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A Visit to My Headache Specialist: Migranal, Seroquel, Biofeedback & Headache Management

Another visit to my headache specialist, another round of medications and therapies. This is the first time I don’t have any anticipatory excitement that one (or some) will help. It’s not that I don’t think there’s a chance, I’m just too tired to get caught up in what ifs.

The prescriptions I left with are for Migranal, an abortive, and Seroquel, a preventive. I’ve never tried Migranal as on-the-spot abortive. I did use it when a three-week intensive treatment of injectable DHE caused muscle pain. (DHE and Migranal are essentially the same drug, just in different delivery forms.) That three-week treatment was cut short after I failed to respond even the tiniest bit.

Seroquel has been on my mind since reading this success story. I know what works for one person doesn’t always work for another, but I needed to ask. Since I’ve tried multiple meds in all the classes of drugs used for headache with no success, my doctor and I decided it was worth a shot. It can be sedating, but I have to wonder if being sedated with less headache would be better than the exhaustion that accompanies a migraine. (I need to read the full side effect profile before I fill the prescription.)

Biofeedback and headache management therapy are the other two treatments I’m going to try. That’s right, I have never tried biofeedback. I feel like an impostor writing a headache blog without trying it. I’ll be able to shed my shame soon.

Even though I don’t really know what it is, headache management is what I’m most excited about. Apparently I will learn tricks to help when I have a bad headache, like massage and neck exercises.

As I write this, my head is bad so my outlook is bleak. Whenever I have a low migraine, low pain, high energy stretch, like I did last week, I return to “normal” with a thud. Having had a total of three good weeks in the last two months, I now believe I’ll have more migraine-light days in the future. But I quickly grow impatient for the next time to arrive.

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Expert Answers to Questions About Migraine & Headaches

Teri Robert and John Claude Krusz, a neurologist and headache expert, have been hard at work on answering patients’ questions about migraine and other headache disorders. You can learn a lot by poking around in the previous answers or ask your own questions.

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Ask the Expert About Headaches & Migraines: National Headache Awareness Week

A daily Q&A with headache experts is being posted each day of National Headache Awareness Week. Submitted by patients, questions cover the gamut of headache topics. Some so far: sinus headaches, sudden onset headaches, new daily persistent headache, headaches triggered by sun or sex, and burning and tingling in the back of the head.

Q&As from Monday, Tuesday and Wednesday are available as Word (doc) files. Many more questions are covered in past issues of NHF Head Lines, the organization’s newsletter. Read archives of readers’ mail and Ask the Pharmacist.

I’m often asked for recommendations of headache clinics or specialists, but only have experience with a few. The experts participating in this week’s Q&A are listed below with links to their clinics.

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Don’t Give Up on Finding a Treatment

In the last week, four people have told me that while they are comforted to know that other people have similar experiences with headaches and migraines, they are saddened to learn that their headaches may never go away. This is distressing as one goal for this blog is to encourage people to keep seeking relief.

It’s not as impossible as it seems. While I haven’t found a magic bullet for myself, the vast majority do find a successful treatment. Even after you feel like you’ve tried every possible treatment, you have probably only scratched the surface. There are so many drugs and drug combinations that no one has tried them all (including Paula Kamen and me).

Most folks with headache define success as having their headaches disappear. Doctors have a different understanding. A treatment is successful if a person’s headaches are reduced in frequency and intensity by 50%.

Don’t get angry yet. Many people become headache-free, some don’t. No matter how much education and knowledge a health care provider has, they aren’t mechanics. Unlike a car, uniform results aren’t possible. The human brain and body are too complex to expect that.

But you can get relief. Be aggressive, but give new meds time to work — which may be as long as three months. See a headache specialist, not just a neurologist. If he or she is dismissive, tells you your headaches are all your fault, or that there’s nothing left to try, see a new headache specialist. Take supplements that have shown some success for headaches (under the supervision of a doctor).

Visit a sleep specialist, even if you feel like your sleep is fine (advice that I need to follow myself). Getting good sleep can go a long way toward easing headaches. Talk to a nutritionist. Not necessarily about an elimination diet, but about giving your body the fuel it needs. Try massage and essential
oils. Take yoga classes that don’t focus on sweating and breathing hard, but on taking care of your body and nurturing yourself.

You will get discouraged. You will be exhausted. You will be frustrated. Keep trying; wherever “there” is for you, you’ll make it.