migraine investigative work

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migraine investigative work

Post  tortoisegirl on Fri Jun 09, 2017 8:39 pm

I've been having a string of frequent (assumed) migraines lately. I've had a constant headache for 11 years (diagnosed NDPH), so its often tough for me to know whether it is a migraine until it is very obvious, with severe pain which is way worse on one side and nausea, then it takes hours to get it under a control with multiple doses of Sumatriptan and Zofran.

Nearly every migraine starts in the evening. For awhile I was getting migraines at most 1-2 days a week and they were relatively easy to treat, so I didn't focus much on it. However, lately I had a week where I took a triptan every day, and the week before that, I took one more days than not. Plus the nausea was very difficult to control and I used up my stockpile of Zofran.

However, sometimes I think when I take a triptan at the first sign (like we are told) it may not be a migraine every time, as sometimes I feel better so much sooner than other times. I get severe pain just from the NDPH sometimes, and have stomach issues which cause nausea at times, so sometimes it is just a false alarm.

If I take a sumatriptan, the pain subsides back to baseline, and 24 hours after I took it I feel migrainey again: Is it (1) the same migraine which had been suppressed that whole time by the triptan, (2) a new migraine, or (3) something else?

I had thought it was the same migraine coming back, but I recently read sumatriptan only has a 2.5 hour half life (way way less than I thought), so that makes it seem more likely to be a new migraine.

If it takes 2-3 hours until after taking oral sumatriptan until I am feeling better, does that mean the migraine more likely went away on its own rather than responded to treatment?

Sorry for the long-windedness. I just really want to try to figure out some of my triggers. Seems like I either get migraines too infrequently to figure it out (I tracked every single thing I ate for months one and didn't get a migraine the whole time, so I gave up for awhile), or too frequently to figure it out.

Verapamil seemed to be helping for awhile (less attacks and they were more treatable), then it stopped helping, so we increased the dose and I'm considering adding in Nortriptyline too, as I tolerated it in the past.

The good news is that I've tried most everything for the NDPH so I know what I can and cannot tolerate (much more of the later). Botox was glorious for the migraines (not a single one the whole time), but horrible for the daily headache, so that isn't an option.

I have a neuro who is kind of a headache specialist, but he only wants to see me every 2-3 months, trying 1 preventative during that time. However, most of the time I can't tolerate what he prescribes, and it is crazy difficult to work with the office and have him call in something else.

I think next time I will just ask for a list of suggestions to take to my primary doctor, who pretty much will prescribe what I ask for within reason. I do enough research on my own to probably just go straight to my primary doctor though, especially if it is a mainstream med. Its more the obscure stuff that he won't be comfortable with that I need the neuro for (like Namenda or Ketamine). Best wishes.

tortoisegirl

Posts : 357
Join date : 2009-12-14
Location : Washington

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