Headaches & Migraines

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July 1, 2003:


Dr. Krusz is a recognized expert in the fields of
headache and Migraine treatment and pain treatment
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Please Note: We receive far more questions than can be answered in this format. In many cases, our Guide, Teri Robert, has already researched the topic of the question and may have information already published on this site. Some questions answered here will be answered by Teri. Dr. Krusz will be reviewing her answers before they're posted to offer additional input.
This Week's Questions:

Hello Dr. Krusz,
     I am a 39 year old woman with a 33 year history of complicated migraines and chronic daily headaches.
     Until recently, I had little success finding relief after dozens of different doctors and hundreds of medications. My doctor has had me on Maxalt, Tegretol and OxyContin 40mg twice a day and although I still get the severe migraine twice a month or so, the daily headaches have all but gone. My question is, my doctor insists that if I would quit smoking, my headaches would disappear entirely - I asked him why I started having headaches at 6 years of age if I started smoking when I was 19 years old? He beat around the bush and couldn't answer my question.
     I know as many non smokers who have migraines as smokers! I know it's a horrible habit and I should quit for many reasons but I just don't believe smoking is the only cause for the chronic daily headaches and the migraines!
     BTW, my mother and grandmother both have migraines too.
Thank you for your time,
Susan

 

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I have had a problem for the last few years. We think its related to Barometric Pressure. I live in Florida and we just started rainy season. Every year around this time I get neck pain, pressure in my ears, headache, sinus pressure and my equilibrium is off. I feel like a wibble. If I close my eyes I lose my balance immediately. To much stimulation makes it worse. Also loud sounds. It takes me a lot longer to do anything during these times. I just want to fall down. I want to know if this might be considered a migraine or something else. My husband nor I ever thought about it being a migraine until we did some research on the internet recently that correlated low barometric pressure and migraines. I must have not found the right doctor because every test I have been through says they can not find anything. I am open to suggestions and alternatives.
Thank you,
Stephanie

 

Click HERE for our reply.

Hi! My name is Donna. In March 2001, a steel cellar door slammed down on my head (resulting from a hinge giving way). I suffered neck injury and laceration to the middle of my scalp. I have had severe headaches 80% of the time since this. I have been on Fioricet, Elavil, and other medicines I can't even recall. My doctor always wanted to give me anti-depressants. I take Ativan, or Xanax at night to help me sleep. A lot of times I go to bed with headache and wake up with one. My doctor has been giving me Ultracet since October 2002. This has seemed to help me more than other meds, but I have to go off them every now and then because my body gets used to them. However, I have been going to traction and therapy sessions since January. They don't seem to help much. I see a pain management specialist once a month. She has given me 4 steroid injections since March. The first injection helped, which was given in the location of C4-5 (I have bulging discs in neck from accident). This did help, but only for about 10 days. It was a short relief. In April, she gave me 3 injections, which did not help at all...unless, of course, my headaches would actually been more excruciating then they already were. Now, May, I am taking Demerol 100mg 2 times daily. I have done this 2 weeks. I haven't had any pain meds for 4 days now. Demerol doesn't help much at all. She told me to lay of Ultracet, but I find this better for me out of all without being doped up. Is it possible that my bulging discs are getting worse? I have not had an MRI since January 2002. Should I get another? She had prescribed Axert, which I did not get filled. I have slightly high BP (on Atenolol) and was worried about the warnings of this drug. Do I actually have a migraine from this accident? What other options do I have to control this headache? Is there a stronger med that would work for horrible headaches? A lot of times I must lay down all day, as it gets go unbearable. I don't think my doc's know what to do about me! I need help! Thank you for your time.
 

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Doctor: My headache began a week ago today. At first I thought I had a mild hang-over having gone to a party the night before. But the headache that began last Saturday is still going strong. It is very strong and I can hardly move. I find myself taking pain killers every couple of hours. The pain is all over but mostly on the right side of my head. Please give some pointers. I have called the doctor today but as always they can not give me an appointment until Monday. I am tempted to go to emergency. Thank you. GDLL

 

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I have a sharp pain behind my ear which occurs about every 30 seconds or so. It lasts for only a second, if that. Sometimes the pain is so bad that my body tenses up (kind of like a jolt of electricity). It started about 2 days ago. Can you tell me if this is common? Should I see a doctor about this?

 

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About 18 months ago, I was first treated by a neurologist. I tried several medications for migraines and began to use Maxalt 10 mg. and also Topamax. I had a lot of problems with headaches waking me up from sleep. My doctor gave me Topamax and the headaches at nighttime completely went away. Unfortunate, I began to have pain behind my eyes and was advised to immediately quit the medication. It has now been 6 months since I stopped the Topamax and the night headaches have come back with a vengeance. Also, after almost pain-free days I am again experiencing more headaches. I hesitate to take the Maxalt because I also take Zoloft and my ob doctor has a certain concern about taking both of these medications. Do you see a problem with taking both? Also, have other new preventive medications come out in the last 6 months since I have seen my doctor? Any advice that I could pass on to my neurologist would be appreciated. I have an appointment next month. I need help now but am having to wait on an opening. Thank you very much.

 

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Dear Dr.:
     I have had migraines 31 years the first occurring while I was on a sugar-restricted diet. Later on I began experiencing hemiplegia affecting my right side, my speech and my ability to think clearly. After a particularly bad period I was left with partial loss of feeling in my leg and my arm and was sent to a neurologist who found irregular seizure (left frontal lobe) activity during a four EEG's. He has also told me that there may be some slight brain damage causing the loss of feeling.
     I am a 42 year old woman. My question is about medication. I was on Topamax for 2 years and experienced rapid weight loss, fatigue, end of menses and a gradual return of symptoms. The dose started at 150mg twice a day and was raised progressively to 425mg daily. The neurologist now wants to try Depakote which I will not take.
     Are there any medications that can successfully treat someone like me without causing fatigue and weight gain? I am now not taking anything, but I am concerned that my risk of stroke or brain damage may be significantly increased.

Thank you in advance for your advice.
Sincerely,
Ann Marie

 

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For the past 12 years I have been getting migraines, but over the past 10 months my headaches have been daily. I live in Wisconsin and have been seeing a wonderful neurologist 1 1/2 hours away for about 3 years, in December he sent me to the Diamond Headache Clinic with no relief as of yet. As far as the pain goes Diamond only prescribes beta blockers, my neurologist prescribes me Esgic plus. I have had very good results from Esgic plus (Fioricet has also worked well). My question is on some days the Esgic plus just does not do it (I also have Migranal with no relief) for the pain, is there something close to that I could ask him for that is stronger that I could use when the Esgic just does not do the trick? I have been off work since December and my headaches are debilitating. Thank you, Candi

 

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