PREFACE: My health issues really aren’t something I like to blog or even talk openly about — I find people much prefer silly anecdotes, juicy updates, recipes, or even religion (gasp!). But, I just heard today of another poor soul trying to find a way to manage as well. While I don’t like dwelling on my own pain, I’ve learned a lot since I’ve suffered with Migraines and neck pain for many years, and pray that even just that one woman may benefit from my journey through the past 20 or so years.
If you can relate to my “medical maze” below in any way, I sincerely hope you have or can find something and someone to help, and if you have other tips or treatments to add, please do. By no means can one blog post comprehensively cover this huge topic (or all the docs or meds I’ve tried), but I did this (1) in thanksgiving for the many people who have helped me along the way; (2) to pay it forward.
This has not been a “cheap” journey; and I had gone a few years without health insurance. If you do not currently have health insurance, and cannot afford it, I do have some tips at the end (and interspersed throughout) that you may also benefit from.
DISCLAIMER: This is not to have you diagnose yourself, or be convinced that any of my specific treatments will necessarily work for you; but perhaps it may help you or your friend/sister/coworker (INSERT whomever in your life suffers with Migraines) along their path to healing.
So, here goes a long post with a lot of (personal) information… P.S. I inserted lots of hyperlinks throughout the post, so you can learn more specifics as necessary.
My onset of Migraines started at some point in Junior High. I had no idea what was happening, but it would start in my eye with an aura - which would impair my vision. Shortly thereafter, I would throw up – after which my stomach would feel better – yet leave me with an excruciating headache for the rest of the day. My pediatrician at the time suffered with Migraines as well, so was able to describe on my level what essentially was happening in my body:
Everyone has different “triggers” (causes) for their Migraines, and I need to pay attention to discover what mine were. For some it may be wine, food allergy, stress, bright lights, lack of sleep, dips in blood sugar, sugar substitutes…etc. When my triggers occur (which took me some time to figure out), then my brain and body react. The blood vessels in my eye constrict (causing the auras – which could go on for about 20 minutes) and then the vessels eventually get very big and this affects the surrounding nerves, causing the rush – resulting in nausea/vomiting, afterwards leaving my head throbbing very sharply on one side.
She prescribed Anaprox, which is a nonsteroidal anti-inflammatory drug, to take immediately when the auras begin.
My Pediatrician also told me some things to when I felt my first symptoms (for me that’s the aura, which not everyone gets), utilizing Biofeedback. For Migraines, there are specific types of recommended Biofeedback. She shared with me some of the things occurring in the body as the Migraine forms, here are a couple:
- Hands getting cold
- Cheeks getting hard
- Tension on the forehead (between eyebrows)
In order to combat those, there were some techniques I could utilize, such as:
- Cold hands: Try to keep my hands warm – run under hot water, even…
- Hard cheeks: Puff out my cheeks (like you’re blowing up a balloon)
- Tension on forehead: Using my fingers, press down on my forehead (above and between eyebrows) – massage it. Don’t lift eyes (like surprised) – keep it down.
- Try muscle relaxation technique: Inhale, hold breath for 10 seconds, tensing all the muscles in my body. Exhale, and relax all the muscles. Repeat a few times.
There’s certain chemicals in foods that can can be triggers, as they have an effect on blood vessels — the expansion and contraction of which press on the nerves — that eventually causes the pain of Migraines. For me, super sweet drinks/foods can be a trigger, i.e. Orange Juice, too much refined sugary-snacks.
Also, at some point in Junior High, I remember my first lower back (right side) injury occurred in Gym class: Learning to jump hurdles. I hated hurdles then, I hate them now. In high school, I started to join sports teams. I can remember having a bad flare-up after a Volleyball game in that same spot — lower right. It was so painful, even breathing in made the pain radiate out. I iced it, and did whatever the trainer and parents instructed me to do. But at some point in my high school years, my neck began to really hurt, and I’m still not exactly sure when or why.
Doctors weren’t sure either, and never really knew how to address my neck pain – so they didn’t do much. My Dad was seeing a Chiropractor, and recommended that I try Chiropractic as well. That Doctor told me that I had lost the natural curve in my neck. I don’t know when I lost it, or how I lost it, but there it was on the X-rays – straight as a board. They did lots of adjustments on me, and different techniques to try to help. Relief was felt at the time, but would fade as the days went by.
Skipping ahead to my college days, where we had lots of fun and stress side-by-side. But there was a few particularly rough patches, where my Migraines began to get out of control – occurring daily, inability to sleep, couldn’t think straight, etc… My parents began to work through our General Practitioner to see my first Neurologist.
Dr. Aurora also suffered with Migraines. She asked me to explain what they were like, from onset to finish. She did MRIs, talked about triggers, etc. At that point, my Migraines had spiraled out of control, and there apparently was some brain swelling, and my headaches were rebounding one after the other. Dr. Aurora, from India, wasn’t a fan of Chiropractic and strongly urged me to stop them from “cracking” my bones. On the other hand, she definitely approached it from the brain chemistry angle: Basically, Migraines are “related to disorders of a specific nerve called the trigeminal nerve, as well as changes in the level of a specific neurotransmitter called serotonin. As a neurotransmitter, serotonin allows neurons within the brain to send signals to each other. One of the signaling pathways in which serotonin is involved is the communication of pain” (Read more: http://www.livestrong.com/article/15984-do-migraines-cause-brain-damage/#ixzz2CdQwNZn6.)
So, I took a low dosage of Pamelor daily, and then a regimen to take at the onset of a Migraine including an anti-nausea med, Reglan, and I can’t even remember which Migraine drug… I’ve tried Maxalt, Imitrex, Relpax…etc. Honestly, some of the side effects of the drugs were as bad or worse as the Migraine (Relpax made me feel like an Elephant was sitting on my chest, but then again, I do have Asthma as well). Since everyone is different, and responds differently to medications, much of the process is trying different meds to see what works best. I did get through that bad patch of Migraines with her help, definitely feeling better at the time – experiencing relief. I even earned mention as “one of her favorite patients” – not too shabby!
After college, there were different things tried at different times, with different types of doctors, in different states (sounds kind of like a Migraine variety show, doesn’t it). There were a couple of times that I felt relief for a time using Beta-Blockers daily, I think Propranolol, which relax the blood vessels. Again, things would help – for a time. I’d apply what I learned, take the meds until they ran out, etc. But what appears to the root of the problem had yet to be discovered…
I had a bad flare up of Migraines this past June, and my neck pain has persistently gotten worse. Pretty much daily, since I can remember when, I’ve been dealing with different forms and levels of headaches, (radiating) neck pain & extreme muscle tightness, bad pain behind my eyes, etc. I’ve learned to adapt, and push myself to function through it, but it does affect my concentration at times and inhibit me from doing things I want/like to do – including different forms of exercise (a few tips on exercise below). If I do mention that I have a headache, it’s got to be bad, because I’m so used to them by now.
That being said, you can imagine my gratitude (now, looking back) that my Primary Care Physician referred me to a specialist, who is now my Neurologist. It seems like such a simple thing – to refer a patient to a Doctor with a specialty concerning their issue; but, based on my experience, I feel certain that my PC Doctor would’ve diagnosed and treated my Migraines differently then the way my Specialist is approaching them. But believe me, at the time I was very skeptical of going to see another Doctor who likely had another approach to try to fix my Migraines.
And I have been pleasantly surprised. So, here’s where I’m at currently with things, for my fellow Migraine-sufferers.
Neurologist: Dr. Brian Sorin, MD
Treatment location: North Texas Neurology & Headache in Plano, TX
MRIs – Brain/C-spine – with and without contrast. Results: My Brain looks good at this point, despite years of Migraines, YAY!
Nerve Conduction Test. Results: no signs of pinched nerves or nerve damage, YAY!
My Diagnosis (glad to finally have what appears to be the most comprehensive one!):
(1) Dystonia = my muscles involuntarily contract. It seems like a back injury may have moved up to my neck and locked down there.
(2) Occipital Neuralgia = irritation of the 2 occipital nerves that emerge from between bones of the spine in the upper neck, which go through muscles at the back of the head and into the scalp. This causes radiating pain, mainly in my right eye.
(4) Neck pain
Preventative regimen (conservative approach, per my request):
(1) 2x Daily supplement: Magnesium sulfate/Riboflavin/COQ10 (Dr. Sorin’s compound that I pick up in the Pharmacy in the building)
(2) Physical Therapy: Traction, stretching, massage, and optional Chiropractic. I did 6 weeks of that, 2x per week. Considering the length of time I’ve had the issue, and the types of issues I’m dealing with, they prepared me for little results from the beginning. I estimated improvement of approximately 30%, but I was doing a combination of things, so hard to pin-point what precisely has helped – probably all of it. They want me to go through 6 more weeks of PT.
(3) TENS Unit: 20-30 min/day, or as needed. Note: If your neck muscles are stiff as (what mine have been called) a tire, do yourself a favor – if your Doctor doesn’t prescribe one for you, I’d say pick one up. They aren’t that expensive, and the massage stimulated by the electrodes will definitely relax even the those of us requesting elbows to be driven into our knots.
(4) Trigger Point injections - provides relief (instants) in that it relaxes the muscles, but that length of time will vary from person to person.
Then I have a Headache/Muscle Spasm regimen: Which included an anti-inflamatory, if my muscles spasm or at the first sign of aura, which is Naprelan. For my Migraine – 30-45 minutes after Naprelan – take muscle relaxer, Baclofen (which I’ve not tried yet). Step 3 in treating the Migraine is to take Zomig, which I’ve not tried yet either.
I’ve found Deep Tissue Massage to be very helpful in the past. My Doc wrote a script for me on my last visit, to see if it will help once again.
The Trigger point injections haven’t provided long enough relief, so the next thing I have just agreed to try (pending insurance) is a form of Botox injections into specific points in the neck and head. I think I may be the only woman in Dallas skittish to get Botox, ha HA! But the results have been very good with Migraine patients – can be 3 months of relief – and Dr. Sorin has yet to see issues with it. So, we will see…
A FEW TIPS (things that help me, advice I’ve gathered through the years, besides my preventative regimen above):
- I try to stick to a schedule. Since sleep deprivation and big dips in my blood sugar can be 2 of my triggers, I try and get 8-hours of sleep and have more frequent smaller meals/healthy snacks, so something good to eat about every 3 hours throughout the day
- My PT and the Chiropractor advised against strenuous physical activity/exercise. My Scalene muscles are a big issue, and so from my abs down, I can utilize more – but no running – as it jolts the neck.
- Stretch, everyday. I learned a lot of stretches from my PT, and Dr. Sorin also taught me some quick and easy ones to do, yes, every day.
- Ice, not heat. Heat packs feel so nice, but ice relieves swelling. Putting the base of my neck, and down my shoulders, on an icepack provides relief – especially when the muscles begin to spasm.
- They say to avoid caffeine in general; yet a strong cup of black coffee immediately when the Migraine is starting can help some people. I did it before, and the caffeine did help me.
- A friend of mine with bad Migraines takes and has found great relief through natural Reliv shakes. If you are interested in learning more, let me know so I can put you in touch with her.
- Do whatever you can (my view is outside of drugs) that works towards relax your muscles. Use a foam roller, roll on tennis balls in a sock or golf balls in your shoulder-blade, gentle and calming yoga (no standing on your head!), Epsom Salt baths, deep tissue massage, daily stretching, etc…
- An Asian Doctor told my friend to drink soup when the Migraine begins – the high salt content can help. If you wait too long, it may make you sick though
Well, I gotta get off to work, and that’s all I’ve got on the subject for the time being. As always, I love to hear from readers, so feel free to leave comments if you have questions or additional thoughts on the subject of Migraines and Neck Pain. I like to learn, and I like to help people – I’d be blessed if both occur through opening up on this topic!