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Tuesday, November, 10, 2009
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A Specialist Speaks: IV Infusion for Intractable Migraine

Teri Robert
Teri Robert
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Author of "Living Well with Migraine Disease and Headaches"

Patient advocate and writer Teri Robert's career moved in this...

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Monday, June 29, 2009
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All of us have probably experienced at least one intractable Migraine or headache -- the ones that don't want to respond to any of our medications. This situation can be one long Migraine or headache, or it can be a series of Migraines or headaches, day after day. These Migraines and headaches oft...
  1. Great Video
    Jamie Sohn
    Tuesday, June 30, 2009 at 08:31 PM

    It IS a shame that more people in the pain and headache fields don't include infusion therapies into what can be done in their clinical setting. I think that the fact that many practitioners won't (or can't)  add infusion therapy to their treatment methods shortchanges their patients. IV infusion therapy opens up the limitations posed in most cases- where the doctor has no idea if a specific agent has a higher probability of providing relief to the patient. Dr Krusz explains how with infusion therapy, he is able to potentially use less guessing as to which medications to try, or other agents to provide relief, as he'd be able to choose something would target that same receptor as something that had worked during the IV therapy.

     

    This needs to be available to  more patients. It can prevent an ER visit, and even more aggressively target the symptoms associated with that particular Migraine or headache  cycle with specific agents targeted to the immediate needs of their patients, and not waste time treating symptoms that are not occurring with the specific attack. Even more importantly, by doing Migraine and headache specific therapies in the office, the patients are not forced to bounce around the ER, hoping that they will get appropriate treatment there, and not just narcotics, or other things to mask the pain.

     

    The therapy in the office can be as specific to the particular patient as needed, with the actual procedure and choice of beneficial medicinal agents given by professionals in the field, and given as aggressively as the particular physician desired. This could potentially change the compliance rate of patients already in Status Migrainousus who would not normally get professional treatment for their SM,  as they will not go to the ER, either for financial, time, or other reasons.  However: If they knew that by going in to their own specialist's  office for an infusion, even in a SM status, the Migraine would be broken with targeted treatment-- and thus could avoid the risks associated with SM without the wait (and potential incompetence) associated with going to the Emergency Room. We know from anecdotal reports that there are patients who will not use the ER for a Migraine, but will suffer needlessly for days, or even weeks, flirting with MOH.  That suffering, and potential risk(s) to the patient might no longer be necessary if a greater number of practitioners could see how well this IV infusion therapy worked, and then might even develop an interest in bringing it to their clinic. Unfortunately, these same Migraine and headache specialists probably will never see how well it works for themselves... Let me tell them a little story

     

     

    I used to get massively nauseous with Migraine, and could more easily count the number of times that I didn't throw up, than the ones that I did. In fact, I even became nauseous with a pain scale 1-2 level Migraine during the first appointment with my Migraine Specialist, and despite the Zofran IM, I was not able to stop. My pain level rose to about a 6 or 7.

     

    Luckily for me, I was in the right place. An IV was started, and a few different agents were tried, both IV and intramuscularly, until he hit on droperidol. That finally stopped the nausea and even the Migraine. Since it had worked so well during the IV treatment in the office setting, I was taught how to give myself an injection of the droperidol at home, and given a prescription for injectable droperidol.

     

    I'm lucky. But it's not so easy right now- since there are so few physicians who currently do IV therapy- it's not like I can go to just any Headache Clinic in my area and have it done there. No. Not yet. But maybe one day this protocol will be second-nature to pain and headache treatment, and it will no longer be necessary to fly a thousand miles to be a recipient of specialized treatments.

    Reply
  2. Untitled Comment
    jettygirl
    Wednesday, July 01, 2009 at 08:37 AM

    Its been quite awhile since I've come to this website but it just so happens(and I'm glad I did) i read this post and do have these type of migraines. I just got out of the hospital. Which, I might add, was treated horribly-like a drug seeker, but i have been through enough to know at least "what doesn't work" . I had a migraine coming on for about a week and then on my Birthday it became full blown and went to hospital cause i couldn't hold anything down. Unfortunately, Triptans do not work for me, still took maxalt or anything just so i wouldn't have to go, but nothing worked. This is the third time they did iv fluids, mag. DHE, and other fluids but no pain meds. OMG! Last they did all and i got better, this time the Dr. said. "Lets give this 8 hours and see if it helps" i wanted to jump off table and have him lay here with 2 cyinder blocks by each ear and crush his head and tell him lets wait 8 hours and see if this works, be patient. This is not my 1st time. Anyway, frustated. 2nd day after another day of no sleep a P.A. came in and ordered Dilutitid went rt to sleep, continued all other meds felt better in am. It took pain away enough to SLEEP. No one listens!!!!!!!!!!!!!!! I need whole package. Not just pain meds, not just fluids, not just DHE!!! Please Please listen.

    Reply
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This animation shows one of the key causes of pain during a migraine--changes to the blood flow within the brain.

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