15 year old - can't tolerate Triptans and has asthma
Help - my 15 year old has chronic migraine (to the point of not going to school in months) we are trying to treat and are treating lots of aspects (ie. therapist, physical therapy etc) but we still have yet to find a migraine medication that works for her on the really bad long lasting ones. Excedrin or even Tylenol can work on the not so bad ones. She does take Topomax and Migralief.
We've broken a couple with a hospital visit and Reglan but obviously that can't happen often. She has asthma so that rules out the whole Beta Blocker class of meds (although I think she's mostly outgrown it and might push them to try that) and Triptans of all shapes and sizes kick her ass - she just tried a new one today (the 4th or 5th one she's tried) and she passed out cold about 2 hours after she took it when she stood up. The side effects of that whole class of drug seems too much for her (scary rapid heartbeat, flushing and heating of face so it's almost like hives, pounding head, the feeling that her chest will just explode, fainting etc) Not ready to go the Botox route or even sure that the insurance company would do it with a 15 year old.
Her triggers are really far reaching so we can't avoid them all. Stress and Anxiety are the biggest, but then hay fever, insomnia, her braces, TMJ, mold/dust and other stuff are also triggers. These are not all avoidable or fixable.
Any suggestions would be greatly appreciated. I'm going to call the Headache Center back again tomorrow to ask about a new medication to try.
I have had headaches all my life. I have several triggers, dust, mold some foods too. My biggest headache trigger is that I have a muscle out. Seems silly it can cause major/violent migraines. I used to have migraines that would last a week and I throwing up for days. I don't know I even have a sore muscle until I actually rub it-hard too, light rubbing will not find it. Massage her back and dig into the muscles and see if there is a sore one. You will know because these cause major pain when you find them. You should be able to find it in about 10 minutes, rub out an sore muscles, which may take longer. If there is nothing major sore here go to her calves and work your way up. I found a knot on my newphew's calf that he didn't even know he had, but it caused him a migraine and he can't take a lot of medication due to severe allergies, he can't even take ibuprofen. He cried and yelled at me why I rubbed it out, but it stopped his migraine. My thigh muscles are often sore on the sides and I use my knuckles to rub any sore muscles out. One place that is almost always sore is the muscle (on the side of my butt) probably 4 inches from my hip. I discovered my muscles being the cause of my migraines while soaking in the shower one day due to having a migraine for over a week and constantly throwing up. While I was soaping up I hit a muscle under my arm that hurt so bad, I rubbed it out then took a nap. When I woke up my headache was almost completely gone. I have since found several people that have the same headaches. Please try this with her. This is so simple to test and not all of my headaches are from muscles, but this is drug-free.
I'm sorry you have to watch you child struggle so much. She is fortunate to have a parent so dedicated to her treatment. Here are some suggestions based on your post.
For possible preventives, take a look at this list of recommendations from the American Academy of Neurology: https://migraine.com/blog/new-migraine-prevention-recommendations-from-the-american-academy-of-neurology/. It includes both prescription medications and supplements. Cyproheptadine is another preventive often used for children and adolescents. (I’m partial to it because it is the first preventive that have me any relief!)
While triptans tend to be favored for acute migraine treatment, there are alternatives. Here’s an overview: https://migraine.com/blog/migraine-management-essential-5-abortive-treatment/. Another good article is: https://migraine.com/blog/how-to-treat-migraines-without-triptans-or-ergotamines/
Behavioral therapy can be really helpful for migraine. This isn’t to say that your daughter is making up her migraines or causing them with her behavior or thoughts, but that learning to manage stress and anxiety – whether separate from migraine or a result of it – can make chronic migraine much easier to cope with. Since you have already identified stress and anxiety as triggers, this could be a great help in teaching her how to manage them and possibly prevent them from triggering migraines so frequently. Some migraineurs use behavioral techniques to abort migraine attacks.
Biofeedback and neurofeedback are also possible treatments. “Seeing” the tension can be really effective in teaching people to manage it better. Both can be good for preventing and aborting migraines.
Acupuncture is another option for prevention. It works wonders for some people.
Cefaly is a device that has just received FDA approval for migraine prevention. It hasn’t explicitly been tested in people with chronic migraine, but some report that it is helpful for them. Here are some details on it: https://migraine.com/blog/cefaly-questions-answered/Best wishes in finding some relief for your daughter.
Kerrie
Ask your neurologist or Primary doctor for a sample of Treximet or just look online in their website and bring in a printed page from their site to the doctor's office. Treximet is a combination of Imitrex and Naproxen. I know you said she can't handle Triptans but maybe if it is combined with the Naproxen it will be okay. This med works in about 60-70 minutes to calm the nausea and dull a good percentage of the pain. I have had 30+ years if migraines and multiple meds. This one is the best so far.
