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  • By Kasey

    Hi! My name is Kasey. I have between 12-17 migraines a months. I am currently using Relpax 40 mgs, Depakote 250mgs and Stadol NS with phenergren to treat these. If the “monster” doesn’t take me out in the first 15 minutes I try foricet. It has been a long road, I have had these since a motor cycle accident when I was 16 years old and I am 58 now.

    I have tried several other vaso constrictors, meds that expand vessels, different seizure meds etc. I have had occipital lobe injections of Medrol which only lasted about 10 days. I have had cervical facet injections and finally ablation of the ganglion nerves at C-2 on both sides. These things only made matters worse. This was done through Pain Management.

    I tried taking the Depakote at 500mgs and it did make a difference, the issue was my liver functions studies came back at “critical” levels and we had to reduce it. I also have non-alcoholic fatty liver disease.

    So to my question is this, a year ago I went to the ER because I had been in migraine 17 days straight and unable to break it with my at home meds. The ER doctor gave me a shot of anti inflammatory and phenegren and tried to send me home. I told him I needed something to end the pain, I was beyond a 10 on the pain scale. He accused me of coming to the ER looking for narcotics. Quite frankly, at that point he was right! I wanted the pain to end because I was nearly suicidal. He did give me a shot of morphine and told me to never come back to his ER again. I was so humiliated. I am a Pastor and I am not a drug seeker for “fun”.

    1.When my at home meds do not work and I have to go to the ER what do I do? I can’t Relpax or vasocontrict more than once on the same day because I have Ventricular Tacycardia.
    2. Is my current treatment plan the best I can do? Thanks, Kasey

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  • By Nancy Harris Bonk Moderator

    Hi Kasey,

    Welcome to the forum! Please forgive us for not getting to you sooner.

    There is lots to talk about so let’s get started! For a long time vasoconstriction was thought to be a big component of a migraine attack but we have since learned vasoconstriction is not needed to have a migraine. That’s right – vasoconstriction may occur but is NOT required to have an attack. Here is some information to help explain things; http://www.helpforheadaches.com/articles/2010/Migraine-Vasodilation-Not-Necessary.htm.

    It’s important for each person with migraine to have a plan in place for when their abortive medications can’t be taken or don’t work. This is when rescue medications may be used. Rescue medications are different from abortive medications because they will not stop a migraine attack, rather help ease the pain and other symptoms. Rescue medications are important because they can help us stay away from the ER. We have some great information on rescue medications in this link; https://migraine.com/blog/migraine-management-rescue-treatment/. Have a conversation with your doctor about these medications so you can keep away from the ER.

    There are people who cannot take triptans or ergotamines to abort a migraine attack for one reason or another. Don’t lose hope though, there are other options available such as steroids and a few other things. Here is information on this to help you out; https://migraine.com/blog/how-to-treat-migraines-without-triptans-or-ergotamines/.

    I can’t really say if your plan is the “best.” Each persons migraine plan varies so much because we all react differently to medications and treatments. I can tell you that a good migraine plan includes an open conversation with your doctor, who will work with you as your partner (not a boss!) to find the best migraine management plan for you. If you find that isn’t the case with your current doctor, it may be time to seek the expertise of a migraine specialist. Let me share some more information with you on what is so special about a migraine specialist and then if you want to look for one you will know how to find one! https://migraine.com/blog/looking-for-a-migraine-specialist/ and https://migraine.com/blog/how-are-migraine-specialists-different/.

    I hope this helps and again, please forgive the lateness of this reply, but do let us know if we can help you further.

    Nancy

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