Migraines...what helps you? - page 2
Hi, I am kinda at my wits end.I am a RN and I have had a cervical fusion in this past year.The spacer the doc used was a lil too large and NOW I have this thing called cervical facet syndrome.My... Read More
May 3, '04Occupation: Management / Education and now a NEWBIE in Correct Specialty: 20 year(s) of experience in ER, ICU, Nursing Education, LTC, and HHC ; Joined: Jul '03; Posts: 822; Likes: 31I have not found Imetrex to be very helpful. I find that my constant headaches are related to stress mostly. I have learned to live with the constant headache everyday.... My question is how much tylenol can one take before you kill the liver. (Just a thought)
May 3, '04Occupation: Operating Room Nurse Specialty: 5 yrs OR, ASU Pre-Op 2 yr. ER ; From: US ; Joined: Jun '03; Posts: 17,036; Likes: 1,006Most pts. in the hospital are limited to 4,000 mg of Tylenol per day.
May 4, '04Occupation: Remote Data Review Consultant Specialty: 22 year(s) of experience in OB, Telephone Triage, Chart Review/Code ; Joined: Jan '03; Posts: 771; Likes: 77I suffered from migraines for many years. Had to resign a position during orientation because of them. Now that hospital won't hire me back.
I had the usual brain scans and all came back okay. One day, I thought I was having a stroke. My right pupil was dilated and my speech was slurred. Called my doc. He wasn't in. Covering doc said to come in to after hours clinic. He ordered an MRI of my cervical spine.
Guess what! I had Arnold Chiari Malformation I. I waited a year before having surgery. Since then, I have had only 1 migraine! Only one in 3 years!
I tell everyone with migraines to have their physican "check the neck". It may not be the cause for everyone (they say it is rare, but go to an ACM website and you wouldn't believe how many people have it!)
May 4, '04Joined: Oct '03; Posts: 121; Likes: 83I used to get migraines but discovered I can't drink diet drinks that contain Aspartame. (it's a common side effect)
however, I've heard that Feverfew (which you can purchase at a healthfood store) is incredibly effective if taken at the onset of a migraine. It's an herbal which some may scoff at, but it's worth a go.
May 4, '04Occupation: RN Specialty: 4 year(s) of experience in Med-Surg, Psych ; From: US ; Joined: Mar '04; Posts: 611; Likes: 24I get a migraine several times a month. I have been on Verapamil for 4 months as a preventative and it seems to help.
When I get a migraine, I take Butalbital and a Compazine suppository (if needed) right away and lie down in a dark room with as little sound as possible. Ice sometimes helps, other times it makes it much worse. If after an hour it is worse, I take 1 mg of Ativan and try to ride it out.
I have ended up in the ER twice this past year for a migraine I could not manage at home. I got the same nurse both times and she made the comment "Weren't you just in here?" It was six months before!
My husband's reaction is usually "another migraine???" But, my Mom gets them too, so she is very supportive. It's frustrating when someone does not understand the amount of pain you are in...
May 4, '04Occupation: PNP, Director of Sim Lab, University of WA Specialty: 27 year(s) of experience in Pediatrics, Metabolic genetics, Neuro ; From: US ; Joined: Apr '01; Posts: 29Migraines....what a PAIN!
Migraineurs were my #1 patient population when I practiced in neurology. Having suffered from them since I was 6 (at least), my patients knew I could relate...
Unfortuantely, what works for one, may or may not work for another, since migraines are all tied in to our serotonin system, & in women, further complicated by our hormonal system.
What has worked best for me, is Topamax 100 mg at bedtime (120 mg gave me the tingly feet & hands side effects), Zoloft 100 mg at bedtime both as prophylaxis. During my periods, I take Amerge, 1mg BID as prophylaxis, and Immitrex tablets 100 mg for breakthrough. You can take up to 3 Immitrex in a day, not to exceed 6 in a week if necessary. I do use the injectabel 6mg Immitrex if I'm traveling, because then i need to be at a talk, or I'm in a plane or some such thing, otherwise, I stick with the tablets cuz I hate injections.
In the world of triptans, the newer, non-narcotic medications, there are many options to choose from. If one doesn't work for you (you need to give each a chance, about 3 tries) then another may work well. I find nasal sprays are the most difficult to use, only because the technique is difficult to master. The newest, eliatriptan, promises to work the fastest, but physiologically, they all take about 30 minutes. The key here is to take them at ONSET! Not to wait & see if your headache gets worse - cuz it will, you know it will...taking the triptan is better than going to the ER any day!
As far as ER visits go, I was amazed that anyone went to the ER for self-limiting pain. Now, people will say I've never had a bad migraine then. 3 days of crawling on the floor vomiting is a pretty bad headache, I think. I just always knew it would go away. In the ER, you will ALWAYS be treated like a drug seeker, the lights are bright, it's noisy, you 'only' have a headache, & you will be triaged to the end, so you may be waiting hours to be seen. I'll take my own bed in a dark room any day. And yes, I told my patients this, too.
I'm a big advocate of massage. That being said, it's frightfully expensive, unless there are training programs in your locale, then you can get an hour massage for 10-15 dollars. I've tried accupuncture, and it is effective, but time consuming & not covered by insurance, so I'll pay for massage over that. There has been research demonstrating effectiveness of accupuncture with migraine. I wouldn't recommend chiropractic in your case, only because of the surgery you've had. Cervical manipulation is not a good idea in your case. Feverfew is a good plan, and so is vitamin B2 as a preventive, however, it takes 3 months before a noticeable effect occurs.
One of the VERY best things you can do for yourself is to keep a headache diary. You can find them in various places on the net, there are many fine headache sites that have examples. I've been keeping one for 10 years now, & it has shown me when I can expect to get headaches, when I need to be more careful about diet & sleep, etc. Knowing your triggers is perhaps the most important thing in learning to gain some sort of control over your migraines. I had patients who would tell me they had no triggers, but after keeping a diary were amazed to find that indeed, they did. Self-awareness, always a wonderful discovery.
Best of Luck! You can beat these rotten headaches!
May 4, '04Occupation: ED RN Specialty: Emergency Dept, M/S ; Joined: Jan '04; Posts: 1,462; Likes: 104I'll take the ER, even thinking I'm drug-seeking, over a 3-day migraine anyday of the week, and twice on Sunday. With 4 kids and school and a household to run, I can't be in that much pain for 3 days. I give it a good 12 hours before I go, unless I can't control the vomiting. I'm a Type 1 diabetic, so too much vomiting is dangerous for me.
May 4, '04Occupation: RN Specialty: 2 year(s) of experience in med/surg ; Joined: Jun '03; Posts: 13I have chronic migraines. Mine last for weeks at a time and after having tried everything to include the kitchen sink I am now taking Neurontin which works wonders. I was at a point where I seriously thought of not living anymore because the pain was so bad and it lasts for months. I take 1800 mg. It has almost no side effects and really works well for me.
May 5, '04Joined: Jan '02; Posts: 5,673; Likes: 159I don't understand how these can be true migraines. Migraines involve the vasculature...and your underlying problem is musculoskeletal...unless I don't understand your full diagnoses correctly. Did you have migraines prior to surgery?
I have had a cervical fusion also and occasionally have killer headaches with muscle spasm...it becomes a vicious cycle. I use 800 mg ibuprofen, heat, relaxation techniques...it seems to help but I know how this can get out of hand when I'm stressed particularly.
I had facet syndrome of my LOWER spine (I have degenerative disease everywhere along my spine) and it responded very well to ESI's and local site injections...q month x 3. You might ask about this.
I would NOT see a chiropractor (not with a spinal fusion) unless its just for heat, massage, ultrasound tx etc...do not let him manipulate your spine unless your neurosurgeon approves. I doubt he would.
Consider asking to see a pain doc for more suggestions/ injections and hope you get some longlasting relief....sometimes the headaches overwhelm me too. (((HUGS)))
May 19, '04Occupation: MICU Joined: Sep '00; Posts: 581; Likes: 164I have NO intention of seeing a chiro doc.I have a titanium plate and screws in my neck...no way am I going to risk damage there.I have had the trigger point injections without much help.I am currently on the Neurontin....and it is helping a little.But.....it is a vicious cycle...muscle spasms....pain...migraines....muscle spasms ...pain etc etc ....but I cant exactly stay in PT forever.I do appreciate everyones advice.....thanks guys!
May 19, '04Joined: May '02; Posts: 4,581; Likes: 4,883I got my first migraine three months after I started nursing! For me it's the associated symptoms, not the pain, that are the problem - they typically start with peripheral vision flickering, photophobia, sometimes auras, nausea, increased olphactory and aural senses (I can hear what people are saying next door, and smell further), vomiting, THEN headaches.
At the first sign I take metoclopramide (Maxolon), prochlorperazine (Stemetil), cafeine/ergotamine (Cafergot) and paracetamol/codeine (Panadeine Forte), then go to bed and sleep for twelve or so hours. I usually feel wrecked the next day but okay after that.
I've had headaches where the pain was much worse. I've always had headaches, or at least since I hit early adolescence, so it wasn't until I started seeing an orthodontist (after I ground through my dental splint and needed a root canal) that I discovered it's not normal to have headaches five times or more a week. Did I mention I work in neuro?!
The first thing he did was file down a point on one canine, and the headache dropped to one or two a week, and now I can go a few weeks without a bad one. So simple!
Also, I don't think advice that you'll 'get used' to them is at all valuable. You need to find a way to at least reduce them, not only because of the pain and suffering (and time or work, lost wages, less time with your friends and family) but also because the meds can be nasty. We regularly detox migraine patients who've become habituated to their meds - not just pain-killers, but antimigranoids as well. Good luck - you have my sympathies.
May 19, '04Joined: May '02; Posts: 4,581; Likes: 4,883I also see a massage therapist every two weeks (after four WorkCover injuries I wouldn't be working without him, and I've had no serious back pain since then). I also kept a headache diary - the only trigger I found was stress, so now I make sure I eat well, get exercise, do yoga, and spend a couple of minutes before I go to sleep concentrating on slowing my breathing and my pulse. You can practice with a pulse oximeter!
I know a lot of people swear by chiropracters, but after we had three patients in a fortnight stroke out within a couple of hours of their appointments, nurses on my ward decided to pass.
May 19, '04Occupation: Student Joined: Dec '03; Posts: 337; Likes: 20[QUOTE=ARmickie]I had really bad migraines a few years ago, and my dr gave me samples of some type (wish I knew the name). It was a pill that dissolved on your tongue, and it only worked w/ migraines. I found that when I first felt the headache coming on,
That would be Maxalt--MLT
*I get cluster headaches. If I get one usually just have to knock me out.