Re: Rep Retirement Lodge #185: Summer Activities
Since we are dx'ing things........I get a couple bad headaches/migraines a year. On 3/30 I got a nasty one ( and by nasty meaning out of commission for a few hours nasty). After that I had a dull constant headache and I was "foggy" and just out of sorts. I was getting a nasty headache every few days and now my ears had a constant ringing. Had an MRI, bloodwork and other stuff and nothing came of it. Doc gave me some medication to take daily and medication if I felt a nasty headache coming. Drugs didn't work so new drugs were prescribed. The new daily drug made me loopy/drowsy so I quit. Saw a neurologist. I had another nasty headache a few weeks ago and once that subsided my constant dull headache went away. I am still getting a nasty headache about once a week. The new medicine to take once I get a nasty headache works well. No answers yet............
Migraines are fascinating and suck. Went to a whole day conference on them, had one at the time. Talk about teh suck squared.
Factoids I learned (cliff notes version)
-mechanism of migraine- trigeminal nerve has 3 branches- one in the forehead, one in cheek/sinus area and one in lower jaw. This nerve is overly sensitive when triggered causes blood vessels to dilate and become porous. This allows fluid into surrounding tissues. Excess fluid compresses nerve~viola~ painful HA>
-think of nerve as a horse in a starting gate being kicked by jockey. Anything stimulating can cause it to trigger the above. This can include- certain meds, foods, light, noise, anything that stimulates the senses including fragrances, to name a few
-prevention meds are meant to decrease the reactivity of the nerve. They can take up to 12 weeks before becoming effective.
-rescue meds work by stopping the reaction as it happens, preventing the cascade of swelling, pain, triggering more swelling. Ibuprofen/caffeine works by suppressing the inflammation. The Triptans work on blood vessels.
-Rescue meds work best (80% of time) if taken at onset. If you wait too long or don't take a high enough dose <50% resolution. If you get to point of hypersensitivity to touch on face scalp you will almost always have failure of complete resolution with rescue med.
-meds taken too late will suppress but not extinguish HA. THe headache cause is not fixed, only masked. When the med wears off you get rebound.
-Tylenol doesn't work because it does not take care of inflammation.
-most common cause of rebound HA- decongestants. People say they have sinus HA (we are the only country who calls it this. The rest of world knows this is migraine) take decongestant which can relieve sx because it constricts vessels buuuuuut it is a stimulant so you most always will get a rebound HA
-the most common sx of migraine is not HA but feeling muddle headed/confused/fuzzy headed/stupid.
- even after taking rescue meds most people will have post HA stupid/fatigued feeling.
SHorter cliff note version- avoid stimulants including caffeine,decongestants which may cause increased reactivity, vasodialators/meds that lower threshold for reactivity- alcohol, and other chemical triggers that stim the trigeminal nerve.
Get lots of rest because this makes the nerve less reactive.
They no longer feel you can always identify triggers.
Taking any analgesic, even OTC stuff like Tylenol, more than a few times a week or more than one time a day for a few days in a row can cause rebound HA.
IF you are doing this a washout period of NO analgesics for about 2 weeks will almost always decrease HA freq and many times will stop the rebound HA.
(You can see some awful rebound in people taking NSAIDS regularly after surgery and then stop because they have been instructed to take for X days regularly and then only as needed)
Aaaand- that is all she wrote. (It was a really fascinating course. My migraine did not like the stimulus of having to think or dealing with the fluorescent lights)
Nighty night nocturnal ones!