Migraines. Who gets them?

[SnakeCharmer]

I've had them for the better part of about 18 years.  Mostly start out with visual disturbances such as grey/white/cloudy spots in one or both eyes, or lightning bolts (for lack of a better word) that just stay there.  The visual disturbances usually last about 3-30 minutes with varying degrees of intensity and varying amounts of 'coverage' (what I can see and what I can't see).

Lately, however, I've had a weird sensation in one eye that almost feels like one eye is 'pulsing' to no real rhythm.  My balance gets a bit shakey, things go out of focus in that eye. I have had on two occasions where my vision turned into what I can best describe as a kaliedescope effect.  Once, everything greyed out except about the size of a quarter.  That was more than a bit scary as you can imagine.

I rarely, if ever, take anything for them.  Usually just close my eyes and try and muscle through it.  Aftereffects feel like a good hangover.

Of note:  MRI noted a cyst on the pineal gland a few years ago.  Have suffered about 5 or 6 fairly good concussions over the years.  Occasional bouts of vertigo.

Probably should say I'm not soliciting medical advice on a usefully cynical website, but am curious as to if others out there have migraines as well.

[DraconianOne]

Yes. Have done for 25+ years.

Is that sensation in one eye coupled with a headache or just by itself?

[SnakeCharmer]

The pulsing sensation?  Usually *never* with a headache.  It's something relatively new (last year or so).

[DraconianOne]

Well, curiously, about 18 months ago I started getting the same thing in my left eye. It felt like conjunctivitis at first but after a while felt like I'd been punched in the eye - coupled with the twitching etc. It was particularly bad when I was tired and I couldn't focus with that eye at all. 

Two things I've subsequently discovered - one is that I've got a wondering eye which I've never known about it doesn't happen all the time but generally when it does, it coincides with the pulsating feeling.  Secondly, I had an ingrowing eyelash which caused a mild infection and turned into a cyst. I had the cyst removed in a not very nice operation (think the end of A Clockwork Orange and that was the sort of device I was strapped into. Also - needles, scalpels, eyeballs, awake through the whole damn thing). After that was sorted out, I got a chronic infection around the eyelid which was also very mild and harmless but annoying. I had my eyes tested and saw a specialist as a matter of course but there was absolutely no danger and nothing significant.  That was about 6 months ago and while it occasionally flares up, I don't have a lot of problem with it now. The pulsating eyeball thing I still get on the odd occasion.

Usual disclaimer - not a doctor and your case might be entirely different.  If you were in the UK and worked with VDUs I'd tell you to go get a free eyetest and get it checked out. As I think you're in the US, I don't know what's available but getting it checked out is not a bad thing.

[Mazakiel]

I used to get migraines pretty regularly, but it's become rare over the past few years.  The big indicator is spots/flashes of light.

I used to also get the 'pulsing eye' feeling.  Once I got an updated prescription and started wearing my glasses regularly, it stopped happening though. 

[Nebu]

Imitrex should do the trick.  I recommend seeing a specialist if you haven't already.  Migraine management has improved quite a bit in the past 20 years. 

If nothing else, you may be eligible for medical marijuana! 

[rattran]

I get occasional migraines, Imitrex never seemed to help much. Hiding somewhere cool, dark, and very quiet helps.

The kaleidoscope effect happens in some of mine, I get one every couple years that has that, susurrus, and an almost out of body disconnected feeling. With no pain. Really, really neat. 

[Lantyssa]

I'm not sure if it is a migraine or sinus headache, but in summer I am especially prone to them.  Being out in the heat, high humidity, and bright sun seems to be my main trigger.  (I'm rather sensitive to light anyways...)  I'll average seven or eight of these a year.

It starts with my vision getting blurry and losing all of my peripheral vision.  That lasts 15-20 minutes at which point my vision clears up, but the headache starts.  Taking a nap at that point will dull things when I wake up several hours later, but the rest of the day is shot.

When I broke my toe and happened to get a migraine during that period.  I found taking a Vicodin nullifies the headache and the normal effects of the pill.  I'll still be a little off, but it's like they cancel each other out.

[schild]

I've been getting super bad headaches a couple times a month for the past few years. I've found it's a result of uneven levels of caffeine. Excedrin Tension Medicine does the trick. Or Tylenol. Really any combination of acetominophine and caffeine has worked for me.

[SnakeCharmer]

I get occasional migraines, Imitrex never seemed to help much. Hiding somewhere cool, dark, and very quiet helps.

The kaleidoscope effect happens in some of mine, I get one every couple years that has that, susurrus, and an almost out of body disconnected feeling. With no pain. Really, really neat. 

The first time the kaleidoscope thing happened me, it freaked me right the fuck out.  Felt like I was turning into The Fly.

And Nebu, the Imitrex makes me feel all kinds of loopy.  I've found that the best cocktail of sorts for me is to take 2 extra strength tylenol gelcaps, and chug a Starbucks Frapachino (cold) or two. 

I'm kinda in the same boat as Lantyssa.  Over the last couple of years, I've developed a bit of a sensitivity to light that can trigger one in a heartbeat with just the right flash or glare off a piece of glass.  Camera flashes and the sun reflecting off the window of a car can do it, albiet rarely.

[Hawkbit]

I'm highly light sensitive, always have been.  Glancing at a bright light or the sun causes an almost immediate sharp headache and sneezing.  One pupil constantly stays open larger than the other, too.  It makes it really hard to regulate light coming into my eyes, so I've found its easier to just avoid light all together.  Staying out in the sun for a day, like at an amusement park is very, very hard to do.  I will generally take a vicodin towards the afternoon because it just gets to be too much.  By the end of a day like that I've got a full head, deep rooted headache. 

Other people don't get it.... my wife, even after 10 years of marriage thinks it's bullshit.  I wear sunglasses (insert cory hart reference) pretty much all the time and I've blocked off the windows in my home office and our second bedroom.  What's odd about it is that I'm very color sensitive.  I've spent time working in photo and color labs, even pointing out various problems with processing machines that more experienced people didn't pick up on. 

Oddly, I'm a fairly happy person... never spent time as a goth or emo.  Go figure. 

[Jimbo]

Emergency side biased here :)

Migraines are headaches that the patient tells me is a migraine.  What I want to know and can usually screen the need for a head CT is all in the history taking and talking with the doc/mid-level about the patient, also, we can spot the drug seeker 90% of the time that is "jonesing" for a fix.

As our head doc said, "if you had to send home one of these two patients which one would you want to have screwed up and sent home?  1--guy with an MI, 2--guy with a headache that is a head bleed?"  Answer is the heart attack, you never want to miss a head bleed.  History and exam should reveal the need for treatment.  Believe it or not, a headache may be a freaking balls to the walls emergency where we tell the 55 year old chronic chest pain to sit still while we stabilize the bleeder.

Headaches come in so many flavors & migraines get their own flavor section, Chicago has a wonderful clinic called the Diamond Headache Clinic, plus there are more specialist and treatment centers all over the nation, look to your family doc, neurologist, & pain management doc (hey Nebu how are those certified?  I see some people say they are a specialist in "pain management", but no board certs...) for help in preventing and controlling them when they appear.  I'm not getting into the types (one group will say 3 types, another 5, another will break the 5 types down more...) because the treatments are about the same (okay in the ED they are).

Go google headache and read up on it, if you like.

What I'm worried about is someone who comes in and says, "this is the worst headache of my life, it came on suddenly (during sex or strenuous activity), and it is way different than any headache I've had before."  Or there friend brings them in and they have fever, headache and neck tenderness/immobility.  Those are the ones we worry about.  Brain bleeds and Meningitis suck.

On to what can help:

Home stuff:
Dark and quite room
small sips of water (if you are puking, expect this to come up)
ice pack to head or cold wash cloth to head
Headache cocktail:

1st set of pills:
Tylenol/paracetamol/Acetaminophen 500 mg
Aspirin 500 mg
Caffeine 130 mg
  *This comes in Excedrin Extra Strength, just take two tablets of Excedrin Extra Strength
or
Motrin/ibuprofen 600mg

2nd pills:
Benadryl/diphenhydramine 50mg
 ***WARNING IT WILL MAKE YOU SLEEEPY! NO GUNS, BULLDOZERS, ETOH, OR DRIVING!

3rd pill:
Pepcid/famotidine 20mg
 or
Zantac/ranitidine 75mg
 or
Tagament/cimetidine 200mg

Fluids!  Water is the best, once your stomach stops puking, push that water till you pee clear.

You won't find this in the books, it is more or less a home brew that helps, what we give patients when the come in:
IV of normal saline to hydrate them up, usually 1 liter, then a 2nd liter
Toradol 30 mg IV
Reglan 10mg or 20mg (depends on how much they are puking)
Benadryl 50mg IV
High flow oxygen (non-rebreather mask set on 15 lpm)

We don't like to give narcotics due to the fact that a rebound headache can occur in an hour or two after we give it to them.  So usually we give them Compazine for the nausea, then some Nubain (as long as they are not taking narcotics or have some freaky history and are elderly).  If it is anxiety we can give benzo's, if it is muscle related we can give relaxers.  One gal swears by nubain and vistiral, of course I found her naked in the bathroom...

I do feel sorry for anyone who goes to the Emergency department and has to list a real allergy to Toradol.  Toradol is a great pain killer and anti-inflammitory, but the ones who come to the ED for a "fix" don't like it because it works on pain without getting you high.  Demerol used to be drug seekers choice, but with less ED's using it (some have a sign out front saying, "we are a demerol free-facility") more had turned to dilaudid to get there buzz.  Since they don't want Toradol they will just tell us they are allergic to it, so give them the choice of tylenol rectally then :)

Hope that helps some of ya!

[Raguel]

I don't have migraines. I just have a headache that basically has never gone away for about 24 years now.
That, and apparently I now have Meniere's Disease, so now I have vertigo, nausea, and tinnitus to complete the package. 

[lamaros]

I don't have migraines. I just have a headache that basically has never gone away for about 24 years now.

That's a long time to be married.

/obvious.

[apocrypha]

I used to get migraines almost exactly like you describe in your first post SnakeCharmer. Strong visual component, nausea, shakiness and balance problems. They'd last for a few hours and then turn into a bad headache for another few hours and the following day I'd feel exhausted and like I was serotonin-depleted. I'd get them (very) roughly every 2 months, no obvious trigger.

Used to take, umm, rizatriptan I think it was called. Can't remember the brand name. My doctors prescribed several different things over the course of a few years and that was the only one that seemed to work, and then only if I took it in time, i.e. as soon as the symptoms started. If I was 30 mins late taking one then it just wouldn't work and I'd get the full-blown migraine.

Then about 2 years ago they stopped completely, shortly after I gave up my job as a lab manager actually. Makes me wonder if they were either stress-related or psychosomatic. Either way I hope they never come back!

[Signe]

I get what I consider nasty headaches now and then but not migraines.  Schild and Jimbo mentioned my cure, too.  A nice cup of coffee, for the most part.  Sometimes I don't even need the ibuprofen or other OTC pain medicine.  My nephew, on the other hand, had some terrible terrible migraine headaches when he was younger.  I used to be very worried for him.  He cut out all nitrates in his food, which was hard, and it worked.  He was like a different kid.  As an adult he still gets bad headaches every now and then, but manageable.  They'd probably disappear too, if he would go back to carefully watching his diet.  They happen so rarely now, though, that he's willing to take the risk for that big yummy steak filled with juicy nitrates.

[Broughden]

Well as an outdoor medicine/guide guy now...they tell us that 50% or more of headaches result from being dehydrated.  So I always tell people drink drink drink until the urine is clear and copious.

[shiznitz]

Allergan, the maker of Botox, will be launching (with FDA approval) a new use for Botox this year: migraines. Apparently, injecting botox into certain parts of your head will alleviate migraines for extended periods of time.

[Raguel]

Allergan, the maker of Botox, will be launching (with FDA approval) a new use for Botox this year: migraines. Apparently, injecting botox into certain parts of your head will alleviate migraines for extended periods of time.

Hah. I'm supposed to get these injections today. Hopefully they work for me. I've lost count of the meds I've taken.

[Bunk]

Interesting stuff. A couple times a year I get the kaleidescope effect in the eyes. No real headache to speak of, just weird sparklies and bluriness all around my peripheral vision. Usualy goes away after an hour or so.

[SnakeCharmer]

If the botox doesn't work for the migraines, you'll at least look 10 years younger!

[rattran]

Regular headaches for me go away with ibuprofen & coffee, migraines are something else entirely. It's an different kind of head pain, hard to describe it other than some bastard wearing spiked boots standing at he base of my skull poking the back of my eyeballs with a hot pointy stick.

[Signe]

What is  an outdoor medicine/guide guy?

[Sky]

What is  an outdoor medicine/guide guy?

Shaman.

[Oz]

If the botox doesn't work for the migraines, you'll at least look 10 years younger!

At least until the surrounding muscle fibers start to compensate for their slain brothers and you start to look 20 years older then when you started...but, then you can just get another injection making you look younger...at least until the surrounding...you see the infinite loop, right?  well, semi-infinite.  once you hit plastic face stage the loop is over.

[Mr_PeaCH]

Wow; mine are almost exactly like yours, Apocrapha (and thus pretty much like the OPs).

I'm in my 40s now.  Started getting them in my late 20s.  Lot of life changes at that time, got married, first kid, first real job, different geographical area (Seattle, very 'moldy').  Geographically I haven't been in Seattle for the past dozen years but the migranes are here to stay it looks like. 

Every couple months or so, almost like clockwork, I will wake up with what feels like the start of the mother of all hangovers.  Except it is as likely to happen when I have had a few too many as when I've had my usual one or two beers as when I've had none at all.  (Although as has been mentioned, I do a poor job of staying hydrated with good old H2O so I will bear that in mind.)  Sometimes, if I go to the bathroom and take a couple Alleve (Naproxen?) and go back to bed and lie down (dark, quiet) it will peter out and I'll be left with a very minor, fuzzy-headed feeling and can go about my day.  If not then I have all the usual symptoms; sensitivity to light, sound, nausea (very bad sometimes) and the absolute certainty that my head is about to split in two.  This will last for about a half day and then finally dissapates and I can get back to sleep and when I wake up I have the fuzzyheadedness I mentioned before.

For me, only Alleve has had a positive affect.  Tried some prescription migrane stuff, tried Tylenol (acetaminephen), Ibuprofin, regular Asprin... all of those just make the nausea come sooner.

It aint a lot of fun when I have them but I guess a lot of migrane sufferers have it much worse.  I can remember a childhood friend who would suffer for days with one.

[Jimbo]

Mr_PreaCH brought up a good point, the Excedrine combo works great, if you get it in before you start puking.  Asprin, tylenol, & caffine combo plays heck on your stomach.  What can help stop vomiting, even though it isn't really officially used for it, is benadryl, we have used combinations of zofran and benadryl IV to stop some of our really puking patients (ones that have pancretitists and are heaving green bile up around the NG tube).  Pepcid, Zantac, & Tagament offer some relief to dry heaves, but then it is a matter of getting them in and keeping them down.

Oh duhh....forgot about the other ones, Meclizine/Bonine is over the counter, Dramamine/Dimenhydrinate, Emetrol, and Pepto-Bismol are some others you can try. The Dramamine and Meclizine really zonk people so be careful when taking those meds.

[JWIV]

My wife used to get them basically once or twice a month and was on a mix of topamax and a few other things.  Eventually, they discovered that she had a severely deviated septum and after the surgery, I think she's had one in the past few years.

[Morfiend]

I get raging headaches about once a month, I dont know if they quality as a migraine or not. Its usually linked to tired eyes. I have found the only thing that will get rid of it is 4 to 8 Advil and sleeping for 3 to 10 hours. Knowing about the dehydration thing, I try to drink a lot of water also. One thing that I have found to bring it on fairly reliably is driving on the freeway at night when there is a low divider and lots of on coming traffic. The headlights in my eyes just kill me.

[Sjofn]

Once upon a time, Ingmar and I lived on opposite sides of the country. Flew back and forth for about a year without too much trouble, but on one of my last trips out, during the descent, my right eye started watering and pulsing, and seriously felt like it was going to explode. And my head behind and above it hurt like nothing ever hurt before. I was actually worried I was having a brain aneurysm, it hurt so bad. Then we landed and I felt better by the time my bags arrived. It didn't happen on the way home, so I didn't think much about it.

Had a couple more flights without an issue, but then Ingmar and I were either flying to see my parents or back home, and it happened again. Ingmar, sympathetic as always, was worried I was making a scene, because I was gasping and crying from the pain. THAT headache lingered for longer.

So after it happened a few more times, talked to my doctor (yes, I should've EARLIER, hush), and it turns out I get migraines triggered from the pressure changes of descending in an airplane. This is apparently not uncommon! So I take Imitrex and turn into a complete idiot for a little while (I also lose my sense of taste, wtf is that about). I don't usually get visual weirdness, although once in a while my right eye will blur. What I find odd is if I time it right with the drugs, I don't feel actual pain, but I can feel where the pain would be.

[apocrypha]

Oh yeah something I forgot to add - my girlfriend gets them but their frequency has dropped 10-fold since she switched to a constant cycle of the pill. I.e. she no longer takes a break from her contraceptive pill every month. So she no longer has proper periods and this has had a huge effect on her migraine frequency. All done with GP consultation etc.

Might be of use to any female migraine sufferers here or in proximity.