Migraine help please

[*knittingmomma*]

Hi ladies,
I am currently 18 weeks pg with my 2nd and have had a migraine headache for 8 days now. I have tried everything my midwife has suggested, accupuncture, chiropractic, garlic, magnesium, b-complex, cayenne, primrose oil, lethicin, ice. Anyway, she is recommending that I see my doctor on Monday. Now, I definitely trust my midwife and know she's done a lot of research for me. My questions are, have you had a client that has had a migraine for longer than a week? Do you have any suggestions that I haven't tried? And, I'm really nervous about seeing the doc because I can't imagine what she'll be able to do except high intervention things and recommending narcotics. Do you think having a migraine for this long warrants a visit to the doctor? Thanks for any advise you may have, I really appreciate it.

[jengacnm]

I'm not sure what you mean by "high intervention", but I've seen Imitrex used for stopping migraines in pregnancy, and beta blockers (Inderal) for prevention if the woman has more than four migraines in one month. Imitrex is pretty new, so there isn't a lot of information about it, but so far has not been shown to cause birth defects. Narcotics have a longer track record of use in pregnancy, but it's not something you want to be on the rest of the pregnancy. Beta blockers also have a longer track record, but won't work to stop a migraine already in progress.

Situations like yours are why pharmacology is there, IMO. It should never be the solution of first resort-medication should only be used when all other options are exhausted, and when NOT treating the condition becomes of more concern than the risks-known and unknown-of the medication.

That being said, before rejecting medication for the sake of the baby, please consider that the physiologic effects of severe, unrelieved pain will also have an effect on the baby and the pregnancy. So risk will not be avoided by avoiding medication; it's a question of deciding which risk is more acceptable to you.

HTH!

[wombat]

I'm not a birth professional but I had the worst migraines while pregnant. The worst one went for 3 days. When I had to I took codeine or Fiorocet for them. I had to balance days of not being able to eat, lying around in a dark room and being in major pain with short term use of strong painkillers. One or two doses would kill the migraine although I'd seem to get a 'hangover' after it but was at least able to function. OBs told me that drugs like codeine have a long history of usage and considered quite safe for short term use in pregnancy.

I did find taking magnesium regularly helped prevent migraines. I didn't know about it during my 1st pregnancy and really suffered. 2nd pregnancy while taking the mag, I still got migraines but not nearly as frequently. When I stopped the magnesium, the migraines would return within a week or two.

Good luck!

[storychick]

The only time I've ever gone to the ER with a migraine was in my last pregnancy. I was about 32 weeks and got 4 acute episodes of headache in 3 days, including one of the worst I've ever had. My midwife finally said just go to the ER if it comes back again, so we did. They gave me a drip and Dilantin, just a half-dose initially at my request and that was enough. I got very happy and relaxed and it reversed the pain cycle enough to stop it.

The docs were also very keen to rule out pre-eclampsia for me, but I knew that wasn't it. (They were also very fuzzy about what midwives actually did, and seemed to imply that I had chosen substandard prenatal care, even here in WA where homebirth is reasonably common and midwives licensed and covered by insurance, and at a hospital that has a very good reputation and CNMs in practice! The nurse, while otherwise wonderful, was also shocked that I had managed to give birth twice previously but never had an IV. : )

I hope you feel better soon.

[Arwyn]

nak

5-HTP? massage? (breaks the pain cycle)

pharmas have their place.

[lisarussell]

I'm currently preg with #6 and not a birth professional at all, but I didn't see anyone else offer this information, so here it is.

At 18 weeks preg, your body is rapidly increasing its blood volume, and dehydration can cause a problem where your brain isn't getting the oxygen it needs.

Having been plagued with migraines during non-pg times, I am very very wary whenever my head gets the slightest ache (Oh God, please don't let this get worse) and while pg I have always been able to head-off a migraine by increasing my water intake. It's amazing how much water is required to hydrate a pregnant lady, especially in the summer.

I know it might SEEM like you're hydrated when you're peeing every ten minutes. Some women mistakenly assume that if their body needed the water it would have 'soaked in" while it had the chance, but that isn't always the case.

Good luck. I hope your solution is as simple and natural as this. Pharmaceutical drugs freak me out, especially during pregnancy. Tylenol is the strongest thing I can imagine taking. So in my case the best defense is prevention.

[chandasz]

I will agree about being wary of perscription drugs when pregnant. Imitrex is strong stuff. NO DRUG HAS BEEN PROVEN SAFE IN PREGNANCY AND BIRTH.

Hydration could be the problem. Are you sure this is a migraine. Most headaches can be resolved with hydration and relieving tension.

If you are sure about the migraine (I have them too but not during pregnancy)-- oxygen therapy is an option to try. Ask your dr. about this. I used an oxygen machine at home for quite a while when I was having cluster headaches. Caffeine also works. Have you tried a cup or two of coffee?

On that thought-- could this be caffeine withdrawal?

[Mindi22]

I have to say that chiropractic care is incredibly effective with migraines, but you generally shouldn't expect instantaneous results. You say that you have had a migraine for a week - how many adjustments have you gotten in that time? It can often take more than one to really have an effect, especially when you are already in the full blown migraine stage.

That said, a trip to your MD isn't a bad idea entirely. There are many things that can cause headaches and migraines, and it might be worth ruling out some of the more serious ones since the migraine has lasted this long. Just realize that when it comes to pharmaceuticals, there isn't a lot of research on what drugs are truely safe during pregnancy. That said, some seem to be safer than others, and it can often be a choice of the lesser of two evils.

ITA with the pp's who mentioned hydration. Keep us posted.

[erthe_mama]

Have you tried hydrotherapy? It may not entirely relieve the migraine, but it may help reduce the pain. It has worked for me, and for a friend I tried it on. I took a course in hydrotherapy when I was in massage therapy school.

A migraine is a vascular headache which means there's too much blood flow in your head. This hydrotherapy is a way to decrease the blood flow in your head by both passive and active derivation. It will draw the blood from your head to your lower limbs. (Check with your midwife first though before you try it.)

So here's how it works:
You fill a container (the size of a mop bucket is about right) about half full - 2/3 with water about as hot as you can tolerate it without scalding (approx 105-110F). Get two towels: one for under the bowl, one to dry your feet.
Also fill a container/large bowl with very cold water with some ice cubes in it. Get four cloths ready. Cotton is best.

So you soak all of the cloths in the ice cold bowl. Then, stick your feet in the hot water bucket. Put one cold cloth on your forehead, and one on the back of your neck. Leave them there until they start to lose their coolness (check temp with your fingers), and when they do, put them back in the bowl, and take out the fresh ones to put in their place. Repeat as many times as necessary during the tx.
If the hot water starts to cool, you may add more if you like. I usually keep an electric kettle next to the treatment area.

You may do this treatment for about 20-25 mins. Hope it helps.


Oooh, almost forgot, keep a glass or two of water handy as this treatment sometimes makes people thirsty.

[pamamidwife]

did you try cal with magnesium or a better version of it? i've heard good success with migranes using a magnesium aspartate, rather than magnesium citrate. i've been reading a ton on magnesium and it's pretty remarkable - not to mention we rarely get what our bodies need daily.

[pamamidwife]

Originally Posted by erthe_mama

Have you tried hydrotherapy? It may not entirely relieve the migraine, but it may help reduce the pain. It has worked for me, and for a friend I tried it on. I took a course in hydrotherapy when I was in massage therapy school. .

i just bookmarked this because it sounds so promising!

[Arwyn]

Migraines are not actually a vascular issue, though long believed to be so. They are a neurological one, with vascular effects. That said, addressing the vascular issue can certainly help the overall pain (which is why I find relief with massage, ice packs, etc), but they are not the cause of the migraine.

[Arwyn]

Speaking of, and I'm kicking myself for not thinking of it earlier, have you gone over a list of potential triggers? Scents are one thing many people overlook, but are a guaranteed trigger for me. Have you changed shampoos or soaps in the last couple weeks? Laundry detergent? Moved into a new home, or repainted? Had your partner change deodorants? Anything like that can trigger continuous migraine pain in me and many other migraineurs.

Other triggers to lok for - foods, supplements you've started or stopped or changed forms of. Visual stimuli, anytihng with strong contrasts or patterns (stripes kill me), especially something at the edge of your vision - hav eyou put up blinds recently?

Squirmy baby, gotta run, but those are all things to consider.

[erthe_mama]

Originally Posted by pamamidwife

i just bookmarked this because it sounds so promising!

Thanks! It really does help....

Originally Posted by Arwyn

Migraines are not actually a vascular issue, though long believed to be so. <snip>

Good thing someone mentioned this -- I totally forgot! :
Oooh, yeah... and good suggestion about the triggers as well. My sis (who lives with me) changed her hairspray a coupleof weeks ago and it gave me a few migraines before I found out what it was....

[Cheshire]

I, too, would second the following to try before going on to medications:
-hydroptherapy (I didn't know it had a name. I just know that whenever I get a migraine my hands/feet get cold and if I soak them in warm water it makes a big difference and can sometimes even stop the migraine).

-oxygen therapy (I wish I would have thought of it when I was in labor. I had battled a migraine for five hours and labor for about 12 when I decided I couldn't do both at the same time so I got an epidural. When my blood pressure fell through the floor and they had to practically revive me they put me on oxygen and the migraine went away no thanks to the epidural). Be prepared for your labor just in case. My midwives told me they hadn't had a woman experience a migraine in labor so I should worry about it. UGH! I know better now.

-Drinking more water and trying a little coffee.

Because Imitrex affects blood vessels I personally wouldn't take it while pregnant. I would be more likely to try a narcotic as the last resort.

Hugs to you. Migraines suck!

[nethead]

Originally Posted by lisarussell

I'm currently preg with #6 and not a birth professional at all, but I didn't see anyone else offer this information, so here it is.

At 18 weeks preg, your body is rapidly increasing its blood volume, and dehydration can cause a problem where your brain isn't getting the oxygen it needs.

Having been plagued with migraines during non-pg times, I am very very wary whenever my head gets the slightest ache (Oh God, please don't let this get worse) and while pg I have always been able to head-off a migraine by increasing my water intake. It's amazing how much water is required to hydrate a pregnant lady, especially in the summer.

I know it might SEEM like you're hydrated when you're peeing every ten minutes. Some women mistakenly assume that if their body needed the water it would have 'soaked in" while it had the chance, but that isn't always the case.

Good luck. I hope your solution is as simple and natural as this. Pharmaceutical drugs freak me out, especially during pregnancy. Tylenol is the strongest thing I can imagine taking. So in my case the best defense is prevention.

:
I wouldn't rule out a visit to the doctor. I would also try acupressure that has instantly rid me of a migraine before.

[Maggi315]

The only thing that has helped with a migraine that long for me was chiropractice adjustments, usually 2-3 days in a row. And I have tried everything from herbs, homeopathy, accupuncture, imitrex pills and shots, supplements, yoga, meditation, exercise, diet restriction.

good luck, I love the other suggestions, I think I'm going to compile them into a handout for my clients.

migraines suck!!!! I just found out I am allergic to chocolate (rast blood test) and was in denial, ate a whole bunch, 3 days later, one of the worst migraines of my life, would not quit! I learned my lesson! I also them from other foods, being out of alignment, not enough sleep, hormones, any excuse to get one!