Had a migraine the other day...

Discussion in 'Community Discussion' started by glocke12, Jan 12, 2011.

  1. glocke12 macrumors 6502a

    glocke12

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    #1
    all i can say is wow, just wow. I these maybe once a year, and am always just amazed at how downright debilitating they are.
     
  2. MacDawg macrumors P6

    MacDawg

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    #2
    Debilitating pain
    Sensitivity to light
    Nausea

    Yeah, I get them... not as bad as I used to

    Not easily described to someone who has never had one
    It isn't just a headache
     
  3. GoCubsGo macrumors Nehalem

    GoCubsGo

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  4. RaceTripper macrumors 68030

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    #4
    Imitrex (or generic Sumatriptan succinate). Works wonders.
     
  5. MacDawg macrumors P6

    MacDawg

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    #5
    Imitrex was like swallowing a button for me :(
     
  6. Koodauw macrumors 68040

    Koodauw

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    #6
    As someone who suffers from them it frustrates states me to no end when someone says they have a migrate when they are referring to a bad headache.
     
  7. rdowns macrumors Penryn

    rdowns

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    #7
    I got migraines twice when I was a teenager. I kid you not, I was >< that close to jumping out the window to end the pain. Never had them after that. So yeah, unless you've experienced them, you have no idea.
     
  8. Mord macrumors G4

    Mord

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    #8
    All the tryptamine related drugs work reasonably well though they all pale in comparison to LSD, interestingly that class of drug was explored with an aim to find drugs as effective at aborting migraines and cluster headaches as LSD but that are far less hallucinogenic. Funny thing is you only need a single tiny sub-hallucinogenic dose of LSD to abort migraines for a period up to months, this isn't legal for political reasons so we have to make do with weak analogues that only work for a day or two.

    I get cluster headaches which are similar, I missed a bunch of school as a kid because of them though I keep them well under control these days. They seem to come and go in quite regular timeframes and I've not had any for about a year now, they should kick in next summer if they follow the same pattern they have over the last 10 years.
     
  9. RaceTripper macrumors 68030

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    #9
    Really? They are tiny. Maybe 1/4" across.
     
  10. MacDawg macrumors P6

    MacDawg

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    #10
    Not the size, goofy, the effect :D
     
  11. RaceTripper macrumors 68030

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    #11
    Maybe your dose was too high. That happened to me. I lowered the dose. Plus you get used to it after a while. I have fairly mild migraine, but it recurs every 10 days or so. I take 50 mg Imitrex and it usually takes care of it pretty quickly.
     
  12. glocke12 thread starter macrumors 6502a

    glocke12

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    #12
    I was talking to my brother about it afterwards, and basically said the same thing, that if I got these with any frequency Id put myself out of my misery. I know that there are people that get these often, my heart goes out to them.

    It was just absolutely horrid. The nausea was incredible, I didnt have that much light sensitivity, but even still I spent the day in bed with the covers over my head cuddling my Weimaraner (who I think knew i was in distress).

    Ive had my share of health issues, broken bones, food poisoning, various other bacterial and viral ailments and Id have to say that having a migraine is probably the worst thing medically I have gone through.
     
  13. Dmac77 macrumors 68020

    Dmac77

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    #13
    Wirelessly posted (Mozilla/5.0 (iPhone; U; CPU iPhone OS 4_2_1 like Mac OS X; en-us) AppleWebKit/533.17.9 (KHTML, like Gecko) Version/5.0.2 Mobile/8C148 Safari/6533.18.5)

    I get migraines frequently (normally at least 4 a month) and unfortunately I have yet to find an abortive that works for me with out fairly bad side effects (both Imitrex and Midrin give major GI issues).

    If I had a penny for everytime I'm told to take an advil by a friend, teacher, or relative who have no clue about migraines, I'd be a millionaire. It truly pisses me off to no end. My mom is especially horrible with the whole "take a Tylenol" thing; she was lucky enough to be the the generation that got skipped with the migraine gene and therefore thinks me and my grandma play up how band migraines are.

    Anyways, I get how you feel, I know it sucks.

    -Don
     
  14. Dagless macrumors Core

    Dagless

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    #14
    I used to get migraines an awful lot as a teen. My vision was always the first symptom, a little flashing blob would grow and grow until the migraine really peaked. My last major one was just before a French exam, I was given my own dark room to do the exam in and, well it was just ace.

    I reacted really well with medication. Never went much beyond Ibuleve, and now whenever I feel one coming on (rarely) a single dose of paracetamol or ibuprofen does the job.

    Friggin hated the things.
     
  15. iJohnHenry macrumors P6

    iJohnHenry

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  16. NickZac macrumors 68000

    NickZac

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    My heart goes out to migraine sufferers as it really is a living hell. I have a few clients who get them and seeing them during is just awful. Given the debilitating effects of migraines and the prevalence of them, it is surprising that current treatments are not more effective and safe. Hope this helps point someone in the right direction.

    There are at least 200 medications used for migraines; most are used off label and many have unknown levels of effectiveness so research the medications you are given as there is no reason to start with a questionable drug when there are ones that have helped a good portion of migraine sufferers. A favorite here for frequent migraine sufferers is Topamax and the triptins. The triptans are the first to be used as up to 3/4 of people get some level of relief from the pain, throbbing, and nausea, but they really are more rescue meds. Some people however get no relief at all. Of the triptan class, Sumatriptan is often the preferred drug for moderate to moderate severe migranes. Treximet may show promise as well. Gabapentin for prevention is great if it works, but it is a hit or miss. Lyrica (pregabalin) is starting to be used off label and there is not enough evidence to say how helpful it is, although many individual users report sustained relief.

    As opposed to traditional caffeine products taken after onset, guarana has the potential to stop some migraines on its own and prevent them. Numerous blinded studies has shown it has statistically significant effects. It acts as a stimulant and has a lot of caffeine in it, but it does not give you the caffeine jitters of coffee provided you are getting unprocessed guarana seed extract which can be found almost everywhere. Also, guarana speeds metabolism and gastric emptying, increases long term memory better than ginseng, aids in thermal regulation, and aids in blood flow. A few of the body changes guarana causes are thought to produce a compilation effect. It is also a primary ingredient in energy drinks and why some people feel better after drinking them, although they do NOT have much guarana in them compared to taking it as a supplement and I doubt the amount of it would have any effect on a true migraine. The other supplement which may hold value is called Kratom, and it becoming more and more popular in the western world.

    As far as rescue for the most severe migraines, many users never find relief and often are the most frustrated as most doctors will not prescribe any pain medication that is considered a narcotic, which is sometimes largely warranted. Metoclopramide (Reglan) does have a reduction affect for migraine pain. Promethazine (Phenergen) helps the GI aspect dramatically and some people report pain relief, although I doubt it is from the promethazine directly. Unfortunately, once a severe migraine is in full swing, opioids may be the best option for satisfactory relief. Tramadol and codeine may bring some relief, but for others they are often not enough. The use of methadone, oxycodone, hydromorphone, fentanyl, and morphine sulfate for migraines has been so minimal, that not enough studies exist to make any intelligent statement about rates of effectiveness and rates of misuse. However, virtually all studies show that stronger opioids have the best pain-reducing capability and some opioids can be administered via a patch or lollipop, which is a major advantage for migraines as many people simply cannot take a pill once they reach a certain point of pain and stomach sickness without vomiting. Hydromorphone (commonly Dilaudid or Palladone) has become a standard of severe pain control and may have beneficial affect for severe migraines. It's onset is among the fastest of narcotics and it has fewer moderate-severe reactions than morphine sulfate. If other treatments fail, it may be a viable option. Unfortunately, as said earlier, not enough is known to say a whole lot about opioids and migraines and more research is needed. Furthermore, some people may have amplified pain from lower doses of certain narcotics.

    Finally, a medication called ketorolac (Toradol), an unusually potent cox1 NSAID and can provide relief at the narcotic level. It's first dose needs to be IV/IM and you cannot use it more than 4 days straight. Above all, it is probably the most dangerous medication on the US market today as it has a tremendous side effect profile, can cause permanent disability, and thousands of deaths may be directly linked to its use (much like Vioxx and Celebrex). Personally, I do not even consider its use unless every other option fails, and even then, I am very, very cautious about its use, especially with older adults with preexisting chronic disease, especially cardiovascular related. Some ERs however, will use it as a first line treatment for moderate to severe pain before using strong opioids, which I feel is wrong as it shows more concern about your medical license than the patient. If you know you may go to the ER for a migraine, read up on ketorolac before going and decide if you want to have it given to you if need be. If not, make it clear when arriving. If you have any cardiovascular condition, do NOT accept it.

    Above all, for something like migraines which are chronic conditions, you need to be your own medical proxy and advocate. No standard treatment exists and so you need to be aware of what your best option may be. PCPs and GPs may or may not have enough experience in the area, and so seeing a specialist is a good thing. If you have frequent migraines, you need to see a neurologist as it has been theorized (with some evidence) that recurring migraines are actually related to a regressive brain disease. You will probably also need to get a MRI. There are neurologists who deal with nothing but migraines and they are who you want to see, as standard neurologists may tell you that there is nothing they can do. It is well worth the time and money as your odds of getting sustained relief and learning what the underlying cause is (and how to manage it) will be best done by the people who deal with the migraine issue frequently. Migraines are a very, very complex issue and while they are very poorly understood, migraine specialists can still help you get relief. Hope this helps point anyone suffering in the right direction.
     
  17. RaceTripper macrumors 68030

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    #17
    tl;dr ;)
     
  18. Mac'nCheese macrumors 68030

    Mac'nCheese

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    #18
    Try lying down with a heating pad or warm wash cloth on ur head. Opens the blood vessels, helps some people.
     
  19. Eldiablojoe macrumors 6502a

    Eldiablojoe

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    #19
    I get them almost annually, usually around Thanksgiving. They started when Iw as about 35. They are incredible. I've endured major trauma without pain killer s (Snapped femur, broken knee, torn ligaments, compound fractures extending out of my limbs, torn ear, broken elbow, broken shoulder blade, torn rotator cuff (all at once, btw), and suffered them without benefit of morphine or vicodin, or any other opiate.

    Migraines are worse. I curl up in a ball in a dark, still, quiet room and moan for hours until they go away. I can do nothing else but endure them like a debilitated dog on the side of the road.

    The only thing that comes close to comparison, are gall stones, IMHO.

    I can't imagine having them as often as 4x/month, you have my deepest sympathy!!!!

    NickZac, your obviously in-depth knowledge of the pharmacological therapeutic options for this malady are a great contribution, and highly valuable, thank you for taking the time to contribute!
     
  20. Chundles macrumors G4

    Chundles

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    #20
    I get them once or twice a month, sometimes more especially during Spring/Summer. Mine are generally weather-related and triggered by quick changes in humidity etc. that generally precede a spring storm or southerly buster in the summer. Winter and Autumn are far more stable weather-wise as it's much drier.

    They're killers, like a mini stroke, auras, pain, sensitive to light and sound, nauseous but rarely bad enough to make me throw up which in turn makes it even worse. The pain is unbearable, like someone is stabbing me through the temple, my speech slurs a bit, my temperature goes up and down dramatically, it's just awful.

    My worst ones last three days sometimes. Awful nasty bastard migraines.
     
  21. VictoriaStudent, Jan 12, 2011
    Last edited: Jan 12, 2011

    VictoriaStudent macrumors regular

    VictoriaStudent

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    #21
    I used to suffer from cluster headaches. They wrecked my life over 14 years.

    Acupuncture completely eliminated them...permanently. It has been years since I've had one and I know I will never have one again. When they first began, when I was 18, I felt like I was cursed. After they continued on for a few years...I felt I was doomed..never thought I'd -ever- have a normal life again. If you haven't ever had a cluster headache..holy crap. the pain is like nothing...nothing. The normal pain scale goes from 1-10 (1 is nothing, 10 is screaming). My pain was more like 11-15. Sometimes I passed out.

    F***k the drugs as a solution. They have severe side-effects and long-term consequences. Acupuncture may take it's time - but if one finds the proper acupuncturist - he or she can help you fix the underlying imbalance (cause). However, yes, if you find a drug which works for you...use it in the short-term to help the pain, but also get acupuncture to eliminate the underlying cause.

    tl;dr - forget the drugs, go for acupuncture. It cure me and probably can cure you, too.


    edit: btw: I'm currently a student of Chinese Medicine/Acupuncture. Acupuncture can definitely understand and address/treat headaches (migraines/cluster headaches) and a lot of other conditions. It's not "woo woo" - it's actually a 4-5,000 year old science which Western Medicine can only hope to one day approach. yes, Western Medicine (BioMedicine) is great for broken bones, collapsed lungs & the like - but, for the other 95% of the problems which humans face...Chinese Medicine is there waiting for you to discover it.
     
  22. iBlue macrumors Core

    iBlue

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    #22
    It may help but probably not for that reason. As I understand it, Migraines happen when something in the brain triggers the trigeminal nerve to release chemicals that irritate and swell the blood vessels and that causes pain. This is why vasoconstrictors are used to treat them. Cold is usually more recommended because it tends to constrict rather than expand but I hate the feeling of cold so warm suits me better.


    I'd say calling cluster headaches similar is putting it pretty mildly. Migraines are horrible but I actually comfort myself during them by thinking "at least it's not a cluster headache." My hands start shaking just talking about them because the idea of having a cluster cycle return completely petrifies me. :eek: (I haven't had one in about 5 years.) I really hope you've seen the back of them, Mord.


    Regarding migraines - I also really hate it when people who have a bad headache call it a migraine. Sadistically I always wish a real migraine on them. I'm fairly tough about them because my perceived pain scale went way up because of the cluster headaches but they still wreck me good and proper for about 12 hours. I can't take "triptans" because I react badly to them but I find sitting on the floor of the shower letting the water run over my head while I wait for opioids to kick in to be a reasonable alternative. Never takes it fully away but it knocks it down a peg or two. I get them about 3 times per month along with regular headaches I seem to have at least a few days a week. My head is full of trouble but I'm used to it. :p
     
  23. localoid macrumors 68020

    localoid

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    #23
    I've had migraines for about 40 years. The pain and nausea are much easier for me to deal with than the aura, which always occurs before and quite often last into the onset of the migraine for 30 minutes or more. I'm usually blinded in the center of focus. If you put a book in front of me I can't read a word on the page. Sometimes I have trouble figuring out where the doorknob is on a door by sight alone.

    The only thing good about the auras is that no two of them are exactly alike, so at least they're not boring. Perhaps, in a mcabre sort of way, they're inspiring. Here, for example, is a sampling of migraine aural art to ponder...
     
  24. Dagless macrumors Core

    Dagless

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    #24
    That's exactly what I get too. Whenever I stop seeing tiny detail (I work as a designer and artist so the details are important!) or if I stop seeing some letters when reading - it's time to get the paracetamol and do something else for a bit.
    It's a good warning system, IMHO!
     
  25. NickZac macrumors 68000

    NickZac

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    #25
    Complimentary medicine is very good and the benefits of acupuncture are proven. Also, certain herbs and spices, white and green tea, and chiropractors have all have at least some ability to mitigate pain. I have indeed recommended acupuncture to many people in chronic pain. I've also used it as part of a multi-method-approach for class I and II obesity with great luck in appetite reduction without using gastric surgeries. I also believe that aging facilities should have a certified acupuncturist either on-site or capable of doing work on site given the benefits. With that said, acupuncture is one method of treatment out of literally hundreds of options. Anyone in the professional practice who even attempts to coordinate a migraine treatment system MUST use a multi-method-approach, as people using numerous treatment methods almost always have the best health outcomes.

    All medications have side effects, but not all are severe. Some of the medications have been used for upwards of half a century and are well understood and have great safety profiles. Obviously, anyone has the potential to react adversely to any medication, but you can say the same for food. It is ALWAYS about potential risks vs. potential gain. Medications like Toradol and Demerol are widely thought to be extremely dangerous compared to other medications and I would never recommend either. Medications such as Ultram (tramadol) have an accepted level of safety and abuse statistics.

    You cannot just pick up and go to an acupuncture specialist once a migraine starts as you probably know. People who have bad migraines often need what is termed 'rescue' medication.

    Above all, the most important aspect of pain control is the quality of life according to the patient. Medication is not always a bad thing although I would agree that 'old school' docs still prescribe medication that seems to have more side effects and less gain. In the population I work with, it is common for people to commit suicide and obviously, the side effects of medication are rarely that extreme. The self-assessed quality of life of people with persistent migraines is quite low and furthermore, depression rates are disproportionately high. Treating someone who has the most severe of migraines is best done through a multi-disciplinary team effort. If you want the greatest benefit, you need a PCP as a coordinator, a nutritionist who can show you which foods trigger migraines, an accupunturist who can help prevent migraines, a personal trainer to stay in shape, a specialized neurologist who can work to find the underlying cause (which can often be a regressive but treatable brain disease), a pharmacist to monitor all medications, a mental health specialists to deal with the ramifications of living with frequent pain, and a pain medicine specialist which can manage pain, and other specialists as needed. Virtually all human beings can reach a level of pain in which they would prefer to die than continue to suffer. I am neither opposed nor unopposed to using virtually any means to find relief. What works for you will not work for others and stating that one treatment will help nearly everyone is simply false. If you look at double blinded studies for migraine relief, the one thing you will see is completely different methods bringing the most pain control to people with the 'seemingly' same condition.

    Migraines are still very misunderstood, under-studied, lack a 'gold standard of treatment', are as individualized as any condition can come, and are a huge factor in decreasing the quality of life and causing depression. People who want relief need to be willing to at lease explore different options. Obviously, the patient is the one to decide what they will and will not use, but I would suggest abiding by the treatment set by a specialized neurologist who has the best understanding of causes and treatment.

    Finally, if you have frequent migraines, you need to see a neurologist about getting a MRI as migraines can be indicative of a underlying condition that can be treated.



    Thanks! Anything I can do to help people who suffer I try to do.
     

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