Antiemetics - experiences? advice?
I've been stalking the forums for advice and gosh, I wish I knew about websites and organizations and the such for migraines back when mine started getting so serious in 2009. I could have saved myself a lot of stress, anxiety, and possibly the first part of my academic career, but what's done is done, and now, I have need of help and advice.
I get really bad nausea and vomiting with my migraines. I always have, but with my transition into chronic migraine, my nausea is almost daily, and I'm vomiting multiple times a week. I saw a GI for the vomiting thinking that maybe it was gastroparesis but they did a gastric emptying study and it came out negative. I'm afraid that my severe nausea/vomiting spells with my migraines might be morphing into cyclic vomiting or something, and my suspicions for this require a short explanation. I was admitted into the ER in August for 9 days (my first time being admitted to the hospital for anything relating to migraine); initially, they admitted me for pain and nausea control, and then they transitioned me to a DHE protocol with Phenergan every 4 hours. I just went to the ER two nights in a row because again, I couldn't stop vomiting, and this was after trying every antiemetic in my arsenal, even giving Benadryl and meclizine a shot. I have been nauseous and dry heaving for four days now and only just stopped vomiting maybe two hours ago, even though I'm still dry heaving probably every 2-3 minutes. My abs are killing me, my throat is shot from all of the bile that forced its way up, and my brain feels like it has an axe buried in it. I'm already on Day 20 of status migraine. This whole cyclic vomiting thing on top of status migraine? It's a Very Bad Feeling.
Phenergan doesn't work work me - it isn't strong enough. I'll keep vomiting after 25mg IV/IM/etc. and believe me, it's not fun to feel flung out into space and then lose the contents of your stomach. Zofran used to work, but this year it's lost its effectiveness. And despite me telling the ER doc this - repeatedly - he kept insisting on giving me same stuff and then sending me packing with no scripts to help me whatsoever. It was, ugh, a bad experience. Reglan gives me what I like to call the "heebie-jeebies" i.e. it triggers akathisia, so I can't use it unless I want to start squirming in the ER cot uncontrollably. I just started seeing a new headache specialist in November, and I'm trying hydroxyzine with limited success and Tigan with even less success. I go back for a follow-up in early January. I don't remember the date. I have really severe brain fog at the moment because of the migraine and also because I haven't really slept in a week. I'm typing this while sick because I'm desperate for help. Really desperate.
If I wind up in the ER again (which I fear might be the case, which would be really really bad because right now my uncle is literally under the knife right now for a lung transplant and my mom is pulling an all-nighter with my grandma while we wait for news), I need an idea of something to ask for. At this point, I'm pretty sure they're labeling me as a drug seeker, even though I have extensive records showing my diagnosis of chronic migraine, their charts showing how many times I've had to go for treatment there since I was 15, and the contents of my stomach in a vomit bin, as if they need any other proof. Hell, my eyebrows are frozen from Botox - what more do they need to see? I'm 25. I don't need cosmetic surgery, gosh. This same ER doc also indicated to me that I should probably be going to a bigger hospital (which is an hour and ten minutes away) to "get better treatment there", which in ER slang basically means he wants me out of his ER because he assumes all I want is an opiate. And ya know, I'd make the drive, if I weren't vomiting my head off and suffering from vertigo and allodynia and photophobia and all of those lovely things which clearly make it a danger for me to be behind the wheel of a moving vehicle.
I apologize if this seems rant-ish, but I'm pretty sure we've all been at that point where we just don't know what to do anymore and could use hugs and a couple pounds of abortives and a soft blanket and some love.
Anyway, to the point: I've heard of compazine and Haldol and a few other antiemetics that I've never had the chance to try, but given my miserable experience with vomiting as of late - regardless of food intake - I just don't know what to do. Has anybody else been in my shoes? Can anybody offer some advice?
They made me sleepy. My head problem started with acute, intense vertigo. But it was only this bad once. After that, the vertigo slowly dissipated, leaving only the migraine symptoms.
I do remember that one kind of med gave me a hang-over headache and another kind didn't. If I think of their names, I'll come back and let you know. But it was worth it to switch brand-names for me.
Its an out of the box idea, but I would also suggest looking at the symptoms of Meniere's disease and paying close attention for hearing loss and tinnitus around your next attack. You can have both migraines and Meniere's. There are some things you can do for MD that are really harmless and pretty easy, like adopting a low salt diet. Its worth a few minutes of google time.
I have been having akathisia with my ER treatments as well, and I couldn't pinpoint what was causing it. I thought it was just my heart rate dropping super low. I'm kind of glad someone else has had this, and could isolate it to Reglan. Thank you so much! (Going to discuss this with my doc, now!)
For nausea, my doctor was at a loss, and couldn't figure out what to do. Zofran barely touches my nausea, and phenergan does okay. Several doctors recommended going on a raw diet and reintroducing foods slowly to look for triggers for nausea and migraines. I cut back to very basic fruits and juices, and have slowly added food back to look for things that may be triggering.
Turns out, tomatoes, pineapple, dairy, and most processed foods make me super duper nauseated. After avoiding those, and eating raw, I found my nausea is localized just to my migraine attacks. I also found I was allergic to something in gummy candies, which actually landed me in the hospital the beginning of last year. (At the time, they couldn't figure it out.)
Maybe trying to look for dietary triggers may be helpful? Your body may be trying to reject something you're eating.
