Migraines - help needed please!

[Igglepiggleandhisboat]

I am a migraine sufferer . Usually once per week. This is managed well by sumatriptan and beta blockers. I’m now pregnant and have been told that I cannot take these during pregnancy.
I have spoken to a GP and pharmacist both of who said to take pain relief that is safe in pregnancy. Which is limited. Problem is that this doesn’t even touch the migraine. I’ve had one since last night and need to get up for work in a minute. How do I cope with this pain?
At this stage I will do anything (that is safe in pregnancy). I can’t take the pain. Any tips?

I went to acupuncture for this when I was pregnant and it helped a lot.

The answer is not to go to work but to stay in bed. My GP told me the best solution is not to fight a migraine but to sleep

About to say the same. And reflexology so you can learn techniques to help if it happens.

I tried the hot water feet back on my DD and it actually worked. I put her feet into the hottest water she could stand for about 5 mins and her migraine got a lot better quite quickly

I also had acupuncture for migraine and it worked really well. Give it a try !

When I was pregnant my migraines stopped!

A local osteopath runs headache clinics in our area. Have you considered that?

If paracetamol isn't cutting it then NICE suggests second-line treatment with sumatriptan or (in 1st and 2nd trimester) ibuprofen.

https://cks.nice.org.uk/topics/migraine/management/pregnant-or-breastfeeding-women/

Have you tried prophylaxis/preventative treatment before? I think you'd probably want to see a specialist about it, but this webpage from Medicines in Pregnancy (run by the UK Teratology Information Service, which is commissioned by the UK Health Security Agency to keep up with what's safe in pregnancy) seems to suggest that there may be options on that front:

https://www.medicinesinpregnancy.org/Medicinepregnancy/Migraine/#:~:text=Low%2Ddose%20aspirin%2C%20propranolol%2C,in%20pregnancy%20to%20prevent%20migraine.

Only other thing I can suggest is doing a headache diary and logging anything that might possibly conceivably be a migraine trigger, then avoiding any triggers you find. Your triggers might have changed with pregnancy — the different hormones are supposed to have quite an effect on migraines (usually positive) IIRC?

ETA: obviously consult with the GP about the sumatriptan etc., don't just take my/the website's word for it, as you might have other medical reasons not to take it in pregnancy that I don't know about. I know that's obvious, but I just wanted to say it anyway… I know how desperate migraines can make you feel.

Low tyramine diet has helped me enormously, alongside cutting out nitrites/nitrates (found in most preserved meats like pate, bacon, ham), avoiding the older artificial sweeteners (I can tolerate sucralose, stevia, xylitol), & switching to organic poultry & dairy products (all eggs & chicken have to be organic as they're a major trigger, I have organic milk & yoghurt etc at home but don't worry about small amounts if I'm out.) I don't eat much cheese as it's fairly high in tyramine.

Experiment with warmth & cold on your head. I find a hot shower is helpful, many people swear by frozen peas etc.

Don't assume caffeine will relieve a migraine- it's a common suggestion but many people do better avoiding it.

You poor thing, it's just awful isn't it.

I think you just need to sleep this one off (sorry)

I used the curable app for a while when I couldn't take sumatriptan. It certainly didn't cure them, but it was useful for reframing the pain and my response to it.

I found the old coke (sugar + caffeine) plus dispersible aspirin trick worked better than paracetamol/ibuprofen. Can you take aspirin when pregnant? Be careful with aspirin though. I started to get stomach pains so have to avoid it now.

I was prescribed dihydrocodeine and cyclizine when I was pregnant with migraines.

@DumboHimalayan gas sent you links to the BUMPS website - this is always the best to check and discuss with a doctor.

I found that the doctors on triage/maternity were much better than my GP - can you go to triage/EPU and speak to a doctor there?

Acupuncture is recommended by NICE for migraines and is totally safe in pregnancy (just go to British Acupuncture Association registered acupuncturist or similar)

I had four sessions of physiotherapy on my neck joints including acupuncture, ultrasound and manipulation. For the first time in my life, aged 70, I am migraine free. It feels like a miracle.

Another vote for acupuncture. I was getting 2-3 a week in my early 20s, and just one session reduced the frequency to approx 7-10 days.

The other thing that can be helpful is identifying triggers. A lot of people are triggered by certain foods, or food combinations, so keeping a food diary can help. Some can be environmental: fluorescent light was a trigger for me, as were some smells (some paints, paraffin, and some perfumes).

They can also be hormonal. Mine all but stopped post-menopause.

Do you have things you use normally if it's too late for the Sumitriptan? Mine are darkness (sunglasses if I'm not at home), full sugar lemonade and sleep stories on Calm (if I can sleep, even just for 20 minutes, it can stop the migraine).
Prevention is key. If you know lack of sleep (or too much sleep) can trigger a migraine, going to bed at a regular time is important.

I heard this remedy only yesterday...

Back in the summer I was advised to have two Solphadine, taken along with a highball glass of original Coca Cola and a bag of salty crisps... The sodium helps relieve the effects apparently it's the out of the box thinking 🤔🤷🏻‍♀️ however I know friends have had acupuncture and this definitely helps them. Hope you're feeling better soon 💐

Honestly you need to sleep it off. Paracetamol and cocodamol/codydramol do absolutely nothing for me, only triptans work (I am also on beta blockers).

If I don't have sumatriptan the only thing that helps is something very cold on my forehead and sleep. Boots do cold patches for the forehead which I use but in your current situation some veg from the freezer and sleep is worth trying.

I've never tried the hot feet trick but I'd say that was also worth a shot. Longer term I'd try acupuncture.

I sincerely hope you feel better, and something on this thread helps

God I really sympathise I had the same issues in pg. I had a acupuncture it did help a bit.

Can you take aspirin in pg? My paramedic friend gave me the advice that you can take 900mg of aspirin at once to attack a migraine and it's v effective but I don't know about pg.

I was advised I could take 900mg of asprin in first and second trimester. With a migraine paracetamol and ibuprofen just make me feel more sick. I also cut all migraine triggers from my diet - that I knew about at the time. But also good sleep pattern, less stress etc. Are you able to get signed off sick for a while if they don’t improve?

I had almost daily migraines in pregnancy between 8 and 16 weeks (they then completely went away for the rest of pregnancy).

There's evidence that a magnesium supplement can help, and is safe in pregnancy, for me it reduced the severity but not the frequency.

I used to use a migracap - basically a hat with gel packs inside that can be kept in the fridge or freezer, I found cold very helpful.

The other thing I have now and really wish I'd had in pregnancy is a Cefaly device. It's an expensive option, but I use it a lot now when I've got a milder migraine, or a bad one while I'm waiting for meds to kick in. It's a tens machine which sticks to your forehead, it's a really weird feeling and can leave half your head feeling a bit numb, but disrupts the pain signals really well while it's on.

The hot water hack is apparently meant to open/dilate your blood vessels.

I did google the science behind it and it’s not something proven in trials but it has a lot of anecdotal evidence that it can work.

When I was pregnant my gp also said not to take triptans etc. I then found out I was having twins and had to see a consultant regularly, and she said in her opinion my usual triptans (naratriptan) would be completely fine if I didn't exceed one a week, and that I could absolutely take co-codamol for bad migraine pain until the third trimester. Interestingly, she told me not to touch ibuprofen at any stage of pregnancy.

Not at all telling you to ignore your gp, OP, just that there's a range of professional views, and if you really are desperate (as I was) it might be worth getting a second/specialist opinion. Good luck with the migraines and the pregnancy!

The pharmacist said the same! Im concerned as I get at least one a week :(
work is a trigger for them too :(

My GP and the surgery’s pharmacist both told me that sumatriptan was an absolute no!

As I said, I don't know your specific medical circumstances (and also, I'm not any kind of medical or pharmaceutical professional — I have an English degree 🤣), but at least to me, the NICE info doesn't seem to be giving a hard, blanket, absolute "no"… though it does discourage medication where possible, which makes sense.

But all of us who get migraines understand that it's not only a real quality-of-life issue, it could also affect your ability to function and take care of yourself properly, and mess with things like your job. It might "only" be pain and other temporary symptoms, but it does seem like they recognise that for some women, despite all efforts to manage migraine non-pharmacologically, the benefits of drug treatment will outweigh any risks to her and her pregnancy.

I'm not sure why your GP and pharmacist would say otherwise, but perhaps they know something about your health in particular, which changes the equation? Or I wonder if maybe they tend to say "no" at this stage in the hopes that it will encourage the patient to find an effective non-drug management strategy, on the assumption that if she can't, she'll come back, and then a conversation might be had about next steps. Though to me, that wouldn't seem a very open and modern way of doing medicine, so hopefully I'm wrong there.

(I've never been pregnant myself, but from the descriptions people give of the medical information and advice they're given by professionals when pregnant, it seems like it's often a lot more absolute and paternalistic than what I'd usually expect, and less likely to involve trusting the patient to understand and balance the nuances and risks/benefits herself.)

I don't know whether you looked at the page in much detail, but if you want to see why they say what they say about triptans, then if you go to the section titled "How should I manage a pregnant or breastfeeding woman with migraine?", scroll to the bottom of that section where it says "Basis for recommendation" and click the "Show" link just below it, it will expand to display links to the information they used for each recommendation.