on your MRI result. Hang on and stay positive always. Take care and hope to hear about the MRV results.

[mamatwoboys]

Well, the neurologist I saw on Thursday didn't like the white spot on the MRI and ordered an MRV to rule out clot, seeing that I have the symptoms of cerebral venous thrombosis.  I am having the test in two weeks and I am really scared now given what I have been reading about this.  However, if I have a clot, heprin will clear my clot and my headaches quickly I think.  I guess it's better to be safe than sorry.  The cervical epidural and facet joint injections I had yesterday were fine in and of themselves, but today, my headache is about the worst I've ever had.  I just took two doses of Maxalt and the pain is now bearable so that is good at least.  I guess I have to get worse in order to get better.  I am looking forward to being a functioning part of society and my family in the near future.  I am also starting Elavil tonight at bedtime, but am unsure what kind of relief it will give my pain.  I will try anything at this point.  Thank you so much for all your insight.  I really appreciate it.

[Dr Santos]

Hi,
Thanks for the updates. It is good to know that the MRI result was fine. The differentials left are the migraine and skeletal issues you have, which are manageable with the advent of new medications and medical techniques. If the procedures are new to you, clarify any doubts - the procedure itself, the side effects, prognosis, etc.,  to ease any anxiety. Do keep us posted with the result of your doctor's follow-up. Take care and do keep us posted.

[mamatwoboys]

Well, MRI revealed no mass of any kind so that's a relief.  There was a small white area they saw but the report said is was of unknown clinical significance and did not inhance so may be artifact.  I am having a cervical epidural on Friday and he is injecting the facet joints too.  He feels this is mostly cervical in nature and maybe a little of my regular migraines too.

[Dr Santos]

Hi,
A new MRI would certainly help rule out any tumor or space occupying lesion in the brain. At this point, we are not certain if the PT and chiropractor or the panic attacks exacerbate the headache. It is best that you discuss this with your doctor first. Take your prescription medications and hopefully, the symptoms will be relieved. Discuss also medicine for panic or anxiety attack.  You can survive the pain and the panic attacks, just hang on. Support group at this point may be very helpful for you and for looking after the kids. Do keep us posted with the MRI results. Best regards.

[mamatwoboys]

Hi.  I had the headache before, during, and after the PT, and I have started seeing a Chiropractor as well.  For the first time this morning in months, I had no headache, but the nausea was unbelievable, I am now having the headache back full steam and feel like throwing up.  I am scheduled to have a MRI of the brain in a week and a half just to rule out a brain tumor.  I am devastated and can't even leave the house now.  I don't know how I am supposed to live through this pain and panic attacks.

[Dr Santos]

Hi,
How are you? I'm sorry to hear about what happened last night. Did the headache occurred after your PT session? Tumor headache usually presents with pain that progressively worsens, projectile vomiting, possible visual disturbances speech or personality changes; problems with equilibrium, gait, or coordination; and even seizures. This is usually seen in radiological studies such as your recent MRI. I know this is very upsetting but hang on and think positive.  Continue your management plan and treat one condition at a time. Regular follow-up with your neurologist is also highly recommended. Take care always.

[mamatwoboys]

Well, I started PT yesterday and ended up in the ER last night.  They did IV fluids and Reglan, and I took some Xanax when I got home.  I am now worried about a brain tumor, however the ER doctor said since I've had headaches of some sort most of my adult life, the chance is very slim.  He also said that the neurologist I saw last week would have ordered an head MRI if he had any concerns after examining me.  My BP was high, but they thought it was from the panic I am having.  They also think there is a connection to the worsening of the headaches and the fact that I am still recovering from a month long sinus infection.  From what I could infer last night from what they WEREN'T saying, they think my anxiety is now at a level that it is creating these headaches or at least making them worse.  They think I am doing the right thing with the PT and that I saw a neurologist and that I have a consult with an orthopedic doctor to discuss shots in the neck for the herniated disc.  My accident was three years ago almost to the day and I wish I had gotten treatment when it first happened.  This is so very upsetting.  I am still trying to be the best mama I can be to my little ones, but I am now so worried about a brain tumor, although other than the headache and nausea, I have no other symptoms of one.  THe neuro looked in my eyes and made me do all sorts of things in the office for balance and strength and I was fine.

[Dr Santos]

Hi,
Thanks for the update. Initial treatment for a herniated disk is rest with pain and anti-inflammatory medications.This is usually followed by physical therapy.  In your case, physical therapy may help. Most people who follow these treatments will recover and return to their normal activities. What about anxiety medications? Anxiety is a major factor to consider. Discuss medical management with anxiety and both preventive and abortive migraine medications with your doctor also. If the prescribed medicines do not work, it is important that you inform your neurologist also for a change of medication.

[mamatwoboys]

Thank you for your response.  I am miserable to say the least.  My anxiety is at it's max and I am quite desperate to find some pain relief.  Now I can't sleep either....since I usually wake with a headache even when I may not have had one before bed, I wake up with one EVERY day.  With this being said, I am now afraid to sleep.  It's been three days like this so far.   Maybe I need some sleep meds.  I start PT tomorrow, maybe they can help me?

[Dr Santos]

Hi,
How are you? The pain may indeed be exacerbated by the accident and the herniated discs. You could try the more conservative approach like trying the medicine and see if there is improvement. Otherwise, more invasive approach or surgery is considered. Neorontin or gabapentin is used to help control certain types of seizures in patients who have epilepsy, various types of neuralgia. prevention of frequent migraine headaches, neuropathic pain and  postherpetic neuralgia. Like other medicines, it also has side effects which may or may not be present in every patient. Gabapentin's most common side effects in adult patients include dizziness, drowsiness, and peripheral edema. Discuss this with your doctor for proper evaluation. Take care and do keep us posted.

[mamatwoboys]

I forgot to mention I am taking Fioricet and that sometimes helps, but not all the time.  I take it with Reglan and sometimes vallium.