Wife's migraines getting worse?

Full Question:

my wifes migraines seem to be getting worse.

Two years ago my wife had surgury for a cerebral aneurysm at UT Southwest by Dr. Duke Samson. It was 7mm, did not rupture and a clip was installed. She has had migraines for quite sometime prior to the surgury and we were told that the anuerysm was not the cause of the migraines. As time progresses, the pain and frequency of these headaches have become unbearable and does vomit on occasion. She does see a pain management doctor who has said she was addicted to hydrocodone, Walgreens pharmacy medical review board said the quantity and dose she was taking did not represent an addiction, but this pain doctor put her on suboxone anyway. This medication does not seem to put much of a dent in her pain. Personally, I thought she felt better and acted better and could function better with morphine, but that is my take on it. She sees a neurologist, now that is only once a year, We need help. She is a great person and does not deserve to be in pain. Any advise would be great. We live in Plano and could see you if you would like. Please help if you can. I know she is at the end of her rope and the present doctors don't seem to care. She has been on most migraine meds at various times. None seem to work. I look forward to a reply. Thanks , Henry.
 

Answer:

Dear Henry,

Migraine is a genetic neurological disease that needs a comprehensive treatment plan consisting of:

1. Proper diagnosis and a good medical team.
2. Trigger identification and management.
3. Preventive treatment if necessary.
4. Abortive therapies to stop the Migrainous activity that occurs in the brain during a Migraine attack.
5. Rescue treatment for times when abortives don't work or for patients who cannot use abortives.

Has your wife identified what triggers her Migraines? Some triggers are avoidable; others aren't. It's important to identify triggers so that they can be managed by avoiding those that can be avoided. A good tool for trigger identification and management is a Migraine diary. There's a free, downloadable diary workbook available with our article Your Migraine and Headache Diary.

If your wife has three or more Migraines a month or if they are especially severe and debilitating, it's time for her to talk to her doctor about preventive medications.

Pain medications are not the first choice for treating Migraine attacks. Pain medications cannot stop the Migraine attack, only mask the pain for a few hours. Neither hydrocodone nor morphine are good choices for treating Migraine. Both, if used more than two or three days a week, can make matters worse by causing medication overuse headaches, aka rebound. See Medication Overuse Headache - When the Remedy Backfires for more information on this issue.

There are abortive medications that work in the brain to stop the Migrainous activity, thus stopping the headache and other symptoms of the Migraine attack. The most frequently used abortives are the triptan medications -- Imitrex, Maxalt, Zomig, Amerge, Relpax, Axert, and Frova.