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Ask the Clinician: Answers to Readers' Questions

May 10, 2004

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Updated: May 11, 2004

Ask the Clinician

Dr. Krusz is a recognized expert in the fields of headache and Migraine treatment and pain treatment. To read more about Dr. Krusz, click HERE.

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  • 1)  I am a 34 year old male just diagnosed with migraines. My question: Can you have migraines without the headache? About a year ago I first experienced the "Aura" stage of a migraine....loss of vision in the lower left quadrant of my eyesight, zig-zagging beams of light around this blind spot, occasionally things looked like an abstract or VanGough painting, dizziness, nausea, a general "weird" feeling. This lasted for about 15 or 20 minutes then gradually disappeared....but no headache occurred with it. This happened a few more times over the last year. Three nights ago the "Aura" stage appeared again but lasted for more than an hour. This time though I did develop a headache on the left side of my head as the aura was clearing up. It was a dull ache that turned to a sharper pain whenever I coughed. The next morning I was still experiencing a lightheaded feeling with little headache. I went to the doctor that morning, he asked a few questions and then gave me a prescription for Imitrex. He told me to take one the next time this happens. I rarely have headaches, maybe one, at the most two very minor short lived headaches in any given year. Does this fit the description of a migraine? If so, will thw frequency as well as the associated pain of a migraine intensify over time? I am frequently dizzy and lightheaded, I have high blood pressure and am experiencing my fair share of stress right now. I did experience temporary paralysis on the left side of my face and head as a 12 year old kid. Are all of these signs leading up to prolonged migraines or is there any merit to seeking a second opinion?
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  • 2) For the last several months I have been having severe headaches. At first I thought that my headache was caused by taking chewable Singulair because it has NutraSweet in it and I am sensitive to that ingredient. However, I have not taken Singulair in 3 weeks and still have headaches. Sometimes I have visual disturbances before my headache. Sometimes I have visual disturbances, numbness in my face and problems keeping my right eye open that last for an hour or so and no headache develops. Other times if I cough I get a severe stabbing pain in the left side of my forehead above my temple that may last for a few seconds to a few minutes. I also just get severe headaches in the left side of my forehead above my temple that wake me up in the morning and may last all day. I have tried taking Tylenol Sinus, Advil, Afrin nasal spray, Flonase nasal spray, Zomig nasal spray, Zomig tablets, and Relpax. Sometimes these work but most times they do not. I currently do not have insurance so an x-ray, CT, or MRI is out of the question. Is there anything more I can do or try to rid myself of these headaches? Are they migraines, cluster headaches, sinus headaches or a combination of all three?Beth.
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  • 3) Many avenues of intervention including utilizing a variety of drugs (both pharmacology and psychopharmacology), several physician changes, reduction of stress to the point of work stoppage and total disability insurance, dietary changes and curtailment of most social and outdoor activities have only produced minimal improvement over a period of 3 years in the frequency and duration of migraine headaches in a now 31 year old male. Is there any advantage to a significant period of hospitalization to afford control of the environment and medication in such a manner to determine what if anything can really be effective? Or is it a waiting game to see if after a 5-year period, the problem will abate as some have suggested? Thank you!
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  • 4) I am currently trying an elimination diet to see if there are any food triggers for my migraines. How long after eating something could it possibly trigger a headache? Two hours? 24? With other triggers (flashing lights, insect sprays) my pain comes on within minutes. Secondly, since I have as many as 12 migraines a month, and can only get 9 Imitrex, I thought about trying to treat milder head pain with Midrin so I could save the Imitrex for the worst ones. I know I can't take the Imitrex within 24 hours of another triptan or ergo med, but the labels say nothing about Midrin. If I take Midrin and the pain continues to get worse, is it considered safe to go ahead and take the Imitrex? Thanks for your insight on these issues. Ann.
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>>Please click on the link below to go to the next page.<<

  1. About.com
  2. Health
  3. Headaches & Migraines
  4. Ask the Clinician
  5. Ask the Clinician, 2004
  6. Ask the Clinician with Dr. John Claude Krusz and Teri Robert for About Headaches and Migraine: Questions for 05/10/04.

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