[Glyde 11209]

Originally Posted by mrsD

This is a further explanation for your hair loss diagnosis.



Have you had that carotid artery fixed? This could be the source of your attacks. There is an internal and external carotid branch.




This path is very close to the trigeminal nerves as well.

You are young to have a completely blocked carotid. Is this the side of your head that you hit when you had your bike accident?

If your pain is ischemic (blocked blood flow)...then using ice would not be a good idea.
I wish you had told me this in the beginning. I'd stop the ice for now....and just do the magnesium and the lidocaine.

What supplement did you buy? I hope it is not Oxide form. That does not get absorbed from the GI tract.
SlowMag would be best for and easiest for you. It is available at WalMart for a reasonable price.



If you read that website it will explain why some magnesium oral supplements do not get absorbed as well as others.

If you get injections IV of mag, do stop your oral versions.
The RDA for adults is around 380mg a day, elemental.

Here is my magnesium thread.... this is a very important subject and most Americans are low in this mineral.


Magnesium is used for certain vascular headaches in some people. But it really needs to be a daily intake, and not pulsed with megadosing IV only. So please read my thread to learn how to provide it for yourself eventually.

And stop the ice for now... you have a vascular issue... which is irritating the nerves. That is more complex than just nerve damage.

And please do continue here so we can all see how you are doing.
It is difficult on readers of forums, when people just leave ...it is much better all around to provide some updates, because people who come to the internet tend to be helper types....

Reply:
The vascular issue was taken care of with surgery this past July - I just had a check up and everything is fine (pristine in fact).

This trigeninal(?) sharp shooting pains started in 2008, well before any vascular problems.
I was checked by my cardiologist in 2012, and was clear. The vascular problem
appeared in July 2013. I really don't think it is related to the shooting sharp pain that has been a problem since 2008.

[mrsD]

Am I reading your last post accurately?

You had your bike accident, and a few months this scalp issue began. It became worse, except for one lidocaine block.
Then during a check up to clear you for back surgery, this carotid thing was noticed? It was never evaluated prior to that? It could have been there and no one looked? But now it is fixed?

Anyone explain to you how or why this happened? Are you taking statin drugs now? I would expect you would be using them. They are given after carotid surgeries.

You do have some pretty heavy stuff going on for your age.
An MRI of your head and neck might be very revealing.

[Glyde 11209]

Reply:
The vascular issue was taken care of with surgery this past July - I just had a check up and everything is fine (pristine in fact).

This trigeninal(?) sharp shooting pains started in 2008, well before any vascular problems.
I was checked by my cardiologist in 2012, and was clear. The vascular problem
appeared in July 2013. I really don't think it is related to the shooting sharp pain that has been a problem since 2008.

[mrsD]

So your carotid clogged up that fast? That suggests something is seriously wrong somewhere. It will be interesting when that blood work comes back. What did your doctor say caused this problem?

Arteries can clog due to calcium deposits which come when there is an injury to the inner lining of the vessel. This can be a tiny tear, from lifting heavy things, like furniture or weights, or uncontrolled hypertension.
It can come from autoimmune damage. People with Rheumatoid arthritis can get this...same with vasculitis.
Elevated homocysteine levels damage vessels too.

Usually blocked carotids are slow to form and are found mostly in the elderly. But younger people do get them too, because of diet, lifestyle, etc.

[Glyde 11209]

I'm flattered by your phrase "you are too young..." I am 60 years old!
As I have outlined, the bicycle accident was in July of 2008 and the piercingly sharp pains on my scalp started in September (three months later)
For the first two years i and my dermatologist thought it a dermatological condition, and we went through all the skin tests, etc.
finally in December 0f 2010 we decided it might be neurological.
In the meantime - In November of 2012 I felt pain in my chest as I climbed stairs. I went to my allergist who thought at first it might be asthma - then decided that I needed a cardio stress test.
He was right - within a week I had two stents inserted into the arteries leading to the heart.
Since then I have been on a regimen of baby aspirin, plavix and crestor.
everything was fine - I had lowered my cholesterol levels substantially by the following summer.
I have always been active, I rode my bicycle across New York State a few summers ago along with tent, sleeping bag etc.
I continued to ride my bicycle and practice yoga up until October 2012 when back pain turned out to be spinal stenosis. I checked with three doctors, had numerous MRI's and finally came to the point where I was willing to have surgery to correct the spinal condition.
I scheduled surgery for July 22 of last summer.
I had to get a "cardio-readiness" check up due to the stent situation.
I came through with flying colors, stress test, everything until they checked the
carotid arteries. the artery on the left of my neck leading to my head was 99% clogged and the doctors were worried about a stroke or worse. I had the surgery and in two weeks was back teaching (rather gingerly) my summer drawing and painting classes.
Last week was my 4 month check up and everything is as the doctor said "pristine"
I am now on a three month check up schedule.
The doctors said in July as well as now when i asked them how this artery became as clogged as it did so quickly that my situation was "atypical" and due to genetic issues. This made some sense because my diet has been altered since the stent operation to rule out fatty food, soda etc.
I am not sure that the sharp pains which have been diagnosed as "cluster or ice pick" headaches, then as possible occipital neuralgia (I received a occipital nerve block inOctober of 2012, followed by a radio frequency block, this actually relieved the pain entirely for almost 6 months!
At this point however - this method has been tried twice with no results at all.
I have a migraine doctor who is convinced that this is best treated by Nortryptaline (sp) or one of the tri-sicyates(sp).
They make me sick, yet this doctor is convinced that if I only give the medication enough time my body will get used to it.
I also have been taking Tegretrol for about 4 years for a seemingly unrelated issue - mood control. I can't take anything apparently, Lyrica, wellbutrin, Luvox, Prozac -
When I first started taking Tegretrol it caused what my doctor called a "seratonin spike" I felt red and flushed.
I have over the last 4 years upped the daily dosage to 6 100 mg tables, two in the morning, two evening and two before bed.
I now understand that Tegretrol may be doing double duty in terms of mood stabilization and the apparent neuralgia.
I honestly don't have a clue because nothing has worked long term for over 5 years now.
You mentioned that I had a lot going on.....yes i do actually and it gets more confusing and frustrating every day.
I do thank you for all of your help............

[mrsD]

I have an explanation of what the anti-seizure drugs to for pain.

Here:
this is a preface with some physiology before the actual drug
post...explaining neurons.

http://neurotalk.psychcentral.com/post828704-7.html

This is the drug post about the various drugs:
http://neurotalk.psychcentral.com/post829772-9.html

In general the anti-seizure drugs, often affect either calcium or sodium, and change the movement of these ions into the cell...which is the beginning of a nerve impulse transmission.
NMDA receptors use calcium as a stimulant, and magnesium as an antagonist. This is why magnesium is important for nerve pain. But there are other NMDA antagonists. Some people here use Namenda. And DM found in common cough medicines is used now in a drug called Nuedexta (this remains off label for pain still however).

One reason (and the doctors may not even know this yet), that Nortriptyline is really a good choice, is that new studies are showing it helps repair peripheral nerve damage. But it has been a pain treatment for quite a while because of the actions on serotonin, it has in the pain loop in the brain where pain is perceived and interpreted. This loop is the site where most pain is occurring....so it is technically "in your head". But the nortriptyline has the potential for fixing damage in the peripheral nerve systems that may be sending messed up signals.

In what way is nortriptyline so unpleasant for you? Usually in low dose that is all that is needed, and many tolerate it much easier than Tegretol, in fact.

So you teach painting? Is it acrylic in the class or oil paints?
Oil paints over time would defat nerves, and can be a trigger for PN. Some paint colors contain cadmium, and other heavy metals.
Have you ever had a test for heavy metals? That might be revealing.

[mrsD]

Rode across NY state on a bike, lived on the ground in sleeping bags?

Sounds like LYME possibility to me.

There is a new test as of 2012, that a poster here has discussed.
He had terrible PN for a long time and came back positive on this test. Here is the link.

He claims NY is filled with Lyme infections.

I'd check this thread out:
http://neurotalk.psychcentral.com/thread195046.html

[Glyde 11209]

Reply :
decided to take nortriptyline again, 10mg once a day, anything higher than that makes me feel lousy and i snap at people, which is not a good thing if you are a teacher.
This dosage is termed "a baby dosage, and not doing a thing" by the headache neurologist I've seen.
Too bad, it's all I can do and I have tried

[mrsD]

It takes a long time to see the benefits from the nortriptyline.
3 wks to affect the serotonin in the brain pain loop at least.

Longer than that to help stimulate nerve growth factors.
Many people take it at night, so by morning you don't have much in the way of side effects.

Give it a try, for 3 months...at that low dose of 10mg. See what happens. It is one of the more useful drugs for PNers, and not expensive or nasty. In high dose that is another animal entirely.
I don't believe you need higher doses. Maybe 25mg tops after the 3 months.

I hope your doctors monitor your blood white cells and electrolytes while you take that Tegretol. The toxicity from that drug can really sneak up on you suddenly.

[Glyde 11209]

I just had a blood test to check tegretro in my liver, bloodstream etc....it was way under the danger zone.
I have been taking nortriptyline for about 5 days now and haven't had a stabbing scalp pain since, it might be that there is a lot of tegretol in my system
and the Nortryptian is working faster ? (they are very similar drugs)
What ever the cause, I haven't had an attack in almost a week now.
I see my migraine specialist tomorrow, and my neurologist (back and this issue)
on tuesday.
Things feel better.....
And thank you for all of your help...