Hi mytrx450r. Your story seems very similar to mine. I never had a migraine until this summer and since then, they have been fierce. I actually had a hysterectomy in January because my neurologist told me there was a 50/50 chance it would help the migraines (some would say having a hysterectomy to get rid of a "headache" is pretty desperate - I was). Well, it didn't - actually, they seem to have gotten worse. The doctor truly believes now that they are related to the barometric pressure. You can read my other posts about barometric pressure migraines but basically, he has me on a regimen of meds to help. I take Verapamil and Trileptal daily as preventitives (I cannot take Topomax because I have kidney stones) and then if I feel a headache coming on, I take 1/2 Prednisone(4mg), 1 8mg Zofran, 1 Relpax, Lidocaine Nasal Spray and a 2mg Dilaudid. If I still have headache, then I repeat the Relpax in 2 hours and the others (except for the Prednisone) as prescribed (every 4-6 hours). However, the problem was that I would go to bed fine (no headache at all) and wake up from a dead sleep in the middle of the night with my headache already out of control. Then, I couldn't stop vomiting long enough to take the meds. Now, he has me watch the weather and if severe weather is predicted or we are predicted to have a big change in pressure (a high pressure or low pressure system coming), I start the meds that night whether I have pain or not. He says that the worse thing you can do is wait, thinking your headache won't be bad and then start off already behind.
I know this sounds like a lot of medicine - in all honestly, I guess it is; however, it has now kept me out of the ED for going on 8 weeks - that is a record since my migraines started last summer. I justify taking these meds by saying it is better to have those meds by mouth than to have to have higher dosages IV in the ED. Some might disagree but all I know is that I feel like I have my life back. Someone could say that taking that Dilaudid is inappropriate but that person hasn't had to live my life. I have 3 kids that need me to be able to function and until I started this regime, I couldn't function 3-4 days a week - I would be curled up in the fetal position, in the dark, with a bucket. So, I have chosen this. Now, usually, I don't even have to lie down. For the most part, if I start this when the headache is small or not there at all but I know it will be, then I never even get it and never miss a beat. Usually, my family doesn't even realize that I have had a headache - that is such a nice change for them - they were used to me forever saying that "I have a headache".
Hope this helps. Sorry that my posts always seem to be so stinkin' long.
DX: Migraines since June, 2006, kidney stones
RX: Daily - Verapamil, Trileptal
PRN: Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray