Help for new headaches

Hello everyone, I'm new to this forum and have entered brand new territory, and am looking for help/insight if anyone can provide some (I apologize for the length in advance)

I am 31 and was diagnosed with migraines when I was 14, and currently suffer from from chronic migraine, getting as many as 18 a month, some of which are hormonal.

I'm currently on Topamax, 150mg daily & propanolol, 200mg daily, along with Ponstel 250mg (I take this starting 2 days before my cycle begins & continue for the duration) as preventative treatment. I also take 5mg of Ambien for insomnia.

I use Imitrex, Reglan, Benadryl, and am able to get Toradol injections if needed for acute attacks. I take the Imitrex on a very limited basis because I have severe adverse reactions to it (locking jaw, vomiting, flushing, muscle pain) and it's effective only in taking the edge off. I don't take any other triptans because I've had the same reactions to them. This regimen is pretty hit and miss, but it's the most effective solution that I've had in 17 years.

Just recently, I had a trip to the emergency room for headaches that were nothing like my usual migraines. I followed up with my PCP, and she put a name to these new headaches (they've been coming every hour for the past week, sending me into fits of tears, anxiety and agitation and moments of wanting to throw myself off a bridge). I've now been diagnosed with cluster headaches in addition to the migraines.

Does anyone else experience these? What medications do you take for prevention and/or abortion? Is there a way to get relief for them? I was given a steroid injection & steroid taper in the ER which took the edge off a couple days of pain. My PCP is sending me to a neurologist and I have an MRI scheduled in a couple of days. If anyone can help, with suggestions for the clusters or the migraines, it would be greatly appreciated.

Hi lissa,

I just saw your post today. When you have a minute, check out the posts on "Nerve Blocks" on this forum. One of the other members, "chandlertoo" posted about her success with a new sphenopalatine ganglia block procedure (SPG), but she did not detail her meds, etc. She did mention getting migraines every day for 38 years and went pain free for seven months. Hope this helps.

Thank you for the tips! I will definitely bring them up at my appointment with the neurologist. I've heard of the nerve blocks before, but the SPG procedure is new to me(will read up on that). Hopefully one could be an option for me.

On a side note, I heard back from my pcp yesterday afternoon about my labwork, my potassium levels are low, and my TSH levels were off. Starting potassium supplements & I have to have my thyroid checked with another test for hypothyroid. Not sure if any of it's related to the migraines & clusters, but hoping that getting these issues straightened out will help with some of the pain.

Not a problem, glad to help out. Did you see the post yesterday concerning melatonin? That information looks very encouraging. I also noticed another post under "So Sick and Frustrated" where her/his migraine pain was apparently caused by a CSF leak. A subsequent blood patch cured their headache pain, thankfully.

Good luck with the lab work-up and neurologist consult. Just so you know, the SPG nerve block procedure has been described since 1908. However, the SPG block with SphenoCath is new in that this catheter allows for the precise delivery of lidocaine to the sphenopalatine ganglia. Another nice benefit is these SphenoCath SPG procedures are done without needles or conscious sedation, so you will not be stuck and can drive home the same day. I have another uTube video for you to check out, too. This one shows how they have done the SPG nerve block with needles through the side of the head. Have a good weekend.

https://www.youtube.com/watch?v=-lFUVkJS29Y

lissa: Have you looked at this nerve block, done by dentists who are Cranial Facial Pain Specialists:

http://floridapain.net/treatments/sphenopalatine-ganglion-block/

I tried it one time, unfortunately, it did nothing for me, since my headaches are more due to muscle restrictions due to a by-pass surgery chest scar. My dentist said that he has had some success with the procedure. He told me that some times it takes a couple of times for it to work.

Martin

Martin,

I just checked out your link describing nerve blocks being done by dentists who are Cranial Facial Pain Specialists. Based on their procedural description, they are doing "traditional" or "topical" SGP blocks by inserting sterile 10cm cotton tipped applicators (long Q-Tips) coated with the nerve block anesthetic, attempting to guide them blindly superior to the middle turbinate. The challenge with this approach is this is a blind procedure; if the tips are not superior to the middle turbinate, then the nerve block anesthetic will not reach the sphenopalatine ganglia and will not relieve pain. Plus it can be very uncomfortable. But it certainly can work effectively (check out their "Outcomes" analysis and references). They also describe the "needle through the face" approach on their website. Which procedure did they attempt for your headaches? Cotton applicator or needles?

I will try to find out if any patients with headache pain due to muscle restrictions from bypass surgery chest scars have been successfully treated with a Sphenopalatine Ganglion Blockade (SPGB) with SphenoCath. BTW, they have seen patients who require two SPGB procedures before the block is effective.

Steve

Steve, the dentist did the cotton applicator procedure. It was uncomfortable, but considering chronic (24/7) headache pain, I gave it a try.

As to the my headache, both my PCP (an Osteopath) and another Osteopath (outside my HMO) said that the by-pass surgery chest scar caused restrictions in the pericardium (the sac around the heart) and the left diaphragm muscle. From my experience going to Myofascial Release therapists (indirect and direct pressure), Cranial Sacrum Therapist, the outside Osteopath (who specializes in neuromuscular-skelatal disorders), Acupuncturists, Chiros, Somatic Therapist, and Bowen therapists, these two areas appear to be the source of the problem. Through out this long road, the muscle restrictions in these areas have been very slow to release and thereby the continuing headache.

The outside Osteopath also gave me "Neural Therapy" procaine shots in the leg and sternum chest scar.

Now, I have good days with very low level headache pain. I still have bad days, but not as bad as before. I also take the supplement "Gaba-Calm," to help with sleep and the anxiety of the chronic headache.

Martin

Martin, I don't know what to say...you must have been ready to pull your hair out with all those doctors visits while dealing with acute headaches...

First, I am not surprised the cotton applicator procedure failed. More than likely the nerve block anesthetic did not make it to the sphenopalatine ganglia to create the block. That being said, I have no idea if the conditions you described could be even treated with this SPGB procedure. I am going to copy your last note and send it on to the SphenoCath medical advisory board. Perhaps they can provide an opinion as to wether you would benefit from another procedure. Are you near Utah by chance, or do you travel to Utah for business (I think you are in CA)? Dr. Raul Weston, who treated chandlertoo, is in Centerville, Utah. BTW, did the "Neural Therapy" procaine shots in leg and sternum help at all?

Steve

The "neural therapy" procaine shots in the upper sternum helped the most. Also, trigger point therapy, by a chiropractor, in the area below the clavicle also helped. That is the area where the scalene muscles attaches to the body and the upper reaches of the pericardium.

I only had two sessions of Neural therapy shots in the upper sternum plus osteopathic manipulation. I had a total of 5- or 6 sessions with the D.O., unfortunately, he was only coming to my town once a week and he is no longer doing so. My PCP Osteopath said I do need more sessions of both osteopathic manipulation and neural therapy. He did recommend a local Cranial Sacrum Therapist that he sees for his problems. I can get the neural therapy shots with a local Naturopath.

There is a small study, of this procedure, that was done in Taiwan that indicated that the success rate for people with mixed headaches (I suppose they meant different sources of headache pain) was nil. That may be the problem with me.

I live near Sacramento CA. I should also mention that I am 75 years old, and have had multiple operations through out my life. I will be moving to San Jose in the next few months and will find more specialists in this larger metro area.

Martin