HELP WANTED

Mrs MP suffers from migraines. Of course, being Mrs MP she is not content to just have headaches, flashing lights and nausea she has to have the type of migraine that causes sinus pain. This (which sometimes happens twice a month) is an agony which she can only compare to acute toothache.

This is has been going on for years and although her GP tries to help I've decided, having read up on the disorder, that I have to get her GP to refer her to the migraine clinic at one of our local hospitals. I doubt that they will be able to "cure" her but, hopefully, being specialists, they will do more to manage her pain than the GP.

Now, I'm a great believer that when dealing with medics, anywhere, forewarned is forearmed. So, if anybody out there has personal experience of this type of migraine and has been successful in reducing its agony do, please, let me know what helped. One of the problems I find with doctors is that they always start off with the mildest treatments and have to be pushed quite forcefully into prescribing treatments that actually work. If Mrs MP knows what these will be beforehand she can start badgering the doctors for it straight away.

And please pray for Mrs MP. She is so miserable at the moment as her Christmas holiday has been pretty much ruined by it. And migraines and depression go together like pouring water onto a chip pan fire.

Comments

HELP WANTED — 57 Comments

  1. Poor Mrs MP. Her malady sounds dreadful. I added her to my prayer post for Tracy, TheMe’s wife, who has an infection in her leg. You English keep a woman busy!

    I hope that while Mrs MP suffers you are compassionate enough to give her relief from moaning about your own woes. 🙂

  2. I never moan about my own woes until I am over them. That’s the English way. It’s considered incredibly rude to complain about something while it is actually happening.

  3. Having no experience in the migraine department, I can only pray for Mrs. MP. Others more powerful in that department will be praying, too, I’m sure. And Mimi has already put it up on her blog.

  4. Prayers are okay, but you would think that the Witch Queen of New Orleans could swing a chicken round her head and conjure up some of that voodoo that she does so well.

  5. People who have followed this blog for any amount of time will have us both down as first class moaners, Mimi. The difference between you and me is that I will accept their judgement whilst you will moan about it.

  6. I occasionally get migraines that effect my eyesight more than anything else. I find that Imitrex, the nasal spray (not pills) works miraculously for me but doctors will not offer that right away – I only knew about it because my sister had some and tried it. Then my daughter had migraines and the doctor gave her something else that didn’t work so I had my daughter ask for imitrex and she found it worked.

  7. Poor her..

    I suffer from Migraines – with the flashing lights and nausea and feeling thoroughly washed out the following day…

    However, I am lucky enough that if I spot the tiniest flashing light I can take Migraileve and lie down and it goes away.. I think it is just getting the drugs before it has properly taken hold…

  8. Sumatriptan, under brandnames Imitrex, Imigran, Imigran recovery. Works beautifully.

    Then: magnesium plus Vitamin B2. These help a great deal.

    I’ve tried them all. Sumatriptan is the marvel, but magnesium + B2 helps a huge lot.

  9. I have very painful headaches as a result of a head/neck injury. It feels as if I’ve been hit on one side of the head (the left side) with a big stick. My PCP won’t prescribe drugs – which is good, I’ve been told. The only thing that works for me is neuromuscular massage but my insurance won’t pay for it and I’ve run out of money to pay for it out-of-pocket. So when I need to get through the day, I arm myself with significant doses of Exedrin and ibuprofin. Ice and heat help with the most difficult of scenarios. Headaches are tough. WP has cluster headaches and he goes mad when he has an episode.

    Good luck to Mrs. MP with this ordeal. Pain sucks.

  10. I get migraines, as does my sister, her kids, our father, his mother, her father, and various collateral branches of the family. They tend to be genetic (you think?). Mine tend to be pain around the eyes (like a vise around the eyeball). Some nausea later in the episode if not treated.

    Immitrex (aka Sumatriptan) is a miracle drug. I use both the pill form and the injection version (it comes in a spring loaded thingie, much like an epi-pen so the injection isn’t a problem). The injection version works in about 2 or 3 minutes – the pill can take 20 minutes. As I have no patience you can guess which I prefer. You need to take it early enough so that you are ahead of the pain. I have not found the nasal version helpful for me.

    Maintenance drugs (indural, etc) don’t seem to be all that helpful for me. In ladies, I am told it tends to be highly correlated to monthly cycles and hormone changes. My niece I understand gets them like clockwork every month. My grandmother’s ended with the change. My father used to say he was looking forward to it. Mine tend to be correlated to stress (the end of, not during – used to get them Friday afternoons like clockwork), tempurature (it is a vascular condition, although neurologists tend to be the doctors who end up treating them – and when I get too warm they can come on – beware of cold rooms at night leading you to stay under the covers and get too warm), alcohol (that can be a real trigger, not that I give up wine, although my father doesn’t drink because of them), and getting overly tired (sleep is a good thing). All that good stuff your mother told you turns out to be true.

    Fiorinal (Aspirin, Butalbital, and Caffeine) used to be good, but they changed the formula a few (number of?) years ago and it isn’t as good as it was when I was young.

    I have not found the food triggers (nuts, etc) to work for me – I can eat nuts, cheese, etc without problems.

    Hope this helps. Good luck to her.

  11. My grandmother’s ended with the change. My father used to say he was looking forward to it.

    It’s a ridiculous thing to wish for, but we do.

  12. PS – I am sorry, but your doctor not giving you meds is not good nor acceptable. Narcotics may not be the answer, but your having to live in pain is all to easy for the doc to say, it isn’t his life! I suggest you find a new doc.

    I am sorry if this sounds like I am upset with you; I am not. I AM very upset with doctors like you describe.

  13. I know nothing about how to deal with
    migraines, though my mother used to suffer from them, so I have some awareness of how agonising and horrible to bear they can be. But I will certainly pray that Mrs MP can find relief from them.

  14. It’s a ridiculous thing to wish for, but we do.

    Not ridiculous at all at a certain point in a woman’s life. I wished for it, even without migraines, and I’m sure Tom did, too.

  15. {{{Jane}}}

    [Wot?! My hugs are therapeutic—ask skittles! ;-p]

    Seriously, may every member of the Mad Gang feel better SOON.

    ***

    Could I get some more prayers for my (18 year-old) Namesake & fam? Life is Being Difficult again. 🙁

  16. OK, I’m coming at this from a different tack and will no doubt get my first dose of guff for the year. How do you know it is not a sinus condition triggering migraines rather than migraines triggering sinus pain? The closest I get to migraines are sinus headaches. I have also known a handful of individuals who were diagnosed with all sorts of maladies when in fact the problem was a particularly stubborn sinus infection or abscess. Has a good ENT doctor checked up there? OK, you can hit me now for once again being contrary.

  17. Yes, Renz. She went to an ENT specialist early on and it does not respond to sinus medication. Also the sinus pain comes after the migraine. Having read up on migraine related sinus pain I think it very likely that the GP is correct in her diagnosis.

  18. On Christmas Day I visited with a friend whom I hadn’t seen in some time, and she told me that for the first time in her life she has gotten relief from almost daily migraines through eliminating certain foods from her diet, or at least restricting quantities. Her physician recommended cutting out the whole list to start with and then reintroducing the suspect foods one at a time. Through that process she learned which ones are her ‘triggers’ and avoids them, especially in combination. (She can have a little chocolate, for example, but not at the same time as a glass of wine.)

    My stepmom had migraines all her life, so I know this is no joke. Mrs. MP is in my prayers. Happy New Year to you both.

  19. Magnesium was miraculous for me – along with taking beta blockers daily for prevention. The beta blockers have to be at a therapeutic dose, though. I was started off at too low a dose and then got a new doctor out of desperation – an internist who really knew what he was doing and who insisted I take more. That turned things around.

    Really stepping up vigilant observation for triggers can also be a good idea. It was years before I discovered that too much salty food on an empty stomach was a major trigger for me. Fatigue as well.

    Pagan Sphinx, are you in the US? I completely agree with Andrew on the medication issue. There are pharmacies overseas from which you can order over the counter pain meds with codeine and it’s perfectly legal. Email me and I’ll send you the details. (See my Blogger profile page.)

  20. Thanks, Ellie. Magnesium seems to be a common suggestion and one we have not looked into before.

    Mrs MP is on beta blockers, so we will look into increasing them, as well.

  21. The internist quadrupled my dose, can you believe it? He said, “You’ll hate me at first for this but then you’ll love me.” I did have to get used to considerable lightheadedness and lowered energy with the increased dosage but then my system got used to it and it wasn’t so bad. I have since gone through menopause and cut the dosage in half and that seems to be doing the trick.

  22. I’ve had the visual disturbances associated with migraines but only mild headaches and sometimes no headache. They last only 30 or 45 minutes and gradually disappear.

    The first time I had the flashes, I thought I had a detached retina, and I rushed to an eye specialist. As I told my story, before I reached the end, he was nodding his head, but not in an alarming way, and I knew he had already diagnosed my problem, and then I stopped, and said, “It’s migraine, isn’t it”? And he said yes. I diagnosed myself.

  23. Mine also ended with “the change”. Triggers for me were dark chocolate and red wine. The only thing that worked for me was ergotamine, or saying away from the triggers. Stress didn’t help.

  24. I have no medical help to suggest. I get “optical migraines” from low sugar episodes but they are at least so far, painless visual distortions. I am told they mimic some of the impact a migraine has on a real sufferer but for me the answer is food. Once my blood sugar is in better shape I am fine.

    What I can offer is prayers for the lady. And I will.

    FWIW
    jimB

  25. To reduce the frequency of migraines, try coenzyme Q10 and the herbs feverfew and butterbur, in addition to daily magnesium and B2. All of the above should be taken on a daily basis, and it takes several weeks to achieve a noticeable effect. This is something of a scattershot regimen, but it has helped me considerably. I am not sure which supplements are doing the most good but have noticed that if I run out of feverfew, the migraines become more frequent. Also, butterbur was my most recent addition, and after about a month on it, I experienced a further dropoff in migraines.

    As far as I know, all of the above are safe and free of side effects; however, since magnesium is a mineral, be careful not to overdose on it. Google around for information and dosage on all of them. When buying butterbur, be careful to choose extracts guaranteed to be free of pyrrolizidine alkaloids (PAs), which are toxic to the liver. Take butterbur with meals. If you don’t have a health food store nearby, a good, affordable online source for the herbs and supplements is Swanson. You can also check out Amazon.

    Mrs. Madpriest might also look at her consumption of caffeine, red wine, aged cheese, and monosodium glutamate, all of which have been implicated in migraines. I happen to love coffee and so make a practice of blending caffeinated with decaffeinated to cut down on the caffeine intake, and it seems to have helped. In addition, she might chart the frequency of her migraines to see if they correlate in any way to her menstrual cycle. Mine correlated quite strongly. This is a specific type of migraine, and having this fact on hand might help her doctor in treating her.

    If Mrs. Madpriest doesn’t use caffeine, she may find it very helpful in fighting off a migraine. This works best for people who don’t use caffeine regularly. Caffeine is a vasoconstrictor, and the pain part of the migraine involves vasodilation.

    Good luck to Mrs. Madpriest in dealing with this. One nice thing about aging, for women, is that migraine attacks drop off considerably. So it does get better.

  26. My migraines essentially went away after a thorough eye examination revealed two small tears in my left retina. The ophtho was looking into my eyeball and asked if I had migraine, without me even mentioning it. A few bright flashes of laser light and one final hellacious headache later, I’ve scarcely been bothered in about 12 years. This after two years of visiting other specialists for help with the migraines and none of them suggesting an eye exam.

  27. How about also seeing a chiropractor and having an adjustment done? One of my coworkers used to have migraines rather frequently until she started having regular adjustments of her spine, and now she very, very rarely gets migraines at all. There may not be any need to use drugs to deal with this at all – *maybe*.

    Disclaimer: Doc Holladay I am not. I’m not a physician and I don’t play one on TV.

  28. Hi MP
    I have very similar (though less frequent) headaches. I’ve found that if I take a standard dose of soluble aspirin plus a dose of paracaetamol/codeine at the first sign of visual disturbance it always prevents a subsequent headache.
    Worth a try
    Brian

  29. Migraines are hell. I’ve had them since I was a baby and over the years they got worse and worse. Menopause has not lessened them, though that was the case with my mother. I was an RN and have been on disability for 14 years – partly due to the chronic, severe migraines. I was followed by our top Migraine Neurologist for over ten years until he gave up in frustration and refered me back to my GP. I have tried every preventative and abortive drug and combination of drugs possible, often at obscene doses. Even tried several experimental and off-label meds, as well as Botox. Nothing worked. Neurologist wouldn’t prescribe a Triptan because of blood pressure issues.

    In the end, my GP agreed to let me try the Triptan, Zomig – the drug my daughter uses with great success. (BOTH my son and daughter have had migraines since young children)

    The Zomig is the only drug that has ever been able to stop an attack. I’m still very resistant and it takes at least two hours before the pain starts to ease off. If I wait too long, it doesn’t work at all – just makes me feel sicker. At least now, I have the HOPE of easing the pain, and for me, that’s a lot.

    Some things I’ve learned in 50 plus years of dealing with migraines:

    Rapidly changing air pressure, and very low pressure systems, are one of my biggest triggers. A diuretic helps, and so does a stable room temperature – that means air conditioning and central heating as needed.

    As already mentioned, daily high doses of Magnesium and the B vitamins helps to lessen the frequency and severity. Extra Magnesium during and attack is helpful.

    Avoid alcohol, getting over tired or over sleeping, avoid low blood sugar (regular, healthy meals and snacks), avoid scent triggers (for me that means some heavy perfumes and chemicals like chlorine – no indoor pools for me), do what you need to help you cope with stress (excercise, meds, therapy, massage, etc.), take all meds – triptan, analgesic, extra magnesium, at the first sign of a serious migraine.

    It’s rarely one thing that helps. Find a sympathetic doctor who will listen and isn’t afraid to try different things.

    Learn what works for you and do that. Have a loving, compassionate Spouse. 😉

    Good luck! (Please God)

  30. Moist heat for the sinuses.

    Remember that you are in control of your health care so get bossy and do your research on migraine treatments, and then study them and insist on them, and don’t take anything less. Doctors think patients are an uneducated lot when it comes to what we know about ourselves, our conditions, or those of loved ones. Keep pestering them until you get what you or Mrs MP needs, but don’t let them be patronizing or condescending. You will brook no such nonsense.

    Yeah, I get steamed about how providers think they are so superior to the patient. Unfortunately we are driven to be aggressive when it comes to getting good treatment but sometimes when you show your passion and determination, they end up respecting you more.

  31. I know what you mean about the ineffective treatments GPs usually start out with. Have you tried heroin or another substitute though it tends to be a bit groggy-morphine. After that only full blown decapitation seems to work best. Avoid milky tea. Let me know if this helps with the depression.

  32. Oh, I forgot something yesterday. Back in my math teaching days, I had a student who had debilitating migraines and they tried everything with the poor boy and nothing worked until he went for biofeedback sessions. They gave this young man his life back. It was amazing.

    My brother has the visual distortion kind of migraine without the pain. Lucky devil. (I mean if you HAVE to have them at all…)

    I’ve also found that if I take Excedrin (an asprin, Tylenol/paracetemol, caffeine combination) RIGHT AWAY and then go to sleep (if that’s possible) that will nip it in the bud. That usually will work for me because I tend to wake up with the headache or get it first thing in the morning so I can often manage to go back to sleep for a few minutes. If sleep is impossible, lie down in a darkened room. An ice pack at the base of the neck often helps.

    And lest I forget: Listening to “The Lark Ascending” by Ralph Vaughan Williams as long been part of my personal migraine treatment regime once the actual headache gets underway. It is incredibly soothing and I’m convinced it does something physiologically.

  33. Mr B took imigran by mouth towards the end of his (awful) migraine years. He seems to have grown out of them now, thank God. Two good friends inject imigran with an epi-pen, so it works when their gut seizes up with the migraine. Side-effects include increased sensitivity to heat and cold (so you have to let the tea cool down)
    Good luck with this – our experience was that even he consultant merely remarked on Mr B’s stress levels (and don’t point out that it would be cos he’s married to me: I know!)

  34. and don’t point out that it would be cos he’s married to me

    Now that is going to be very difficult and not just for me.

    The epi-pen, which someone else mentioned, we have not come across before and sounds like something we should look into.

    I have a sneaking suspicion that I’ve just used the word “like” incorrectly. Oh dear.

  35. Had migaines BEFORE my car accident in 2000 (the worst of which landed me in a hospital for close to two weeks and caused me to lose almost all my vision) and then in 2006 started having headaches 24-7 which really sucks. Started out with migraine after migraine after migraine. Did chiropractic, did the neurologist thing, went to the pain doctor (useless and a jerk), two physical therapists (#1 useless and another jerk, #2 very helpful). The headaches are due to a neck injury which second therapist finally figured out. (I too get the sinus pain like Mrs. MP). Therapeutic massage helped a lot, ice helps, but the only thing that really stops them in their tracks is Treximet, which is horribly expensive, but kills the migraine. But not the headache. Hope this gives you some ideas. I’m going to try that magnesium one myself.

  36. I have migraines that are now pretty manageable (ie, go away with ibuprofen if I take it early enough) and I now only take maybe one day every couple of months off work with them. They were much worse – every two weeks and hellish – until I worked out that they were triggered by the SSRI antidepressant I was on (sertraline/zoloft). It’s a rare but known side-effect. After I came off them my migraines got much better. Oh, and B12 actually triggers migraines for me too. I’m just weird.

    One place I found really helpful if she’s desperate enough to travel down south here, was the City of London Migraine Clinic. They’re a private clinic but a charity so you just pay what you can afford. I think you can self-refer or ask your GP to refer you. They’ve got some world experts on migraine:

    http://www.migraineclinic.org.uk/

  37. OK, MP, you know how I can be…
    First off, I can read the blog from my new phone but can’t read or comment – phone can’t handle it and read the blog through Google Reader. Anyway…

    My migraines/sinus headaches never get to the sinus pain start. They present simply as horrendous headaches – fortunately they respond to regular over the counter sinus meds.

    The folks I referred to were told they had allergies, etc. Antibiotic therapy didn’t work. However, once an ENT went up into their sinuses with a scope and could find the polyps or abscesses etc. Or some had a CT scan of the head that revealed the sinus nature of things.

    I’m really not trying to be contrary and perhaps she has had these diagnostic work ups. However, from some of the posts regarding the health system over there and with my own experience as a health care professional witnessing the misogyny that occurs at times – “she’s a woman, just give her some valium…”

    That is only the reason for my persistance. Thank you for listening and happy new year!

  38. An “epi-pen” is an injectible pen that dispenses epinephren for folks with severe (life threatening) allergies. I imagine that you mean an imigran pen, essentially either a single or multidose device to inject a drug into the skin.

  39. Yes. I do. It resembles what I think of as an epi-pen, that’s all. It seems to work more rapidly than taking the stuff orally.

  40. I think I may try that magnesium myself!

    If you haven’t already noticed the trend, it is very important to try to nip this stuff early. Do NOT wait to take the meds (once you figure out what works).

    Imitrex is basically a fast acting SSRI, so Prozac or similar stuff may help as a maintenance drug. It would also make sense that a side effect of the Zoloft would be migraine as it is effecting the same seretonine circuits.

    Mimi – odd you should mention the eye docs. After many years of severe headaches (often triggered by flashing lights – riding the bus home from school along tree lined roads was hell!) I finally went to the eye doctor in college and complained of headaches. He couldn’t find anything wrong and in exasperation said “If you have headaches, see a nuerologist” (he had recently had a heart attack and I think it had effected his personality as sometimes happens). The neuro doc took one look and diagnosed migraines. Given the already known 5-generation family history with them I felt rather silly.

    And good luck to you and her both.

  41. FWIW, my brother-in-law saw the prayer request for Mrs MP at WB and emailed to say he had the headaches that caused sinus pain, and a medication called “Caffergot (caffeine & ergotamine)” relieved his pain. His headaches ceased spontaneously sometime in the 1990s.