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Chronic Headache

I'm a 42 year old female with uncontrolled migraine heachaches. I have had a heachache everyday for the past 4 and a half years after having a Venous Sinus Thrombosis (brian stem stroke), which was lucky as the lasting issue from the stroke is every migraine. During my numerous visits to different neurologists, it was also determined that I have a blood clotting problem, and narrow veins in the brain stem which resulted in the stroke. I have gone through numerous CT's, MRI's, heart tests, and blood tests over the last four and a half years. For the past three weeks I have been off work due to the pain that once under control, at least under control enough that I could function day to day. I have been to the hospital twice in the last week and a half for IV drugs, that only dulled the pain enough that I was able to function for a few hours. I have my family doctor and my neurologist, who specializes in migraines, at wits end, as they have no idea what to do with me, since I am unable to take any Migraine preventative medication and cannot take Beta-blockers, as per my other neurologist (stroke specialist).
I am currently on Sprolactone, because of my high blodd pressure due a problem with my adrenal glands that makes me retain salt and water and lose potassium. I am also on Anit flammatory Sulindac, Nortriptyline and blood thinner, unfortunately these drugs also have the side of headaches, so that doesn't help.

I don't think that I can stand the pain much longer, between pressure, throbbing, nausea, vomiting, auras, dizziness and putting my life on hold. I need to find a solution to at least getting the headaches under control again or best case senario getting ride of the migraines completly.

I have changed my eating habits to healthier, and losing weight and I know my food triggers, but unfortuately that isn't really helping.

I know this is kind of long but if anyone out there can help, it would be greatly appreciated. As I am my wits end and my doctors are stumped. I cannot let this run my life, as it currently is.
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768044 tn?1294223436
HI robgin!

I am so sorry to hear that you have had daily chronic migraines for over 4 years. I am also sorry that it is become a serious disability, in that you are missing so much work. Chronic migraines are a disability, and if you find that you cannot work due to your migraines, you should qualify for disability pay (temporary and permanent).

I know that you said you cannot take beta blockers, but I was wondering if your neurologist had also told you that you cannot take Calcium Channel Blockers. Calcium Channel Blockers are a class of preventative migraine medication that are also used to control blood pressure. They are similar to beta blockers in some ways, but they are also a completely different class of medication. You may want to ask your neurologists if Calcium Channel Blockers are an option. If they are an option, they might control both your migraines and your high blood pressure.

Have you tried Botox Injections? Botox Injections are a preventative migraine medication and are very effective. You may want to ask your neurologist about Botox Injections.

It sounds like you do not currently have an effective acute treatment plan. Until you find a medication you can take to prevent your migraines, you may want to focus on perfecting your acute treatment plan. What is your current acute treatment plan?

It is important to take acute migraine medication as soon as you start to feel a migraine. If you wait too long, the migraine medication often will not help as much or at all.

I used to have to go to the hospital a lot for my severe migraines before I had a successful acute treatment plan. Once the pain is bad enough to go to the hospital, there can sometimes be very little they can do other than give you enough drugs to knock you out.

The first line of acute treatment for migraines are triptans. The majority of migraine patients should have a fast-acting triptan as part of their acute treatment plan. Since you have had a stroke and have high blood pressure as well, triptans are probably not an option for you. Still, if you have never talked to your doctor about triptans, it would be worth having a conversation about them.

Naproxen is another medication that many migraine patients should have as part of their acute treatment plan. Naproxen is an NSAID that will not cause rebound headaches. I do not know how Naproxen and your medical history would mix, it could be appropriate and it also could not be appropriate. If you have never tried Naproxen before, you may want to discuss with your doctor if adding naproxen to your acute treatment plan would be appropriate in your situation.

Metoclopramide is an antiemetic that works in two ways for migraine patients. First, as an antiemetic, Metoclopramide stops nausea and vomiting. You mentioned that you get nausea and vomiting. If you do not already have an antiemetic in your acute treatment plan, then you should speak to your doctor about adding one in. If your doctor prescribes you an antiemetic, usually you are supposed to take it at the same time as your first-line medication. Metoclopramide does more than a regular antiemetic for migraine patients, as it increases the effectiveness of all other migraine and pain medication you take at the same time. If you find that your current acute treatment plan sort of works, but not enough, adding Metoclopramide may be an answer. You may want to ask your doctor about using Metoclopramide along with other migraine medication.

I know that you mentioned the IV medication they gave you at the hospital dulled the pain but did not work very well. If you are able to take the same sort of medication at home when your migraine first hits, you may find that you have much more success with it. I do not know what they gave you at the hospital, but they usually give me a pain killer called hydromorphone. Hydromorphone is like morphine but it does not have the same side-effects. Hydromorphone will not cause stomach upset, nausea or vomiting like morphine does for some people. If you get a prescription for an opiate medication, you may find that you need much less than you do at the hospital since you are able to take it before the pain gets out of control. When given by IV at a hospital, many people find that they usually just go to sleep after being given an opiate. Some people feel uneasy or even dizzy. Since you would be taking much smaller doses at home, these sorts of side-effects usually are not an issue for most people. Speak to your neurologist about a possible prescription for the medications they used at the hospital.

I am also wondering what they gave you at the hospital? If you found that the emergency treatment was unhelpful in the past, you can request different treatments. At the hospital they often will give patients: IV fluids (this is especially helpful if you have been vomiting or if you have been unable to drink liquids); a standard migraine medication by injection such as a triptan (specifically Sumatriptan) or an ergot alkaloid (usually DHE); an opiate such as morphine, hydromorphone or Demerol; and an antiemetic such as Metoclopramide. If the hospital gave you the antiemetic Zofran and it was not helpful, you might want to suggest Metoclopramide instead (or vice versa). If the hospital gave you morphine and you did not find it helpful, you could suggest hydromorphone instead. Always confirm your medical history (stroke, etc.) with the doctor or nurse at the hospital if you do suggest a different medication.

There are also some vitamins and minerals that have been proven to prevent migraines. The following are statistically proven to prevent migraines: 400mg of Magnesium per day; 400mg of Vitamin B2 per day; 300mg of Coenzyme Q10 per day. I do not know which or iif any of these would be appropriate considering your medical history. You may want to ask your neurologist and/or pharmacist if these would be suitable in your case. Always consult a doctor or pharmacist prior to taking any vitamins or herbal supplements.

I hope some of this information is helpful! Keep in touch!

- marilee
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180749 tn?1443595232
To to get relief from headache/migraine naturally, the full pranayam exercises are described below.Do it seriously, regularly  and at the suggested duration, and you can call it a cure or control without medication.Your feedback is important, as I want you to continue this pranayam and guide you.
Initially do Anulom Vilom (as much as you can) for the fist few days and then start the full set of pranayam.This works gradually, so allow time (1 week upto 24 weeks) and concentrate fully on the breathing. Avoid cold drinks and drink warm water.

Build up your timing gradually.If you feel tired or dizzy, stop and resume after 1 minute.
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 upto 15 minutes twice a day. Not for pregnant women. Seriously ill people do it gently.

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.
You can do this before breakfast/lunch/dinner or before bedtime or in bed. Remember to take deep breaths into the lungs.

Bhramri Pranayam -Close eyes. Close ears with thumb, index finger on forehead, and rest three fingers on base of nose touching eyes. Breathe in through nose. And now breathe out through nose while humming like a bee.
Duration : 5 to 15 times

Continue the pranayam once a day to stay healthy.The factors helping are the extra oxygen and the relaxation(reduced stress) you get when doing the breathing exercises.
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