headaches and migraines

inpain2424

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So for a little over 2yrs I have been having headaches and increasing migraines. The headaches are everyday and my migraines sometimes 1-3 per week. My neurologists has advised
Me to stop taking the one med that has helped me when things get to full onset. So my question is should I go to the ER or sickcall for every true migraine that i have during this 4-6 weeks of not taking my fiorecet? With the med, I could at least function somewhat at work. I just dont want to run to the doc every time as I don't like missing so much work. Trying to fight and hang in there as long as I can.

inpain2424
 
inpain2424,

I'm currently being reviewed for Migraines which is my 1 and only unfit condition. My migraines are completely incapacitating and I get them with the abortive medication about 4-5 times a month. It all depends on how you can handle them. I would suggest that you keep a log of time and date, and if there is constancy go to sick call. The hospital won't do anything but tell you see you neurologist or your PA.
 
I deal with extreme and debilitating migraines. Your best bet is to keep a log and take it to your neurologist. Try Cambia for the less severe headaches and Sumavel Dosepro for full blown migraines. Keep in mind that these are "rescue" meds. I take a large dose of gabapentin in addition.
 
So now I have been told double up on my meds. Im so loopy in mornings that I don't feel comfortable working with my patients. Meds are Elavil and topamax. Here is a normal day:

Up at 0100-0300am (depending on how sleep meds work)
Gym by 0445 until 0610
work by 0700 until complete (most days 1630-1700)
Home by 1745-1800
online classes 1815-2000
Try to sleep 20120 until.

IP24
 
They're declining my submission.
 
Not enough meds tried and neurologists appts. Even though they span back over 2 years now. I will keep fighting and yes my mistake has been not going to the ER or Sick call for every episode I guess.
 
who wrote the p3? You should ask the neuro what to do w/ the migraines if they have no abortive for you. My neuro said don't go to the ER as my treatment plan, just rest, dark, quiet, etc. Going to the ER makes mine worse (very bright and loud there) and they don't provide a treatment worth anything anyway. As long as neuro has a plan in writing in their notes that you understand, should be GTG. Sick call didn't even annotate the visit let alone treat.

Until doc says all treatment plans have failed to get you to retention standards and no different plan has a basis for improvement, they need to keep treating. For me we found the best abortive med, but it was insufficient, and we tried one preventive which failed and my other conditions made trying the others a bad idea. I'd think if it wasn't a neuro that said enough is enough, most likely they have other tools to try. We'd been at it for a little over a year, but it wasn't the timeframe that mattered it was exausting the med options.

Its like if you had knee problems. They try physical therapy, no go. If you're a good candidate for knee surgery they have to try to see if that fixes you next, not just throw thier hands up and say, well, we tried, screw it.

If you literally have tried all the options that are realistic, then whoever wrote the P3 just didn't annote that right on the write up and they can do another one. MEB people won't look through your files to find out, that's hard.

But it depends on who turned you down, i suspect neuro is in the middle of playing with meds and its fubaring your work so you're asking for the P3 to start the MEB and someone said no. Try for a T2 or T3 to account for limitations you're experiencing. Topomax was doing ok for me at low doses, but once they upped it, i got messed up bad. Topomax is some serious juju. But they have to give it time, many times side effects diminish. Just need something to cover you until they can say good or bad med. The cognative problems can be severe enough that they may need to restrict you to minor paperwork for awhile or something.
 
Update: my P3 was submitted and im finally in the MEB process. Im being told that right now my referring conditions are Asthma, migraines, and Bilateral foot conditions. Supposedly, all other conditions will go to the VA. My BH provider told me to make sure that my PCM/meb docs review my BH records as she diagnosised my PTSd w/depression and anxiety. Im trying to put together my dd 2807-1 now. Mind numbing. Side question: if my dentist advised me and then did facial injections. This was botox 12-14 injections from jawline to temple. Is is to try and see if my grinding and facial muscles will relax. One of the most painful experiences I have had. How will this factor into my meb?

Inpain2424
 
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Update: my P3 was submitted and im finally in the MEB process. Im being told that right now my referring conditions are Asthma, migraines, and Bilateral foot conditions. Supposedly, all other conditions will go to the VA. My BH provider told me to make sure that my PCM/meb docs review my BH records as she diagnosised my PTSd w/depression and anxiety. Im trying to put together my dd 2807-1 now. Mind numbing.

Inpain2424

Do you agree that those "referred" conditions cover all of your potentially unfitting conditions?
 
Do you agree that those "referred" conditions cover all of your potentially unfitting conditions?


Mr Perry,

I have my first face to face with the MEB soon. I still have a specialist appt 2 days prior to that appt for hands and wrist. For my Active Duty job migraines, asthma(can't run for apft), feet/ankle, and my hands/wrist issues makes it hard to work daily without constantly taking breaks or stopping. The PTSD has me constantly worried that im being watched, I don't go out (shopping and even going to a movie is hard), short tempered at work (I have step away from the area multiple times to keep from overheating), and I do have dreams/ reoccurring thoughts (from past deployments and helping with carry a friend/battle buddy that killed himself after returning from deployment from his barracks room). Just trying to get ready for all this.

Inpain2424
 
@inpain2424

Very sorry to hear what you are going through. The reason I asked was that just because the docs say your other conditions are not "referred" is not the end of the story. When your MEB and NARSUM are done, you can disagree, you can ask for an impartial review, and you can have your additional conditions "added" to your MEB.

I hope all goes well for you. Feel free to ask any questions.

Regards,

Jason
 
Thank you an I will try to update throughout this process.

Inpain2424
 
By the way, in the past, the military took the position that "prostrating" migraines/headaches only occurred when you stopped what you were doing and went to seek medical care. Later, they "loosened" the standard to state that you did not have to go to the ER/doc if you had a approved plan by a neurologist stating that you did not need to do so. Now, all of that has changed with the VA providing the ratings. Essentially, a "prostrating" headache is one that causes "extreme weakness or exhaustion" (this is not a set definition, but one that has been used by many VA rating officials and has become somewhat of a standard). One thing that you could do is keep a migraine log/diary, detailing dates/times, what steps you take to deal with the migraine, how long it lasts, and any residual effects.
 
I have one, but lost some of the info as the app was on my phone. Had to replace it. I do have multiple trips to ER and sick call directed by neurologists and PCM.

inpain2424
 
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What is the possible rating for constant headaches?
 
8100 Migraine:


With very frequent completely prostrating and prolonged attacks

productive of severe economic inadaptability.................................................... 50

With characteristic prostrating attacks occurring on an average once

a month over last several months........................................................................ 30

With characteristic prostrating attacks averaging one in 2 months over

last several months.............................................................................................. 10

With less frequent attacks......................................................................................... 0
 
While everyday headaches suggest a 50% rating, the reality is they will then almost never consider them prostrating in that instance. Making a 0% rating a real possibility. Generally its good to separate them into ones that suck and ones that rise to the level of putting you on your arse. Why people talk a good deal about keeping a daily log.

While there is some variation away from this theme in the VASRD, by law they're only supposed to rate things that effect employability, not things that make life suck. Which headaches are going to effect the type of job you can do. Otherwise you're trying to say you should get 100%/IU for headaches, which can happen, but from examples I've read takes a different level of documentation. You'd never be do able to do anything if it was a constantly prostrating type of thing, which yes is probably possible, but needs to be carefully documented that its that serious a problem.

As pointed out, the prostrating is a very weird standard that can be hard to predict, and everything about the 50% standard is poorly defined. So this type of blanket, have them everyday, statement can wash out in weird ways.
 
I am also going for everyday headaches. The Neurologist has clearly written on my medical record that I have to leave my workstation frequently to rest on a dark room as my headache is too unbearable. On top of that I have several days of quarters and a profile for it.
But most importantly, the ratings depends on how the C&P is written about your headaches. I filled my DBQ and the C&P examiner kept it exactly the same. I answered all the questions except the last one. I am currently waiting for my ratings so I am not sure how it will come.

Duration of typical head pain?
- Everyday
Does the Veteran have I have prostrating attacks of non-migraine headache pain?
Yes -More Frequently than once per month.
Does the Veteran have very frequent prostrating and prolonged attacks of non-migraine headache pain?
-Yes
Does the Veteran's headache condition impact his or her ability to work?
-Yes

As ScoutCC mentioned, its very hard to figure out the ratings for headaches but you should get a general idea about what it should be.
 
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