[Ruperts_mom23]

I'm feeling a bit more frustrated as of late with the pain and its causing my pregnancy some problems. For the last couple weeks I've been experiencing steadily increasing pain along with more frequent and severe migraine headaches. Migraines have always been a symptom of my TOS but I have found through trial and error that if I don't over-do it, I could keep them down to just a few a month; lately, however, they have increased to three or four a week, regardless of my activity. I do have the TENS unit, which doesn't seem to do hardly anything anymore, and I do have some hydrocodone that I take when the migraines come on, but its becoming a vicious kind of cycle that has me almost to a breaking point. Two weeks ago I had to go to the hospital for pre-term labor because I'd had a particularily bad pain week that caused me just a bit more stress than my body could handle; I'm on partial bed-rest and medication to keep the contractions under control, but the more pain I'm in, the more contractions I have, the more medication I have to take and I would really like to NOT be on the hydrocodone for at least a couple weeks before I deliver so that the baby won't be born dependant. My pain doc can't do a whole lot for me at this point, and my O.B. is just kind of shrugging the pain off like its no big deal. I have thought about maybe switching to different O.B. that would listen to my concerns more than the doc that I have, but I don't know if maybe I'm just over-reacting.

[gibbrn]

Hi Ruperts_Mom,

I hope you are having a good day......what a dilemma. I feel your pain....I was getting migraines for about five days a week until I got on a blood pressure medication ....lowers it....propranolol .aka inderal...
http://www.wyeth.com/content/ShowLabeling.asp?id=106

Here is an article on migraine and pregnancy......
http://www.fetal-exposure.org/MIGRAINE.html
http://headaches.about.com/od/medsar.../pregnancy.htm
http://www.colmc.org.uk/Images/migraine_in_preg_fs.pdfhttp://www.aurorahealthcare.org/services/headaches/types/pregnancy.asp
Be careful reading this one.....is only for your knowledge not trying to scare you


Birth Defects Res A Clin Mol Teratol. 2006 Aug;76(8):592-601.
Maternal severe migraine and risk of congenital limb deficiencies.

Bánhidy F, Acs N, Horváth-Puhó E, Czeizel AE.
Second Department of Obstetrics and Gynecology, Semmelweis University, School of Medicine, Budapest, Hungary.
BACKGROUND: Migraines occurs frequently during pregnancy; however, there are no published data on their possible teratogenic potential in a controlled epidemiological study. Therefore, we examined the risk of congenital abnormalities in infants born to women who had migraines and other headaches during pregnancy. METHODS: Between 1980 and 1996, the Hungarian Case-Control Surveillance of Congenital Abnormalities evaluated 22,843 cases (newborns or fetuses) with congenital abnormalities, 38,151 control newborn infants without any abnormalities, and 834 malformed controls with Down syndrome. RESULTS: Migraines anytime during pregnancy occurred in 565 (2.5%) mothers of the case group compared with 713 (1.9%) mothers in the control group (crude prevalence odds ratio [POR], 1.3; 95% confidence interval [CI], 1.2-1.5) and 24 (2.9%) pregnant women in the malformed control group (crude POR, 0.9; 95% CI, 0.6-1.3) The mothers of 247 cases, 533 controls, and 21 malformed controls had severe migraines during the second and/or third months of pregnancy. There was only 1 congenital abnormality group: limb deficiencies, which had a higher rate of maternal migraines during the second and third months of pregnancy both at the comparison of cases and matched controls (adjusted POR, 2.5; 95% CI, 1.1-5.8) and of cases and malformed controls (adjusted POR, 1.7; 95% CI, 1.3-3.0). There was no association between other headaches and different congenital abnormalities at the comparison of cases and controls. CONCLUSIONS: Our data showed that maternal severe migraines during the second and/or third months of pregnancy were associated with an increased risk of congenital limb deficiencies. A similar association was not detected between congenital anomalies and other headaches during pregnancy. Our study was not based on a prior hypothesis; therefore, these data can be considered only as a signal that needs confirmation by independent data sets. 2006 Wiley-Liss, Inc.
PMID: 16955495 [PubMed - indexed for MEDLINE]

J Headache Pain. 2005 Sep;6(4):172-4. Links
Headaches in pregnancy.

Silberstein SD.
Jefferson Headache Center, 111 South Eleventh Street, Gibbon Building, Suite 8130, Philadelphia, PA 19107, USA. Stephen.Silberstein@jefferson.edu
Most women with migraine improve during pregnancy. Some women have their first attack. Migraine often recurs postpartum and can begin for the first time. Drugs are commonly used during pregnancy despite insufficient knowledge about their effects on the growing fetus. Most drugs are not teratogenic. Adverse effects, such as spontaneous abortion, developmental defects and various postnatal effects depend on the dose and route of administration and the timing of the exposure relative to the period of foetal development. While medication use should be limited, it is not absolutely contraindicated in pregnancy. Nonpharmacologic treatment is the ideal solution; however, analgesics such as acetaminophen and opioids can be used on a limited basis. Preventive therapy is a last resort.
PMID: 16362655 [PubMed - indexed for MEDLINE]



Just a couple of things to see....

hope this helps you.
love and hugs
Victoria

[Jomar]

I wonder if there are pain management /OB/GYNs?
or one of each that will work together??

[DiMarie]

massage and bio-feedback.
I had a great psych that when I was overehelemed and in a vicious cycle got me on track with a managable plan...It took time but I found how much I could gain control over...especially stress.

My daughter in law had to take effexor during the pregnancy, no problems.
There may be herbs and natural items to take that will help. Did you think of a Dula (sp) to support you. Maybe she ca come and massage and monitor and be an ear every few days?
A good support person and extra set of eyes and ears.
Hugs
Di
PS...there is a natural pain relief, almost a natures built in cocain for managing pain if you can get your body to that point. Many also in pregnancys' have a loosening of muscles that helps with spasms relief.

[LinJane]

Just wanted to write to give you support in your pregnancy. I have had a baby since my diagnosis but was extremely lucky not to have any symptoms or problems. I had a planned c-section to make sure I did not do any damage to my neck. I had been in the hospital a few times for pre-term labor due to dehydration. When are you due? Best of luck for a good delivery and healthy baby. I know my daughter, who is now 4 1/2, was the greatest thing we have done. She is my 4th. My others are 17, 15, and 12. She has brought a great deal of laughter to a house that had a lot of pain for many years. Enjoy! Linda

[astern]

sounds familliar.

I was on bedrest with delivery #2 and medication to prevent labor. having to care for a toddler durring this didn't help. I delivered 7 weeks early with #1 and 5 weeks early with #2.

how far along are you? Yes, it might be worthwhile to seek a pain mgmt OBGYN? having your pain ignored or not treated adequately could be bad for mom and baby!!!

much love and pain-free hours

[Ruperts_mom23]

I'm thirty-one weeks right now; my due date is September 7. My biggest problem at this point is keeping the pain managable enough that I can care for my five year old, and that is becoming more difficult as time passes. My husband has been very supportive and helps as much as he can. I do have both neurological and arterial components of TOS, which makes it all that much more difficult to sleep at night and do things around the house that I'd like to do. Sleeping has become such a painful thing for me that I actually dread going to bed at night; I have tried different pillows, different positions, and even trying to sleep on the couch. My bed is brand-new, we bought it just over a year ago at the suggestion of one of my docs, so the matress is not a problem. My five year old was born a day late and I pushed for over two and a half hours before he was born; my fear right now is causing more damage the the plexus than has already been done, and from the research I've done, that is a very likely possibility. My OB doesn't seemed concerned with that possibilty, but he isn't the one that will ultimatley feel the effects (literally) of that view. I would like to discuss the possibilty of an early scheduled induction or c-section (though I'd like to avoid that if possible) and I'm just not sure how to bring it up.

[johannakat]

Hiya Rupert's mom....
I wish I had a good suggestion for you. But the only really good one I have is massage. Massage and hellerwork are the only things that make me really feel better without drugs. Have you had a chance to look for a neurologist who could do botox? It could help now and during delivery....because it will relax the scalene muscles and relive that pressure.

As for your doctor, I think the best way to bring up something that is on your mind is just to make up your mind to put it out there straight. " I am SO concerned about sustaining more damage to my BP that I would like to have a c section to avoid pushing" is pretty direct. If your doctor does not respond to you and either address your concerns or explain very clearly why this is a bad idea, well, perhaps you could look for one who will.

My second pregnancy I had a doctor who would/could not understand my description of back pain. I think my son was just facing backwards, so instead of soft smushy face I had hard skull pressing against my tailbone. I would get very frequent contractions, all through the pregnancy that weren't terribly painful themselves, but the BACK PAIN..OMG..it was like having back labor for 3 months...any activity would bring them on-walking, cleaning, working, whatever. At one visit, after spending three days on my couch resting so that they would go away...I finally asked him to reduce my work hours. I was about 30 weeks, I think. I was in a lot of pain at my visit and feeling very worthless to have to ask to reduce my work hours and I was crying as I asked him.

Instead of sympathy he asked me dumb @ss things like was my husband knocking me around... and yes he guesses they could "come up" with some sort of reason to reduce my work hours, but usually they can't do that until 36 weeks. (that part where I can't move from pain isn't real enough???) He was a huge jerk.

My husband was of course very upset as was I, but I was afraid to leave him because I was so far along. What is my point? Well, I went into labor at midnight on a night my doc was not on call...so someone else delivered the baby (caught him before he came flying out at the wall is really more like it), and I ended up switching to that doctor for my next baby, and it was all fine and I think it would have been very easy to switch during my pregnancy. Baby doctors deliver babies, and if they have your records, they will see what has been happening all along the way. i don't think it is near as big a deal as we the moms seem to think it is.

Actually, for you, if you did switch it could be a wonderful fresh start with the new doc- and a good doc should give you a chance to really express how important it is to not cause increased damage to yourself. If you explain why you are switching docs, he/she will know it is really very important to yo.

Also, there is the kind of OBGYN that people with high risk pregnancies use (forget the name) perinatologist?, maybe you need one of those- they are more used to dealing with people who have issues, and might be more flexible.

I wish I could help more. Having two little kids is the hardest thing I have ever done. I don't think it would be easy if I wasn't hurt, and, feeling like I do, well, it just makes me cry a lot. To be fair- I am prone to crying to begin with, but TOS sure doesn't help.

I wish you easier days ahead....

Johanna