Students that have fixed their chronic migraines/medication overuse headaches?

[scguy16]

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So I have migraine/tension type headaches almost every day, all day. Needless to say, this sucks as a medical school student.

I have had to take Ibuprofen and/or Tylenol almost every day for the past 2 years, which I'm sure isn't helping the problem, but when does a med student ever have time to withdraw from analgesics long enough to reverse this??? There has to be some other way to stop this vicious cycle!

Been to PCP about it, saw neurologist for a year with no relief, now trying OMT, but with little luck so far. Botox didn't even touch the headaches. Imitrex aborts the headaches but side effects take away study time, plus I only get 9 pills per month. Exercising 4-5x per week.

Has anybody else had this problem and figured out how to stop it? Med school is hard enough without dealing with this 😕

 

[NeuroLAX]

Have you tried altering your diet? My old boss (a neurologist) got migraines, which were provoked by things like sharp cheeses. Just a thought.

 

[DestinedDoctor]

Red wine and anything with sulfites gives my mom killer migraines (including eggs). I get them from those little green dried pumpkin seeds. Dietary is totally a possibility. Good luck trouble shooting your triggers!

 

[sylvanthus]

If it is really migraines, you could try getting on a beta blocker such as propranolol. That cut my migraines down big time.

 

[facetguy]

Either start a detailed diet diary and try to ID triggers, or start an elimination diet. Otherwise you may well be overlooking the root problem here. Neither is as easy as popping a pill but may prove very helpful.

 

[cabinbuilder]

So I have migraine/tension type headaches almost every day, all day. Needless to say, this sucks as a medical school student.

I have had to take Ibuprofen and/or Tylenol almost every day for the past 2 years, which I'm sure isn't helping the problem, but when does a med student ever have time to withdraw from analgesics long enough to reverse this??? There has to be some other way to stop this vicious cycle!

Been to PCP about it, saw neurologist for a year with no relief, now trying OMT, but with little luck so far. Botox didn't even touch the headaches. Imitrex aborts the headaches but side effects take away study time, plus I only get 9 pills per month. Exercising 4-5x per week.

Has anybody else had this problem and figured out how to stop it? Med school is hard enough without dealing with this 😕

Go to the OMT guru at your school. Probably have OA dysfunction. Try accupuncture.

 

[Blondiechick919]

I had been struggling with this for years. I had my first migraine at 13 and had no idea what it was. In high school I started getting them about once or twice a semester (4-5 times a year) but I would just stay home from school, take some painkillers and attempt to sleep it off. In college, they REALLY amped up. By the time I was a senior, they were getting to be 2-3 times a week to the point where I would get over one, have the next day "hangover" and get a new one on day 3. I was missing classes left and right and was eating pain pills almost like candy.

My doctor and I realized something was wrong obviously. I'm a yoga instructor so I exercise very often, and I'm not any more stressed than the average student. I went through all the nuances of trying to "find my triggers" with no success. I cut out caffeine, red wine, cheese, MSG, basically everything on a laundry list of food triggers. They still kept coming. She finally suggested I try topamax. I was hesitant at first since I didn't want to be depending on daily meds but I was desperate, but it has CHANGED MY LIFE.

I take 75 mg of topamax a day, 50 mg in the morning and 25 at night. You have to titrate up to the dosage your doc wants you on slowly. I have been on this for 6 months and have had 2 (yes 2) migraines since. When I did have them, they were about a 4 on the severity level rather than a 9. Topamax does have some pluses and minuses though. It is a significant appetite suppressant, so it will make you lose weight whether you try or not. I was 130 and now I am in the 112 range and I am a 5'2" female. I lost 10 lbs in the first month. This was welcome for me as it is for most. What usually isn't is the fact that it can sometimes make things taste a little different (like soda) and there can be a mild cognitive impairment. The best way to explain it is "when a word is on the tip of your tongue" but you can't seem to get it out. This was something I experienced slightly when I was on 100 mg. I dialed back to 75 and I can't be happier. No word loss and still no headaches. Some girls who read up on this may see on birth control packets that there is a possible interaction between topiramate and hormonal birth control. I was advised by multiple doctors not to worry as long I was under 200 mg and I didn't spot.

I know that this was a long post but for the OP, make sure you get a doc to diagnose your headaches first. There is a big difference between tension headaches and migraines. But if you are experiencing migraines and don't know where to turn, this is an option. It is not the solution for everyone. But it has worked beautifully for me.

 

[cabinbuilder]

May take a while. It took 4 years for my OMM person to fully stretch my surgical adhesions to the point I could raise my arms above my head, very painful and slow process. Be patient, it may take some time.

 

[ChaiMeow]

Amen to the person who mentioned food sensitivities and allergies. I suffered for years with headaches and sinus infections, and a visit to the allergist gave me a long list of things to avoid. If I accidentally eat some of the offending foods, I get migraine headaches. Definitely check it out. this may change your life for the better.

 

[JaBoomDay]

I was a life long migraine sufferer too since I was a child. I would get like 3 or 4 of them a month, some of them lasting up to 3 days. Last year they got so severe they would cripple me to where I couldn't even see or walk. I got into the hands of the most amazing neurologist I have ever met. I had an abnormal brain MRI with multiple white matter lesions. He ruled out everything from MS to lupus. In one last ditch attempt he ran a celiac disease blood panel and found that I was positive for anti-gliadin antibodies which apparently can cause an autoimmune attack on your CNS. I have been on a gluten free diet for over a year now and haven't had a migraine since. I suffered for over 20 years being crippled by those migraines and it was a food sensitivity this entire time. I totally think that trying to clean up your diet is a good idea. It's definitely worth a try and there aren't any horrible side effects like you get from meds.

 

[vwgirl]

I am what is considered a "difficult case" to quote my neurologist. I've been hospitalized twice, done out patient infusions once, been on so many preventatives, including 800 mg of Topamax a day. Had nerve blocks done, trigger points, seen psychiatrists (2), am in therapy. Have DHE and Toradol as abortives, neither of which work. I go to a headache center at a major teaching hospital. (Where they don't do triptans, the use DHE). I am currently on Minocycline and Mexiletine. I tried chiropractic, acupuncture, and still live with some level of migraine every day....for the last five years. I contemplate suicide on a regular basis. I am thinking of trying another neuro, but the guy I see is one of the top ten neuros in the country (I am not exaggerating.) Anyone got any wild ideas?

 

[NewCanadian]

I am what is considered a "difficult case" ...... Anyone got any wild ideas?

This may seem wild to some:

Flickering lights and very bright sunshine are my triggers.
Ceiling flourescent lights can be a trigger, especially when overhead lights are about to go bust, they flicker - guaranteed migraine for me. Very bright sunny days, especially in the summer - guaranteed migraine for me. .

Some people snicker, but I wear sunglasses most of the year and sometimes wear a hat inside.
Hormones used to be a trigger; done with that now.

 

[kedrin]

Radio frequency ablation of the greater occipital nerves worked really well for a family member of mine. They had tried all kinds of combinations of drugs with no preventive effect. Now her migraines are much less freq and much less severe.

 

[Ebola4Breakfast]

Careful with Topamax. It definitely helped with my migraines, but at the cost of turning me into a *****. I currently use imitrex as emergency abortive and excedrine migraine as a quick fix. I've also had luck with incorporating regular exercise, a daily B12 supplement, and increasing my omega-3 intake. I can also sometimes get rid of migraines by taking a shower and alternating blasts of really hot and really cold water. Hot compresses work as well. It sounds weird, but its a nice alternative to being drugged.

 

[JediZero]

Prophylactic meds like topiramate can be very helpful. OP, I'd talk to your primary doc about getting a referral to a neurologist. It sounds like you might need some guidance in dietary therapy, and they should be able to provide that. Short version: avoid Tyramine.

On a different note from the Journal of Anecdotal Medicine: I had a classmate who got stress-induced migraines, and wound up with three-day vomiting migraines around all the anatomy exams first year. She mentioned it to an OMM prof, and he did one cranial treatment. She didn't have a migraine for the rest of the year. I know cranial gets a bad rap around here, and I doubt it's a universal solution, but if other things aren't working it's worth a shot.

 

[phoenx]

I'm another for whom diet worked. It may seem like a long shot but it got me off my 3 prescriptions needed to keep my migraines away.

 

[Textbookversion]

Your cranial bones are clearly out of alignment, seek cranial manipulation post haste.

 

[Textbookversion]

Thanks for the advice, but unfortunately I've been having cranial manipulation done for a year now, with only marginal benefits

I've struggled with med school since I started this time last year, and I can't help but think this may be part of the reason. I've always passed everything, but had several close calls... Sure would be nice to get this straightened out by the time we start board prep...

One person mentioned acupuncture earlier, can anyone else speak to this?

I was joking around, because I was under the impression that no one with a modicum of intelligence would take that seriously.

 

[JGimpel]

Had some tough ones come my way. I echo many of the methods presented above. Here's how I would approach it:

Elimination diet that starts with cutting out wheat and soda. Dairy is the next one if a month of cutting out these two doesn't work.

Drinking more water than anything else and avoiding caffeine as your stimulant of choice; it sends your body on too much of a roller coaster to be helpful to people that suffer from chronic headaches. If you look at the mechanism of how migraines are created physiologically, this part will make more sense to you. Excedrin is little more than an old NSAID and caffeine.

Eat as few processed foods and carbs as you can. I know, duh. Eat at least 4 small, healthy meals a day, if possible, to maintain your metabolism from doing a roller coaster like the caffeine suggestion above. You'll start to notice many residents walking into morning report with a yogurt or banana, then getting a more substantial breakfast/lunch after rounds, but not getting as much as others that don't do this at lunch. We have the worst schedules but don't complain about migraines very often.

This and exercise should reduce the production of cortisol that gets people into trouble. To that end, eat a small complex carb, like peanut butter, before going to bed so that your body doesn't freak out about not having enough fuel to repair itself overnight. This also may avoid a trigger for a cortisol surge that is not kind to people that are prone to chronic migraines.

As for the pharmacology of it, this advice is straight out of the neurology standard of care, so feel free to look into it further and see a professional after getting read up on it. No TOS violations here.

If elevated intercranial pressure is suspected, you may want to have a professional with a tono-pen evaluate you to start (every ED has one and the eye drops for it,) and look into a trial of Diamox to see if that helps. If you've got hypertension as well, a calcium channel blocker may be required to influence the way that your vessels are behaving as well as drop your BP to your pre-med school levels.

Imitrex and Migranal are great as abortives, but the above may be a better way to manage your condition in the long run. You'll really want a neurologist to walk you through these and the anti-epileptic drugs such as keppra and neurontin, etc. to see what's right for you. The main idea is to go see one if you have these sorts of headaches chronically.

Bottom line, try the natural stuff first, then have a neurologist help you through your options and leave the RFA and rhisotomy-esque procedures to the interventional cardiologists and surgeons, respectively.

Gimp out.

 

[daisy11]

I was getting terrible migraines my first year. They were gradually increasing in frequency and there 3 or 4 times I basically passed out. They pain would get so bad I would lie down, and then I couldn't remember what happened. I would wake up eight hours later after blacking out. The only thing that seemed to keep them from escalating for me was a combination of Sodium Naproxin and a giant, black cup of coffee for caffeine. (Not to easy on the stomach... and I feel like this might hurt more than help)For me though it turns out the culprit was hypothyroidism. It's a shot in the dark, but its really easy to chalk most of the symptoms up to stress and blame the tiredness on med school. It didn't even occur to me until my hair started coming out in handfuls. Hope something helps!

 

[BobBarker]

Mri?

 

[kler]

I went into the hand of the most amazing I've ever seen a neurologist. I have a multiple white matter lesions and brain MRI abnormalities.

He ruled out everything from MS lupus erythematosus. In a final attempt, he ran a celiac disease platelets and found out I was positive anti - gliadin antibodies, which apparently can cause autoimmune attack in the central nervous system.

 

[RAAS]

Thanks for the advice, but unfortunately I've been having cranial manipulation done for a year now, with only marginal benefits

I've struggled with med school since I started this time last year, and I can't help but think this may be part of the reason. I've always passed everything, but had several close calls... Sure would be nice to get this straightened out by the time we start board prep...

One person mentioned acupuncture earlier, can anyone else speak to this?

As far as the acupuncture recommendation, I definitely think it's something worth looking into. My husband treats chronic migraines all the time. He combines spinal manipulation with dry needling (similar to acupuncture - it's a western approach to an eastern tradition). It's the combination of these techniques, rather that using just one or the other, that shows the greatest number of positive outcomes. Perhaps this could get to the root of your problem and allow you to cut back on, or eliminate, medication.