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Doctor refused to prescribe migraine medication

I went to see a GP today after having my very first migraine. I know it was a migraine. I started feeling weird an entire day before. I felt depressed, overly tired and craved foods I like, but don't normally feel like I must have. The day of the headache I felt very hazy the first half of the day. I had trouble concentrating, carrying on normal conversations, and the noise in my local coffee shop was extremely annoying (it usually doesn't bother me at all even when it's crowded.) Then around 6 pm the vision in my right eye got really weird. I felt like I was looking through a microscope (like the ring you see when you look through a microscope) and everything was super bright in the middle of the circle but fuzzy around the edges. About 15 - 30 minutes later the pain started just on the right side behind and above my eye. It was so bad I put a heating pad on my head for a while. When I described what was happening to my boyfriend he immediately knew it was a migraine because he gets them too. So, he told me to go to bed. After taking two Ibuprofen, a tylenol, and a melatonin (to sleep), I finally fell asleep. Today I have experienced horrible crying fits. Everything, even ridiculous things, upset me. I also still felt slight pain and fogginess. All of this was incredibly upsetting for me (as well as physically painful,) and I never want to go through it again. So, I went to the doctor hoping to get some preventative medicine, since as I've described, in hindsight I realize I had plenty of signs that the headache was coming. The doctor told me he would not prescribe migraine medication nor would any other doctor until I had many episodes of headaches. He said in the future my only option is to go to the ER and receive some kind of injections until I had plenty of documentation of my headaches. Is this for real? I'm so angry and upset. I am really upset about the idea of having to go through this multiple times before I can get any help. Can anyone explain this to me? Thank you.

  1. Oh goodness. I really feel for you. Feeling out of control of your neurology really sucks. And yes, the episode you had sounds like it is likely migraine.

    Here's the tough reality check though, from my point of view.

    All of those "preventatives" you were hoping to get have side effects that REALLY suck, too. They will likely also do things that make you feel like you are not in control of yourself. They are like a neurological straight jacket. They don't let the brain have a migraine, but they also don't let us completely control our emotional or cognitive lives. If you look around these boards, you'll find people for whom there are no bad side effects for the preventative medications, but those are a minority. A lot of us are willing to put up with the side effects because the pain is so consistent and so bad that we don't feel like we have any other choice.

    This is also true of the abortive, emergency, and breakthrough meds that you may read about. They all have neurological, emotional, and cognitive side effects. Some of these are truly horrid. For me, most - no - ALL of the pain relieving meds I've tried will help that day but make me have more migraine pain in the long run. If you look long enough online, you will find hundreds of people in a terrible cycle of being ruled by pain medications, not able to live without them and not functioning on them. Its a really difficult fate.

    You can always go to the ER if you think you need to. I'm not telling you to not go. But I'll say this - the stuff they give you in the ER is not going to make you feel well, and is not going to make your brain less likely to migraine in the future. Its not a solution. It is exactly what the name implies, an emergency stop-gap, meant to save your life but not to give you a good life.

    If you were my daughter and you came to me for advice, I would tell you this: This is the right time to look at some of the non-medical ways of preventing migraines. There are lots of ways to injure your brain that we don't even think about. Stress, lack of sleep, poor diet, alcohol, smoking. Do everything you can to get your brain healthy so that you don't have to ever experience that again, and you don't go down the road that leads to a string of medications. Its no guarantee of health as some people do all of this and still need the medicines, but we do know that these things can help weigh the odds in your favor.

    There are some really interesting studies on cognitive behavioral therapy and migraine prevention. This might be something to look into. For me, I really don't like CBT - I feel like it over-simplifies things. But I've had a lot of therapy, and a lot of people who are new to therapy really like it because its quick and its proven effective. Understanding your stress triggers and working to make yourself as chill and emotional-trigger free as possible is probably the best way to keep your brain healthy. Healthy thoughts create healthier brain chemistry, which in turn creates a healthier brain. Its a cycle of health.

    Getting enough sleep is an easy one, in theory. 😀

    Now is the right time to start looking for possible triggers. A lot of people with migraines know their triggers and can prevent migraines by avoiding them. My big ones are wine, beer, sulfates, and other things I can't control, like my menstural cycle and the weather.

    There are also some herbs and vitamins you can look into to keep your brain healthy. I use St. Johns Wort and Butterburr, but you probably don't need those yet. Again, if you were someone I cared about and came looking for advice, I'd tell you to look into some healthy brain supplements. A nice Vitamin B complex, an omega 3 supplement, and some Vitamin D sounds like a good start. And maybe some magnesium.

    I hope this helps, and that your migraine was a one-time occurrence.

    1. I think your doctor was a little crass in the way he presented, but I don't think he was wrong. I understand where you are coming from, as do I understand your point. I think he is worried that by prescribing the medications he would be prescribing you medications that not only are wrong for you, but are unnecessary, a problem many of us have had so often. I think that what he is waiting for is for you to unfortunately have more attacks to see a pattern so that he can properly treat you, and that is actually a good thing for you, despite all the awful symptoms that means you'll have to endure. It took many of us years and years (I wasn't on put on preventatives until I was in my mid-20's after suffering through them since childhood, personally) to be put on preventatives. Some of us go through several different types until we find the right one. Some of us never find the right one. My best suggestion is to ensure that you are taking a look at if anything in your life changed to possibly trigger that particular migraine. There are so many triggers out there, that may seem an impossible task, I know. And I know you are angry, but look at it this way, he was saving you stress from the medications, and a WHOLE lot of money in the long run. Good luck, dear! I hope you're able to find relief soon! And, Happy New Year from one Migraine Life to another.

      1. Your doctor did the right thing, although he could have presented it better. You may never have another migraine, so a preventative isn't necessary yet. You may need a prescription abortive if the migraines continue, but until you know your triggers, it probably won't help much. I've had migraines since I was a teenager, and I'm 49 now. Each person is different. I know several people who get relief from excederin migraine or other otc medication.
        Good luck & wishing you well,

        1. I think maybe you were asking for the wrong thing? For someone who has only had one migraine, preventative meds are not Ness. Now, I don't see anything wrong with getting a prescription for immitrex or something similar, in case you do get another one, but at this point, you've only had one, so I wouldn't worry too much.

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