Help me stop these migraines. Please.

September 16, 2012 6:06 PM

Lots and lots and lots of migraines. Help, please.

Okay, so I used to have migraines years ago, and they were horrible. I was taking Imitrex and drinking lots of coffee, but the only thing that stopped them was sleeping and being in a dark quiet room.

Then they stopped for years. I had maybe one every two years until a few months ago.

Now, I'm having them several times a week, but they aren't quite as bad as they were several years ago. I'm light and noise sensitive, and standing up always blinds me and feels like someone is squeezing my brain. I get nauseous and extremely anti-social. Still, I can sort of function, where I couldn't at all a few years ago.

I can't figure it out. I'm almost 30, female, and I have a pretty great life with amazing friends, an amazing church community, and an amazing job.

Additional (maybe relevant) details:
1. I have SLE/Rheumatoid Arthritis. I've had this for at least a decade (before the migraines started)
2. I don't have health insurance until the first of October. And I haven't had insurance since the migraines started. I will see a doctor in October when I can.
3. I think there might be seasonal allergy issues at play - I'm allergic to sulfa (I live in the Bay Area, CA and they spray grapes with sulfa) and dust. But I've always been allergic to those things and the migraines have come and gone. I take Zyrtec-D and Benadryl.
4. I don't have any more stress than I did before the migraines started. There are some big things happening in my life, but they don't really seem connected (I know a lot of you will say there is a connection here. Trust me. There isn't. Yes, I'm in couselling and my counselor knows about the issues and doesn't think any of the emotional stuff is connected)
5. I am commuting to work right now, which is about 2 hours of driving. I'm moving from the East Bay to Marin at the end of the month so the commute will soon be 10 minutes instead of an hour. I'm not sure this is relevant but it sure doesn't help.
6. I have some serious muscle tension issues and several vertebrae that are messed up from a car accident years ago, and I know that plays a role, but no one can figure that part out. They've done imaging studies and everything.
7. I'm on pain meds already, but nothing touches a migraine once it starts.
8. I'm a high school teacher, so if I get one at work, I don't have much choice but tough it out. Thankfully, it's only happened once this school year.
9. I'm gluten-free, and have had a lot of pain relief because of switching about six months ago. Again, probably not relevant.
10. I'm pretty vitamin D deficient. Like seriously. I take lots of it via supplement.

I'd appreciate any ideas and help. I know, YANMD.

posted by guster4lovers to health & fitness (37 answers total)

Are you getting enough sleep? Continued sleep depravation (hello being a summer camp counselor!) always causes them for me.
posted by raccoon409 at 6:13 PM on September 16, 2012

I used to get migraines as well as frequent headaches. I always had Imitrex on hand because of the migraines. A couple of years ago, I thought I would try to lose some weight on a diet that focused on minimizing blood sugar level fluctuations. I didn't experience dramatic weight loss, but an interesting side effect was that I stopped getting both migraines and headaches.

I went off the diet and especially over the last year was irregular with my eating and the headaches and migraines came back. So now I'm back to paying attention to glycemic index numbers and the amount of carbs I'm consuming, and the migraines have stopped for now.
posted by needled at 6:20 PM on September 16, 2012 [2 favorites]

Have you kept a diary of what you're eating/drinking? You may have a food/drink trigger.
posted by Ghostride The Whip at 6:22 PM on September 16, 2012

Oh man do I feel your pain - especially as a high school teacher. Having a migraine while teaching is just about the only thing that makes me wish for my crummy old cubicle job, where I could easily lay low on painful days. Anyway, I am going to suggest a diet that some people will say is extreme; before I tried it, I would have agreed with them. Through two pregnancies in the last three years, my migraines were BRUTAL, but of course I couldn't take my usual pain meds. This was a last ditch effort (before weening my youngest child so I could get back on heavy duty meds). I think your #9 is a hint that it might help you, too, because through this method I have discovered that gluten is a bigger trigger for me than I'd ever suspected. So, here goes: the Whole30. It has seriously changed my life. I still get occasional headaches and a migraine every other month or so (typically weather-related or because of poor food choices), but I am so, so much better than I used to be. It is fantastic. One other thing I have also found helpful is supplementing with magnesium (this kind, specifically), before bed every night. Prior to my Whole30, I'd been told by doctors that I should try magnesium for migraines. It never worked, but I have since learned that certain kinds are more easily absorbed - and this is one of the more bioavailable types. Even if the diet is too much for you to take on, I'd give the magnesium a try.
posted by katie at 6:23 PM on September 16, 2012

You definitely need to see a doctor, but until then I highly recommend Heal Your Headache, by David Buchholz. That book saved my sanity; it's the best $10 I ever spent.
posted by cgg at 6:31 PM on September 16, 2012 [3 favorites]

I suddenly began having migraines. I was able to determine it was from birth control pills. I went off The Pill and they went away, never to return. A combination of lucky coincidences helped clue me fairly quickly that was the issue otherwise I might have been extremely dismissive of the idea since I had been on The Pill for many years with no apparent problem.

You didn't mention birth control. Just tossing that out there, in case it is relevant. From what I gather, various hormonal issues can play a role with migraines.

Best of luck.
posted by Michele in California at 6:34 PM on September 16, 2012

One of the worst and longest-lasting migraines I ever had started right after I spent two days laying flooring. I think it was the repetitive motion combined with the stress of trying to get it finished and the hunched-over position necessary for snapping the planks together. So, one thing that really jumped out at me from your list was your commute (2 hours of driving). Did your migraines start back up with the start of the school semester (and the commute)? I am wondering if there is something about the combination of stress during commuting and stiffness because of the position you need to sit in when you drive (especially given your previous vertebrae injuries).

The only thing that started to ease the pain after the floor-laying migraine--I was taking Zomig to no effect--was getting a shoulder/neck massage (and it really HURT while I was getting it, but the pain eased afterward). Can you see a massage therapist?

As another person who has taught through a migraine, I really feel for you. Best of luck. I hope your pain goes away soon.
posted by hurdy gurdy girl at 6:40 PM on September 16, 2012 [2 favorites]

Biased because of my own issues, but reading your list, the muscle tension and commuting jump out at me. I notice myself getting into really bad posture driving, especially when i am tired. Personally, I tend to slump and then raise my chin to compensate, putting a lot of pressure on my neck. In addition, I have some chronic habits of 'storing' tension in my neck and upper back, so I know that right now, I have a knot that lives there. Certain physical exercise and my poor driving posture make this even worse. WHen that area is inflamed, it seems to press on a nerve that goes up the back of my head and cause a headche. I think for a 'normal' person, this might resolve when the tension is resolved, but for me, the tension headache evolves into a migraine... I am planning to work on this by getting some massage to deal with all that tension... ANd I see that the poster above just had the same thought... Try some massage - fwiw, the practitioners I've seen have tried to help in 'medical' ways and recommended the massage as well.
posted by Tandem Affinity at 6:43 PM on September 16, 2012 [2 favorites]

Just want to note that for people getting migraines at such frequency, preventative meds can be an excellent option. Make that doctor appointment now and go in as soon as possible; your situation sounds unbearable!
posted by reren at 6:54 PM on September 16, 2012

Pregnancy? Any hormones you're taking (birth control)?
posted by treehorn+bunny at 6:57 PM on September 16, 2012

I didn't get migraines (after daily migraines) for years and years after I cut a few things out of my diet. Everyone has different triggers, so these two things jumped out to me...

I think there might be seasonal allergy issues at play - I'm allergic to sulfa (I live in the Bay Area, CA and they spray grapes with sulfa) and dust.

Have you kept a diary of what you're eating/drinking? You may have a food/drink trigger.
posted by Ghostride The Whip at 8:22 PM on September 16 [+] [!]

My sinus headaches almost ALWAYS turn into migraine headaches. Almost. Always. Years without migraines and then bam! migraines again.

And it doesn't hurt to check for food triggers. You can not have a problem with food for years and years and suddenly *bang* migraines.

I wish you luck.
posted by patheral at 6:58 PM on September 16, 2012

Used to have migraines from clenching my jaw at night. Dentist adjusted my bite and I have a bite guard. Rarely get migraines now but I notice the difference if I don't wear the guard or I start getting tension in my neck and shoulders. It was also at its worst when I was commuting two hours everyday. Maybe that causes some tension in neck and shoulders you're not aware of that is contributing.
posted by tamitang at 7:03 PM on September 16, 2012

Thanks for the responses so far.

I'm guessing the commuting plays a role, but often the migraines start around 3-4 PM, so I haven't been in the car for hours at that point (my morning commute is about 40 mins). The commute is new though, as I was living/working in the East Bay for the past few years. I have noticed that my posture isn't great - I have a lumbar support now, but the headrest sticks out forward a lot and it doesn't let me align my spine the way I want to. Short of getting a new car (not going to happen), I'm not sure what to do if that's the problem.

The blood sugar theory is interesting. I know that gluten messes me up, but I haven't noticed anything else in particular - just that I'm not eating as well now that school has started. I'll pay more attention to what I've eaten on days where migraines start.

Magnesium is also a really easy add-on for me.

Not pregnant, not on BC, no need to now or in the near future. So that's out.

I've been meaning to get a massage for a while now, so I will try that this week and see if it helps.

Thanks again. I appreciate the help...I'm frustrated and my friends are all frustrated for me too. Looking forward to not having 3-4 of these a week.
posted by guster4lovers at 7:29 PM on September 16, 2012

During your long commute, do you wear sunglasses? Like, good ones that effectively reduce all of the glare that comes into your field of vision while driving? (I get photo-sensitive migraines also, and I have to be really careful about wearing sunglasses during daytime driving.)

Is there any painting/finishing/polishing/other fumes source in your environment? (I recently had a five-day migraine that turned out to be related to nail polish fumes.)

Do you wear glasses, and if so have you had your eyes checked recently? (Having the right prescription has made a difference for me too.)

Good luck - I hope you get it figured out soon.
posted by heisenberg at 7:32 PM on September 16, 2012

I know people mention "lots of coffee" (or lots of caffeine in general) as a migraine cure, but I've found it to be the opposite, and David Buchholz agrees in the aforementioned Heal Your Headache -- in fact, I believe his first suggestion is to get off caffeine for life. caffeine helps in the short term (which is why it's in Excedrin Migraine & similar), but there's a rebound effect when it wears off. I haven't gone as far as swearing off caffeine, but when I stick to caffeine lite beverages like green tea, my migraines are much, much less debilitating.

HUGE hugs. migraines suck.
posted by changeling at 7:36 PM on September 16, 2012 [1 favorite]

Some things I do to manage my constant fucking neverending migraines:

- very little caffeine - no coffee, one cup of tea/day
- no wine, ever. period.
- no stinky aged cheeses
- if someone dares to set foot in my home while smoking a cigarette no one will ever find the body
- allergy pills on days when weather.com says high pollen count
- no drinking anything hard while out in the sun (this is the hardest)
- take imitrex as soon as the symptoms even hint about starting
- yoga
- regular workout schedule
- regular sleep schedule


Also, on days when i get migraines not related to pms, I write down the times I ate, and then for the next week or so I make sure to eat an hour earlier. Low blood sugar definitely contributes, and my other medications make it hard to tell when I'm actually hungry.
posted by elizardbits at 7:44 PM on September 16, 2012 [2 favorites]

on the supplement/vitamin front, i've found that fermented cod liver oil and butter fat oil help keep my migraines in check. I know vitamin A deficiency isn't 'supposed' to cause migraines, so maybe it's one of the other vitamins in the combo (you mentioned taking vitamin d supplements, there is a lot of d2 in the flco/butter oil). awesome bonus: my skin/teeth/hair look fantastic.
posted by par court at 7:53 PM on September 16, 2012

I have a herniated disc which causes a kind of cluster headache (similar in intensity to a migraine which I have also had). I used to get these flare -ups basically once a week or more- during that time I was commuting a long way, did not have an exercise routine, and was stressed out.

Now, I get a much lesser-intensity (and more manageable, before I had to stay in bed all day, now it;s just an annoyance usually) flare up about once a month, usually before my period.

The difference? Regular exercise, ESPECIALLY yoga. Actually, yoga is now all I do, everyday. And it has been infinitely helpful. It even makes the pain go away after it has already started up.

Sleep is also important.

Good luck.
posted by bearette at 7:58 PM on September 16, 2012

I'm on a large number of antihistamines for chronic hives and my 4x per week migraines are now about twice per month. I see that you're on antihistamines -- maybe talk to a doctor about increasing the dose and/or trying a different combination of antihistamines. (I just had to switch back to benedryl for this weekend because my doc didn't call in a refill on the hydroxyzine -- and I got more headachy -- and the stupid hives are growing again, despite the fact that I'm still taking the other four antihistamines.)

I agree with a lot of the suggestions above -- but I also want to remind you to hydrate, hydrate, hydrate (especially while taking antihistamines). I suspect it's hard to effectively drink lots of water while teaching. My best days are when I drink 24 oz by 11:00am and another 24 oz by 3:00. That's not the only liquids I get - but those are the 48oz that take effort.
posted by vitabellosi at 8:18 PM on September 16, 2012

Re the mention of cod liver oil and butter fat oil: I don't think of the headaches I get these days as "migraines" because I have a different mental model of what is going on in my body, but my recent headache + nausea combo often goes away in response to getting adequate salt and butter.
posted by Michele in California at 8:26 PM on September 16, 2012

Also, when I get anything like an aura or migraine precursor or whatever, 9 times out of 10 it is a previously enjoyed scent that becomes suddenly wildly, painfully overwhelming. If this happens I know I need to immediately be somewhere dark and quiet for about 30 minutes with an icepack on my forehead. This can stop a full-on migraine dead in its tracks, but only if I react to the tells immediately.
posted by elizardbits at 8:31 PM on September 16, 2012

I wanted to also mention sun glare as a possible trigger - as the seasons change the angle of the sun in the sky as you commute does too. Are the migraines only during the week or do they happen on the weekends too? If they're only during the week, try leaving work a half hour or hour later than usual and see if the difference in light helps. A good pair of sunglasses may help as well.
posted by sciencegeek at 11:38 PM on September 16, 2012

I agree with changeling and vitabellosi. Years ago, I worked in a building that got cold on winter weekends and I'd drink lots of coffee just to stay warm. I found that too much coffee triggers migraines for me. I also get migraines sometimes when I am dehydrated. So try cutting way back on or eliminating coffee and drink more water instead. Worked for me within a few days.
posted by islandeady at 11:48 PM on September 16, 2012

It sounds like there are some significant changes happening in your life. You have a new commute, your moving shortly. You say some major good things are happening in your life. All of this plays a role. Easily absorbable magnesium is a great idea. No caffeine is a great idea. Keeping as close to a regular sleep schedule as possible is a great idea. If nothing helps, and you do get health insurance, I would highly recommend botox. It's changed my life.
posted by brevator at 3:37 AM on September 17, 2012

This sounds very crazy and woo I know, but I've found that something that helps my occasional, relatively mild, multi-day migraines is the smell of lavender. I put a little essential oil on and within a few hours it lifts completely.
posted by mchorn at 4:06 AM on September 17, 2012

The thing where it happens at the same time every day also leads me to believe it is food based.

Caffeine is not a headache preventer. It might stop one that's already going, but using it as a preventer is ill-advised.

Agree with the stinky cheeses and aged meats (anything with lots of tyramine in it) advice. This has been the #1 thing that has kept my migraines at bay. Please note that the effects (for me, at least) are additive. One stinky cheese sandwich might not trigger it, but a little bit over the course of a number of days will definitely do it.

#2 Trigger is monosodium glutamate.

Keep your environment as humid as you can, to keep your sinuses happy.

The key to keeping migraines at bay is consistency and thinking long term.
posted by gjc at 6:06 AM on September 17, 2012

Fragrances do me in. Are you wearing scent or using scented products? Try going fragrance-free.
posted by Carol Anne at 6:17 AM on September 17, 2012

I don't see anything in your question about being on a daily prophylactic medication for it... I was a 2-3x-migraine-per-week-er, until my neurologist started me on a low dose of nortriptyline daily. It's an SSRI, which sounds kind of weird , but it worked miracles, and the dose was small enough that it didn't cause any of the normal suite of issues that come with SSRIs. Has your doctor talked to you about daily preventative meds?
posted by Mayor West at 6:26 AM on September 17, 2012

About 30 years ago an ER doc prescribed oxygen for my migraines. He said if oxygen didn't cure it than it wasn't a migraine. Have never found another doc who was familiar with it but since oxygen is relatively harmless they've always let me have it. Bonus: no drug hangover.
posted by misspat at 6:50 AM on September 17, 2012

About 8 years ago I had a month-long bout of cluster headaches (oh the misery...) Eventually a doc prescribed me a beta blocker. I took it for about a year, had zero headaches during that time, and can count on one hand the number of migraines I've had since stopping it.
posted by Flannery Culp at 7:13 AM on September 17, 2012

I used to have migraines that increased in frequency over the years. This spring I had them so often that my primary care physician, who specializes in migraine treatment, prescribed a low-dose beta blocker that I take daily. I've had one migraine since then, and that was after a transcontinental flight and probably due to the jetlag. All the triggers I used to have (stress, too little sleep, low blood sugar, ...) are not a problem any more.
posted by amf at 7:26 AM on September 17, 2012

It could be your lupus:

Compared with the general population, people with lupus may be twice as likely to experience migraine-like lupus headaches, commonly known as lupus headaches. The features of lupus headaches are similar to migraines and may be seen more often in people who also have Raynaud’s phenomenon. However, headaches can also be caused by vasculitis, a symptom of active lupus due to inflammation of the blood vessels. If you are experiencing headaches that are not improved by an over-the-counter headache medication, be sure to tell your doctor.

Lupus vasculitis is a very serious condition and can do a lot of permanent damage in a short period of time. I think you should be evaluated immediately to rule that out regardless of your insurance status.
posted by jamjam at 9:23 AM on September 17, 2012

The role of cellular/mitochondrial energetics in migraines has gained some recognition Perhaps you could try Coenzyme Q10 supplements?
posted by nimmpau at 9:51 AM on September 17, 2012

These things are regular migraine triggers for me:

-- sugar
-- dehydration
-- lack of exercise
-- recurrent sinus problems (my family history is riddled with sinus issues like polyps and deviated septums and all sorts of crap)
-- eye strain (just changed my contacts prescription! fewer migraines already)

Things that help my migraines:

-- coffee
-- Benadryl/Tylenol/Advil cocktail (ie taking all three at once; two Tylenol sometimes)
-- avoiding sulfited food and drink

Have you ever had your sinuses x-rayed? Where is your migraine usually localized? Is it consistently on the same side? Do you get auras? How bad?
posted by These Birds of a Feather at 8:26 PM on September 17, 2012

Massage therapist here. I see a lot of people with migraines and the #1 thing that has helped my clients is contrast therapy. There are two ways of doing it, one by alternating hot and cold towels around the neck, and two by placing a hot pack on the head and a cold pack at the base of the neck (lie down on it). Do it as soon as you get an inkling you are getting a migraine, and it may well nip it in the bud and prevent it from becoming a full-fledged living hell.

I also agree with the suggestions to get a massage, to improve your posture, and to do a migraine diary to try to identify any triggers you weren't previously aware of.
posted by parrot_person at 3:15 AM on September 18, 2012

Random thoughts/answers to questions people have asked:

I haven't had a sinus x-ray before. That's a good idea.

The migraines are usually front, slightly more on the right side. I don't get auras anymore.

Because of unrelated back problems, I'm hyper aware of my posture and have made sure to drive/sit/sleep according to the advice in Treat Your Own Neck. It has helped over the last year, at least to make me aware of when I'm not using good posture.

That's interesting about the Lupus connection. I've never read anything about that, and it seems like that's a definite possibility. When my insurance picks up at the end of the month, I'll be trying to find a new specialist ASAP.

I was on an SSRI for a while to control the migraines several years ago, and it caused both alarmingly rapid weight gain (40 lbs a month), sleep issues, and a ridiculously high blood pressure (200/90). That happened with two different ones, so I'm really hesitant to try that again. I've struggled to lose the weight from that for six years, even with great diet/exercise routine.

I will try contrast therapy - sounds simple enough that I can figure it out, even with a migraine.

In REALLY exciting news, it looks like I've got a place to live in Marin on the 1st, so that will help for sure!

Thanks again for all the help ya'll. It's given me a lot to think about and I really appreciate the time you each have taken to respond. Thanks!
posted by guster4lovers at 1:26 PM on September 18, 2012

Can you take aspirin? I have recently started taking 1000mg of aspirin at migraine onset. If I catch it early enough, it stops them dead. And I have triptan-resistant mutant mega migraines. According to my doc, this is an old-time remedy that fell by the wayside once the wonder drugs hit the market. I can't do this every day because I become Betty Bruises, but every few days isn't so bad.
posted by Addlepated at 3:41 PM on September 18, 2012