Hi,
You need to schedule an appointment with a neurologist for your brother. He might get some investigations done and explain what he thinks the diagnosis could be. This is important as painkillers are not working. Also does your brother have any eye sight problems or symptoms that may indicate a sinus infection? You need to convince him to stop drinking so much and try to relax. Are there any trigerring factors for the headaches?
Hi,
I appreciate your concern for your brother. I would suggest your brother to try out magnesium supplements. Magnesium is known to have a beneficial effect in patients with migraine. Taking too many pain killers can result in rebound headache. I would suggest that he with the help of his doctor should slowly wean himself off the pain medications. Also try and identify the trigger for migraine. It could be a food product, or an environment stimuli or simply excessive stress. Please ask him to avoid alcohol completely as it is only going to make his pain worse. Good luck!
well he finally caved and went into the ER, where the doctor took him off all the pills and referred him to a neurologist which here will take up to 3 months just to get in and see them.
as far as eye sight problems there are none, everything else seems to be normal!!
K,r
Find another neurologist. Get out your insurance book or their provider search on the internet and search up to 40 miles away or whatever your tolerance for driving. Call several around and put your name or the waiting list and tell them if their are any cancellations, your brother is urgent case. Just make sure the neurologist is board certified. Your brother is in major pain, I have rarely seen rebound headache after only a month. Now he may be exacerbating the headache by drinking the beer. Once things clear up he may want to try vodka - obviously I'm not advocating he go out and drink now. However, very easy for the ER doctor to say "yes, stop all medication and wait three months for your appt" By then he will have lost his job, lost his health insurance, and the neurologist won't see him. I would never discourage a patient from taking his pain medication until a diagnosis with preventative treatment is undergone and is at an efficacy level. While he is waiting I would get him back to whoever prescribed the painkillers. If no sinus, ear infection ect.. is present, a GP can prescribe plenty of basic preventatives for your brother to try while you wait for the neuro. How much Amitriptyline per day was he on? 10 - 25mg a night is not going to do it. He may need to work up to 100 mg or more. Since you have migraines, the genetic factor is positive. In the mean time yes, he can miss work and no his company cannot take disciplinary action based on the americans with disabilities act. Make sure he "emails" for all conversations and may need to bring doctors notes. Although he won't be getting any promotions he won't be getting fired. Also, he can ask for "reasonable" accomodations for the company. For example, takeing a 1.5 hour lunch, taking a nap in his car, then working late. I don't know what he does for a living. How much Elevil did he work up to. It has shown to be a very effective migraine medicine. I actually break some migraines with it. But I have taken 100mg, and had to sleep for 4 hours. But I have also had plenty of 14 day, 17 day, 21 day migraines. Good Luck.
I know totally where you and your brother are at. I too go to work not feeling well and with migraines because my work did not recognize chronic migraines as a vaild reason for missing work, they only allow 3 absences for illness a year.
In the United States there are several avenues to insure that your brother will still have his job no matter how many absences from work he has.
FMLA the family medical leave act---it was signed into act by Clinton in 93 or 94. it allows up to 12 week of absence do to several reasons but in his case it would be for personal illness, and you might want to do the paperwork at your job so incase you need to help take care of him your employment will not be at risk.
Most jobs have leave of abscence options so that you can take care of anything from illness to adoption to death of a family member.
and there is short term disability at some places of employment.
In Canada
there is short term disability, leave of abscence and there are a few additional options
have him contact the personel manager, human resources department, or his immeadiate department manager. he will need to explain the current medical situation, have documentation from the emergency room, his general practicioner, and the neurologist he was refered to. this is used to verify the realness of his medical condition, prove he aint faking, that there is a treatment plan in place and have the doctors write possible modifications or alterations that will make it easier for him to complete his work. the neurologist's letter needs to include the appointment day and time and the fact that it is the soonest available appointment.
and if that doesn't help he may need to go to the local health department or labor office. and have them help intervene. the health department can speed up the appointment or get him into another doctor sooner. since it is effecting his working ability and thus his method of supporting himself. and the labor office can be as an advocate between him and his employer.
I am the migraine queen I am currently taking ammitriplyine at night and imitrex works the greatest wheyou canot get nothing elese to work. and after two of those and they still dont work i go to the hospital for a shot of newbaine it is injected in the hip but works the best.
yeah My brother is lucky he can take almost anything they prescribe even though it really isn't working. I on the other hand cannot as I was just diagnosed with Epilepsy and most of the drugs on the market including amitriptyline is bad for me!!
as far as speeding up the appt with the neurologist that just wont happen here!! even with my condition I had to wait 60 days our healthcare system is so backed up right now!!
My brother did say today was the first day he did not have the migrane when he woke up so maybe he can make it through some of the wait time pain free??
What happened with your brother? One month ago before my 38 th birthday I developed a migraine for the first time; I vomited evrry time I sat up from bed; I lost 11 lbs and finally went to the ER. They gave me a shot and fluids and said I had a migraine. 3 weeks later no relief (I changed my glasses prescription, went to chiropractor (who said I had scoliosis and pinched nerves), acupuncturist (who said I'm not drinking the right water), Reikie Master (who said I'm allergic to wheat and have chemical problems due to chem trails) and general M.D. ( who gave me fioricet). Now it has been 4 weeks, I have changed all I can think of, and taking medicine I have no desire to take, but still have a difficult time doing daily activities such as working at a job with my husband, who is my best friend, or riding in a car. I need some clarity of what is going on, and I would rather not take prescription poison. However, I am to the point of "do anything to be normal again".
One very important question would be if the headaches are positional; getting better when you lay down and severer when sitting or standing upright. From the original post I get the picture that this might indeed be the case.
This is suggestive of a spinal csf leak. I have written about this in other posts here. It can be hard to diagnose in some cases.
Another option is new daily persistent headache, the cause of which is unknown still. Usually treated with amitriptyline. But this is a diagnosis of exclusion, so you need to be thoroughly examined and tested before this diagnosis can be made.
I wouldn't waste more time on alternative routes in your case; try to see a good neurologist who can diagnose you instead. That is my best suggestion for you.
What happened with your brother? One month ago before my 38 th birthday I developed a migraine for the first time; I vomited evrry time I sat up from bed; I lost 11 lbs and finally went to the ER. They gave me a shot and fluids and said I had a migraine. 3 weeks later no relief (I changed my glasses prescription, went to chiropractor (who said I had scoliosis and pinched nerves), acupuncturist (who said I'm not drinking the right water), Reikie Master (who said I'm allergic to wheat and have chemical problems due to chem trails) and general M.D. ( who gave me fioricet). Now it has been 4 weeks, I have changed all I can think of, and taking medicine I have no desire to take, but still have a difficult time doing daily activities such as working at a job with my husband, who is my best friend, or riding in a car. I need some clarity of what is going on, and I would rather not take prescription poison. However, I am to the point of "do anything to be normal again".