TRIED & TESTED

“Over 50% of Migraines go undiagnosed. Over 50% of people diagnosed with Migraine do not seek proper treatment.”

This is unacceptable. It is unacceptable that in this day and age so many people suffer from migraine when there are so many treatment options available. My condition was originally mistreated and misdiagnosed and as a result my migraines got progressively worse over the years. It’s actually only very recently, after years of doing my own research and pestering Doctors that the root cause, and what I hope will be an effective treatment, of my migraines has been discovered.

Right – the rest of this page is going to be deadly dull for anyone who doesn’t get migraines. I direct you to the ‘Home’ page for the blog proper. The rest of you, please continue:

Whenever I meet someone with migraine I have a really annoying habit of going “I can help you!” Before they can respond I launch into a rousing speech about how they must bypass their GP, go straight to the National Migraine Centre and then I list my top helpful tips. I’m not going to do that now but I am going to list my current medications and various remedies and treatmentsI have tried and tested over the years (the ones I can remember). The list below is probably only half of available options. It should be entirely possible to minimize and manage migraines – and I believe migraineurs should keep fighting until they do so. To suffer needlessly is unacceptable. Unacceptable is my new favourite word.

The first step is to get educated about migraines.

May I suggest everyone reads the BASH Diagnosis and management guidelines (BASH = British Association for the Study of Headache) They're a gold mine of information. Read them now! Written by top Headache Specialists, they contain great strategies and secrets of the trade, plus explanations of how and why you'll be given certain medications. I believe they’re actually intended for Heath Care Professionals – but they’re easy to understand and were on the internet so…

Also, by far the most practical, accessible, intelligent and helpful book I have ever read about migraine is “Conquering Headache” by Dr’s Rapport, Sheftell and Tepper. Click this link and buy it now on Amazon. This was given to me at the Dartmouth Hitchcock Medical Centre, USA, where all patients of the Migraine Centre are given a copy and asked to study it. The quote at the top of the page is from this book, which I call my Bible.* It will change your life, even more than “Eat, Pray, Love”. I take this book to nearly all my Doctors appointments and am planning on donating copies to as many GP practices as I can, and I urge you to do the same. Dip into it and study it. Also, you may be able to tell by now I have a mutual distrust of GP’s when it comes to the treatment of migraine. But they’re not all bad.

I also use "Coping with Headaches and Migraine" by Alison Frith (a Clinic Research Nurse) who worked at the National Migraine Centre from 1999-2011 with Professor Anne MacGregor. Frith is a migraineur herself, so knows what she's talking about. Again, click here and buy it now. That's an order. Professor MacGregor recommends this book on her website, so what higher reccomendation do you need?

P.S Also read any and everything you can find by Professor MacGregor. Ideally learn it off by heart. A fabulous place to start is her invaluable guide to "Migraine and Other Headaches." 

My Migraine Diary
Every self respecting migraineur has a good Migraine Diary. It's a must. Your Doctor and your Mum will insist upon it. I use this one from the National Migraine Centre (online version coming soon) and add notes in my paper filofax (I'm old school). But I've just found this on-line Migraine Tracker by Ubiqi Health, it has an app too, you can also email handy reports straight to your Doctors. The Migraine Trust also have a great online migraine diary that you can also access on your smartphone.  Migraine Diaries are essential, you can keep track of medications, patterns and triggers.

My current Medications and Treatment

*******Legal Disclaimer: Obviously, there are many different types of migraines with different triggers. I have migraine without Aura (visual disturbance) and I don’t vomit. My migraines are also rather complex as they involve neck damage. The medications that didn’t work for me, work for thousands of other people and likewise side effects vary enormously. I’m not a Doctor so please don’t try and buy any of these medications on the internet without consulting a Qualified Medical Profesional! ************

Daily Preventatives:

• TOPAMAX (Topiramate) – building up slowly to 60-100mg daily. Epilepsy medication, proven to be very effective for some migraine. Can have very scary side effects. I will either become anorexic or try to kill my mother! (I’m exaggerating a little) Side effects hopefully avoided with slow build up.

Acute Attack Medication:

• ZOMIG NASAL SPRAY (Zolmitripan, 5mg)

          These bad boys are amazing. It is believed they are absorbed through the nasal passage, so get      

          into your system fast, ideal if you vomit.

• IMIGRAN INJECTION (Sumatriptan, 6mg)

          These injections changed my life. If they’re going to work, they’ll work almost immediately. I    

          use these when I’ve missed the moment with Zomig, or when Zomig hasn’t worked. If the  

          injections don’t work I know I’m in for three days. I will repeat the injection after 12 hours. Inject   

          in your bottom, not your thigh, much less painful!

• Domperidone – anti-emetic. Although I don’t vomit, I do feel sick and an anti-emetic, such as this one also works by helping any painkillers or migraine medications get into your system quickly, as the stomach and gut shut down during a migraine attack.

•   Brufen, Dissolvable Ibroprufen,  (600 mg) – only take during a bad three day attack.

Other Current Treatments:

Physiotherapy
I see my amazing Physio once a week and do spinal rehab exercises 2-3 times a day. When I first met her I had daily headaches, could only walk for ten minutes before getting a neck spasm and then getting a migraine. She also put me on course for getting the right scans and treatment. She completely transformed my quality of life.

Other Spine Treatment - including clever injections in my neck, Dorsal Root Ganglion Blocks and Occipital Nerve Blocks. I will soon be embarking on Prolotherapy (Sclerosing injections) to strengthen my cervical spine and hopefully stop frequent neck spasms.

TENS Unit – I was first given one of these in the hospital in America. I put it wherever it hurts on my neck or shoulders. They generate a small electric current – and basically feels like a nice shoulder massage, and really helps with pain. You can now buy them in BOOTS and most Pharmacists, but they’ll be sold as aids for going into Labour, so expect strange looks!

Some past tried and tested medications and treatments, in nor particular order:

Migraine Treatments Tried:	Reason for stopping/Side effects:
Amitriptyline	For many this is the first port of call and can work wonders but it made me fat, lazy, tired, grumpy and had no effect at all on my headaches.
Nortriptyline	See above.
Propranolol	Nightmares – hallucinations, including snakes on my bed.
Metoprolol	Tried instead of the above, no side effects but no effect on migraines at all.
Prozac	A Doctor asked me to try this as an experiment, did nothing to my migraines, nor did I feel happier!
Maxmalt (Rizatritan) Melt	Melt in the mouth triptan, didn’t work for me.
Naramig (Naratriptan)	A slow release triptan, does work but just very slowly.
Zomig Oral	Occasionally works if I take almost before the migraine, so I prefer the nasal sprays.
Nearly all the NSAID’s (Nonsteroidal Anti-Inflammatory)	Naproxen, Naproxen Sodium, Diclofenac, Indomethacin, Ibufrofen, Mefenamc Acid etc etc – my stomach can’t handle them for more than a couple of days.
Botox Injections – over forehead, scalp and parts of neck.	You need to have three rounds of this before efficacy can be determined and my health insurance wouldn’t cough up. It did get rid of all the wrinkles in my forehead and did, I think, break the cycle of migraines I was in.
Prednisone (steroid)	Been on short courses of Prednisone a few times due to medication overuse headaches. Only meant for short term use – was effective though.
Pethidine (opioid)	Given to me by a pain specialist, not a migraine specialist. Made me vomit. Did nothing for the migraine. Opioids are generally not great for migraine patients.

Other avenues I have explored with varying degrees of success:

Osteopathy, Chiropracty, Yoga, Massage, Alexander Technique, Meditation, Reflexology, Cranio-Sacral Therapy, Acupuncture, Dental brace, Hypnotherapy, Herbal, Vitamin and Mineral supplements such as Devils Claw, Feverfew and Magnesium.

I also don’t eat dairy, including chocolate (mainly because I'm lactose intolerant - chocolate did not trigger my migraines) I don’t drink Coffee, White Wine and try to avoid Red. I do, however, love Champagne. If you would like to buy me a glass I’ll happily be your own personal migraine coach!

I’d love to hear from other migraineurs about what medications work for them. I’ll be blogging more about my triggers and what tricks I’ve picked up along the way.

*A more recent survey again confirmed this quote. Taken from the Migraine Trust Fact Sheet Page

"Migraine remains undiagnosed and under-treated in at least 50% of patients, and less than 50% of migraine patients consult a physician"  (Pavone, Banfi, Vaiani & Panconesi, Cephalalgia, September 2007)