Well I know I just joined but I'm gonna jump right in. I've been struggling with a migraine that doesn't want to go away and I've used up everything in my arsenal (to the proper extent) to try to eliminate it. Usually my migraines will last around 6-8 hours, but this one has persisted for 2 weeks as of today. I currently take Keppra (2000mg per day [1000mg 2x daily]) and Topomax (100mg per day [50 mg 2x daily]). When the migraine started it came on quite severe and I chose to use Migranal as it is usually my fasted acting abortive. I used 2 doses (all I had). It helped for a while but failed to eliminate the migraine. After a few more days of it acting up I switched to Cafergot tabs (100mg 2x at start and 1x following for control) which helped a bit to control the pain but also failed to eliminate the migraine. At this point I was quite frustrated and realized that I was lacking a rescue med, so I had to wait for my neurologist to fill a script of Fioricet for me. I relied on those for 3 days to get me through work (I know working on them isn't the best idea ever but sometimes you gotta do what you gotta do...). I recently took a frustration trip to the ER where I was told by my neurologists office that I would be seen by a neurologist from the same office (my dr. was out for vacation/holiday) and was dosed with Toridal and sent home without seeing the appropriate dr. or having any tests done. I'm quite frustrated and in a lot of pain, what route should I take to get this migraine eliminated? Any help will be appreciated.
Hi again, Steve,
I'm glad you did jump right in. No sense in waiting. We're here to share info and offer support, and that's what we need ot do.
OK. Let me give you a bit of info...
The main thing at this point is that this Migraine needs to be stopped. When our standard abortive and rescue medications have failed, IV infusions will often break the cycle. It can often be as simple as an IV infusion of good old magnesium sulfate. For more information about this, see IV Treatment of Refractory Migraines.
You were obviously being careful about how frequently you were taking medications. Please keep in mind that it's the CLASS if medication that we have to watc, not just the medication itself. For purposes of avoiding medication overuse headache, Migranal and Cafergot would count as the same medication because they're both ergotamines. More on this in Medication Overuse Headache - When the Remedy Backfires.
ERs are really best for times when our own doctors aren't available. When a Migraine has gone on this long, I'd presonally expect my own doctor to be doing something about it, rather than sending me to the ER. If your doctor DOES send you to the ER, at the very least, I'd expect him to call ahead and arrange specific treatment for you rather than leave it up to an ER physician who is not familiar with your or your medical history and is probably quite busy and overworked. In general, ER physicians don't appreciate it when doctors treat the ER as extensions of their offices.
If your doctor isn't able to help you, it may well be time to consult a Migraine and headache specialist. It's important to note that neurologists aren't necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.
Does this help?
Teri
My dr. is very helpful, I had to visit the ER though as he was very busy and the ER that I visited was at the same hospital that he works at. I saw him yesterday and he started me on a steroid taper to take care of the migraine, so far it is working quite well other than the fact that its a little hard to sleep, but its not very easy to sleep with a migraine either so I'd rather be awake and not in pain
. We'll see if it keeps responding positively to the treatment but I'm staying optimistic that it will. As far as seeing a migraine specialist I will look into it, but at the moment my neurologist is important to me as I am also epileptic and my treatments and office visits coincide with each other, and he is a well regarded vascular neurologist. Thanks for all of the info!
I take toradol and reglan (for nausea) frequently. I take it in pill form. I have also been given it intamuscular and also into the vein. It works occasionally but If I had had a migraine for two weeks it would never work. It is what I use first. Then I start hitting my abortives. I take 200mg of topamax daily and misc other meds. I have lortab but my neuro does not like me taking it at all! My abortives are Maxalt and Migranal. There are side effects to both of them. I start with Maxalt (the cheapest). Migranal has worked really well for me but it is $700 for 8 doses. Don't know what my ins will pay yet because just started it in Dec and I had already met my out of pocket and didn't have to pay for it. Thank you God.
I know when I have gone to the ER my Neuro wants me to as for Nubain (sp??) It really doesn't help with my headaches but that is what he wants me to ask for. Maybe it could help you. He has used that and steroids before with me in the hospital one time to get me over a migraine I had had for several weeks.
Good luck!
Prayers for you all out there!!