Okay, so because I’m in a really bad place and cannot help myself, I would at least like to help others. I am online (4:30am est) and will help with questions about sexual abuse, eating disorders, suicide, depression, abuse and rape.
If you’d like help please join. No sign-up, you can be anon. Just be aware I may need to leave suddenly because I am having a lot of personal issues as well.
Still, don’t let that worry, guilt or question eat away at you. I’m here. I have a bachelor’s in sociology and am a certified domestic violence advocate, so I’ll do my best to help.
Don’t be shy. :)
(reblog in case your followers need late-night help?)
-Unknown (via mompains)
Literally have tears rolling down my face from this.
This Town Ain’t Big Enough for the One of Me- Frank Turner
How I wish I could reply:
How I do reply:
Mental health problems are, y’know, health problems. Treat them the same way, or shut up.
YES I NEED FOR EVERYONE TO SEE THIS
This is real real important
Follow these instructions to come participate!
1.) Please click this link http://www.survivingchronicpain.com/
2.) Click the Orange button that says “CHAT” on it.
3.) Where it says GUEST, type your name or a screen name you prefer and add a password to register into the chat.
4.) Where is says “Surviving_Chronic_Pain”, please type Migraineur_Misfit_Musings. Then you’ve entered the chatroom!
TODAY’S CHAT WILL BE FOR 30 MINUTES AND IS A GENERAL DISCUSSION ABOUT ALL VARIANTS OF MIGRAINE AND YOUR EXPERIENCES SUFFERING WITH THEM. *Today’s Chat leader is Seizonsha, Founder of Migraineur * Nikki ”The Hermit” is not available today, although she generally runs the chat room.
You can also enter the chatroom via Tumblr by clicking this link and following the instructions along the side of the page: http://livingwithchronicmigraines.tumblr.com/
Special thanks to our sister site, Surviving Chronic Pain
The American Headache Society (AHS) released a list of commonly treatments or tests for migraine and headache that are not always needed. The list comes about as part of the Choosing Wisely® initiative of the ABIM Foundation. It aims to target five areas, supported by evidence with an effort to support conversations between doctors and patients about what is really needed or necessary. This will be published in Nov-Dec 2013 journal of Headache.
American Headache Society Releases List of Commonly Used Tests and Treatments to Question
“All of us on the front lines of medicine know we have the opportunity to improve the care we deliver by engaging our patients in conversations about what care is really necessary and beneficial to their health. The recommendations in migraine and headache treatment released today provide valuable information to help patients and physicians start important conversations about treatment options and make wise choices,” said Elizabeth Loder, MD, MPH, President of the American Headache Society. Dr. Loder is Chief of the Division of Headache and Pain in the Department of Neurology at the Brigham and Women’s Hospital in Boston.
AHS’s list identified the following five recommendations:
• Don’t perform neuroimaging studies in patients with stable headaches that meet criteria for migraine
• Don’t perform computed tomography (CT) imaging for headache when magnetic resonance imaging (MRI) is available, except in emergency settings
• Don’t recommend surgical deactivation of migraine trigger points outside of a clinical trial
• Don’t prescribe opioid or butalbital-containing medications as first-line treatment for recurrent headache disorders
• Don’t recommend prolonged or frequent use of over-the-counter (OTC) pain medications for headache
This Neurology Now article gets right into the treatments that have been looked into and recommended for migraines… Heading Off Migraine: What’s the evidence for non-pharmaceutical approaches? and is well worth reading if you are looking for some ideas.
I know we often think…
But it is always about more than the medication when it comes to chronic migraines…
In a new guideline on migraine prevention issued in April, the American Academy of Neurology (AAN) reported that the following prescription medications have been shown to be effective for preventing migraine by a high level of evidence: the antiepileptic drugs divalproex sodium (Depakote), sodium valproate (Epilim), and topiramate (Topamax); the beta-blockers metoprolol (Lopressor, Toprol), propranolol (Inderal), and timolol (Istalol); and the triptan frovatriptan (Frova). (See “New Migraine Guidelines from the American Academy of Neurology,” page 15, for more on the levels of evidence supporting these therapies, and go to aan.com/guidelines to access the full guidelines.)
Drugs that have been shown probably to be effective in preventing migraine according to the new guideline include the antidepressants amitriptyline (Elavil) and venlafaxine (Effexor), the beta-blockers atenolol (Senormin, Tenormin) and nadolol (Corgard), and the triptans naratriptan (Amerge) and zolmitriptan (Zomig).
On the other hand, strong evidence suggests that the antiepileptic drug lamotrigine (Lamictal) is not effective in preventing migraine, the new guideline states.
So there are the go to medications. Or not go to medication for Lamictal I guess. There are two that I have not tried, and can try… so gives me some suggestions anyway. I bet they both cause weight gain and zombie brain.
BIOFEEDBACK“Biofeedback helps someone achieve a calm inner state, diminishing the excitation of nerve cells,” explains Dr. Klein. “People can try to achieve this with meditation as well, but biofeedback offers input so that they know if they are doing it correctly.”Biofeedback equipment allows people to monitor their automatic bodily responses, especially reactions to stress. The idea is that once the patient learns to monitor these responses, he or she can modify them, changing skin temperature and heart rate, for example.Two kinds of biofeedback are commonly used to combat migraine: skin temperature biofeedback, which teaches people to warm their hands; and electromyogram (EMG) biofeedback, which teaches people to relax their muscles.Why would these therapies help with migraines? The idea is that during migraines, blood flow increases to certain areas in the head and decreases in the extremities, such as the hands. Modifying a response such as the temperature of the hands might increase blood flow back to that area, reducing the pressure of blood flow to stressed or overexcited areas in the head. It might also have an overall calming effect on the central nervous system.“A substantial body of evidence shows that biofeedback improves migraine, and the difference is almost as great as what you see with some prescription drugs,” says Dr. Lipton.
ACUPUNCTUREMetzger recently started seeing an acupuncturist at the recommendation of a friend, who claims the same acupuncturist rid her of the migraines that had become unbearable since the birth of her second son.But research findings are less than conclusive.In two large studies of acupuncture as a preventive treatment for migraine, migraineurs who were assigned to receive “real” acupuncture, in which the needles were inserted along the meridians (key acupuncture regions according to traditional Chinese medicine), did in fact see a reduction in the frequency of their headaches. But so did patients who received “sham” acupuncture—that is, needles inserted at random sites rather than along the meridians.“One possible conclusion we could draw from these trials is that acupuncture doesn’t work,” says Dr. Lipton. “That’s the conventional view: that these are failed studies. Another possibility is that placing the acupuncture needles just about anywhere is an effective treatment for migraine, not just along the meridians.”Dr. Lipton doesn’t suggest that his patients try acupuncture, but he is happy to refer if a patient asks. “My clinical experience is that a lot of patients do better when they get acupuncture,” he says.
And the vitamins and supplements? How do they fair in the recommendations?
I just had a WTF moment as I randomly was looking at information for something else. Sometimes you hit something and it just knocks you upside the head. In this case because I have had permanent nerve damage in my hand I was told was caused by the viscous status migraine I had, as it occurred during it, but that it has happened because of the status migraine and the fact I always have as it were this pre-migraine state… the persistent migraine auras. Another neuro said, well, it was likely a stroke in your sleep, which then caused the nerve damage. Either way, nerve damage from migraine. Sucks, but there you go.
But… then this wee tidbit. it turns out that triptans and ergotamines are contradicted for treatment in prolonged auras, just as they are for HM and basilar migraines and for the same reason… an increase in stroke risk. Advanced Therapy of Headache Book It Is a good place to find a reference for what I was talking about.
Third, triptans probably do not work for aura,and may in fact be contraindicated in prolonged aura.Three randomized controlled trials found administra-tion of triptans during aura did not terminate aura orprevent the migraine which followed the aura, usingsumatriptan 6 mg subcutaneous, zolmitriptan oral20 mg, and eletriptan.4-6However, 1 small controlledstudy with oral sumatriptan 100 mg reported successin preventing the migraine in 34/38 (89%) of aurastreated.7These 4 trials show triptans do not work to elimi-nate aura. Use of a triptan to try to clear a persistentaura is not evidence-based, and is bound for failure.The question as to whether a vasoconstrictive agentmight be harmful for a patient with a fresh infarctionis another concern.Clinical pearl: don’t use triptansduring aura or for persistent aura. (TEACHING CASE: MIGRAINE STROKE)Juan Gonzalez, MDChief Resident in Neurology, Dartmouth Hitch-cock Medical Center
Over and over I have read it is contradicted and not to be used. In one article I read it said some headache specialists might use them ‘with caution’ and supervision’ and I would assume… if their patient had nerve damage or a stroke, they might reconsider that. One would think.
This would have been nice to know since I have had a persistent migraine aura for decades and have been on triptans since I was diagnosed. And for a while there even estrogen birth control. And that I actually had nerve damage from a status migraine, which is very odd indeed, blamed on the my prolonged auras and the status migraine, or as the other neuro asserts I must have had a stroke.
And knowing this as they did… I am Still on triptans. Even though clearly that could be a freaking factor. I think the neuros treaking me are not aware of this risk at all. Or simply did not find it to be a valid risk. But can we pick and choose risks when migraine with aura comes with more stroke risk already? I mean the birth control with estrogen is an absolute no now… so what about this one? No, but maybe, depends on whether your neuro likes triptans and has a stigma against other treatments?
Or they read this very small study with 13 participants, which meant maybe one or two had persistent migraine auras.:
Triptans in the treatment of basilar migraine and migraine with prolonged aura.Colorado Neurology and Headache Center, Denver, CO 80218, USA.
OBJECTIVE:To report on the use of triptans in migraine with prominent neurologic symptoms.
BACKGROUND:As stated in their package inserts, the triptans are contraindicated in patients with basilar or familial hemiplegic migraine, and physicians are reluctant to prescribe these drugs to other patients with prominent or prolonged aura.
METHODS:We evaluated 13 patients with basilar migraine, familial hemiplegic migraine, or migraine with prominent or prolonged aura who had received triptans.
RESULTS:Excellent; no adverse events.
CONCLUSION:The contraindication of triptans in basilar migraine should be reconsidered. Similarly, prominent or prolonged aura may not represent a reasonable contraindication to triptan therapy.
Well I don’t feel very comforted on that one thank you very much. Your very small study of 13 individuals does little to assure me there are not complications that can occur in All of those, even if it was 13 of Each, and it wasn’t. I think you might want to research that a little bit more. So I think they should ‘reconsider’ that a whole lot more. I have known people who have had strokes from changing triptans. Known people who had strokes from trying triptans. So if a person has a contradiction based on type of migraine or prolonged auras… I take that seriously.
Also… migraine with auras are contradicted with use with beta blockers. Same reason. And before I had asthma… I had tried out two beta blockers that I remember. So clearly that was Also not something that was considered, even though That one was not something that was waffled on… it was a do not put them on beta blockers thing.
Sort of freaky that I was not aware of this. And sort of freaky I don’t think all the neuros I have seen are aware of this.
Chronic migraine is defined as having migraines at least 15 days every month, lasting four hours or more.
Chronic Migraine in America 2013 [x]