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Diagnosis of Migraine & Headache Types

1st Ever Migraine, now in it's 3rd day….what to do??

  • By ChrisR

    Hi There

    My girlfriend woke on on Friday with (what she thought was a headache) and went to work as normal but by midday was laid flat in their sick bay with all the light cut out as one of her co-workers advised her that it could be a migraine. Now, not only has my girlfriend ever had a migraine, she also hasn’t had a day off work sick for ten years so for her to come home from work was a major thing.

    I got Karen some Migra-leave tablets (yellow sort) and she did have for at least the first 24hrs the classic Migraine symptoms (light sensitivity, mild nausea etc). She is now 3 days into her first migraine but most of the symptoms have subsided (though not completely disappeared). The real issue though is standing up. When ever she tries to stand up, she can only be vertical for no more than 30 seconds before the pounding in her head starts and she has to run back to bed. As soon as she is horizontal again, the pounding disappears. What seems to help, though in no way cures the problem is if i support her neck whilst she, say for example brushes her teeth. She hasn’t BTW had any sort of cranial or neck accident.

    I will tomorrow morning (Monday) make a doctors appointment but because she has real issues even standing up for more than 30 seconds it’s going to be really difficult to actually get her there.

    I wondered if any of you here on this forum can shed any light onto this inability to even stand up (a perfectly normal human function!) as it’s getting very scary!

    Thank you for reading this and i hope some light can be shed.

    Warm regards

    Chris

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  • By Kerrie Smyres Moderator

    Chris,

    You’ve done exactly what I would have recommended — call the doctor. Any sudden onset of a headache in someone who has never had a migraine definitely requires a doctor’s attention.

    I’m unsure about positional element. Migraine pain usually worsens when someone moves, but standing itself being a problem is unusual.

    I hope she finds relief soon. Please let us know what the doctor had to say.

    Kerrie

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  • By ChrisR

    Hi Kerrie

    Wow, we are onto day nine now!!!

    So after 3 visits to the doctor and two to A&E (here in the U.K) we are none the wiser but Karen is better but not through the woods yet.

    So we we managed to get a prescription order of a drug called Imigran (it’s available over the counter here in the UK but you have to have a ‘card’ to be able to get it) but it didn’t clear the headache.

    We then were dispatched to A&E (with a letter from our GP) and Karen was given blood tests and a CAT scan. Thankfully nothing showed up on the scan which is a big relief but the other side of the coin is that we are no way nearer to figuring out what the problem is. Karen’s GP then swapped her onto Naproxen so she is taking those along with paracetamol to see what happens.

    Both the A&E doctor and the GP suspect a clutter headache but guess is all they can do and see what works with this Naproxen.

    We are both hoping that this weekend will be a corner turning moment. Karen can stand for longer now (we were trying on new glasses for work purposes today) but after we got back she was so tired she went to bed.

    Lets hope (and pray) that things improve. I’ll update you when `nothing changes

    Regards

    Chris

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  • By Dizzy1i

    Go to a neurologist who treats and respects patients with migraines–particularly the second attribute. At Day 9 since Naproxen and paracetamol have proved useless, the doc should be prescribing another tricyclic (e.g, nortriptylene) and perhaps a anti-seizure (e.g., gabapentin) to suppress suspected migraine. (Drugs work differently in each of us. For example, Imigan is useless for me.) A quick diagnosis can sometimes be confirmed with a rescue drug (e.g., Maxalt). However, all these suggested treatments may (will) require tweaking and adjustment. Not all drugs work for each patient and some patients do not tolerate the same drug combinations that work for many. Hence, the experience, tenacity, empathy, and respectfulness of the physician are most important. Good luck–but don’t be afraid to change doctors if progress is not being made. (Of course, until proven, you should also allow that the malady is not migraine; hence, follow all possibilities .)

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  • By ChrisR

    Tammy and JWH1949, thank you very much for taking the time to post.

    So we are on to day 16 now and even though Karen is better than she was even a week ago it’s still a very slow process. Tomorrow Karen will go to her local GP and get a referral letter for the private healthcare she gets at work. As much as we love our NHS medical system here in the UK, for matters like this the process to get seen by a specialist can be painfully (pun non-intended!) slow.

    The Amitriptyline that has been prescribed isn’t really working and it leaves Karen very sluggish (it was originally designed as an anti-depressant but is more useful in headache relief…apparently ???!!!) . Caffeine does seem to work and has been proved to speed up most medication intake to the body so i’m trying to get Karen to drink a bit more caffeine than she does (no triple expresso’s though!).

    JHW1949 -Hence, the experience, tenacity, empathy, and respectfulness of the physician are most important.——Yes you are completely right about this. I think whatever Karen gets prescribed tomorrow hopefully will be different enough to try and shift this.

    Over the last two weeks Karen has been seeing my Osteopath (one of the best medical people i’ve ever met!) and she has vast experience of cranial-osteopathy (mostly on babies) but has been working with Karen and has noticed a lot of swelling (not on the brain) on the right hand side where Karen’s condition is. The Osteopath has suggested that the problem may be a virus but we’ll have to wait and see.

    Tammy – i’ll show your post to Karen.

    Again, thank you for taking the time to share your thoughts and experiences as it’s ver much appreciated.

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    • By Tammy Rome

      Chris,

      So glad she is getting to a specialist. Getting the correct diagnosis is the first step to effective treatment.

      The Amitriptyline, like most preventives, can take up to 90 days for full effect once she is at the correct dose. Drowsiness is normal and generally goes away with time. I know it can be a painfully slow process, but giving each possible medicine a full trial is really the best way to know if it will be effective. My own specialist keeps me on a med trial for a full 4 months. UGH…

      The doctor is correct that Amitriptyline is often used as a migraine preventive. I know a lot of people who use it with good success. It’s certainly worth a try. Now, if it turns out that she has cluster headaches instead, then that’s a completely different protocol (usually Topamax or Verapamil). I know a lot of people with cluster headaches who have great difficulty getting access to the necessary high-flow oxygen in the UK. If this turns out to be the case (I hope not!) then I can put you in touch with friends at OUCH-UK who can help.

      Let her know we are all pulling for her. She has friends who “get it”.

      Happy Migraine Awareness Month!

      Tammy

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  • By Tammy Rome

    If the doctors suspect cluster headache, have they not tried high flow oxygen through a non-rebreather mask? Naproxen and paracetamol will have absolutely no effect on a cluster headache. A big characteristic of a cluster headache is that it lasts from 30 minute to 3 hours and recurs “like clockwork” at the same time/interval over and over again. Also, why have they not tried a round of prednisone to break the cluster cycle? Please find a qualified headache specialist who can properly diagnose and treat her.

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