Daily Headache Over A Year

by Mary
(New Hampshire)

My name is Mary, 30 yr old mother of three. In 12/2008 I began having daily almost constant headaches ranging in pain from 1-10. Mainly left sided, from back of head, top side and behind the eye. Can be dull, constant, stabbing, throbbing or all.

I have been on all of typical and non-typical headache and migraine drugs. Right now Naproxen x2, Gabipentin 500mg, amitriptiline 25mg and lexapro 10mg(for other reasons)daily.

When the pain gets unbearable the only thing that makes it bearable is narcodics, vicodin or percocet. I know the risk of rebound headaches but I feel like I am left with no choice. To throw a curve ball in the picture my menstrual period lasted 30 days. That had never happened before this last month. Although I had had a headache all that time, when the bleeding stopped this weekend my headache got even worse. I am due for my next one as soon as that one stopped.

I have seen different doctors. My current Neurologist is the one who has me on my current meds and I keep in close contact with her. I have been told by a dr that it is the nervous intermedious, and is in a cluster of nerves inside the back of my skull that is causing the pain. I also at times can feel effects of the headache in my nose, teeth and ringing in my ear.

I am in search of any new ideas and would LOVE to hear back from you. What are your thought on pain medications. I need to at least be somewhat active in my life. Have you ever heard of any type of assistance for people who work full time but are not able to go to work because of such chronic headaches?

Thank you.
Mary

Answer:

Hi Mary,

I am assuming that since you are seeing a neurologist, an MRI and MRA of the brain were performed. If all was normal, then the Dr. is on the right track. Amitryptiline is a great choice for daily headaches, and I have also found Depakote to be effective.

We do not recommend use of narcotics in our headache center, as you surmised they do indeed lead to analgesic rebound headaches.

Have you tried a short course of steroid (2-3 weeks) to try and break this? If not, at this point if your neurologist is not a headache specialist, I would recommend that you see one. The New England Center for Headache is a well known center. If there is no headache center in New Hampshire you can petition your insurance company to allow out of state treatment.

Also, have you tried botox for headaches? I am seeing about a 75% response rate and do several a week at this point.

I regularly sign Family Leave Act paperwork for chronic headaches. Ask your doctor to do this for you so you can take time off without losing your job. The paperwork comes from your employer.

Good luck!
Mary Kay Betz MS RPA-C