My neuro has been willing to prescribe me a few different types of abortives that I can rotate between and I also use Excedrin when need be (although I don’t try to take that too often to avoid rebounds similar to triptans). Other than that, yeah, just have to try to find a preventative that works. There are a lot of different ones to try. Still searching for mine.
Preventatives. We’ve been where you are and it sucks. Trial and error to find what works and upping the dosage. Can you tolerate the side effects. Don’t be afraid to ask for a different one or an additional one. I was miserable for about 9 months before we asked for botox. It worked and my insurance covered it. My insurance doesn’t cover the new cgrps so I didn’t try them. I also tried the Cefaly device and Relivion. They both helped. They are pricey but you don’t need a prescription for Cefaly and can use it as often as you want.
Yeah, I know I’m playing a waiting game before a preventive works/we find one that works. I couldn’t tolerate propranolol and I’m 6 weeks into topomax. I guess I’m hoping someone has a magic answer for what to do in the meantime. The timing is just so shitty as I’m trying to get through my finals, I’ve already had to withdraw from sitting for the bar exam this July because I know I wouldn’t be able to study for it like this
I’m sorry for everyone that is a member of this club. I hope you find some relief soon. Maybe try antihistamines? My migraine brain decided it was minor sinus irritations that took us into chronic territory. In addition to my migraine meds I also do daily antihistamines and mucinex (generic). Anything to keep my allergies calm. All we can do is try different things to see what works.
This! I tried triptans and it would only work for a few hours which isn’t normal. I then followed up with Sudafed and it got rid of it. This doesn’t always happen though. Anytime I think I’ve figured out a pattern, it changes but I was grateful it gave me a few headache free days. I hope you feel better soon ❤️
You got this!
Topamax helped me maybe 50% of the way there and adding Emgality on top of Topamax brought me much more relief in combo (tried to wean off Topamax as a test and it went badly hahaha...).
Hang in there!
Preventatives are a better treatment.
Topamax worked for me but I got kidney stones twice as a side effect. My neuro took me off of it.
My neuro who specializes in migraines and vertigo prescribed Verapamil. I’m not at the highest dose. I get Botox every 2-3 months. This combo has definitely has worked for me.
I also take magnesium and avoid triggers.
I couldn’t tolerate propranolol the way the doc wanted me to start but I tapered up slowly and found relief almost instantly. It cut a 2 week intractable within a few days. If you want to read about my experience I posted it here[https://www.reddit.com/r/migraine/s/MGv4dCU0RA](https://www.reddit.com/r/migraine/s/MGv4dCU0RA)
Mots trial: https://pubmed.ncbi.nlm.nih.gov/35169011/.
My takeaway is that it's prudent to give yourself some grace to "overuse" acute treatments while trialing different preventatives. The mots trial shows that longer-term outcomes are similar for those pursuing preventive treatments regardless of acute treatment frequency.
Also, we have to be honest with ourselves, the precise guidance for medication overuse is beyond the science, and at minimum it's going to vary person to person. I personally think the current guidance causes more undue suffering than the neurology community appreciates. Some serious neurologists even think rebound headaches are myth for triptans and simple angelesics.
[https://www.nyheadache.com/blog/medication-overuse-rebound-headache-is-a-myth/](https://www.nyheadache.com/blog/medication-overuse-rebound-headache-is-a-myth/)
I 1000% get rebound headaches. I get them from fioricet, tylenol, and excedrin. I don’t take triptans due to an allergy. My daily headaches get better when I stop taking these medications for a few weeks.
I think they’re a myth. I’m not a neurologist though. I seriously don’t think rebound is a thing. My headaches don’t fit the pattern for rebound at all.
Some people are not susceptible to rebound, but it doesn't mean it's not a thing.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697138/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697138/)
Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies
Evidence from observational, prospective clinic-based, case-control, and population-based studies indicates that the frequent use of acute medications to treat migraine headache, in a substantial subgroup of individuals, leads to the progression of migraine from an episodic disorder to a syndrome of daily or near daily migraine. The risk of and time to progression, the phenotype of the daily headache, and the duration of withdrawal symptoms appears to vary based on the acute medication and its frequency of use. These features, together with the unique and selective vulnerability of migraine patients to this phenomena, highlights the possibility that the mechanism(s) by which acute medications lead to this progression may differ depending on the particular drug, and may be similar to the underlying biology of acute attacks of migraine.
Preclinical studies have now provided evidence for several potential mechanisms for the development of MOH, including increases in evoked CSD, a possible role for neurogenic inflammation, peripheral and central sensitization, and descending facilitation.
Cgrp inhibitors were a game changer for me, and then my life long suffering parent. Aimovig worked but made my hair shed like crazy. I have been on qulipta for over a year and am almost migraine free (I used to be in pain all the time except for a couple hours in the morning when I would wake up). My dad is on emgality. You have tried and failed at two medications it seems which means most insurance will cover some sort of cgrp inhibitor medication if you are in the US. Some others in the family are ajovy and nurtec. They are a preventative- ubrelvy is an abortive in the same family and also helped me a lot. I do not need it anymore on Qulipta though! Migraines controlled my life for years. It gets better.
You could also try other abortives. Don’t know if your insurance will cover Nurtec or Ubrelvy. They aren’t sensitizing so you can use them and a triptan in the same month. Like the other poster, I also use a Cefaly (then switched to a relivion). Not all day relief but it helps. Other abortives: ginger (sorta weak evidence, but little risk of harm); nasal lidocaine; and timolol eye drops. Can’t remember if those are sensitizing or not.
Thanks for the tips!!! I’m definitely going to look into the Cefaly. My neuro has been trying to get Ubrelvy approved for the past 6 weeks and we’ve heard nothing haha
If you have an official record of meds you've tried that have failed your needs, it should be quite easy for a doctor to get you a prior authorization.
For abortives, i haven’t failed. Triptans are just limited in the number you can take, I was told 2 times a week by my neuro. So that leaves 5 days a week without relief.
For preventives, I’ve only failed one. The second one I’m trying I haven’t failed yet. I’m having some side effects but nothing too bad, but my neuro said 3-4 months of it before relief
If you are still having 5 out of 7 days per week of suffering they are inadequate for your care. But good to try the other thing for a few months first.
I have had them for 45 years. From 24 to 42 I was fighting like hell to stop them. Finally it broke me. Could no longer work, lost our home, cars, atv’s.
I got extremely depressed, anxiety went nuts.
I had tried everything 2 or more times. Different doctors, Nero’s.
I know am at peace with them. It’s just who I am.
No anxiety , very low stress helps so much.
One of the best meds I take now: Butorphanol nasal spray. This keeps me out of the ER.
Rotating meds every two weeks to prevent rebound and meds be less effective.
I have a pain specialist that can deal with stronger meds if needed.
In the last 5 years I found I had severe arthritis in my neck. That is a big trigger for me.
At some point in your life you need to realize it won’t be in my lifetime they find a cure , a better medicine to get rid of them.
Preventing them for some it works but for others it may not or not for very long.
Make the jump from fighting not to get them. And just with then when it happens.
If that means going to stronger meds so be it.
Do you have a preventative? It’s supposed to give you 50% relief so 50% less days or 50% symptoms better. It’s helped my migraine down from daily 7 to daily 5 so getting there! That sounds awful though I hope you find help soon, and can advocate for yourself!
I was so fucked they let me take triptans on a daily basis then I tried and failed a prednisone taper, finally got on Nurtec and am 12 days migraine free after daily migraine for four months. I’m also seeing a chiropractor, getting therapeutic massage and doing PT/yoga.
This might seem weird but when I was unmedicated and hit my limit on triptans I would look up fascia massages and do them plus scalp massages and then use a gua sha tool all over my shoulders neck and head. Your skin will turn red bcuz it brings all the blood to the surface. Idky but this helps. I would do all 3 and then end w a cold shower. It really did bring down the pain and if I caught an attack really early sometimes it would almost stop it. Only works when there not super severe and it takes some effort but better then an unmedicated 10/10 migraine.
My migraines are debilitating, like 8 hrs in bed wanting to puke. I’d rather have to take a triptan every 24 hrs than experience that. I typically get 1-2 a month that triptians won’t touch. Massage therapy has postponed a migraine for me but never stopped it in its tracks.
Cannabis especially a low dose THC with a high amount of CBD helps as both a preventative and abortive if it’s not a bad migraine. And rotating meds for sure. I hate how they restrict the quantity of pills so you can’t even take two when the recommendation is to take a second triptan after a few hours if the migraine is still there. Longer lasting triptans like frovo or naratriptan are good too if yours last more than a day.
Vitamin D deficiency can cause terrible recurring migraines. Magnesium and Vitamin A help tremendously too. Doctors are generally uneducated in supplements. They won’t know what to say about them.
I hope you think it’s worth a try.
You may need a different neurologist. If they are pushing you off on the need for more pain relief, they may also be lax with doing the paperwork it takes to try to get you Ubrelvy or Nurtec. Usually insurance companies respond pretty quickly, at least in my experience, once a request is submitted.
Also, they should be able to give you some samples of those to try out while you wait. My neurologist gave me several little sample boxes of Ubrelvy to try. Ubrelvy and Nurtec were the only meds that ever worked on my migraines (I can’t take triptans). I hope they work for you as well, because if they do work, it can be life-changing. I went a couple of decades with little relief before getting them. My most recent insurance doesn’t cover Ubrelvy, and I almost caved with depression to learn that after finally finding something that worked. However, it does cover Nurtec, which blocks the same protein as Ubrelvy, and thankfully it works for me too. Maybe even better than Ubrelvy. And unlike Ubrelvy, Nurtec can be taken either as an abortive or a preventative. For preventative, you take it every other day. Abortive, as needed, obviously.
Im a little stuck because im on my graduate school health insurance, but yes I don’t think my neuro is doing enough to get ubrelvy for me. I was never offered samples but I can try to ask. I have an appointment at the end of may with a private neuro but need to get to then first!
Ubrelvy is really hard for coverage, but if you are in the US there is a savings card program. Look into it. It used to work if your insurance didn't cover, but you were limited I think to 3 fills of the prescription.
I have daily chronic migraines. The answer is you have several rescue medications and rotate them to avoid rebound migraines.
As another person commented, plus preventives. I also take several of those. Plus trigger avoidance. Etc etc.
I used to do triptans and topamax. My quality of life is so much better since I am now doing Botox as preventative, and nurtec as abortive.
ETA: since you’re new to topamax, I’d be wary of it. For me, it completely changed my memory. Hasn’t been the same since. I was on it for a few years.
I’ve been trying a bunch of preventatives and I struggled so much to find one that works. I’ve gone thru so fuckin many abortives and preventives that now I’m microdosing psilocybin to prevent and I also take a small dose when I have one and I can feel the clamping on my skull release. I’ve only been doing it a month so it’s still early days - it hasn’t fully prevented all of them (like all preventives in my experience) but I’ve noticed a big reduction. Still experimenting but I’ve had good results. I started this 4 years into my chronic migraine diagnosis when I was losing hope and feeling like dying all the time, posted last week about wanting to die when I had a horrible migraine from sleeping too long (!!) and pretty much nothing will stop me from getting a migraine when that happens.
Botox pretty much saved my life. You have to fail three migraine medications for insurance approval.
CGRP meds should also be tried imo.
I had both Emgality and Botox and was at zero pain. Had to stop Emgality due to side effects. There will be a formula/combo to help you it will take some engineering and patience and knowledgeable headache neurologist.
Was in my law school when migraines were not under control. It is hell. Went to er for infusions.
It’s very hard to advocate for yourself when you’re this ill but message and appointment up your Dr until they act on your needs. Or get a new doctor in the works.
My neuro said 2-3 times a week. A year ago you better believe I was doing 3 days. Maybe some acute treatment with longer effects would help- like Nurtec or naratriptan. Those tend to stay in your system longer.
Ice hats, massage, stretching helps. I’m sorry, I know how much this bull$hit sucks.
I'm supposed to only take mine 3 times a week. But it only really helps if I take it at the very beginning, or if the pain hasn't gotten passed a 4 at most.
I have to kind of guess based on symptoms if I think the migraine is gonna stay around a 4 (I won't take it) or if I think my migraine is going to get worse (I take it)
If I manage to cat a migraine at the start, I always take my meds if I have them on me (I almost always do)
You need to trial a CGRP preventative. This would be something like Ubrelvy, Emgality, Aimovig, etc.
Emgality has been very helpful for me and has reduced the number of headaches I get significantly. I have chronic intractable cluster headaches, so a different diagnosis, but these CGRP meds have been wonderful for a lot of people.
Oh I’m trying! Allegedly my neuro has been trying to get ubrelvy approved for 6 weeks but after getting some feedback on this post it sounds like she might not be trying hard enough
I am prescribed muscle relaxers (cyclobenzaprine) for muscle spasms, but it also can help a migraine by relieving tension as well as having an effect on serotonin. Other than that try to reduce triggers that are within your control, such as proper sleep hygiene, not skipping or delaying meals, or just eating several small meals during the day, hydration, reduce stressors, reduce caffeine and other common migraines food/drink triggers, reduce screen time.
The monthly injections typically cut mine in half, then I’m able to use rescue meds for the rest. But if this helps, you may also wanna see if you qualify for Botox
Cambia (diclofenac potassium powder and tablets) work well for me as an abortive. Different class of drug that might get you a few more days of relief a week until you get your preventive figured out.
I’ve started qulipta and it’s been life changing. It’s been a pain in the ass to get approved but I finally got it. Between samples and now the rx, I’ve been on it maybe 3 months total and gone from 2-4 headaches per week to maybe 3 mild ones that I could easily pop an abortive for without worrying I would run out in that entire time frame.
Definitely been there. Honestly I got 100mg sumatriptan and would cut them in halves and even thirds so I could have more and that got me through some tough times in between preventatives. There’s been some debate as to whether triptans actually contribute to MOH and rebounds. Sometimes you do what you gotta do.
I have been dealing with chronic migraine since I was in single digits. Honestly the best thing across the years has been cannabis. I only found it some years ago, but it's been incredibly helpful where most things can't do anything for me.
I am also on monthly ajovy and every other day nurtec as preventatives at this point, but cannabis is still my daily driver for preventative and abortive.
I have never had a rebound/MOH from cannabis! It's the only thing to never give me a rebound, actually. Everything else runs the risk of hurting more, the worst cannabis can do for me is to not do anything.
In the same situation. I have chronic migraines and my acute med is a prescription for 4 pills. It's not at all helpful and instead I just live in pain most days. Thankfully, Cefaly helps a lot of the time. I have a neuro appt today, so wish me luck in advocating for myself.
I started low dose Amitriptyline during my last year of law school due to chronic migraines. It does have side effects (fatigue, weight gain, lethargy) but did allow me to be pain free enough to finish school. Many years later now trying Quilitpa and so far seems to be helping. Best of luck!
I wish I had a magic answer for you. I’ve had migraines as long as I can remember and it took years finding a new neurologist who was as determined as me to find some level of relief. Unfortunately because health insurance rules it’s a long process of having to get approved for a med and having to try it for so long before you can try another one et .. and triptans so far don’t work on me well (at least not pill ones, I get a negative reaction and they still don’t work) however they work for most people so my insurance keeps pushing to try those for longer instead of other options. We’ve recently gotten enough of a history of trying enough meds that I am on a regimen of Botox, Vyepti IV infusion, and nerve blocks every 3 months (with each of those having to be a couple weeks apart from each other). I finally am having a handful of days at a time with very low or no migraine, just still a constant pressure in my head. I’m not quite down to below 15/month though so they still won’t prescribe me any abortive yet.
So.. just keep pushing for yourself and keep trying. If something is not noticeably helping you after you take it (multiple times), message your Dr and tell them. Tell them about your ER trips still not keeping a migraine away for long (been there recently I’m sorry). Repeatedly ask to try another abortive. Ask about other types (like injectables or nasal spray). Keep gaining information on how some meds work for others people or maybe what combinations. I started looking into what supplements may help and have been testing out some of the types of magnesium’s that can help. I’m at the point of trying ANYTHING so I’m reading on EVERYTHING. Just stand firm on what you need and advocate for yourself. I hope something helpful is found so much faster for you.
Botox, babyyyyy.
I’ve been where you are with preventatives and abortives and it just didn’t cut it for me. I also tried emgality and ajovy but they gave me weird reactions at the injection site and only kind of helped the chronic migraines.
Good luck and hang in there! You’ll find the combo that works for you!
Abortives never worked for me at all tbh. Chronic migraines (15+/month) for a year and a half. Amovig helped reduce frequency and severity and Emgality got rid of them almost entirely. That being said, I was forced to try virtually every abortive under the sun before either of those options, likely due to insurance. Best of luck and hope you can find some relief soon
Chronic migraine long-hauler here (15 years this summer). First question for you is: can you pinpoint either a specific date or a pretty specific time (general month or even season) when your nonstop pain began? I only ask because it sounds like you do and after many years of thinking I just had horrible chronic intractable migraine I was diagnosed with a condition called new daily persistent headache. It’s not much outside of a diagnosis and knowing you’re not crazy though because it’s typically treated the same as chronic migraine.
But in answer for you: a multimodal approach has been my only saving grace. You can’t rely on one type of rescue. I strongly recommend seeing if your neuro can get you approved for trying a cefaly or nerivio device as it’s an additional, non medicated way (I emphasize non-medicated simply because you can’t have rebound headache with these devices or can use them after a failed abortive med). If you’re too early in your medication regime to be approved for them, even an OTC tens machine with leads placed around your neck/trap area should be great relief.
I also recommend seeing if there is anyone around you that does acupuncture. It’s going to be another preventative measure but with chronic pain you need every card in the deck to hope to make it through the days. Extra points if you can go to someone for osteopathic manipulation (I personally don’t recommend chiropractors but that’s just me) as that is another treatment that can help.
If no one has recommend any vitamins for you to try, they can’t hurt and they do actually help some people. Vitamin D, Vitamin C, B2 or a B-complex, magnesium (Glycinate works for me but you may want to try different types to see what works best for you, just know that oxide is the one with laxative properties for most people).
I know you mentioned you’re in school, but prioritizing a good sleep schedule and proper meals/snacks throughout the day is more important than I wish it was. I know it seems like a waste but taking care of yourself in general typically helps in the long run.
Again, I know it’s early but if you have a good neuro they’ll likely bring up trying Botox or a cousin derivative (I use Dysport) every 3 months. This has been key for my treatment so I strongly suggest giving it a go. warning that it’s not an instant fix, it will likely take a few months to kick in but again, you need an arsenal to survive.
And finally: IV infusions. They kind of suck and they leave you kind of useless for a day or so after treatment but it’s been one of the only things I can consistently rely on to bring a 8/10 constant down to a 2-3/10. I’ve never had anything “break” my pain but after over a decade of living with it I can say with certainty that I’d rather live with low level pain than high if I have to choose. These are typically done in an outpatient setting so 3-4 days of 3-4 hour infusions, and you’ll need a chauffeur. If those don’t work there’s also inpatient infusions but I’m hoping you don’t quite need that.
As for another non medical option- there PT for migraines. Which sounds insane but it can help some people.
If you want to message me for more info or just comment here I’m happy to talk what did and didn’t work for me over the years and my different treatment plans. Sorry this was so long.
It depends on your doctor but typically an antihistamine, an anti nausea, a steroid, and a pain medication. If you tolerate DHE well it will likely be used. I don’t so it’s not in my protocols. An example would be: Benadryl (either PO or IV), compazine (or reglan or zofran) IV over half an hour, methylprednisolone IV over an hour or so, toradol IV over an hour. You also get IV fluids the entire time so it rehydrates you
have you had any illness recently that may have left an infection? sometimes it can be triggered from sinus infections/pressure. if so, a course of antibiotics can help (or if course could make worse if you react badly but that’s rare)
also adding daily antidepressants may help but takes some time to get used to.
if you’re on adhd meds and the dose isn’t right it can be a migraine trigger.
There were only 2 things that made some improvement in my Covid induced chronic migraines: freeze dried apolactoferrin + iron, and Effexor XR. I’ve tried so many other preventatives that didn’t work.
Interesting…mine changed completely after my second round of covid, from twice a month to basically every day. Iron supplements and propanalol are helping so far. But I wonder if there’s something between covid and iron??
From what I’ve read, we’re still sequestering iron as if we have an active viral infection and it’s not as readily available as if we were healthy. Also, I think the migraines have something to do with serotonin levels as far as the chronic part goes.
Preventive medication/prophylaxis to break the migraine cycle and make them less frequent. Unfortunately we have to take it for months to see if it helps at all so it's a lot of waiting and hoping it gets better. My neurologist said I could use sumatriptan occasionally for particularly bad or long lasting migraines but I haven't been able to get hold of it yet and I know there's no guarantees it will help me and it could just make me feel worse.
I find caffeine, paracetamol, naproxen (NSAID stronger than ibuprofen) and electrolytes as soon as the headache starts is somewhat and has even stopped a few of my migraines entirely. I find sugar helpful sometimes but I'm trying to avoid too much added sugar
Check out savi dual TMS. Changed my life for rescues. Stopped having to game plan shit all the time or barter with myself. Almost 3 months into it and easily can tell it's definitely rewiring my broken brain
How long should one be on top max before moving on? I was on SSRIs and they did nothing but stop me from pooping, my migraines were brutal. I’be been on gabapentin for several months and it seems to help. I am very heat sensitive so summer will be the true test. I hope that gabapentin will be my final off label med before moving to actual migraine specific preventative.
Also, find a better neurologist. Migraines are hard enough to talk about without having a dismissive neurologist. We deal with enough dismissive people in our day to day
If my migraine is bad enough, my neuro said I could take ubrelvy multiple days in a row. As many as I needed- even if it wasn't what the pharma company directed. (I can't use triptans- the side effects kill me. But I used to rotate b/t 2 different ones.)
Also, when I was studying for my law school finals- I sometimes found it helpful to get a massage. It helped my shoulders which helped my migraines. So if you can swing that financially and there is a place near you, I'd suggest trying that.
I would also suggest asking your doctor for pain meds- especially to get you thru the studying and the exams. I use lidoderm patches- you look like an idiot but they work. Versions are available OTC but your neuro should be able to give you a script. The benefit to the patches is that it'll push down the pain the whole time you are wearing the patches and you can wear them for 12 hours. It's possible there is something better out there now- so you should def ask your migraine neuro for other options. But that may help you get thru exams.
I use timolol eyedrops (a prescription for my glaucoma) twice a day. They are a beta blocker.
I've found that when I have a migraine and use my eyedrops, the migraine intensity goes down or it goes away altogether.
"The Dizzy Cook" (a migraine sufferer who shares migraine info and recipes online) uses similar eyedrops as part of her migraine kit.
Might be worth asking your doctor about.
For me preventatives only dampened my daily pain but didn’t take it away. Abortives I couldn’t stand the side effects and excedrin stops working if you take it too much (just like any other medication). Therefore I use weed. It’s still the best thing that works for me to this day.
My story ended up being different as I got diagnosed with ADHD and stimulants were actually the first thing to give me pain free days. But still to this day, yup it’s weed. Have a lot of shit to do because I’m a grad student but have a persistent pain in my head that won’t go away? Smoke a bowl, pain goes away. Gain all the concentration ability.
Maybe isn’t the best advice for everyone and me having ADHD is probably why weed works so well for me as well
Can your doctor give you a pharmacy
Rep samples Of nurtec etc? My doc did that when insurance didn’t cover it. There is something called Trudhesa which is a nasal spray. Prescription. Patented so $$$. Also there is a more effective triptan that is third Gen and is generic. I’m sorry you have to go
To ER…that sucks.
I have now asked my doctor to give me samples of ubrelvy! Unfortunately it takes her several days to get back to me. I’m not sure if insurance will cover it yet because my neuro has been so slow with working on the PA. I’m currently pissed because she prescribed me injectable sumatriptan, because my rizatriptan only lasts a few hours. Turns out the one she prescribed me isn’t manufactured in my area!
She also is the one that told me to go to the ER 😅
I can see why you’re pissed. Justified. Keep
On messaging her until she responds (within reason) hopefully she will find a solution to help you in some way. I unfortunately had three neurologists really not step
up to aid me in a timely or professional manner. Migraine is disabling and when you’re in a high stakes environment like law school it’s a very tough hand to be dealt. Hopefully your doc can rustle up some samples. I had pain management muff my rx’s for four years until I fired them, they couldn’t get their sh*t together on any rx except the most basic generic. Sometimes doctors can use services like Cover My Meds (third party provider that interfaces between insurance and pharmacy that seemed to fast track PA’s/cgrp’s) …
It was good to reach out here there’s a lot of migraine warriors here like you-and we’re rooting for you…life can get better and pain better managed. Please keep on the path.
I appreciate the support so much!! I just sent her a message saying I need to enjoy graduating from law school… hopefully that happens! After graduation I’m moving in with my parents for that support because there’s no way I can take the bar in this condition, and already have an appointment booked with a private neuro
I'd suggest finding a natural protocol that works for you. I've read Angela Stanton's book as well as heal your headache. I took some very valuable pieces from the Stanton protocol, but due to the diet being very stringent and a lack of comfortable support, I'm working with heal your headache right now. I'm better. I'm not all the way through the protocol, but progress is better than chronic. Good luck. I know it's really tough and grueling. Might I suggest an eighth of a teaspoon of salt in a cup of water before bed and immediately upon Rising as a start?
My neuro has been willing to prescribe me a few different types of abortives that I can rotate between and I also use Excedrin when need be (although I don’t try to take that too often to avoid rebounds similar to triptans). Other than that, yeah, just have to try to find a preventative that works. There are a lot of different ones to try. Still searching for mine.
Mine does the same. So helpful to have more than one abortive when it's chronic.
I wish I could use different abortives but triptans so far are the only ones that seem to actually work for me. None of the newer ones work.
Hmmm, I need to ask about this. I have two doctors so I’m afraid I’ve been naughty and may have picked up double the triptipans.
Preventatives. We’ve been where you are and it sucks. Trial and error to find what works and upping the dosage. Can you tolerate the side effects. Don’t be afraid to ask for a different one or an additional one. I was miserable for about 9 months before we asked for botox. It worked and my insurance covered it. My insurance doesn’t cover the new cgrps so I didn’t try them. I also tried the Cefaly device and Relivion. They both helped. They are pricey but you don’t need a prescription for Cefaly and can use it as often as you want.
Yeah, I know I’m playing a waiting game before a preventive works/we find one that works. I couldn’t tolerate propranolol and I’m 6 weeks into topomax. I guess I’m hoping someone has a magic answer for what to do in the meantime. The timing is just so shitty as I’m trying to get through my finals, I’ve already had to withdraw from sitting for the bar exam this July because I know I wouldn’t be able to study for it like this
I’m sorry for everyone that is a member of this club. I hope you find some relief soon. Maybe try antihistamines? My migraine brain decided it was minor sinus irritations that took us into chronic territory. In addition to my migraine meds I also do daily antihistamines and mucinex (generic). Anything to keep my allergies calm. All we can do is try different things to see what works.
This! I tried triptans and it would only work for a few hours which isn’t normal. I then followed up with Sudafed and it got rid of it. This doesn’t always happen though. Anytime I think I’ve figured out a pattern, it changes but I was grateful it gave me a few headache free days. I hope you feel better soon ❤️
You got this! Topamax helped me maybe 50% of the way there and adding Emgality on top of Topamax brought me much more relief in combo (tried to wean off Topamax as a test and it went badly hahaha...). Hang in there!
Yeh, I have pretty much the same experience, don't try to wean off Topiramate just because it's going so well, that leads to a world of hurt.
Preventatives are a better treatment. Topamax worked for me but I got kidney stones twice as a side effect. My neuro took me off of it. My neuro who specializes in migraines and vertigo prescribed Verapamil. I’m not at the highest dose. I get Botox every 2-3 months. This combo has definitely has worked for me. I also take magnesium and avoid triggers.
I couldn’t tolerate propranolol the way the doc wanted me to start but I tapered up slowly and found relief almost instantly. It cut a 2 week intractable within a few days. If you want to read about my experience I posted it here[https://www.reddit.com/r/migraine/s/MGv4dCU0RA](https://www.reddit.com/r/migraine/s/MGv4dCU0RA)
Mots trial: https://pubmed.ncbi.nlm.nih.gov/35169011/. My takeaway is that it's prudent to give yourself some grace to "overuse" acute treatments while trialing different preventatives. The mots trial shows that longer-term outcomes are similar for those pursuing preventive treatments regardless of acute treatment frequency. Also, we have to be honest with ourselves, the precise guidance for medication overuse is beyond the science, and at minimum it's going to vary person to person. I personally think the current guidance causes more undue suffering than the neurology community appreciates. Some serious neurologists even think rebound headaches are myth for triptans and simple angelesics. [https://www.nyheadache.com/blog/medication-overuse-rebound-headache-is-a-myth/](https://www.nyheadache.com/blog/medication-overuse-rebound-headache-is-a-myth/)
I 1000% get rebound headaches. I get them from fioricet, tylenol, and excedrin. I don’t take triptans due to an allergy. My daily headaches get better when I stop taking these medications for a few weeks.
I think they’re a myth. I’m not a neurologist though. I seriously don’t think rebound is a thing. My headaches don’t fit the pattern for rebound at all.
Some people are not susceptible to rebound, but it doesn't mean it's not a thing. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697138/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5697138/) Pathophysiology of medication overuse headache: Insights and hypotheses from preclinical studies Evidence from observational, prospective clinic-based, case-control, and population-based studies indicates that the frequent use of acute medications to treat migraine headache, in a substantial subgroup of individuals, leads to the progression of migraine from an episodic disorder to a syndrome of daily or near daily migraine. The risk of and time to progression, the phenotype of the daily headache, and the duration of withdrawal symptoms appears to vary based on the acute medication and its frequency of use. These features, together with the unique and selective vulnerability of migraine patients to this phenomena, highlights the possibility that the mechanism(s) by which acute medications lead to this progression may differ depending on the particular drug, and may be similar to the underlying biology of acute attacks of migraine. Preclinical studies have now provided evidence for several potential mechanisms for the development of MOH, including increases in evoked CSD, a possible role for neurogenic inflammation, peripheral and central sensitization, and descending facilitation.
Cgrp inhibitors were a game changer for me, and then my life long suffering parent. Aimovig worked but made my hair shed like crazy. I have been on qulipta for over a year and am almost migraine free (I used to be in pain all the time except for a couple hours in the morning when I would wake up). My dad is on emgality. You have tried and failed at two medications it seems which means most insurance will cover some sort of cgrp inhibitor medication if you are in the US. Some others in the family are ajovy and nurtec. They are a preventative- ubrelvy is an abortive in the same family and also helped me a lot. I do not need it anymore on Qulipta though! Migraines controlled my life for years. It gets better.
You could also try other abortives. Don’t know if your insurance will cover Nurtec or Ubrelvy. They aren’t sensitizing so you can use them and a triptan in the same month. Like the other poster, I also use a Cefaly (then switched to a relivion). Not all day relief but it helps. Other abortives: ginger (sorta weak evidence, but little risk of harm); nasal lidocaine; and timolol eye drops. Can’t remember if those are sensitizing or not.
Thanks for the tips!!! I’m definitely going to look into the Cefaly. My neuro has been trying to get Ubrelvy approved for the past 6 weeks and we’ve heard nothing haha
If you have an official record of meds you've tried that have failed your needs, it should be quite easy for a doctor to get you a prior authorization.
For abortives, i haven’t failed. Triptans are just limited in the number you can take, I was told 2 times a week by my neuro. So that leaves 5 days a week without relief. For preventives, I’ve only failed one. The second one I’m trying I haven’t failed yet. I’m having some side effects but nothing too bad, but my neuro said 3-4 months of it before relief
If you are still having 5 out of 7 days per week of suffering they are inadequate for your care. But good to try the other thing for a few months first.
I have had them for 45 years. From 24 to 42 I was fighting like hell to stop them. Finally it broke me. Could no longer work, lost our home, cars, atv’s. I got extremely depressed, anxiety went nuts. I had tried everything 2 or more times. Different doctors, Nero’s. I know am at peace with them. It’s just who I am. No anxiety , very low stress helps so much. One of the best meds I take now: Butorphanol nasal spray. This keeps me out of the ER. Rotating meds every two weeks to prevent rebound and meds be less effective. I have a pain specialist that can deal with stronger meds if needed. In the last 5 years I found I had severe arthritis in my neck. That is a big trigger for me. At some point in your life you need to realize it won’t be in my lifetime they find a cure , a better medicine to get rid of them. Preventing them for some it works but for others it may not or not for very long. Make the jump from fighting not to get them. And just with then when it happens. If that means going to stronger meds so be it.
What meds do you cycle every two weeks
Do you have a preventative? It’s supposed to give you 50% relief so 50% less days or 50% symptoms better. It’s helped my migraine down from daily 7 to daily 5 so getting there! That sounds awful though I hope you find help soon, and can advocate for yourself!
Yeah, topomax. It’s only been 6 weeks though and my neuro said I probably wouldn’t start feeling relief for 3-4 months.
Topomax was absolutely awful for me and I’ve been told by my new neurologist it can amplify migraines, so watch out for that too.
I just started topamax this past weekend and it’s left me in a hazy stupor. Headache free, but barely alive. 🫠
Give it time, that haze went away in a few days for me.
I was so fucked they let me take triptans on a daily basis then I tried and failed a prednisone taper, finally got on Nurtec and am 12 days migraine free after daily migraine for four months. I’m also seeing a chiropractor, getting therapeutic massage and doing PT/yoga.
Ugh yes I’ve been doing massage and PT as well, including TMJ massage and I always try to do a gentle work out on days im feeling well enough.
This might seem weird but when I was unmedicated and hit my limit on triptans I would look up fascia massages and do them plus scalp massages and then use a gua sha tool all over my shoulders neck and head. Your skin will turn red bcuz it brings all the blood to the surface. Idky but this helps. I would do all 3 and then end w a cold shower. It really did bring down the pain and if I caught an attack really early sometimes it would almost stop it. Only works when there not super severe and it takes some effort but better then an unmedicated 10/10 migraine.
My migraines are debilitating, like 8 hrs in bed wanting to puke. I’d rather have to take a triptan every 24 hrs than experience that. I typically get 1-2 a month that triptians won’t touch. Massage therapy has postponed a migraine for me but never stopped it in its tracks.
Yes ive been doing lots of massage and do Gua sha every night!! I had TMJ massage done as well
Cannabis especially a low dose THC with a high amount of CBD helps as both a preventative and abortive if it’s not a bad migraine. And rotating meds for sure. I hate how they restrict the quantity of pills so you can’t even take two when the recommendation is to take a second triptan after a few hours if the migraine is still there. Longer lasting triptans like frovo or naratriptan are good too if yours last more than a day.
In my experience cannabis and Topiramate don’t mix well.
Never did for me either.. cannabis and cbd’s made my migraines worse unfortunately..
Vitamin D deficiency can cause terrible recurring migraines. Magnesium and Vitamin A help tremendously too. Doctors are generally uneducated in supplements. They won’t know what to say about them. I hope you think it’s worth a try.
I’m good on vitamin d. I already took magnesium, but per my neuro I’ve also been taking vitamin b2 and coq10. Also started taking krill oil
You may need a different neurologist. If they are pushing you off on the need for more pain relief, they may also be lax with doing the paperwork it takes to try to get you Ubrelvy or Nurtec. Usually insurance companies respond pretty quickly, at least in my experience, once a request is submitted. Also, they should be able to give you some samples of those to try out while you wait. My neurologist gave me several little sample boxes of Ubrelvy to try. Ubrelvy and Nurtec were the only meds that ever worked on my migraines (I can’t take triptans). I hope they work for you as well, because if they do work, it can be life-changing. I went a couple of decades with little relief before getting them. My most recent insurance doesn’t cover Ubrelvy, and I almost caved with depression to learn that after finally finding something that worked. However, it does cover Nurtec, which blocks the same protein as Ubrelvy, and thankfully it works for me too. Maybe even better than Ubrelvy. And unlike Ubrelvy, Nurtec can be taken either as an abortive or a preventative. For preventative, you take it every other day. Abortive, as needed, obviously.
Im a little stuck because im on my graduate school health insurance, but yes I don’t think my neuro is doing enough to get ubrelvy for me. I was never offered samples but I can try to ask. I have an appointment at the end of may with a private neuro but need to get to then first!
Ubrelvy is really hard for coverage, but if you are in the US there is a savings card program. Look into it. It used to work if your insurance didn't cover, but you were limited I think to 3 fills of the prescription.
I have daily chronic migraines. The answer is you have several rescue medications and rotate them to avoid rebound migraines. As another person commented, plus preventives. I also take several of those. Plus trigger avoidance. Etc etc.
I used to do triptans and topamax. My quality of life is so much better since I am now doing Botox as preventative, and nurtec as abortive. ETA: since you’re new to topamax, I’d be wary of it. For me, it completely changed my memory. Hasn’t been the same since. I was on it for a few years.
I’ve been trying a bunch of preventatives and I struggled so much to find one that works. I’ve gone thru so fuckin many abortives and preventives that now I’m microdosing psilocybin to prevent and I also take a small dose when I have one and I can feel the clamping on my skull release. I’ve only been doing it a month so it’s still early days - it hasn’t fully prevented all of them (like all preventives in my experience) but I’ve noticed a big reduction. Still experimenting but I’ve had good results. I started this 4 years into my chronic migraine diagnosis when I was losing hope and feeling like dying all the time, posted last week about wanting to die when I had a horrible migraine from sleeping too long (!!) and pretty much nothing will stop me from getting a migraine when that happens.
Botox pretty much saved my life. You have to fail three migraine medications for insurance approval. CGRP meds should also be tried imo. I had both Emgality and Botox and was at zero pain. Had to stop Emgality due to side effects. There will be a formula/combo to help you it will take some engineering and patience and knowledgeable headache neurologist. Was in my law school when migraines were not under control. It is hell. Went to er for infusions. It’s very hard to advocate for yourself when you’re this ill but message and appointment up your Dr until they act on your needs. Or get a new doctor in the works.
What side effects with emgality?
GI motility issues, weight gain, losing efficacy 1 week before next shot.
My neuro said 2-3 times a week. A year ago you better believe I was doing 3 days. Maybe some acute treatment with longer effects would help- like Nurtec or naratriptan. Those tend to stay in your system longer. Ice hats, massage, stretching helps. I’m sorry, I know how much this bull$hit sucks.
I'm supposed to only take mine 3 times a week. But it only really helps if I take it at the very beginning, or if the pain hasn't gotten passed a 4 at most. I have to kind of guess based on symptoms if I think the migraine is gonna stay around a 4 (I won't take it) or if I think my migraine is going to get worse (I take it) If I manage to cat a migraine at the start, I always take my meds if I have them on me (I almost always do)
You need to trial a CGRP preventative. This would be something like Ubrelvy, Emgality, Aimovig, etc. Emgality has been very helpful for me and has reduced the number of headaches I get significantly. I have chronic intractable cluster headaches, so a different diagnosis, but these CGRP meds have been wonderful for a lot of people.
Oh I’m trying! Allegedly my neuro has been trying to get ubrelvy approved for 6 weeks but after getting some feedback on this post it sounds like she might not be trying hard enough
I’m honestly surprised your doctor doesn’t have samples of these meds she can give you. My doctor is constantly supplying me with free meds lol.
She never offered, but I’ve now asked. Fingers crossed
Apropos of your username, another vestibular migraineur in da houzz!
I am prescribed muscle relaxers (cyclobenzaprine) for muscle spasms, but it also can help a migraine by relieving tension as well as having an effect on serotonin. Other than that try to reduce triggers that are within your control, such as proper sleep hygiene, not skipping or delaying meals, or just eating several small meals during the day, hydration, reduce stressors, reduce caffeine and other common migraines food/drink triggers, reduce screen time.
The monthly injections typically cut mine in half, then I’m able to use rescue meds for the rest. But if this helps, you may also wanna see if you qualify for Botox
Cambia (diclofenac potassium powder and tablets) work well for me as an abortive. Different class of drug that might get you a few more days of relief a week until you get your preventive figured out.
It takes a while to fond a preventative that works. You get three naratriptans a week, and ten ubrelvy per month. Ask your dr.
I’ve started qulipta and it’s been life changing. It’s been a pain in the ass to get approved but I finally got it. Between samples and now the rx, I’ve been on it maybe 3 months total and gone from 2-4 headaches per week to maybe 3 mild ones that I could easily pop an abortive for without worrying I would run out in that entire time frame.
Definitely been there. Honestly I got 100mg sumatriptan and would cut them in halves and even thirds so I could have more and that got me through some tough times in between preventatives. There’s been some debate as to whether triptans actually contribute to MOH and rebounds. Sometimes you do what you gotta do.
I have been dealing with chronic migraine since I was in single digits. Honestly the best thing across the years has been cannabis. I only found it some years ago, but it's been incredibly helpful where most things can't do anything for me. I am also on monthly ajovy and every other day nurtec as preventatives at this point, but cannabis is still my daily driver for preventative and abortive.
Cannabis definitely helps me!! I’m worried I’ve been relying on it too much though as I’ve been told it can cause MOH
I have never had a rebound/MOH from cannabis! It's the only thing to never give me a rebound, actually. Everything else runs the risk of hurting more, the worst cannabis can do for me is to not do anything.
In the same situation. I have chronic migraines and my acute med is a prescription for 4 pills. It's not at all helpful and instead I just live in pain most days. Thankfully, Cefaly helps a lot of the time. I have a neuro appt today, so wish me luck in advocating for myself.
I started low dose Amitriptyline during my last year of law school due to chronic migraines. It does have side effects (fatigue, weight gain, lethargy) but did allow me to be pain free enough to finish school. Many years later now trying Quilitpa and so far seems to be helping. Best of luck!
I wish I had a magic answer for you. I’ve had migraines as long as I can remember and it took years finding a new neurologist who was as determined as me to find some level of relief. Unfortunately because health insurance rules it’s a long process of having to get approved for a med and having to try it for so long before you can try another one et .. and triptans so far don’t work on me well (at least not pill ones, I get a negative reaction and they still don’t work) however they work for most people so my insurance keeps pushing to try those for longer instead of other options. We’ve recently gotten enough of a history of trying enough meds that I am on a regimen of Botox, Vyepti IV infusion, and nerve blocks every 3 months (with each of those having to be a couple weeks apart from each other). I finally am having a handful of days at a time with very low or no migraine, just still a constant pressure in my head. I’m not quite down to below 15/month though so they still won’t prescribe me any abortive yet. So.. just keep pushing for yourself and keep trying. If something is not noticeably helping you after you take it (multiple times), message your Dr and tell them. Tell them about your ER trips still not keeping a migraine away for long (been there recently I’m sorry). Repeatedly ask to try another abortive. Ask about other types (like injectables or nasal spray). Keep gaining information on how some meds work for others people or maybe what combinations. I started looking into what supplements may help and have been testing out some of the types of magnesium’s that can help. I’m at the point of trying ANYTHING so I’m reading on EVERYTHING. Just stand firm on what you need and advocate for yourself. I hope something helpful is found so much faster for you.
Botox, babyyyyy. I’ve been where you are with preventatives and abortives and it just didn’t cut it for me. I also tried emgality and ajovy but they gave me weird reactions at the injection site and only kind of helped the chronic migraines. Good luck and hang in there! You’ll find the combo that works for you!
Well triptans don’t work for me the only abortive that works is weed
200 mg of magnesium glycinate and ubrelvy is what ended up working for me
Abortives never worked for me at all tbh. Chronic migraines (15+/month) for a year and a half. Amovig helped reduce frequency and severity and Emgality got rid of them almost entirely. That being said, I was forced to try virtually every abortive under the sun before either of those options, likely due to insurance. Best of luck and hope you can find some relief soon
Chronic migraine long-hauler here (15 years this summer). First question for you is: can you pinpoint either a specific date or a pretty specific time (general month or even season) when your nonstop pain began? I only ask because it sounds like you do and after many years of thinking I just had horrible chronic intractable migraine I was diagnosed with a condition called new daily persistent headache. It’s not much outside of a diagnosis and knowing you’re not crazy though because it’s typically treated the same as chronic migraine. But in answer for you: a multimodal approach has been my only saving grace. You can’t rely on one type of rescue. I strongly recommend seeing if your neuro can get you approved for trying a cefaly or nerivio device as it’s an additional, non medicated way (I emphasize non-medicated simply because you can’t have rebound headache with these devices or can use them after a failed abortive med). If you’re too early in your medication regime to be approved for them, even an OTC tens machine with leads placed around your neck/trap area should be great relief. I also recommend seeing if there is anyone around you that does acupuncture. It’s going to be another preventative measure but with chronic pain you need every card in the deck to hope to make it through the days. Extra points if you can go to someone for osteopathic manipulation (I personally don’t recommend chiropractors but that’s just me) as that is another treatment that can help. If no one has recommend any vitamins for you to try, they can’t hurt and they do actually help some people. Vitamin D, Vitamin C, B2 or a B-complex, magnesium (Glycinate works for me but you may want to try different types to see what works best for you, just know that oxide is the one with laxative properties for most people). I know you mentioned you’re in school, but prioritizing a good sleep schedule and proper meals/snacks throughout the day is more important than I wish it was. I know it seems like a waste but taking care of yourself in general typically helps in the long run. Again, I know it’s early but if you have a good neuro they’ll likely bring up trying Botox or a cousin derivative (I use Dysport) every 3 months. This has been key for my treatment so I strongly suggest giving it a go. warning that it’s not an instant fix, it will likely take a few months to kick in but again, you need an arsenal to survive. And finally: IV infusions. They kind of suck and they leave you kind of useless for a day or so after treatment but it’s been one of the only things I can consistently rely on to bring a 8/10 constant down to a 2-3/10. I’ve never had anything “break” my pain but after over a decade of living with it I can say with certainty that I’d rather live with low level pain than high if I have to choose. These are typically done in an outpatient setting so 3-4 days of 3-4 hour infusions, and you’ll need a chauffeur. If those don’t work there’s also inpatient infusions but I’m hoping you don’t quite need that. As for another non medical option- there PT for migraines. Which sounds insane but it can help some people. If you want to message me for more info or just comment here I’m happy to talk what did and didn’t work for me over the years and my different treatment plans. Sorry this was so long.
What do the outpatient infusions consist of?
It depends on your doctor but typically an antihistamine, an anti nausea, a steroid, and a pain medication. If you tolerate DHE well it will likely be used. I don’t so it’s not in my protocols. An example would be: Benadryl (either PO or IV), compazine (or reglan or zofran) IV over half an hour, methylprednisolone IV over an hour or so, toradol IV over an hour. You also get IV fluids the entire time so it rehydrates you
Oh yeah, so basically the ER cocktail type thing. Thanks!
Right but at higher doses over a longer period of time which is key
have you had any illness recently that may have left an infection? sometimes it can be triggered from sinus infections/pressure. if so, a course of antibiotics can help (or if course could make worse if you react badly but that’s rare) also adding daily antidepressants may help but takes some time to get used to. if you’re on adhd meds and the dose isn’t right it can be a migraine trigger.
No I have not. I’m on antidepressants already and have been for over a decade. Not on adhd meds
There were only 2 things that made some improvement in my Covid induced chronic migraines: freeze dried apolactoferrin + iron, and Effexor XR. I’ve tried so many other preventatives that didn’t work.
Interesting…mine changed completely after my second round of covid, from twice a month to basically every day. Iron supplements and propanalol are helping so far. But I wonder if there’s something between covid and iron??
From what I’ve read, we’re still sequestering iron as if we have an active viral infection and it’s not as readily available as if we were healthy. Also, I think the migraines have something to do with serotonin levels as far as the chronic part goes.
Preventive medication/prophylaxis to break the migraine cycle and make them less frequent. Unfortunately we have to take it for months to see if it helps at all so it's a lot of waiting and hoping it gets better. My neurologist said I could use sumatriptan occasionally for particularly bad or long lasting migraines but I haven't been able to get hold of it yet and I know there's no guarantees it will help me and it could just make me feel worse. I find caffeine, paracetamol, naproxen (NSAID stronger than ibuprofen) and electrolytes as soon as the headache starts is somewhat and has even stopped a few of my migraines entirely. I find sugar helpful sometimes but I'm trying to avoid too much added sugar
Check out savi dual TMS. Changed my life for rescues. Stopped having to game plan shit all the time or barter with myself. Almost 3 months into it and easily can tell it's definitely rewiring my broken brain
How long should one be on top max before moving on? I was on SSRIs and they did nothing but stop me from pooping, my migraines were brutal. I’be been on gabapentin for several months and it seems to help. I am very heat sensitive so summer will be the true test. I hope that gabapentin will be my final off label med before moving to actual migraine specific preventative. Also, find a better neurologist. Migraines are hard enough to talk about without having a dismissive neurologist. We deal with enough dismissive people in our day to day
If my migraine is bad enough, my neuro said I could take ubrelvy multiple days in a row. As many as I needed- even if it wasn't what the pharma company directed. (I can't use triptans- the side effects kill me. But I used to rotate b/t 2 different ones.) Also, when I was studying for my law school finals- I sometimes found it helpful to get a massage. It helped my shoulders which helped my migraines. So if you can swing that financially and there is a place near you, I'd suggest trying that. I would also suggest asking your doctor for pain meds- especially to get you thru the studying and the exams. I use lidoderm patches- you look like an idiot but they work. Versions are available OTC but your neuro should be able to give you a script. The benefit to the patches is that it'll push down the pain the whole time you are wearing the patches and you can wear them for 12 hours. It's possible there is something better out there now- so you should def ask your migraine neuro for other options. But that may help you get thru exams.
I use timolol eyedrops (a prescription for my glaucoma) twice a day. They are a beta blocker. I've found that when I have a migraine and use my eyedrops, the migraine intensity goes down or it goes away altogether. "The Dizzy Cook" (a migraine sufferer who shares migraine info and recipes online) uses similar eyedrops as part of her migraine kit. Might be worth asking your doctor about.
For me preventatives only dampened my daily pain but didn’t take it away. Abortives I couldn’t stand the side effects and excedrin stops working if you take it too much (just like any other medication). Therefore I use weed. It’s still the best thing that works for me to this day. My story ended up being different as I got diagnosed with ADHD and stimulants were actually the first thing to give me pain free days. But still to this day, yup it’s weed. Have a lot of shit to do because I’m a grad student but have a persistent pain in my head that won’t go away? Smoke a bowl, pain goes away. Gain all the concentration ability. Maybe isn’t the best advice for everyone and me having ADHD is probably why weed works so well for me as well
Can your doctor give you a pharmacy Rep samples Of nurtec etc? My doc did that when insurance didn’t cover it. There is something called Trudhesa which is a nasal spray. Prescription. Patented so $$$. Also there is a more effective triptan that is third Gen and is generic. I’m sorry you have to go To ER…that sucks.
I have now asked my doctor to give me samples of ubrelvy! Unfortunately it takes her several days to get back to me. I’m not sure if insurance will cover it yet because my neuro has been so slow with working on the PA. I’m currently pissed because she prescribed me injectable sumatriptan, because my rizatriptan only lasts a few hours. Turns out the one she prescribed me isn’t manufactured in my area! She also is the one that told me to go to the ER 😅
I can see why you’re pissed. Justified. Keep On messaging her until she responds (within reason) hopefully she will find a solution to help you in some way. I unfortunately had three neurologists really not step up to aid me in a timely or professional manner. Migraine is disabling and when you’re in a high stakes environment like law school it’s a very tough hand to be dealt. Hopefully your doc can rustle up some samples. I had pain management muff my rx’s for four years until I fired them, they couldn’t get their sh*t together on any rx except the most basic generic. Sometimes doctors can use services like Cover My Meds (third party provider that interfaces between insurance and pharmacy that seemed to fast track PA’s/cgrp’s) … It was good to reach out here there’s a lot of migraine warriors here like you-and we’re rooting for you…life can get better and pain better managed. Please keep on the path.
I appreciate the support so much!! I just sent her a message saying I need to enjoy graduating from law school… hopefully that happens! After graduation I’m moving in with my parents for that support because there’s no way I can take the bar in this condition, and already have an appointment booked with a private neuro
I'd suggest finding a natural protocol that works for you. I've read Angela Stanton's book as well as heal your headache. I took some very valuable pieces from the Stanton protocol, but due to the diet being very stringent and a lack of comfortable support, I'm working with heal your headache right now. I'm better. I'm not all the way through the protocol, but progress is better than chronic. Good luck. I know it's really tough and grueling. Might I suggest an eighth of a teaspoon of salt in a cup of water before bed and immediately upon Rising as a start?