Migraine question

[mstang67chic]

I know some of you suffer from migraines so I thought I would go to the experts. My 15 year old sister has them bad enough it keeps her home from school. She's been on a medication (I don't know what) but it wasn't working well so the doctor is in the process of switching her to something else. (Possibly Topamax???) The insurance company however, is being a PITA (or head in this case) so currently Sis is on the original medication but at a reduced level because they have to titrate her down. She should have been on the new medication by now but because of the insurance company, the doctor had her hold at a lower level so she would have SOMETHING in her system. But, since it's at a lower level it's not doing nearly the job it was so she's missed quite a bit of school lately.

I suggested wrapping her head in a wet towel but she said she's tried it with no sucess. Is there anything else she can try to help ease these headaches???

FYI: She's already had a CAT scan or MRI....one of those....to rule out any tumors or other visible causes for the headaches. And we did get to confirm that yes, there really is a brain in there. (We had lots of fun with that)

I just don't know what to tell her to help. I think if anything OTC was a possibility, she'd OD before it did anything as she's not yet 5' and weighs about 85 lbs. 'Course, if OTC stuff worked, I wouldn't be asking.

 

[Mattsmom277]

Ouch!! Sorry to hear about her migraines. I've only had 2 true migraines and they were nothing I'd wish on my worst enemy. Only thing I could do was lay completely still, no light, no noise, no breeze, and when it brought me to the point of vomitting, it was better to get it over with than fight it.

I do know some people who have medications that do help. I hope her insurance comes through quickly and the new medication works!!! OUCHIES!

 

[GoingNorth]

I suffered with classical migraines starting with a bad concussion when I was 11. I used the painkiller mixtures available back then, but the only thing that helped was ice packs, a completely darkened room, and a handy bucket by the bed to barf in.

Years later I started using Midrin and that was helpful so long as I took it when the aura first started.

I found that avoiding coal-tar based dyes helped, avoiding chocolate for the most part, and being careful with alcohol helped as well.

They seem to tail off as you get older, if that's any help

 

[mstang67chic]

Her? Avoid chocolate???? Dear God....are you trying to kill us all???????? No way THAT would happen! LOL Although...maybe she needs to cut back on the energy drinks. Alcohol isn't a concern so hopefully the insurance company gets their stuff together and the new medication helps.

 

[GoingNorth]

Actually, the caffeine loaded energy drinks are probably really aggravating her migraines. I went almost entirely off of caffeine (used to drink a 6 pack of cola per day plus several cups of very strong english tea).

Caffeine withdrawal presents with headaches and in a migrain-ish person, can cause savage headaches.

I'd very strongly advise that she quit using the energy drinks. She'll be miserable for a few days, but in the long run it will reduce the frequency and intensity of her headaches.

Almost completely knocking out caffeine makes a world of difference. I can now usually catch an impending migraine and stave it off with two Excedrin and a cola or coffee.

 

[GoingNorth]

Actually, I wasn't talking about problem drinking. I was talking about WHAT you drink. For example, I can drink a glass of white wine without problems, but the same of red wine will nail me.

I can only drink certain types of hard liquor. Usually the darker the liquor the worse it is, but tequila in any form lays me out, which is a pity as I like the occasional margarita.

With chocolate I can eat a couple of squares of a bar, or a standard sized scoop of chocolate ice cream.\

I am addicted to Schwan's choco-mint sundae cones and I can have one with no problem even though I'd really like two, knowing I'll be sick isn't worth it.

 

[Andy]

I agree - as little caffene as possible. Energy drinks are the "in-thing" for teenagers so it may be hard for her to avoid. If you could encourage/challenge her to go 2 - 3 weeks without the energy drinks it would be interesting to see if she has less migraines. That in itself can make a large difference.

Once a migrane hits, it is so hard to control it. So, recognizing the onset of one is crucial. I would be tempted to take OTC extra strength medication once a day about 1/2 to one hour before the migrane usually hits (mine would start anywhere from 1:30 - 2:30 from when I was a teenager until late 20's when I became pregnant with Diva). For migranes, you are allowed a little higher dose of OTC so when the migrane actually does start, take that extra dose.

I have told difficult child that as soon as a headache even appears to start, he is to take his OTC headache medicine. He got to the point that he recognized if what he was getting would be a regular headache or was a migrane.

I hope her insurance company starts behaving so she can continue with medications. Being a teen with migranes is super hard. You feel like you miss out on so much.

 

[flutterby]

Ice packs. You can get the one time use and the gel reusable one. I would recommend both, so you can always have a cold one available.

They help me on the back of my neck. easy child's girlfriend gets relief when she applies them to her forehead.

 

[slsh]

Youngest son's come on wicked fast. We've used a Tylenol/Motrin combo, with Tigan for the vomiting. When they hit, he's down for the day. He was on ciproheptadine for a couple of years when he was having migraine variants on a monthly basis. He got Imitrex last year for prn use but (knock wood) we haven't had to use it.

GN - the caffeine cure is interesting. He went on a field trip last spring out of town for the day and of course, felt one coming on. I didn't even think to send his Imitrex. He doesn't generally drink cola/coffee, but for some reason he decided to get a cup of coffee at the museum and he said it halted the headache.

 

[Lothlorien]

I got them a lot when I was younger. I don't get them as often, now. My dad, however, suffers with cluster headaches....basically migraines that can last for days. Oddly enough, several years ago, he started to feel the aura of one coming one. He was suffering with a head cold, so hoping to control some of the congestion while suffering with the clusters, he sprayed his nose with Afrin and took Comtrex (specifically Comtrex) and the cluster headaches never took hold. Now, about 90% of the time, if my dad does this when he feels the aura of a migraine/cluster headache, he does this combo and it goes away. Worth a try, right?

I usually take Torodol for a migraine and it gets rid of it. I probably should take my own darn advice, because I've been getting them (functional ones) almost every darn day, lately.

 

[Lothlorien]

Oh, Slsh, I'm addicted to caffeine. If I don't have a cup of coffee, by 11am I have a wicked headache.

 

[Nomad]

Topamax is a preventative and is taken daily. It has a good reputation for either stopping migraines or lowering their frequency. It is FDA approved for this purpose. It has a nasty side effect of cognitive dulling, but at the lower dosages, it usually isn't a huge issue.

Not sure why your sister can't start her new medication while lowering the other and why the insurance company would have problems with- all of this...but each company is different, etc.

There is a new "abortive" type medication out called Treximet. It's used to stop the pain of a migraine once it is in progress. It really is simply
the medication in Imitrex and Naproxen. It's a little pricey, but works well.

Some just take Imitrex and Naproxen together and get very good results from that. 50 mgs. of Imitrex plus Naproxen often works very well. For very stubborn migraines, 100 mgs. of Imitrex alone or with- Naproxen often does the trick.

If your sister is not a regular coffee drinker, it certainly can help to drink a little coffee along with Imitrex and/or the Naproxen to make things go a little faster.

I personally try to only drink 1/2 and 1/2 coffees during the day...perhaps one or two of these ...totalling to no more than one cup of regular coffee.. Sometimes when I have a migraine, I'll take Imitrex and a couple of sips of strong 100% coffee and it does make the medication work faster. I think if you drink lots of coffee all the time, this wouldn't work.

If she is taking in lots of caffeine, it might be a good idea to gently cut back. Withdrawal from the caffeine can cause a headache...a bad migraine really.

For those prone to migraine...lots of caffeine can really trigger them. I think its almost like a constant withdrawal.

Certain vitamins/supplements are said to help prevent migraines. They include: CoQ10, Calcium, Magnesium, Lipoic Acid and possibly the B vitamins (B Complex would cover it).

 

[skeeter]

She's going to have to figure out her triggers. I need to have any 2 of the following happen - hormones (got them terrible during periods, and now that I'm going through menopause, I get a LOT of them), weather pressure changes, allergies, low blood sugar, high blood sugar, excessive caffeine, too much alcohol.

IF I can lay down for about an hour when I first feel one coming on, I may stop it.

But mine always present as nausea, so most medications don't work because they had a side effect of nausea.

Small amounts of caffeine actually help prevent (for me). I drink a diet coke at lunch every day. Mine usually seem to hit early afternoon and get worse from there.

Ice packs alternating with heat sometimes help. I always ALWAYS have the pain on the left side of my head (I feel like if I could remove my left eye and the sinus cavities behind it I would be fine).

Birth control pills may help, or may make it worse. For me, they made is so I only had a headache during my period (when I wasn't taking the pills). That was at least managable vs. never knowing when one might strike.

 

[mstang67chic]

Thanks guys! Between all of this info and the 3 part pm I got, I think I sent her about 6 emails with your responses cut/pasted in them. LOL

The problem with the insurance company is, I believe, that they don't think the new medication is needed and as such, are refusing to pay for it. Apparently, 15 year olds don't get migraines. The doctor is good though and is in the middle of putting the insurance company in their place.

**I also gave Sis the standard CD speech about any medication recommendations are from personal experience and she needs to talk to her doctor about them.

 

[susiestar]

The ins co is balking at Topomax and other "new" preventatives because of the cost. I actually would suggest that first she try at least 2, and optimally 3 beta blockers. They are dirt cheap and FAR easier on the body. If she has low blood pressure this may not be possible.

Next should be a calcium channel blocker. Then a trycyclic antidepressant. Each of these medications is easier on the body than the antiseizure medications like topomax. After that topomax or another anti seizure medication is an option. Unless she is having more than 3 per week my docs would NEVER consider topomax. It is SUPPOSED to be about the last ditch medication to try. This is per 4 different neurologists including my current one, my endocrinologist, my rheumy and my pain doctor. ALL say the same thing.

The doctor probably has her on a lower dose of a beta blocker, likely propranolol.

When she GETS a migraine, at the FIRST sign she needs to take a medication to stop it. Midrin is an older medication but a good one. IF you take it, or any OTC medication more than 3 times per week or 5 times per month you will end up with headaches caused by the medication wearing off. It is a horrible cycle. Very painful to get out of if you are not using a triptan to stop the migraines.

Imitrex and maxalt are examples of triptans. RelPax to. they are awesome if taken at the first sign. Pretty dang good if taken later. They actually stop the migraine, as opposed to other medications which don't stop them but make you not care as much. Best way I can describe it.

The newest triptan medication is imitrex (now sold in generic as sumatriptan) and aleve. I think it is the equivalent of 2 aleve and 1 imitrex. It is called treximet and is a last ditch effort to keep imitrex's vice grip on the market. My doctor raves about it. But I am very allergic to all NSAIDS, including aleve and motrin. If she has the generic sumatriptan (imitrex) and takes aleve with it, this seems to be about as effective as the new treximet.

To truly get a handle on this your niece needs to start writing down every bit of food/drink that goes into her mouth. All her activities, and when she gets each miigraine. It can take a while (months) to see a difference.

You can google foods that cause migraines. There is a whole list. Avoiding them all for a few weeks and then adding them in one at a time is the ONLY way to really find the triggers.

I am sorry she has these. I can not think of anyone I would wish these one. And until menopause they usually do NOT stop.

 

[Lothlorien]

Apparently, 15 year olds don't get migraines.

I had them from age 7 to about 11....frequently. When I went through puberty, they just about disappeared. I know most women with them get them when during mensturation. If the insurance co. doesn't get that then they need some serious straightening out. Has the doctor written a letter of medical necessity?

 

[susiestar]

I was formally diagnosis'd with migraines in 1973. I was 4. Wiz was diagnosis'd at age 2, Jessie at age 4. thank you has not yet had one. Her insurance company is off their rockers.

The beta blockers are very very cheap. I took a fairly high dose of atenolol for about $6 per month. And took others for around that price. There are a LOT of beta blockers so maybe the doctor would try those instead of topomax?

 

[Nomad]

Personally, Midrin never worked for me...even if I took it right away.
I was always envious of friends who had good results with- this 'cause it didn't seem to cause any side effects at all, etc.

Also..never had any luck with- Beta Blockers...but I do think that is a little unusual.

I have high blood pressure...and I got some minor relief with Atacand for both high blood pressure and headaches. A win/win combo if there ever was one!

Also got some minor relief with Desipramine (like Elavil).

The best help I've gotten was from Toapmax...but don't care for the side effects.

I've had to juggle all three of these medications in small dosages...sort of trying to side step the side effects while trying to get the headaches/migraines under best control.

Also...I watch my triggers, try to keep the stress at bay and take helpful vitamins.

It's a real all out effort...but really worth it when a plan comes together.

Yep, its the Triptans that seem to have the most power to stop the migraines.

Imitrex is now generic...in fact, I do believe it would be very expensive to get brand Imitrex these days.

I am amazed what good results can be had with just 50 mgs. of sumatriptan and naproxen. in my humble opinion, it is worth experimenting with. One can always add a few sips of coffee with that.

There is a good book; something like Heal Your Headache: 123 Program by Dr. Bucholtz http://www.amazon.com/s/ref=nb_ss?url=search-alias%3Daps&field-keywords=123+Headache
that is kinda popular. I don't agree with- literally everything in it, but the author talks about the "overflowing" barrel theory of headache triggers and how esp. when we are prone to headache, it is important to know our triggers.

For example...I know for a FACT that a ripe banana with those little black specks on them will trigger a migraine for me FAST!

If I'm under a lot of stress...I really can't have chocolate. But if I'm in a good place emotionally, I'm pretty much okay with chocolate.

Yep....we are all different. Personally, I think it requires medication (probably the smaller the dosage(s) the better), vitamins, stress relief, good health habits....a multitude of factors to get things in a better place.

 

[Andy]

I have been thinking about the caffene inputs. It does seem like opposite view points - no caffene yet caffene helps lesson the pain? What I have concluded is that like medications, if you take it all the time, it can do harm - however, when taken as needed, medication is what helps lesson the pain.

So, my new view point is that a lot caffene taken on a daily basis can add to the migrane problems. However, if you do not overdo caffene on a daily basis, caffene may (not necessarily - we are all different) be the answer to keep the migraine from getting worse?

hmmm - just a thought.

 

[Nomad]

Andy, Yes...re: the coffee thing.

Ny doctor...who is an expert on migraine prevention says it is best to wean yourself off of all caffeine if you are prone to headaches or migraines.

If you get a very bad/stubborn headache or a migraine you could add a little coffee with- your medications to make things move along faster.

I personally have noticed that if I keep my caffeine intake small/reduced then I can still pull that off.

When I take in a lot of coffee...more than two cups a day...then adding more coffee...like a few sips of coffee or even a cup with- my medication isn't going to help me. The added coffee during headache time, makes no difference if I' m drinking a fair amount on a regular basis.

Additionally...I seem to have more headaches in general when I drink coffee a lot.

After many years of this, I kinda know when and where to draw the line...but its very debatable to be playing this game in the first place.

Honestly, I am sure that my neurologist is correct. It is a slippery slope...one is kinda lplaying with- fire to drink regular coffee as a habit (especially more than one cup a day) when you are prone to headaches.