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Should I go inpatient?

I suffer with many different types of migraines:chronic migraines, hemicrania continua, tension migraines, transformed (my neurologist threw that in) and the latest vestibular migraine. I have tried numbers preventatives but can’t tolerate side effects to most of them. When I wake with a killer one Relpax doesn’t complete the job and need a pain killer and even muscle relaxant. I went through a lot of health issues this winter and was on steroids for about 3 months because of steroid withdrawal symptoms. I also suffered debilitating migraines as a side effect of the steroids.

About 2 years ago I went to the Jefferson headache clinic and given my history and treatment attempts they wanted to admit me and do the lidocaine drip. I scheduled it and then cancelled because I was afraid and wanted to give preventives another attempt. Same story. Still unable to successfully tolerate one. Lately my vestibular migraine has set off some pretty awful Motion disturbances. I also have a creepy crawly feeling in the right side of head, temple, spreading to eye and cheek. I was told this is neuralgia. I have it all the time. Ativan or a Muscle relaxant like soma will calm it down a bit. The back of my neck, traps down my back are so tense and tight. I also get cervical Migraines and hav some disc issues. I’ve had nerve blocks and even a nerve ablation last year.

Yesterday I went for trigger point injections to try to break the spasm and will hopefully be able to start PT soon. I’m see my neuro Tomorrow and will discuss possible going back to the headache center in Philly. Eve though I don’t abuse meds Jefferson told me I probably have rebound as well. That was 2 years ago and I would have to be off Ativan while in Patient. I suffer anxiety and depression and it is the only medication that I can take. J have been in a small dose for about 20 years since being diagnosed with fibromyalgia to help me rest and sleep. From .5 mg I now take 1 mg bedtime and my psychiatrist wants me to take another .5 during the day. I was told I would not be able to take them. I’m at a point that I don’t function very well and am plagued by migraines of one type or another every day. I am considering going back to Jefferson but I know they will want to do the lidocaine infusion and am afraid of side effects and even it not helping me.

  1. I can only share my experience... but I can say I went in-patient at Jefferson and it helped me immensely. I was so scared going in. It wasn't a pleasant experience by any means, but the RESULTS were worth it. I wasn't on ativan or anything else that I would have needed weaning off of, but maybe they can wean you off it while you're there? It's worth asking. I still get migraines - about 8-10 a month, actually. But I have MANY pain free days (unheard of before I did inpatient) and most often the pain is manageable with triptan and anti-nausea or sometimes it doesn't even get bad enough to take meds. Good luck!

    1. Becky
      Thank you for responding and sharing your experience. I went to the neurologist today and after examining me he feels this cycle of migraines is coming from the neck. All the muscles are so tight. Everywhere he touched elicited more pain. He said disequilibrium feelings that I am having are from the neck. When I move my neck in a certain position I get off balance. It feels like I am drunk. In spite of doing all the stretching and heat the pain persists. It is going up to the base of my skull and the. down to my mid back. From the base of the skull where it meets my neck I can press in certain spots and have the pain shoot up to my eye. I have a daily crushing pain in my right head, temple, pain goes to eye and cheek and is even now going to the top of the head. I am also starting to get neck pain on he left. He wants me to take muscle relaxants twice a day to break the spasm that he even feels running all the way down my spinal column. As for the other migraines I get he didn’t change my meds but encouraged me to go back to Jefferson and possibly do the lidocaine drop inpatient that they wanted to do 2 years ago. I called and made an appointment for May 31. They said I can call to see if there are earlier cancellations. I have an appointment with ortho to review the MRI next week and will see what they have to say. I discussed coming off the Ativan with my neurologist and although he is not the prescribing doctor for them he feels that with all I have going on right now it would not be a good idea to go off. My husband is in treatment again for his chronic leukemia and it’s been very upsetting to me. I also have anxiety and depression from my other health issues. He said I might be able to take less Ativan while taking the Soma but if I don’t feel right to take the Ativan. My psychiatrist of course wants me on it. I am slowly going to chip away at the pills and try to take smaller doses so hopefully by the time I get to Jefferson I will be on less. He also told me that I could actually hurt myself and make things worse by just stopping. I feel like I am stuck in a viscous cycle. This neck pain is shooting to my head and is awful and now he midback is screaming too. I have pain pills which I hardly ever take but his pain is so bad that I can barely move so I just forced myself to take it. He also wants me
      To go to PT for the neck to keep those muscles loose so there is less tension and squeezing on the nerves that are shooting up to my head.
      Something has to give soon! Thanks for making me feel a little better about the lidocaine drop. Did you hallucinate on it?

      1. I did hallucinate and even though I was expecting that it was a possibility, I SWORE I wouldn't. I hate not being in control of situations and to me that was a very out of control thing that scared me the most going in. I even said to the nurses (who are LOVELY, by the way), "I' not hallucinating, I'm dreaming but my eyes are open" (to which they replied, "oh, honey, that's hallucinating"). They were very quick to adjust the meds and that was the end of it. My hallucinations were not scary once I realized what was happening - one was that a little mouse was chewing on my IV cord. The meds did make me very emotional and quite sick... however, the doctors and nurses there are wonderful and are very quick to help and adjust meds or try a different one. The staff is amazing. I believe everyone's experience with the medicine is a little different, so I'm just letting you know what mine was. The support groups, even though I felt going in like I didn't need them, were quite helpful. For me, it was so go to talk with others who had similar (or even worse) pain, and all ages. Good luck with all of it!

      2. Hi/ I can relate to a lot of what u write: stress will bring more migraines. I’m worried re ur dr’s mix of muscle relaxants, Ativan & pain killers (opioids?) U didn’t specify the kind. I take Fiorinol for severe headaches- if u r female, that is a very good pain killer, not an opioid. I also take Neurontin, which might help u with the nerve pain. I take preventives: 300 mg of Wellbutrin with 1 mg of clonazapam and 50 mg of atenolol and about 600 ( 3 200 mg) of Neurontin, spread thru day. I also do very gentle chiropractic. If u can find a good acupuncturist or shiatsu practitioner, they might help u break the head/body block/ —- the goal is to integrate your head/brain/neck blood flow with the rest of the body. I recently had a death in the family so I felt I had to start to get very aggressive with breaking my migraine cycle/// it really sounds like too much Ativan to me. I would suggest clonazapam instead

    2. Thanks again for the information. What type of migraines did you have and how often. Would you do it again? I’ve heard that some do this repeatedly.
      I’m trying to break the muscle tension in neck, traps and back which goes right to my head with awful pain and neuralgia. I’m not sure what comes from what. Throw in the eye stabbing migraines and it’s a cocktail for disaster. I’m very emotional his morning and so tired of the pain. I’m exhausted. The spasm Is traveling down my to my midback and up to my head ughhhh 🙁

      1. Going to Jefferson tomorrow. Hope they can offer me some help. My head feels like it is in a vice and a creepy crawly feeling in my right scalp to eye and cheek.....all day. Ughhhh. So deprssed over all this....which doesn’t help

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