rla76
Member

Reged: 09/20/02
Posts: 156
Loc: San Francisco,CA
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I've been to the emergency room a few times for my severe Migraines. They usually end up giving me Ativan and Vicodin HP to relieve the pain. My PCP gives me Migrin-A and Vicoprofen for the pain. I've tried Imitex and all those kinds of meds, but they just made me sick. My PCP has reccomended me to see a neurologist, because he doesn't like giving me narcotics for the pain even though I explained to him that's the only treatment besides deep tissue massage that works. Has any one been to a neuro and what kind of treatment should I expect. Any info would be greatly appreciated.
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kittie74
Board Addict
Reged: 02/16/04
Posts: 310
Loc: Hollywood
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I also suffer from terrible migraines. I had disk replacement surgery 2 months ago and it's helped a lot. I saw a Neurosurgeon for this, not a Neurologist. But you should definitely see one. Not to scare you, but I've heard that migraines, over a long period of time, can cause lesions on your brain. Each time you get one, it causes a small amount of damage. And over time, it adds up. It's also very important to treat the pain, if you don't, the headaches can come back WORSE than before. I switched to a new drug recently called Maxalt. See if your doctor will give you that. Vicodin ES has always helped me - maybe you could switch to that - see if the APAP works better than the Ibuprofen.
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turcica
seeker
Reged: 12/21/03
Posts: 312
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The neurologist will take your history, ask you to describe your Migraines and do a neuro assessment. This consists of some very simple uninvasive checks, pupils, EOM ( extra occular movements)and some other checks. He will probably want to do am MRI of your brain to rule out other problems. He might want to also do an EEG ( electro encephalogram) they put wires on your head and connect them to a machine which checks your brain waves. He may do some of this, all of this or even more depending on the information you give him. Might want to do some bloodwork as well. Depending on the particular Neuro guy you see he may do some of the above or he may not. Let us know how it goes. turcica 
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turcica
The only failure is not knowing how to be happy
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yawkaw3
Pooh-Bah

Reged: 03/22/03
Posts: 1193
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Hi rla,
Imitrex and other triptan meds make you sick? Have you tried a bunch of them, in tablet and other forms? Neuros and other docs love to push that stuff. Other non-narcotic options would be ergotamine products, but they can cause an uncomfortable nausea, triptans have really replaced them.
A neuro will tell you that the opiates are a rescue med. By all means take them if whatever he gave you to take first didn't work.
The fact the triptans don't work for you *may* be a red flag in the neuros eyes, I would make it clear you are willing to try other non-narcotic meds...don't just try to get as many narcotics as possible from the guy upfront. Neuros see a lot of migraine sufferers- and this is not meant as an attack on anyone on this board, in fact I am a legitimate migraine sufferer- some of the people with migraines are faking it. You can not prove a person really does or doesn't have a migraine, the diagnosis of migraine is based on what the patient tells you, their medical history, family history, and ruling out other conditions. It is a very easy and fakeable (is that a word?) condition- unfortunately if you really do have migraines, it is extremely painful and it can be hard to be taken seriously. Just make it clear you are willing to try non-narcotic options and don't call the guy's emergency line late at nite to try to refill your narcotic rx's- that will help you avoid getting red-flagged. Neuros get scammed all the time, some of them are more compassionate than others after that happens early in their career. I'd recommend and older neurologist who has seen it all. You don't want a young doctor, eager to prove himself worthy of the other doctors' respect, who is still upset over the number of people trying to scam him.
So just make it very clear you are willing to try other options besides narcotics, you can avoid that red-flag. Some neuros are simply not compassionate, others are very compassionate. You'll have to play it by ear and possibly try a few others if the first one doesn't work out. Tell the guy a family member who also doesn't respond to triptans suggested DHE-45.
Depending on how often you get the migraines, he may went you to try a preventive med.
Also- we're not sure what causes migraines, they used to think it was related to blood vessel sizes in the brain, then fluctuations in serotonin, now they're still not sure. Just as we're not sure why people get migraines (there are just theories), we're still not sure about the lesions in the brain. So don't worry, let the neuro take care of you.
Anyway- good luck, just make it clear what has worked in the past, but also make it clear you are willing to try non-narcotic options, also mention how deep tissue massage has worked. If your neuro has an ounce of humanity, this will work.
-yawkaw
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D2003
Member

Reged: 12/12/03
Posts: 193
Loc: Texas
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One of the positive indicators I've found for migraines is an increase in blood pressure at the time I actually have the migraine. Up to 30 points or more. Mine is usually about 110/70. (Give or take 10 points.) When I have a migraine, it jumps to 170/100. The ER where I go know this about me, and knows if I present with blood pressure that high, I am definitely suffering with a migraine. They very quickly get me out of all those bright lights (I'm photo-sensitive) and into a darkened room. Monitors for BP and pulse are attached, and within 15 minutes or so, they are absolutely certain, with the continuing increase in my BP that I am not faking the pain. Usually takes the doc less than 5 minutes to read back over the BP results and then prescribe a Nubain/Phenergran shot. (Hurts like h*ll!!) I find the Nubain easier to deal with rather than Demerol. That stuff knocks me for a six every time. Nubain is much gentler on my system, and I can usually get up and walk out (without staggering) within 25-30 mins.
Just some info to have up your sleeve if you ever present to an ER with a migraine. Increased, or increasing pain of any kind will shoot up your BP (and pulse, usually) and one indicator that many ER docs look for when you present with pain of some description.
D2003
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rla76
Member

Reged: 09/20/02
Posts: 156
Loc: San Francisco,CA
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I have a family history of Migraines. My dad gets them really bad. I willing to try any non-opiate med. I tried maxalt and it made me sick like Imitrex did. I'm going to take some of your suggestions to the Nerologist when I make an appointment. I really appreciate everyone's help and advice. Take Care... I'll let everyone know how it goes... 
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cat322
Stranger
Reged: 08/11/02
Posts: 7
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My neurologist is cool. I told him I was on soma from an online pharmacy and that maxalt and the "triptan" drugs made me feel like I was having chest pains. He gave me some blood pressure medication along with the soma that I told him made me feel too weak to run (I am a runner). Plus I told him I would rather take as little medication as possible and that the soma was working. #90/month is what I get.
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