11/5/07 #8 - Migraines getting worse; correct treatment not found. Suggestions?

Full Question:
I have been getting migraines for almost 7 years now, and not 1 single physician has been able to find the correct treatment for me and this condition.

My headaches are getting worse to the point where they are hurting the back of my head by my spine. Half of the women in my family had migraines at one point or another. My neurologist doesn't want to do any tests on me, he just want to keep writing prescriptions out for me to take. I wish someone would do an MRI or CT of my head or something (just to make sure everything is okay).

Living with these migraines has really taken it's toll on me and my husband. When I have headache, nobody wants to be around me cause I get so irritable and moody. I have to wear dark sunglasses and take medications like 300mg Topamax, 1mg Klonopin, and 40mg Replax. All those listed aren't even helping to take the edge off my headache. I have reduced my stress level and caffeine intake over the past couple of months. I can't sleep very well because my head hurts to much. Would either one of you possibly have any suggestions that may help me because I am about ready to pull my hair out?

Sincerely, Fellow Mingraineur Jamie N.

Answer:

Dear Jamie;

As you know, many doctors don't order imaging studies when they're confident of their Migraine diagnosis. Still, especially in light of your lack of success with treatment, it certainly couldn't hurt to do a CT or MRI to rule out other issues. Ask your doctor about this. If he's unwilling to order a study to ease your mind, then maybe he shouldn't be your doctor.

How long have you been taking the Topamax and Klonopin? If they're not working, it's time to taper off them and try something else. You're probably also getting into a vicious cycle with your sleep because sleep disruptions and poor quality sleep can significantly impact Migraines, even triggering them. This is something to discuss with your doctor. You need to determine if the pain is keeping you awake or if the messed up sleep is triggering some of your Migraines in the first place. Catch 22 time here!

So, as you asked, here are some suggestions:

• You don't mention what your triggers are with the possible exception of caffeine. Do you know what your triggers are? Trigger identification and management is an integral part of good Migraine management.
• Are you keeping a Migraine diary? If not, give it a try. It can help you and your doctor spot patterns and triggers that you might otherwise not notice. There's a free downloadable diary workbook in our article Your Migraine and Headache Diary.
• Consider seeking care from a Migraine and headache specialist. Neurologists aren't necessarily Migraine specialists. You can find a listing of specialists in Patient Recommended Migraine and Headache Specialists.

Above all, Jamie, don't give up. There are over 100 medications and supplements in use for Migraine prevention (See: Migraine preventive medications: too many options to give up!)