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Posted 8/6/2007 1:11 PM (GMT 0)
Okay, I have been suffering horrible migraines for 7 1/2 months, from whiplash. I am sure you have read about my story so I won't get into it. I am not a druggy, as none of you are, but lately my pain has gotten worse instead of better, despite all of my treatment. I hae a follow-up appointment today from the medical procedure where they burned my nerve endings. I want to ask for stronger medication, both pain and muscle relaxers.

What I am currently taking is Vicaden for the pain and Skelaxin for the muscle relaxers. What is the next step up? What are some of the pain relievers you all take? Also, what about muscle relaxers? I just need something that works to give me some relief before I lose it. Until they can figure out what is wrong.

I am hoping he (the anethesiologist) refers me to a neurosurgeon. I have a name and number of who I want to see, who happens to be a spine specialist. I think he would be the perfect dr to see in my case. I am still thinking I may have a bulging disc that just didn't show up on my MRI in March.

Posted 8/6/2007 5:05 PM (GMT 0)
holmesla:  I will tell you what I take and how I take it - I actually take some pretty strong meds but I will tell you that so far, the meds I take at home have decreased my ER visits (for IV meds, including IV narcotics) down by probably 75%.  There are some that completely disagree with taking narcotics for migraines but, I think all of us agree, we each have to do what works for us.

My abortive meds are Relpax, Prednisone, Lortab, Dilaudid and Zofran (for nausea/vomiting).  At the first sign of a headache (little, big, medium, any heachache), I take a Relpax, 1/2 Prednisone and 1 10mg/500 Lortab.  If I still have any pain at all in 2 hours, I take another Replax and then a Dilaudid.  I only take the Zofran if I am nauseous.  There have been times that I have had to continue taking either the Dilaudid or the Lortab for several more doses if the pain is still there but, every time, the pain has been tolerable but there.  I have learned, the hard way, that if I continue to have any pain at all, I have to keep treating it until it is gone completely or it will rear it's ugly head and come on so strong that my oral meds don't help.

Also, if I know the barometric pressure is changing or I have worked all night, I take the same regime of meds.  Before I started this, every single time I worked, I would wake up with a migraine and most of the time, end up in the ER. 

Hope this helps.  As I said, the Dilaudid, especially, is a very strong med and I don't know many docs that will prescribe it for migraines, but it works.  My neurologist asked me what meds worked in the ER and once I told him it was the IV Dilaudid, he wanted to try the oral version.  The most important thing about all of this is to take the meds early.  My neuro doc says hit a migraine early and hit it hard with everything you have.  Trying to treat a migraine a little at a time (starting with  the least strong med and moving up) is the mistake that most everyone makes.  His theory is to start off at the strongest med and work backwards.

Good luck and let me know if I can help answer any other questions.  I probably don't have any great answers except what works for me.  Right now, I am doing so well with my meds that I tend to want to shout it from the mountaintop!

 

Posted 8/6/2007 5:57 PM (GMT 0)
I am on Relpax too. My problem is I can't hit a migraine early because my migraine started 7 1/2 months ago. Yes, non-stop migraine. I have had bad days and not so bad days. Okay, so maybe I have had 4 headache free days since then, but pretty much that was it. I wake up with one, I got to bed with one. It is always there. If I am lucky the Relpax knocks it down a level or two. Then I take the vicaden and sometimes that helps.

I suffer from migraine, tension headache, occipital nerve pain, neck pain, and shoulder pain. The shoulder pain is from muscle spasm, so it is hard to find medication that can help all the above. It is always hit or miss.

I may mention the other stuff to my doctor today. It is so hard to say how the appointment will go. because I am dealing with whiplash and I have a hunch I have a bulging disc, I am thinking of asking for a neck brace to see if it gives me some relief. if it does, then there is my answer.

I also want to see a neurosurgeon who is also a spine specialist, and perhaps have another MRI done. If surgery is the outcome, I am all for  it.

Thank you for the suggestions. I hope something helps soon!

Posted 8/29/2007 10:00 PM (GMT 0)
holmelsa:  I was just re-reading some of our older posts and came across this one - how did your appointment go?  Any change in your meds?

Posted 8/31/2007 5:51 PM (GMT 0)
Holmesla, I have similar headaches to you, chronic daily headache/transformed migraine. I have had it now for almost 2 years. I have ended up on methadone all the time for a long acting med and dilaudid 4mg for breakthrough pain, I also use toradol and some of the triptans like Maxalt for breakthrough pain when it is less severe. This has improved my life tremendously, my life had been completely destroyed and I spent all day everyday just laying around in agony, now I am at least functional and going to college, though my social life i quite limited. So if you are unable to find a solution anytime soon and it seems that the end is not anywhere in the near future you may want to talk to your doc about trying something for pain daily if your life has been disrupted enough to warrant it (for docs to prescribe for headaches it will have to have been very very severely disrupted). Nayway good luck finding something that works for you, hopefully they can fix the cause of these headaches since it was caused by that whiplash maybe they will be able to fix it with some sart of surgery or something (just some sort of wild guess and my imagination, I am thinking that it was CAUSED by the whiplash, rather than jsut manifesting itself on its own for no reason as a lot of migraines do, like mine did). I wish you luck.

Baseballmomof3 I was wondering, you have that you use lidocaine nasal spray PRN, recently a headache specialist i spoke with on the phone suggested that to me as something to try, what is your experience with it. I am planning on asking my nuero about it at the next appointment, and I have read about it some, but I would like to get someones personal experience with it. Thanks for anything anyone can tell me.

Wishing everybody a good day,
Circa
Posted 9/6/2007 11:38 AM (GMT 0)

I have since went to see my Primary Care Doctor. She basically said the same thing the neuro surgeon did, but in a much nicer way. Since they cannot pinpoint what the cause of my pain is, there is not much they can do. Basically I need to try and move on. She said to lower my expectations about finding the answer and getting better fast. She says I won't be in pain forever, I just need to rewire my pain receptors since they are exaggerated (not me, but the pain receptors) and I shouldn't be in as much pain as I am based on what happened. She put me on tramadol. She also asked me if there is anything I feel wasn't done that should have been done and I mentioned wearing a neck brace. She wrote me a script for it and I have to say that it has worked! I had 4 days without a headache, which has not happened in over 8 months. I took the brace off for a couple hours last night and now my head is hurting, so I have it on and won't take it off for another week or two.

It is sort of sad that there is no answer or solution to my chronic pain, but what can you do when all doctors say the same thing? I have exhausted myself financially and emotionally trying this doctor or this procedure to no avail. So maybe what the doctor said was right, get on with my life and accept the pain as it won't be there forever. Maybe with the Tramadol and neck brace is all I need anyway.

Posted 9/6/2007 2:25 PM (GMT 0)
Hi Holmsla,

I am so glad that your Doctor has taken the time to explain things to you, and has obviously taken on board what you are saying because they have given you the neck brace - I really hope that this continues to work!!!

Hopefully this will now give you a pain break and your body will adjust itself accordingly, so when you take the brace off next time hopefully your head will have forgotten you were meant to be in pain and breaks the habit it has got itself into!!! It is good to hear that your Doc is positive about this reassuring you that this is not forever.

Hang in there, I am really hoping this is the start of the break you so badly need!

take care

Ann
Posted 9/6/2007 6:14 PM (GMT 0)
Glad to hear the tramadol is working for you. That is what you have to do sometimes, accept that you will hurt and just try to continue with your life. Hopefully you will do well with this new treatment and can continue with your life and be fully or just about fully functional.

Good luck and I hope you have a pain free day,
Circa
Posted 9/6/2007 11:00 PM (GMT 0)

Circa:  Hope that you are having a good day today.  In some ways, I feel like you do.  My life had come to a complete standstill until my doctor started me on pre-treating my migraines.  So far, it has worked beautifully.  I still don't take more of the Relpax than is recommended - I actually never take a second dose in the 24 hour period (that the manufacturer says you can) because I have found that if the first dose doesn't work, the second dose never helps at all.  My neurologist says that you can take up to 14 Relpax per month and I am still under that 14.  I do take either the Lortab or the Dilaudid with it and also a steroid but still am only taking what was agreed upon as a proper dose.  Now, whether this is the best way to handle my migraines, I don't know.  All I know is that I haven't been to the ER in 4 weeks and am still going strong.  Had what I thought was a sinus headache today and it started getting pretty bad.  I started not to take the migraine meds but decided to try it and within an hour, no headache.  I truly believe that had I not taken then, I would now be in the ER.  So......it is working so for now, I hope no one changes a thing.

As far as the Lidocaine NS, it did nothing for me.  My pain is always in the very center of my head.  I believe that if my pain was in the front part of my head, it would work great.  I was excited to try it and still try if my head gets bad, but so far, no luck.  If I were you, I would at least give it a shot.

If you ever need to chat, please type away.  I never had much sympathy for people with migraines (including my brother) until I had my first last summer.  I regret all the times I turned up my nose and told my brother to take some Motrin and get on with his life.  Migraines are a beast all to themselves and unless you have suffered with them, you cannot understand how life-changing they can be.

Good luck and please let me know how you are doing.

Posted 9/7/2007 12:03 AM (GMT 0)
My pain is located right behind my eyes and then goes around behind my head so maybe, according to your theors, the lidocaine will work. I hope so. I hear it only works for a short period of time, like enough for your other meds to kick in or something, but Im not sure about that. Ya I know that my treatment doesnt really help 'get rid' of my migraine but it does control my pain and I can get on with my life and that is what is important to me. I am glad to hear you are doing better with the pre-loading idea. I am trying maxalt now for my less severe breakthrough headaches so that I dont have to use so much dilaudid. It works pretty well for about 6-8 hours ussually. It is interesting the how you talk about not being very compassionate to migraine sufferers, I notice that my friends who watched me deteriorate from normal happy fun loving, high school kid, to bed-ridden, practically crying, always in the dark chronic migraine sufferer all have a lot of compassion (these ones saw me in my darkest hour, when I was admitted to hospital, hadn't slept in 3 weeks casue of pain, nothing working for my pain still, dying for them,the docs, to give me a shot of dilaudid just so I could be out of the pain for a couple hours). Whereas the ones who just know that I have the headaches are far less compassionate and dont really care.

Hope everybody is doing well.
Circa

Post Edited (Circa1988) : 9/6/2007 7:58:26 PM (GMT-6)

Posted 9/7/2007 7:19 AM (GMT 0)
If you have luck with the lidocaine nasal spray (which didn't help with my frontal headaches personally), you can try it orally (Mexiletine) or even through IV.
Posted 9/7/2007 5:08 PM (GMT 0)
Well the only reason I even have asked about it is because a headache specialist I talked to on the phone suggested it for me and told me to ask my nuero about it. He is related to my moms friend and so I thought I would ask on here. Ya it would be nice to have a non narcotic answer to my pain to use when I wanted to to.
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