Handhold/advice - recurring migraine

[faial]

Over the last 10 days I've had 5 migraines, I can stop them with triptan and naproxen but they come back between one and three days later. I did an AccuRx to the GP about switching to a different triptan (my triptan makes me feel awful, weak and anxious for about 48 hours after) in the middle of last week and got a message late Friday evening asking me to ring and make a routine appt for 2-4 weeks (which probably means 6). Since I did the AccuRx I've had two more migraines (in the tail end of one now). I've run out of triptans and sent husband out for OTC Sumatriptan (which also makes me feel like shit) in case the GP refuses to see/speak to me tomorrow. But I can't keep throwing triptans at it.

I have a history of hormonal migraines but I suspect I have Eustachian tube dysfunction at the moment (ears blocked about 70% of the time) for which I've been using fluticasone (Sudafed normally helps but I can't have it any more as have high blood pressure). I think the ETD may be the cause of these migraines/not helping.

I'm going to ring the GP tomorrow and say that I've had two more migraines, they keep coming back, but realistically what can they do? Can they give steroids? I really feel I can't go on like this (I've 2 chronic pain conditions that mean I have been in constant pain 3 years and this is the last straw).

Are you using a triptan each time? If so, it sounds like you have overuse headache and the triptans are now triggering your migraines.

Overuse headache is the absolute pits because the only thing you can do it go cold turkey and sit it out until it gets better. I found this incredibly grim and had a long time off work basically lying in a dark room with an icepack but it did get better.

Golden rule is never more than 2 triptans a week or 6 a month. If you are getting more than 6 migraines a month then you need to speak to your GP about a preventer medication - as well as a different triptan as different ones suit different people, I am with you on the awfulness of sumatriptan.

Yes I'm using frovatriptan each time. I thought the threshold was a bit higher than 2 a week. I've had 5 triptans in 10 days. I've never managed to get rid of a migraine by not taking anything because I've always cracked and taken meds at the 4 day mark.

I've tried most if not all of the preventers in the past and they didn't work.

I was also going to say overuse headache. Can you get to an osteopath? When I have an intractable migraine, 9 times out of 10 that solves it.

I hadn’t realised there was a limit to triptans until saw a consultant about my migraines. Ask your dr to refer you to a headache clinic or neurology.
I’m on blood pressure tabs (even though I have low blood pressure) daily now, and it is working mostly.
good luck, they are horrible.

I find 600mg Asprin (recommended by the GP) a god send. Tripitans made it worse I found.

Massive sympathy

You say you have tried most preventive meds. Have you tried CGRP inhibitors or Botox? My relative's migraines are much more frequent than yours: they have both of the above and have seen an improvement. Be warned - Botox is grim. 30+ injections in your head!

The Migraine Trust say you can take up to 300 mg of triptans in 24 hours. I take cocodamol as well as, or instead of, a triptan.

Cocodamol works for me and half a sleep aid tablet, with diphenhydramine hydrochloride. it makes me sleep and I wake up groggy but with no migraine. They are truly miserable. Sending you hope that you have finished your cluster of them

Zolmitriptan or rizatriptan are better than frovatriptan (frova lasts a bit longer but takes longer to kick in, so you have to take it at the very moment you have the niggle, which is hard if you are unsure that it's going to be a migraine).

900mg dissolvable aspirin and a can of full sugar coke works just as well, as long as you can take aspirin and don't also take ibuprofen or naproxen.

No I haven't tried them. I thought you had to have migraine more than 15 days a month to get them on the NHS.

You may be right. As I said, my relative's migraines are more frequent than yours - pretty.much daily. I was the same at that age, though Botox and CGRP weren't available then. I found that regular cranio-sactal therapy reduced the severity and frequency of my migraines.

The migraine came back. I've seen the GP today, my blood pressure's quite high (160 over something) so she wouldn't prescribe oral steroids to abort it. I've been given 15mg codeine, increased candesartan from 8mg to 12mg to get my BP down (although I think BP is high because I'm exhausted and frightened rather than the cause of the migraine), told to also use paracetamol and either naproxen or ibuprofen, no more triptans and to ring 111 if it doesn't go away in a few days, otherwise go back and see her in a fortnight. I'm not confident it will go away because OTC codeine has never worked but the stronger stuff might I suppose.

I was told codeine wasn’t effective for migraines and can make the worse. I’m currently increasing my candesartan back up to 16mg per day for migraines (neurology consultant at headache clinic prescribed) - I have normal to low blood pressure normally! Good luck. It’s horrible.