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Treatment for Migraines - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: Headache and Migraines
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2544 Questions
User :   I am trying to speak to someone about headaches.
Doctor :   hi
Doctor :  
how can i help you
User :   i have a 3 month history of headaches. headaches started in June and have progressively gotten worse. Have had 2 ER visits lots of bloodwork (normal) and CAT scan (normal). Referred to neurologist. She diagnosed me with migraines.
Doctor :  
ok
User :   I have been taking Imitrex and Relpax. The usually work to abort the migraines but they ALWAYS come back. Since i have been using the migraine meds the headaches have gottenworse.
Doctor :   ok
User :   My neuro. prescribed me with a 3 day relpax plus aleve about 2 weeks ago. It worked pretty well but the headaches came back within 3 days. I just started a preventative, noritriptylene 10 mg at night. Now headaches are somewhat changing in nature and scary.
Doctor :  
i will help you
Doctor :  
not to panic
User :   I am having a lot of head rushes, and when I hold my head down I can feel a rushing sensation. Also , since the start of the Relpax I have been having on and off tingling in my arms and legs. The neur. dosent seem too concerned by the tingling. I am just really wanting to start feeling better. This is really interfering with my life.
Doctor :   i will help you in this
User :   I am not convinced that is is just merely migraines.Because I am having symptoms almost every day now. and since taking the noritriptylene the headache has changed and have been having more jolts of pain and weird symptoms. I just don;t know where to go from here. I was completely normal and healthy before all this started this summer.
Doctor :  
ok
User :   I go to the reg. doctor almost once a week. They are telling me that I can take the immitrex more than 2x week. I am afraid the side effects may be getting to me with the tingling and all this. I am worried there is an underlying problem and migraines may be a symptom
Doctor :  
ok
User :   my last few posts are not showing up
Doctor :   is there any techenical problem you are facing

User :   Is anyone there? nothing is happening
Doctor :  
i am here
Doctor :  
i could see the message you have typed
Doctor :  
is every thing alright? are you facing any techenical difficulty
User :   okay now it is better
Doctor :   ok
Doctor :  
please proceed
User :   do you have any idea where I should go from here? I am feeling terrible and I dont know how to deal with a migraine or other weird symptoms every day. I need to find out what is going on
Doctor :   i will help you
Doctor :  
what is your age
User :   31 female
Doctor :   can you please tell me your occupation
User :   speech language pathologist
Doctor :  
ok
Doctor :   all this problem you have since three months
User :   yes it started in mid june
Doctor :   please provide details about your marital status
User :   married
Doctor :   children

User :   no
Doctor :  
ok
Doctor :   did your neurologist after diagnosing migrane did he mention about any sub types
Doctor :  
in the migrane headache
User :   not really. she just tried to break the migraine cycle with the relpax and then put me on the preventative of noritript. since the relpax for three days didnot work
User :   i do not have AAAAAAA associated with migraine headache but I have had nausea and the medicine usually works
Doctor :   ok

Doctor :   what kind of AAAAAAA
User :   i dont have the AAAAAAA
Doctor :  
is it flashes of light
Doctor :  
or ok
Doctor :  
so its headache, and nausea the most worsening symptom
User :   no just headache right now. the noritriptylene has helped with the nausea. just intense headache
Doctor :   ok

User :   i am just wondering if the imitrex is not completely knocking out the headache is it the same headache? or new ones recurring
Doctor :  
is this headache do share any relation with your menses
User :   no not related to cycle.
Doctor :  
migrane is atype of headache
Doctor :  
the cause is not structural
Doctor :  
it is believed to be some serotonergic imbalance in the head
Doctor :  
and imitrex is not 100% effective in all the patients
Doctor :  
as you dont have AAAAAAA it is probably Atypical migrane
User :   does it seem at all common that someone with migraine would have one almost every day? yes I feel that the serotonin and other chemicals in my brain are completely messed up right now. I had also switched from celexa to lexapro 10 mg in may. my neuro thinks that the switch to lexapro may have brought this on
Doctor :   ok
User :   Now I have swtiched back to celexa for the past 3 days. maybe that is also causing this new strange kind of pain
User :   It seems like the noritript. would be working if it is due to a chemical imbalance
Doctor :  
nortript will
Doctor :  
stop the nausea the vomiting sensation
Doctor :  
immediately
Doctor :  
but it will take some time to control the headache
User :   yes. do you think the new kind of headache could be from the addition of noritript.
Doctor :  
i firmly believe not
Doctor :  
cause this drug will relieve headeache
User :   can the noritrip. cause head rushes
Doctor :   it will not

Doctor :   but the character of your migrane is altered by this drug
Doctor :   so it is the other way the headache is percieved some times when on treatment for head ache
User :   last night I had the feeling of pressure like my head is going to explode out of my skull.
User :   now i have the sensation of typical migraine pain on one side of head near eye.
Doctor :  
ok
Doctor :   i believe the severiety of pain has reduced from what it was before the medication
User :   no its the same
User :   i am afraid to take the migraine medicine because I took it a day before yesterday
Doctor :  
is the intensity has it reduced
User :   no it is the same
Doctor :  
what about the frequency of attack
User :   same almost every day at least every other day. but I have only been on the noritriptylne for 3 nights
Doctor :   ok

Doctor :  
it is a type of medicine
Doctor :  
which will take time to build up
Doctor :  
sufficient concenteration in head
Doctor :  
to stop the pain
User :   I feel like I need to take the migraine med but I am afraid because I took it so recently
Doctor :  
no you should not get afraid to take the nortrit medicine
User :   and maybe the use of the medication is causing rebound headache. I have no idea...
Doctor :   if you stop abruptly than you will have rebound headache

User :   i am more afraid to take the immitrex so frequently but the pain is bad. not a fraid to take the otherone
User :   Is there anything you can suggest I do?
Doctor :   the line of treatment which has been initiated is up to the mark

Doctor :  
you need to continue the same medicine
Doctor :  
apart from this
Doctor :  
there is recent evidence suggesting yoga
Doctor :  
the yoga has an effect in reducing the migrane episodes
Doctor :   in people who are not easily controled by drugs
User :   have you ever heard of someone getting them every day?
Doctor :  
yes
Doctor :   in fact some times the pain will persist for 3 to 4 days continously have been reported
User :   it is really hard to deal with the intense pain and not be able to take the immitrex
User :   when I am basically needing it almost every day
Doctor :   you are not able to take immitrex may i know the reason

User :   because you are not supposed to take it more than 2 -3 times a week
Doctor :   you no need to take it every time
Doctor :  
what happens is
Doctor :   the drug might become inefficient if taken too many times
Doctor :  
i believe if you practise yoga this will help in reducing pain
User :   I hhavent been able to hardly get off the couch
User :   i cant see my last post
Doctor :   is there any techenical difficulty you are facing

User :   now okay. I can try yoga but it is hard to move my head because of the head rushes
Doctor :   ok

Doctor :   have you heard of meditation
Doctor :   if the headache is so severe than i think you should do Meditation
User :   do they make a medication that I can take every day for migraines?
Doctor :  
i like to know some details
Doctor :  
what is your normal diet contain
User :   vegetarian and very limited dairy products
User :   lots of soy products
Doctor :   is your sleep disturbed?
User :   not usually but a little since these headaches
User :   have had to sleep and rest more since these headaches
Doctor :  
ok
Doctor :  
do you consume alchohol
User :   i used to but not in past 2 months
Doctor :   ok, smokong
User :   no smoking or drugs
Doctor :  
when is the headache more, is it in the morning
User :   no it is worse in later day
User :   it develops over course of the day
Doctor :  
does the headache aggrevates due to worktension..
User :   i dont know I havent been working this summer since school has been out
Doctor :  
ok
Doctor :  
any neurological symptoms
Doctor :  
like tingling , numbness, palsy,
Doctor :   neurogenic bladder,
User :   tingling from time to time and slight numbness in face during migraine
User :   otherwise no
Doctor :  
do you have power of sight
User :   my vision is okay
Doctor :  
how long it stays maximum, in hous or days
Doctor :  
any prophalatic drugs taken..
Doctor :  
hello
Doctor :  
are you there..
User :   are you there?
Doctor :   yes
User :   I have just taken the noritriptylene like i mentioned earlier. Is this the same person?
Doctor :  
ok,
Doctor :  
any prophalatic like propronolol
User :   no
Doctor :   ok
Doctor :   ok, not to worry
Doctor :  
once the headache comes down
Doctor :   you can go for prophalaxis for few months
Doctor :   so you can attain remission for years
User :   what kind of medicine would this be
Doctor :   its a beta blocker drug
Doctor :  
is also very helpful for prevention
User :   the prob i sgetting the headache to go away
Doctor :   are you worried of head ache which is present now?
User :   yes. it is bad.
Doctor :   you can take a paracetomol right now
User :   also worried about head rushes everytime I get up from a seated position
Doctor :  
to reduce the intensity
User :   what is paracetomol?
Doctor :   its a antipyrectic and weak analgesic
Doctor :  
its a tablet avaliable over the counter
User :   what is antipyrectic
Doctor :  
as i mentioned earliar it takes minimum of 1 week to get good results
Doctor :  
to bring the temperature down
User :   like a tylenol or aleve>
Doctor :   yes
User :   so I should take a tylenol every day?
User :   i have tried these in the past and gotten no results for decreasing the pain
Doctor :  
current neurological prescription will take 1 week for the effects
Doctor :   with the combination of nortrep it works well
User :   oh for the noritriptyline. I took 10 mg last night because I was scared. Dr wanted me to take 20 mg. should I take the 20 tonight
Doctor :   a cup of coffee can bring the head ache in many
Doctor :   yes , you need to follow the dosage of 20 mg strictly..
Doctor :  
these are all highly dose specific
User :   so noritriptyline plus a tylenol? and caffeine
Doctor :   yes,
User :   u still there
Doctor :   yes
Doctor :  
avoid the light and sound
Doctor :   it will come down
User :   is tylenol better or aleve? and how many
Doctor :   tylenol is good
Doctor :  
one may after 4 hours one more, after light non oily snack
User :   what?
Doctor :   one tablet right now
Doctor :  
one after 4 hours
User :   ok so laying down might help?
Doctor :   yes , take tablet and rest now,,,,
User :   okay thank you for your time. I really hope the headache will go a way
Doctor :   with this thearpy it should come down..
Doctor :   take care,,
Doctor :   thanks for consulting health care magic,
Doctor :  
bye for now
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