4/29/11

I need some medical advice, here are the facts. What do you think?


I need some medical advice, here are the facts. What do you think?I am a 17 year old caucasian male, I reside in South Carolina. I have had several problems this year with migraines, but this one by far has been the worst. I was hospitalized back in October for a migraine that lasted for 2 weeks. The objective of the hospitalization was to see what was causing the headache, and for pain management, however, neither of those objectives were met. I stayed in the hospital for 4 days in October, and when I was released I felt fine. It's now December 14, and I have had a migraine for 4 weeks, without any relief whatsoever.

I have been for 2 of these treatments:
Nubain 50mg Intramuscular Injection
Phenergan 25-50mg Intramuscular Injection
Solu-Medrol 1000mg IV

I go for the last treatment today, and I can't tell a difference yet. The headache has only gotten worst and I have had no relief. I am also on the following medication:

Welbutrin XL 150mg – 1 time per day; prescribed for depression and smoking cessation.

Xanax 0.5mg- 1 tablet at bedtime; prescribed for anxiety.

Trazodone 150mg - 1 tablet at bedtime; prescribed for insomnia.

Varapamil 40mg- 1 tablet 2 times a day; prescribed to prevent migraines.

Indreal 20mg- 1 tablet 4 times a day; prescribe to prevent migraines.

Phenergan 25mg- 1 tablet every 4-6 hours as needed for nausea; prescribed for nausea/vomiting.

Percocet 10/325mg- 1 tablet every 6 hours as needed for pain; prescribed for pain.

Maxalt 10- 1 tablet at the onset of headache, repeat in 2 hours if needed. Do not take more than 3 tablets in 24 hours; prescribed for migraine termination.

My neurologist is board certified in neurology, pain management, and psychiatry, what can I ask him to do?

Please help, I can keep going like this.
I haven't been exposed to too much sun, I have pretty much been in the bed for the last month.

Thanks, there is a typo:

Please help, I can't keep going like this!
I haven't changed my diet or anything either. I have actually been eating less becuase, I get sick when I eat. I have lost almost 15lbs in a little over a month.

MishMash
I think you are getting rebound headaches from to much medication.

Have you look considered external causes of headache such as too much sun, certain foods etc.

I think you have a typo in your last sentence.

Panzer
A. I would ask for a pharmacy consult if the neurologist is at an academic or large hospital with a Department of pharmacy/pharmacology, to assess the possibility of any adverse effects and/or drug-interactions in that list of drugs. With such a wide-ranging list, a physician might miss a few interactions or reactions between or of the drugs and this is where Pharmacists/pharmacologists come in.
B. If you do not have access to such a department, you may need to show the list to your pharmacist and ask them to give an opinion as to whether there is a possibility (and there certainly is) of such effects. The dose may need to be adjusted, or it may be a side-effect of one or more of the meds, or it may just be a drug interaction accentuating an otherwise mild consequence of the medicines you take.
C. Once again, a dedicated and thorough examination must be made in such persistent cases of headaches to rule out any as yet unknown medical causes thereof. It often serves to allay your anxiety more than arrive at a diagnosis to do scans like CTs and MRIs, but if it's this bad, perhaps it should be considered. You may need to be seen by an eye-doctor to rule out glaucoma, for example, or simple eye-strain, a dentist to rule out referred pain from an otherwise silent dental malady, an internist to rule out
tension headache, blood-pressure, sinus-trouble, cervical spinal problems and so forth. A neurologist is a specialist, and unless they see a lot of undiagnosed headaches, they might miss a diagnosis that an internist could consider. All headaches needn't have their origin within the skull : )

If nothing at all works, do try alternative healing such as pranic/energy healing etc. Some patients in my experience report benefits from these methods, although I can't back them with any data.

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