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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Severe Migraines Be Treated?

I am a brain injury survivor (burst subarachnoid aneurysm) from 30 years ago. My doctor now prescribes Vicodin (hydrocodone), 30 count about every 6 months or so. When it was determined that my vascular migraines were caused by the limited space in my left temporal lobe, following surgery, my neurologist used Fiorinal as a quick stopgap. I ve had a full hysterectomy (age 42) and the only severe headaches are from surgical site. Why does my doctor prescribe hydrocodone instead of butalbital (Fiorinal)? Can you help me? These vascular events occur so rarely that I would prefer to take something less invasive than Vicodin, but my doctor insists that Fiorinal is more a treatment for migraines than my headaches. Thanks in advance! Pam Looney
Thu, 28 Jun 2018
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General Surgeon,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice.

Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions. Pain relievers such as Aspirin or ibuprofen (Advil, Motrin IB, others) may help relieve mild migraines.Acetaminophen (Tylenol, others), also may help relieve mild migraines in some people.Drugs marketed specifically for migraines, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraine pain. Triptans effectively relieve the pain and other symptoms that are associated with migraines. They are available in pill, nasal spray and injection form. Anti-nausea medications,opioids and steroids may be used in addition in severe cases. Also, you need to rest and relax and have good sleep. If there wont be improvement it would be good to do MRI scan and have neurological exam.

Hope I have answered your query. Let me know if I can assist you further.
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How Can Severe Migraines Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions. Pain relievers such as Aspirin or ibuprofen (Advil, Motrin IB, others) may help relieve mild migraines.Acetaminophen (Tylenol, others), also may help relieve mild migraines in some people.Drugs marketed specifically for migraines, such as the combination of acetaminophen, aspirin and caffeine (Excedrin Migraine), also may ease moderate migraine pain. Triptans effectively relieve the pain and other symptoms that are associated with migraines. They are available in pill, nasal spray and injection form. Anti-nausea medications,opioids and steroids may be used in addition in severe cases. Also, you need to rest and relax and have good sleep. If there wont be improvement it would be good to do MRI scan and have neurological exam. Hope I have answered your query. Let me know if I can assist you further.