Migraine - PLEASE help!

I'm at my wits end, I really hope someone can offer some encouragement.

I've had migraines with aura since I was 10 years old. Imitrex used to stop them in their tracks. When I hit 20 they stopped. From 20 years old until around 29 I was migraine-free. I don't know what happened in my 30's, but they returned. Usually around one every 3-4 months. I'd take Imitrex when it came on and I'd still get a painful headache, but it would resolve in around four hours. Now these past two years during the summer months my migraines returned with a vengeance. Last summer I would go one week without one, and then the following week have 4. Imitrex shortens the duration but doesn't stop them. I made it through last summer and the frequency decreased once I hit September. Now this summer as soon as the weather got hot/humid they made a return. I decided to see a neurologist who started me on Propranolol 20mg 3x daily about a week ago prophylactically. He said the side effects from Topamax were usually pretty bad so he wanted to try Propranolol first. Well the migraines are still coming, daily in the past 4 days. I'm at the end of my rope, I don't know what else to do. I'm living in constant fear that every spot I see in my vision is an aura. My hands and face are constantly tingling, I'm constantly nauseas, I have no appetite. I'm starting a new job in a week and I'm terrified that these headaches are going to threaten it. I currently take Imitrex 100mg as soon as I feel the aura and lay down for a few hours. The headache will come on strong, and last a few hours. I've had this tingling though nonstop the past few days. Yesterday the neurologist told me to double the dose of Propranolol to 40mg 3X daily. I did that last night and was very dizzy and shaking, I couldn't tolerate it. I heard a lot of these prophylactic medications take a few weeks to work. I don't have a few weeks, I need the headaches to stop now - especially since Imitrex isn't aborting them.

I could really use some encouragement, preferably before today's headache kicks in. As we speak, the left side of my face is numb and left hand is tingling (it's not a stroke, I'm in my mid 30's). I don't know if the trigger is the heat/humidity or anxiety or staring at the computer screen, but this is torture and ruining my life. Does anyone have any advice? I appreciate you taking the time to read.

-Joe

Have you had an MRI?  Just because you're in your mid 30s doesn't mean you can't have a stroke - not that I'm saying you are having one.  I'm confused about the tingling, is that a symptom that other people with migraines have too?  Did you tell your doctor about that?

Anyways I'm not going to give you much hope on the medication front.  None of the preventatives worked for me.  Honestly, many people on this forum have not had much success with medications.

What DID work for me, much better than any prophylactic, was to find a trigger in my food.  Turns out I'm intolerant to artificial food coloring - red #40, blue #1, etc.  On food labels in the US it will sometimes say "color added" or "artificial color."  Other people on this forum have found success by cutting out MSG or other ingredients, or tannins.

Have you been tested for food allergies?  My sister came up positive for eggs, and now she feels much better and has fewer migraines.  I was tested and did not test positive for anything.  However that doesn't mean that foods might not be causing my migraines, and I plan to do more testing on that front.

Sorry you are struggling. It can take some trial and error to find a good combo of preventative and abortive. There are other Triptans to try. Sometimes they lose effectiveness over time. However, how often are you taking the Imitrex? If you are now getting daily headaches, there is a possibility it is analgesic rebound. This and the numbness are something to discuss with your doctor.

Any life changes when the migraines started up so frequently--a change in location, diet, medication, etc? They can also give you something to help nausea. Yes unfortunately it can take weeks or months to trial a preventative med.

Staying on the starting dose longer and increasing it as directed slowly over time will have the best chance of tolerating it. The side effects often subside over time if you can hang in there. It is however trial & error to see if it will help you. Hang in there! Best wishes.

Thank you for the replies. I had an MRI a year ago when these happened last summer - it was normal. Besides the heat, I am starting a new job shortly which I'm nervous about, and was having relationship problems with my significant other near the time the migraines started occuring every day (they were however occuring already before). However, I've been stressed out during the fall and winter months with no ensuing migraine, so I don't believe these are stress related. I guess I will stick to the propranolol for now, and try Topamax as I have nothing else to reach for. I'm just praying they either suddenly stop or something starts working.

Joe,
It's good that the MRI came out normal.  I have daily headaches too during a very stressful job.  Maybe some of the meds I listed below can help you.

I agree with tortoisegirl that it can take a while to find the right preventative cocktail that works.  It takes a long time to constantly be trying "a little of this and a little of that". Does your neurologist understand the urgency of your plight?  Is he willing to get a little more aggressive with your medication?  In the meantime, it sounds like you need to concentrate on different abortives and rescue meds to get through your new job and until you can find a preventative cocktail that works.

See if you can try out some different triptans (Maxalt, Zomig, Frova etc).  Also, are you taking Imitrex tablets?  I've had good luck with Imitrex and Zomig nasal sprays.  They act a lot faster than the tablets (minutes instead of hours).  I found that I could usually gut out the mornings and take the triptans with lunch.  Then I could get through my afternoons with the medication's help.

I also got a sample of something called Cambia.  It was a powder that you dissolved in water and I drank it.  It tasted like licorice tea.  I got instant relief that lasted a good day.  The problem was that it's not covered by insurance and was very expensive.  But if you can get a sample from your doctor, it's good stuff to have on those level 8-9 pain days when going home and crying is not an option.

I also have very good results with Tramadol, which isn't a triptan, but it effective for me.  It usually takes about an hour to kick in.  The reason I like it is that it takes away some of the pain without making me super nauseous or sleepy.

I've also made a number of trips to the local urgent care clinic when things are bad.  I've gotten a shot of Torodol (its like super-NSAID).  I've also gotten shots of prednisone (steriod).  Both of these knocked out the headache instantly and they lasted a couple of days.

I even had my neurologist inject the muscles in my temples, neck and shoulders with lidocaine to numb them.  Again, instant relief that didn't last very long, but got me through some rough weeks of big meetings.

Of course, if you go to the ER, they will give you the heavy duty stuff.  Dilaudid, morphine, etc.  I hate that stuff.  It works, but it knocks me out for days.  Having a job is out of the question.

Finally, for nausea and vomiting, I take Zofran ODT which is a dissolvable pill and works immediately. 

Hope all this helps and offers you some options.  Talk with your doctor about all these meds.  Let him know you need to be aggressive with your meds.

Hi,

So Sorry to hear you are having such a rough time.

It certainly sounds like migraines.

Here are a few things that I can think of that might be of some use to you. First of all, Inderal is a heart medication and it can make your blood pressure drop really quickly which would explain the shaking and dizziness. I don't know if your BP runs high normally, but if it runs low the Inderal would drop it.

I agree with the others- you need both a preventative and an abortive approach to control your migraines. Yes, it usually takes a few weeks for preventatives to kick in, and it is basically a trial and error experience. Since you mentioned constant tingling and pain during the migraine- you might want to ask about Lyrica or Neurontin since this can treat some of the tingling and both are preventatives. Topamax does have a ton of side effects- but works for some people. Definitely talk to your dr about other medications.

As to abortives- If the imitrex isn't working. You might want to ask for one of the other triptans such as amerge or maxalt. For the nausea you could try asking about zofrann or Phenergan (Phenergan can make you sleepy though this is not a bad thing during the headache though.) There are other abortives- like Migranol (nasal spray version of DHE.) Injectable DHE, Midrin and some others. As for pain meds- Ultram, tramadol is a pretty good option. Tylenol 3 also helps me a great deal. (Regarding pain medications- a lot of this will be based on whether or not your dr uses pain meds for migraine and what has worked for you in past.) It certainly sounds like you need something to get you through the bad ones.

Migraines are scary and annoying and they can take you down at any time. The only thing you can do is try to prevent it, have a plan for the bad ones, and take things as they come. It can be an extremely annoying and long process to figure out what works for you. But don't give up hope- there is a way to manage this. There are also a lot of great people here with great advice and a good deal of experience with migraine. Feel free to post anytime!

Pain free days
sailingmuffin

Joe929 said:

As we speak, the left side of my face is numb and left hand is tingling (it's not a stroke, I'm in my mid 30's).

The left thumb and forefinger tingling could be due to the left pec minor and the scalene muscles being very tight. I was told by a chiro that a bundle of nerves pass between the tight scalene muscles (there are front, the middle, and the rear) was the cause of the tingling.  That has been the case with me.

The chiro used an activator on the upper left front chest area where the front scalenes attach to the top ribs.  Also, I've been seeing a Cranial Sacral Therapist, who also works on that area.  Another time, an osteopath treated and gave me a procaine shot in that same area.  That did lowered the headache pain a lot.

That is what has helped me.  I should point out that while I do have migraine symptoms, but I am not a migraineur;  my headaches are constant, that vary in intensity.

Martin

Just a note, if you have trouble with diet soda setting off migraines, DON'T use any of the melt style meds. They're all sweetened with either the pink packet or blue packet, and it can be a BIG trigger for some of us.

I know they kick in quicker, but if they're just going to put you into a worse migraine, it's not worth it to me.

Joe
I think the tingling and numbness in your hands may be a side effect from the Propranolol. Also, there is a migraine called Basilar Migraine, it acts like a stroke. You can have facial numbness, have slurred speech and even lose the ability to speak. You can have aphasia, the ability to think of a word, but forming it is beyond ability.

Migraine is really traumatic to the brain, chronic migraine really never gives the brain a chance to recover. I think you are in a cycle and may need to go to the ER if you can. Hopefully, you have a good ER where you live ( I don't) where they can abort the migraine and give you something for pain. Long term, you need to think about how many migraines you get each week/month and for how long, like the last year or more. Do you keep track of how often you migraine?

In addition, it didn't do a lot for me, BUT some folks have a good response to Occipital Lobe injections, Cervical Facet Injections of Ablation of the Ganglion nerves at C-2 on both sides. You need a pain management doctor for those procedures. You need a Pain Management doctor period....

I understand the terror, the "Migraine Monster" strikes me 12-17 days each month for the last 8 years. No one who has not experienced this has any concept of the horrific pain.

Trinity