Question:

Advice welcome: My spouse has been seeing a neurologist specializing in migraines here in Austin, TX, for about 6 months, and he’s not been able to make a dent in their frequency or severity.  He has suggested she go to some clinic called "The Headache Institute", located in San Antonio, TX – he says doing this is like an oncologist (cancer specialist) sending their patient to the M D Anderson Cancer Institute in Houston:  they are more aggressive in seeking out solutions and, through intensive diagnostics, can find a treatment regimine which the local physician/specialist can then implement / monitor.

Do go.  There is a remarkable difference between small town nonacademic medicine (like Austin) and medical center medicine (like Houston or San Antonio).  It is difficult to find out where to go, but for any serious non-emergency medical problem I suggest staying away from small town doctors. Q3:  Does anyone have any other suggestions for coping?

Midran works for me, but my case sound simple compared to yours. -John Clinton

Response:

Advice welcome: My spouse has been seeing a neurologist specializing in migraines here in Austin, TX, for about 6 months, and he’s not been able to make a dent in their frequency or severity.  He has suggested she go to some clinic called "The Headache Institute", located in San Antonio, TX – he says doing this is like an oncologist (cancer specialist) sending their patient to the M D Anderson Cancer Institute in Houston:  they are more aggressive in seeking out solutions and, through intensive diagnostics, can find a treatment regimine which the local physician/specialist can then implement / monitor. Q1:  has anyone heard of this particular place, or of this method of treatment? Q2:  what ideas does anyone have for nausea control?  (when Phenergan doesn’t help). Q3:  Does anyone have any other suggestions for coping? (Any (new) ideas welcome, & I hope you don’t think me ungrateful for your thoughtful suggestions, but please see notes below re: what doesn’t work, so you aren’t wasting your time mentioning things she’s already tried & found not to help). Brief Background: My spouse has suffered from migraines for many years (was medically discharged from the Navy due to them, & is considered a Disabled Veteran – they spent a couple years trying to find a solution, which is how we already know about so many things that don’t work for her ). She has many atypical symptoms; she has virulent, idiosyncratic reactions to most Rx treatments (Cafergot, Imitrex, Stadol, any meds based on codeine or morpheine, etc, etc); and she has been suffering worse & worse symptoms plus greater & greater frequency of onset since our 3-year-old was born.  Current regimine:  Verapamil b.i.d., Fiorocet & Phenergan p.r.n.; when they get too bad, we take her to the E/R and get her an injection of Demerol & Phenergan, & put her to bed. Again, many thanks for the ideas. -John Clinton

Response:

:  I have been using a drug called Cafergot for my migrainses.. : has anyone ever heard of this or of it’s effectiveness? : f I had a prescription for Cafergot once because the Midrin originally prescribed didn’t seem to be working.  I only took the Cafergot once because it made me so nauseated.  Even for several days after taking it my stomache was really sore and unhappy.  I went’ back to the midrin. Anne

Response:

 I have been using a drug called Cafergot for my migrainses.. has anyone ever heard of this or of it’s effectiveness?

I use it.  It is unpleasant, but it works.  The unpleasant side-effects, agitation, queasiness etc., can be partially countered by taking mild opiates.  I do not ever take the entire recommended dose; for me at least, 2 tablets initially followed by 1 every half hour thereafter is way, way over the limit of what I can tolerate.  I take 1, followed by another after an hour if needed.  Your own experience may vary, but I would recommend caution. -Troy — :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::: Dr. Troy Shinbrot :::::::::::::::::::::::::::::::::::::::::::: ::: Laboratory for Chaos, Fluid Mechanics & Mixing ::::::::::::::: ::: Northwestern University :::::::::::::::::::::::::::::::::::::: ::: Evanston, IL  60208 :::::::::::::::::::::::::::::::::::::::::: ::: USA :::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::

Response:

I have been using a drug called Cafergot for my migrainses.. has anyone ever heard of this or of it’s effectiveness?

According to my Migraine book, cafergot works by contricting the blood vessels in the head.  It works for 80% of migraine sufferers if taken within the first hour of the migraine. (I happen to be one of the 20%) Its side effects can be: nausea, chest pain, muscle aches and tension. It should not be taken more than twice a week, or by people with high bood pressure, heart disease or who are pregnant. There you have it. Nicola.

Response:

 I have been using a drug called Cafergot for my migrainses.. has anyone ever heard of this or of it’s effectiveness? f

Response:

Advice welcome: My spouse has been seeing a neurologist specializing in migraines here in Austin, TX Do go.  There is a remarkable difference between small town nonacademic medicine (like Austin) and medical center medicine (like Houston or San Antonio).  It is difficult to find out where to go, but for any serious non-emergency medical problem I suggest staying away from small town doctors.

Many thanks for the input, but…"small town"?!? FYI:  Austin is the state capital, pop. is  500,000 + (about the same as         Portland, for example).  But you’re correct, San Antonio does         have a medical school, and is 4-6 times larger than Austin, so it IS         more likely to have much greater resources / expertise…. Q3:  Does anyone have any other suggestions for coping? Midran works for me, but my case sound simple compared to yours.

Yes, my spouse used Midrin regularly prior to her pregnancy; it was contra-indicated due to possible fetal deformity issues, then didn’t regain effectiveness after our son was born.  Nothing against Midrin, it just doesn’t cut it for her.

BTW – have a sister & her family in Portland, & my mother’s in Eugene.           Nice scenery, if you can handle the rain…..;-) Thanks again, appreciate the input.  Anyone else? -John Clinton

Response:

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