I would prefer not to suffer, thanks

August 23, 2023 5:46 PM

I am in vacation in Colorado and my migraines are in overdrive and almost nothing is helping. Is there anything I can do to get some relief?

I am prone to both migraines and auras and currently take nothing but excedrin, which is increasingly ineffective, to manage my headaches. When they flare up they last for days with the intensity varying from mild to barely-able-to-function. I’ve been in a flare since I got to Colorado on Monday but the headaches are way more intense than usual. I start off the day okay, either with no headache or a mild headache, but the pain starts increasing by mid afternoon until I have an absolute splitting headache by evening. I came here to hike the Rockies and have been increasing my altitude slowly since I got here. I’m staying at 5k, made it to 8k yesterday, and today hiked to about 10k.

To manage/prevent altitude sickness, I’ve been drinking a boatload of water (close to a gallon a day) with electrolytes in it. I’ve also been eating full meals with plenty of protein, moisturizing the fuck out of my sinuses, and getting a lot of sleep. I’ve also been popping excedrin like candy, which isn’t doing much. What’s strange is when I am actually hiking at a higher altitude I feel okay, with a minimal or no headache and no other symptoms of altitude sickness besides maybe some shortness of breath. I actually feel really good! The headaches are starting mid afternoon once my hikes are over.

I have 2 more days here and was going to to drive up trail ridge road tomorrow, which is 12k feet, but this making me feel like maybe I shouldn’t. Is there ANYTHING else I can try? The pain is lingering even at the lower elevation, though it’s less intense. It’s really hard to beat these headaches once they start. Is this just a sign that I need to do more to manage my migraines, like prescription meds? I’m not even sure that would help here but I’m just super bummed out that I may not be able to enjoy trips like this as much because of my stupid head. I’m prone to migraines when traveling anyway. Maybe if they were better controlled they wouldn’t be triggered as badly by the elevation changes? I don’t know.

Thanks in advance for your help,

posted by Amy93 to Health & Fitness (20 answers total)

Over the counter magnesium tablets at bedtime help reduce migraine frequency and migraine severity.

Avoid magnesium oxide, though - it's poorly absorbed compared to other forms of magnesium, and therefore much more likely to cause diarrhoea.
posted by chariot pulled by cassowaries at 5:49 PM on August 23, 2023 [2 favorites]

It doesn't help everyone, but a lot of people find cannabis to be helpful with migraines. And, that is easily available in CO.
posted by Dip Flash at 5:52 PM on August 23, 2023 [5 favorites]

For the two family members I know that are prone to migraines, prescription meds like maxalt will stop a migraine in its tracks. Getting those prescriptions was a major quality of life improvement for both of them.
posted by zsazsa at 6:03 PM on August 23, 2023 [2 favorites]

Try the Boost Oxygen canisters? They sell them in Estes Park and other tourist/gear shops near Rocky Mountain National Park. I also got altitude sickness there recently, so I feel your pain. I haven't tried the oxygen canisters... but I wish I did!
posted by many more sunsets at 6:18 PM on August 23, 2023 [1 favorite]

Give ibuprofen a shot. Ginger, garlic, and iron supplements all have anecdotal rates of success in alleviating altitude sickness. Also, avoid alcohol altogether if you can.
posted by ttyn at 6:19 PM on August 23, 2023

I am also a migraine sufferer who got headaches at high altitude in Colorado. It sucked.

My long term advice is to see a neurologist. There are many, many migraine medications and none of them are effective for a particularly large fraction of people. You will probably have to try a combination of tactics for best success.
posted by mai at 6:29 PM on August 23, 2023 [3 favorites]

Sumatriptan. You can get it at an urgent care.
posted by dianeF at 6:38 PM on August 23, 2023 [4 favorites]

I am pro-meds, but also: since they settle in later in the day, could the sun be an exacerbating factor? Are you wearing sunglasses and a good hat? Migraines can be made worse by both brightness and the tension in your face/head from squinting for long periods of time. And the sun really does hit harder when you’re up higher!

Also, you’re drinking water and electrolytes, but are you sure you are eating enough calories and at a good pace? It’s super common for migraines to be caused or made worse by blood sugar crashes and/or just plain being under-fed.
posted by CtrlAltDelete at 8:32 PM on August 23, 2023 [3 favorites]

when I got to the altitude you hiked to, the only relief I had from the migraines from oxygen boost cannisters and an indica transdermal patch, and then it only really went away when I descended in altitude. I wouldn't go up to 12k if I were you. My migraines are pretty well managed, and I get way more migraines when I'm in CO.
Good luck!
posted by wellifyouinsist at 8:43 PM on August 23, 2023 [1 favorite]

Sumatriptan is a good abortive for me, though it never seems to affect the aura. The only thing that has worked for prevention for me is beta blockers, specifically propranolol.
posted by pazazygeek at 9:37 PM on August 23, 2023

I think maxalt/rizatriptan sounds good and is what I use but I don’t think it would be good to use ten days straight or anything, I would check with a doctor. I would be careful taking too many medications (like triptans every day for 2 weeks or something) just in case you upset a previously stable migraine situation. Can you see a neurologist or talk to yours on the phone? Ice packs are great. I like the old fashioned kind you put ice into. Maybe they have them at a pharmacy.
posted by flink at 10:05 PM on August 23, 2023

maxalt +1. I'll never not have it.
posted by j_curiouser at 11:31 PM on August 23, 2023

My primary suggestion is urgent care for meds, but just on the off chance: switch to Pedialyte (yes the full-sugar kind unless you are diabetic). You can cut it with water (or bottled iced tea, is my hack) if it's too cloying, but it's the one OTC oral rehydration solution actually formulated to prevent serious illness or injury from dehydration. As home remedies go, it's pretty cheap to try. Also, my mother swears by it (and her cardiologist backs her up on this) as first-line treatment for basically everything.
posted by Lyn Never at 4:27 AM on August 24, 2023 [3 favorites]

Today:
I second the urgent care for meds. I had a migraine yesterday, took my meds, and was at 50% within an hour (this is way better than being at 0% for 24-48 hours before I was prescribed meds).

Also today:
- pedialyte, yes
- caffeine (black coffee or tea; artificial sweeteners are a migraine trigger for me), especially in the afternoon before the migraines hit
- alternate pain meds - I can't remember what excedrin has in it, but there is a migraine formulation, and there are also tylenol/ibuprofen/aspirin, but I know excedrin mixes some of those. This would be a pharmacist question.
- salty snacks
- if nausea is a problem for you, ginger works for a lot of people but not me, peppermint works for me, and "preggie pops" work for me - they are sour candies that I find at the pharmacy

My neurologist has mentioned that there are altitude-sickness meds that she would prescribe if high altitude was a consistent trigger for me. They come with other side effects and have to be taken before a trip, but this might be worth thinking about for the future.

Good luck. Migraines suck.
posted by Ms Vegetable at 6:10 AM on August 24, 2023

To add to everyone's great suggestions: You can also try a cold pack on your forehead and the back of your neck for relief in the moment. Do you feel like your sinuses are inflamed? Have you tried allergy meds?
posted by Stoof at 6:54 AM on August 24, 2023

Oh right, my neurologist also recommended magnesium and vitamin B - as in "We're not sure if these work or why, but they aren't going to hurt, so go ahead." I do think the magnesium is helping. (I have no idea if these supplements can have negative effects on other people, though.)
posted by Ms Vegetable at 8:52 AM on August 24, 2023

The one side effect of magnesium supplements (besides diarrhea if you take too much) is sleepiness. Best to take them at bedtime, in case you're one of those who experience this. And as cautioned above, avoid magnesium oxide (look for magnesium citrate or malate or fumarate); also avoid time-release formulas of magnesium as they tend to kick in just when you don't want to be sleepy. Don't expect any benefits of taking magnesium to be quick though. Unlikely to help much this week.

I'm afraid it sounds as though high altitude may not be for you. I'm never going to high altitude again, myself. Definitely try those oxygen canisters to see if they help.

Excedrin is not a good drug to take frequently. If you take it more than twice a week it can end up triggering daily headaches. This is true of many drugs used to treat an existing migraine (as opposed to preventatives), but I think Excedrin's the worst for this.
posted by metonym at 11:08 AM on August 24, 2023

I'm a big believer in caffeine to manage my migraines, whether it's in a combined NSAID pill with acetominophen or a very cold bottle of Coke (or sometimes lemon iced tea). I don't quite know why, but cold, sugary, caffeinated beverages will often stop a headache from progressing, and I am grateful that my brain sees them as "medicine".

Also someone above mentioned a cold pack, which I second, and also would add that I've benefited from alternating between a hot pack (or heating pad) and cold pack until the migraine goes away. Placement always varies a little, but I get a lot of relief from putting them over my eyes, forehead, and front of head. Or around my neck. Sometimes having hot in one place and cold in the other at the same time brings major relief.
posted by luzdeluna at 12:46 PM on August 24, 2023

Strange, but more than one sufferer friend of mine has mentioned licorice. Don't recall if red or black so try 'em both.
posted by hypnogogue at 1:26 PM on August 24, 2023

After this immediate situation is resolved (and I feel for you--migraines suck!), definitely go to a migraine specialist. There are several new drugs, just in the last few years, that are significantly more effective, at least for certain people. For me, ubrelvy has been a life-changer. The triptans I used to take would kinda, sorta work if I combined them with grinding my head in the pillow in a pitch dark room and taking a long nap. In contrast, I can take an ubrelvy and go on with my day, as if I were just taking tylenol, and within 45 minutes or so the headache would usually be completely gone. And if it isn't, I can take one more after two hours and the second one always finishes it off. In the US, at least, this is dependent on good insurance though, because it's a new drug and expensive out-of-pocket.

I've talked to so many people lately that just assume they have to live with their migraines, when that might not be true any longer.
posted by umbú at 6:54 PM on August 26, 2023