It has been 3 months since the onset of my headache. When it first happend I visited my primary care doctor and she gave me an imitrex shot(this was the last week of feb), and told me to call at the end of the week if the pain is not gone. I did call her back and she sent me to the ER for a ctscan and they prescibed imitrex pills, and I went back to my primary a couple of days later. She prescibed percocet for when it got really bad and I could not stand the pain, drew blood, and sent me to an ENT. The ENT did a CT of my sinuses and sent me to a neurologist. It took a month for me to get into the neurologist and in the mean time. I started to get really dizzy and ended up back in the ER where they put me on Antivert. I got so frustrated with all the pain and dizzyness and went back to my primary care doctor and she took me off Birth control pills, and told me she does not believe they are migraines and to call back in a week if it is not better and we will do a spinal tap. I did call her but she had decided that she wanted me to see the neurologist before doing this and she got me into the neurologist the next day. Then within a two week span they did the MRI, MRA, MRV, and more blood work. The neurologsit did start me on topamax which I stopped taking and that is when he put me on the Corgard (blood presure medication), magnesium, and riboflavin..
A couple of the things that you've written about
cause me to be concerned for you. I too developed migraines when I was young and was given a very thorough workup very quickly as well. While I've tried every medication that most headache clinics ever
prescribe, it worries me that it has only been three months since the onset of head pain and you've already been through so many different medications. Aggressive treatment is always desired and I consistently demanded it from my neurologists. However, one unfortunate thing that every one of us migraine sufferers must deal with is the waiting time when trying a new prescript
ion. Frequently daily medications can take over a month to achieve desired results. And very commonly the dose ends up having to be modulated (usually upward). This tacks on another few months to the process. So, the fact that you have already tried and abandoned Topamax and are trying another (much less potent) cocktail is worrisome. Naturally we all want to find the drug that will successfully treat our migraines as quickly as possible, but it requires a significant amount of patience--oftentimes trying one medication for several months or longer. Even if you stopped taking Topamax because of the side effects, it is documented that they typically become significantly more bearable over time. In my own case, Topamax never helped me a single bit, but that didn't stop me from taking it for more than about
3 months to be sure that it could not help (especially given the general efficacy of the drug).
Another thing that actually concerns me significantly more is the appearance that most of your migraine/headache treatment is being performed by your primary doctor or ER doctors. The simple fact is that these doctiors are not at all
qualified to make responsible decisions when a trained neurologist is available. Although I noticed that you said that your primary decided to hold off on the spinal tap until you saw the neurologist, the simple fact is that a general practitioner should NOT be ordering an uncommon, invasive test that is not recommended by a neurologist. Sometimes primary care physicians, as a result of their lack of prolonged study or experience with headache treatment, often go "overboard" when exposed to more severe cases. Because they see so few, they may decide that they want to order nearly every test available for fear of overlooking something due to inexperience. A neurologist, in that position, treating a three month old migraine disorder with no particularly worrisome symptoms (at least, as far as you have shared with us) would know that a spinal tap is unecessary and most likely would not go beyond ordering MRI, CT scans, and bloodwork. Regarding the medication (Antivert) that your ER doc prescribed, it's generally an anti-nausea drug that is unlikely to do much to help your head (this nicely illustrates the problem with seeing ER doctors for severe headaches--you either get prescribed medications like antiemetics that are simply too weak to help or you are given opioid drugs to treat the pain, a solution that in many cases can cause more harm than good--at the very least the most you can hope to gain from that is a few hours of relief). Similarly, I am very surprised that you were given percocet for your head pain, especially in the first month or so that you were experiencing your headaches. In my opinion (and I'm fairly certain that most headache specialists would agree with me), this is just plain irresponsibility on the part of the primary doctor. Because he or she is not trained to try to find a solution for your migraines, you get prescribed strong painkillers to temporarily deal with the symptoms as a result of the generally helpless situation the doctor is in. As I've said time and time again, I have profound respect and trust for doctors. However, having a primary treat severe headaches (even if they haven't been around for very long) is a poor, unproductive choice. Generally these doctors will attempt to treat you out of a sense of responsibility for their patient's wellbeing. But, if you do have the ability to see a headache specialist, do yourself a favor and let her or him make the decisions and, if you both decide it's worthwhile, have your primary work in an adjunct position to work toward your goals.
One more word of advice: having migraines for three months sucks--plain and simple. However, from the tone of your posts I infer that you have become rather panicked about
the situation. While many times these reactions are largely out of our control, do your best to take a step back and relax. Several months of frequent headaches can be brought on by any number of factors. At this point there is really no rational reason to be worrying about
longterm disability. Even if your headaches persist (which may or may not
happen), there are scores of unique, effective drugs available, along with a rather plentiful bundle of associated treatments. The odds are truly in your favor. There is one precautionary measure that I would strongly recommend though. If you can, start seeing a trained professional that will provide you with talk therapy (a psychologist, social worker, and, in less common cases, a psychiatrist). You already seem quite anxious and worried about
your condition and, while I do not know whether you are suffering from depression or not, you have an increasingly high risk factor. Even if this therapy just ends up helping you get through a short term period of bad pain, you'll be a lot more likely to stay mentally healthy if you start as early as possible. If things unexpectedly end up lasting for a longer period of time then you'll have gotten a head start at preventing the deterioration of your lifestyle.
I wish you well. Remember to keep calm and make good decisions and you should be feeling better in no time at all!
DX: NDPH, Recovered CRPS
RX: Lamictal, Provigil, Clonazepam, Ambien CR, Emsam, Namenda, Oxycontin, Oxycodone
PRN: Haloperidol, Zyprexa, Lodine, Zofran, Skelaxin