Are my migraines... well... migraines?

June 17, 2007 9:52 AM

Daily headaches, occasional migraines, now sever chest pain. Is my diagnosis correct? More inside...

You're not a doctor, if you are a doctor you're not my doctor. I understand that, just looking for some things to discuss with my doctor. For the past few years I've had headaches daily. Every few months I will get sever migraines. With all of my headaches they are on the top of my head. (Place your hand across your head sideways, you'll be touching the entire area.) The migraines occasionally have a preceding aura. The reason I question the diagnosis is because none of the traditional migraine meds help. I've tried 100mg of Imitrex, also Frova, Maxalt, and a few others. High doses of Fiorcet help. The other rescue med I take is Lortab. (Vicodin) If these are migraines shouldn't the traditional meds work? I'm a 24 year old male.

posted by TheDukeofLancaster to health (11 comments total)

Have you tried the Imitrex nasal spray? The pills did nothing for my ex-husband, but the nasal spray was a lifesaver for him.

Migraine with aura are pretty textbook, but everyone reacts to the different classes of meds differently (the triptans, the ergots, the barbituates). Have you talked to your Dr. about beta blockers as a preventative?
posted by wayward vagabond at 9:58 AM on June 17, 2007

you answered your own question: discuss with a doctor.

there are lots of reasons for headaches--they're not all migraines (and "migraine" doesn't just mean "really bad headache"). you could have sinus issues, allergies, tmj, bruxism (clenching your teeth at night), anxiety disorder, or something else. you could just need glasses. all of these things can cause really terrible headaches (disproportionate to the severity of the actual problem).

not sure how the chest pain ties in, but again, doctor, asap.
posted by thinkingwoman at 10:03 AM on June 17, 2007

IANAD, but perhaps mention the possibility of vasculitis to your doctor. It is an inflammation of the blood vessels (and is usually a secondary disease caused by something primary, like Lupus in my case) and can cause headaches and chest pains.

Good luck to you.
posted by Oriole Adams at 11:16 AM on June 17, 2007

Do you take the triptans as soon as the migraine symptoms start? Because that's when they are most effective. And you might be one of those who needs the nasal spray or the injection to get effects.
posted by happyturtle at 11:24 AM on June 17, 2007

There was an interesting story on CBS Sunday Morning featuring Connie Bennett (author of Sugar Shock!) and her cure for migraines.
posted by plokent at 11:41 AM on June 17, 2007

Talk to your doctor about seeing a "cluster headache" specialist, some people find relief using migraine medication but there are other solutions, like using oxygen.

If they are not clusters, but are tension headaches are you a candidate for Botox? I was considering that at one point and heard good things. In the end I moved away from SoCal and the headaches largely stopped- turned out they were largely bring triggered by the sun. I still get some headaches that are related to my diet but much less frequently. I also wear very dark sunglasses all the time outdoors and that helps a lot.
posted by fshgrl at 1:45 PM on June 17, 2007

Here's an off-the-wall possibility. How much coffee do you drink? Tea?

Caffeine is an addictive drug, and a common withdrawal symptom is migraine headache. I completely eliminated my once-debilitating migraines by removing all caffeine (including chocolate and "decaffeinated" products) from my diet. After two weeks of no caffeine, the withdrawal symptoms should disappear.

You've got nothing to lose, except your headaches ;]
posted by gaiamark at 7:37 PM on June 17, 2007

I second (and third) the advice about making sure it's actually migraines you're having. If you can walk around and tell people "I have a migraine," it's not a migraine. A migraine is completely debilitating -- you cannot work, drive, or do much of anything but squirm around in a dark room and pray for death.

It's been my experience that many people who think they have migraines just have really bad headaches (and a really bad headache can be awfully bad, don't get me wrong). If it's the top of your head, I'd check sinus issues; there's a group of nerves/pressure points that certain sinus blockages can activate there. This can also cause chest pain issues, and shortness of breath (you're slowly starving yourself of oxygen when you have untreated sinus issues if you're not a mouth breather).

That being said, I have migraines every few weeks (or months, if I'm lucky), and conventional migraine meds (such as Imitrex) don't work at all for me. I have to dose it with Vicodin or Percocet to take as much of the edge off as possible and wait for it to pass.

An intern once told me that there had been some studies about eating very spicy foods and the frequency of migraines, and that it couldn't hurt to try it (theory is that spicy foods=less frequent/severe migraines. Something about capillary swelling; I am admittedly completely ignorant of the reasoning behind this). Anyway, during periods where my migraines are coming more closely together, hitting the hot thai and mexican cuisine actually does seem to help, but this could just be coincidence and/or wishful thinking on my part. ;)

Good luck!
posted by purplegenie at 9:40 AM on June 18, 2007

Have you tried any of the organic butterbur medications, like Migravent or Petadolex? Imitrex worked for my wife, but other people I know have had success with butterbur.
posted by FeldBum at 11:52 PM on June 18, 2007

A type of headache that is diagnosed more frequently in men than women is cluster headache. You don't have the textbook symptoms but I figured I'd toss it out there since a 24 yr old male is the classic person to get these.

The TMJ or bruxism idea someone had above is a good one too. Some people have jaw muscles that go all the way around to the top of the head in roughly the area you say you're having the headaches.
posted by selfmedicating at 6:23 PM on June 20, 2007

I agree that the word "migraine" gets thrown around a little casually, but it is possible to have a migraine and not be debilitated. See acephalgic or "silent" migraine, for starters.

It is also very possible to have migraines and not benefit from triptans. Triptans don't work for everyone every time and you'd have to try them all before you can rule them out. New research suggests that combining a NSAID with a triptan works better than either alone. And the suggestion to take them promptly is right on the money as is the nasal spray.

A daily headache is bad news. The caffeine suggestion is great - Fiorecet contains caffiene. You also need to keep track of how often you're using OTC meds like aspirin, NSAIDs and sinus meds like Sudafed. If you're taking stuff like this (or have in the past) more than 2-3 times a week, get familiar with MOH (medication overuse headache) or "rebound." Caffeine counts as a medication with regards to MOH.

I'm harping on the MOH issue because this can get progressively worse, increasing both the frequency and severity of your episodic migraines.

My migraine connection is a pretty good source of info with a ridiculous name. www.headaches.org by the National Headache Foundation is also good.

Getting the caffeine out of the equation is your best first move. Good luck. Having "unusual" migraine can be a real drag.
posted by egk at 7:16 PM on July 20, 2007