Helping patients with migraines

Sonjailana · May 24, 2011

As a hormone induced migraineur..

I can say, cold, quiet, dark room. Anti nausea meds. Sometimes excedrin. Massage is good sometimes..sometimes I do NOT want to be touched. Really, not too much out there.

boat · May 24, 2011

I just saw something new...Mag sulfate for migraines. Had never seen it until a few months ago in the hospital and had to go home and google it. Sure enough, found research articles regarding its effectiveness.

Interesting.

Steve EMT-B · May 24, 2011

I go to a quiet dark room (no stimulation) and lay in bed with a cold cloth on my forehead and an ice pack behind my neck...

CompleteUnknown · May 24, 2011

Migraines are strange and horrible things aren't they? I find the nausea almost as distressing as the pain. The only thing that truly worked for me was a course of acupuncture, believe it or not. I'm not a fan of 'new age' type things but I was desperate, and ever since I had the acupuncture (several years now) my migraines are less severe and less frequent.

When I even think I feel one coming on, I take 2 ibuprofen and 2 paracetamol together and repeat in 4 hours. This works reasonably well most of the time, but when it doesn't, I have to lay down in a dark room and just wait it out. If it gets that far, painkillers are pretty much useless and cold cloths/ice packs don't really do much for me. If the migraine is on the right side of my head, I have to lay on my right side and if it's on the left, I have to lay on my left side.

jmqphd · May 24, 2011

On Easter Sunday, I had a bad migraine. The following Sunday, same only worse. The next Saturday... awful (head in the toilet all frigg'n night) The next Friday (during clinical with my students) here it comes again. I'm seemingly on a 6 and a half day cycle with migraines debilitating for 2 days, feeling great in between.

The scariest thing is the autonomic symptoms. (Please, if anyone has similar symptoms, please let me know. If anyone knows what to do about them, please tell me.) I am a know-it-all on pathophysiology and have a PhD in Physiology/Pharmacology. I saw one piece of research on this in an obscure journal with a very small sample. Other than that... I am stumped and feel helpless.

1. The nausea and vomiting is a well known and common symptom.

2. During the onset of the migraine when the pain gaining steam, I'm somewhat tachy and my BP soars. (205/110. 190/130... oh,yeah.) Arrhythmias. Feel weird, heavy chest, escape beats. I have no choice but to take labetolol and lay down. Only a bit of photophobia.

3. Then there is (probably?) a sympathetic withdrawal. I tank. 60/palp. (I try to stay away from beta blockers because I know this is coming... but, sheesh.) When this phase starts, I can't stand up. I lay down with my legs up or pass out.

My internist and cardiologist know about this. They are stumped. The only opinion they have is that I should not make any change in my ARB since it keeps my HTN fine in between episodes.

And yes, I'm on premarin and want to stay on it. Don't do at all well without them. Want to slit my wrists or kill people.

I'm not asking for med advice because this is not the purview of Allnurses.com. I have MD's. Like I said they can't suggest anything. I just want to know if anyone has ever seen this before.

workingspaz · May 24, 2011

0 premarin or change hormones.... looks like every one else hit the treatments spot on... good luck

ObtundedRN, BSN, RN · May 24, 2011

The only thing that truly worked for me was a course of acupuncture, believe it or not. I'm not a fan of 'new age' type things but I was desperate, and ever since I had the acupuncture (several years now) my migraines are less severe and less frequent.

I just found it funny that you consider acupuncture to be "new age." Ancient medicine would be a better term. :)

I don't know about premarin induced migraines, but I do sometimes get a random migraine. For me, meds don't touch it. The best thing I can do is run cold water over me head for a few minutes, then lay down in bed, in a dark cool room, maybe with a wet cloth on my head, and try to take a nap.

I've also talked MD's into giving me an order for Imitrex for a patient with a migraine. I've seen the subq injection work miracles! I've seen it completely eliminate migraines in less than 5 minutes. And for those of you with migraines, getting rid of that kind of pain and nausea in 5 minutes is a miracle! lol. I hate it when I see people want to try giving morphine or other narc's for a migraine. Migraines are related to vasodilation of the cerebral artery, morphine is just going to dilate that artery more and cause more nausea.

jmqphd · May 24, 2011

Triptans sometimes work for me. Sometimes just ******* away money. When I have quick onset of severe migraine, nothing is going to stop it.

But you're right. When they work... miraculous. You're also right... opiates make it worse, and magnify the nausea.

dandk1997RN, MSN, RN · May 24, 2011

I don't know about premarin-induced specifically (I'm 36 and have been diagnosed for several years) but I finally hit on the right combo for mine- I have to take my Imitrex WITH caffeine and WITH naproxen. None of them work alone or with just two, but all three together do the trick. If it is too far gone, I put an ice pack on my head. I don't need a dark room, but noises do it for me, so I need a quiet room. Interestingly, I've had one coming on for about ten minutes now, so must go take my trifecta....

CompleteUnknown · May 24, 2011

I just found it funny that you consider acupuncture to be "new age." Ancient medicine would be a better term. :)
I don't know about premarin induced migraines, but I do sometimes get a random migraine. For me, meds don't touch it. The best thing I can do is run cold water over me head for a few minutes, then lay down in bed, in a dark cool room, maybe with a wet cloth on my head, and try to take a nap.
I've also talked MD's into giving me an order for Imitrex for a patient with a migraine. I've seen the subq injection work miracles! I've seen it completely eliminate migraines in less than 5 minutes. And for those of you with migraines, getting rid of that kind of pain and nausea in 5 minutes is a miracle! lol. I hate it when I see people want to try giving morphine or other narc's for a migraine. Migraines are related to vasodilation of the cerebral artery, morphine is just going to dilate that artery more and cause more nausea.

Hahaha you're right of course.

I guess I meant that I don't really 'believe' in acupuncture and I had no expectations that it would work. I was really surprised when it helped.

I also sometimes do a sort of self hypnosis thing I suppose you'd call it. I imagine the pain in my head as a big ball of redness inside my skull. With each calm breath in, I imagine the air going up into my skull and gradually 'squashing' the ball against the inside of my skull. When it's become paper thin against my skull, the pain seems a little less. Then I imagine this thinned out thing gradually making its way down to the base of my skull with each breath and slowly, bit by bit, slipping out. You have to kind of forget about anatomy and stuff to make this work. Anyway, when it's all out, the pain has gone. It works sometimes.

I promise I'm only weird when I have a migraine!

snookiejc · May 24, 2011

Most times, when I feel a migraine coming on, I take two Excedrin, 1-5mg Zomig, and 1 Tall Americano.... usually does the trick, but sometimes I have to repeat within 8 hours. When it works, it's like a miracle, but it doesn't always work. I've had some success with Chiropractic adjustments, but my insurance doesn't cover the visits, so I don't go as often as I'd like to. It seems for the last year or so, my migraines have been 3-day episodes. Day One - Headache, take meds/Starbucks, and then I'm okay for 8 or so hours, repeat cycle for three days. Generally, I wake up with the migraine, and it is WITHOUT FAIL on the left, behind my eye and radiates to my jaw/ear. Goodtimes.