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Facial migraineIn some patients the pain of migraine is felt in the face, either in a distribution similar to that found in cluster headaches or lower down the cheek. In these cases, the pain is less severe, less sharp, and may last for a much longer time than in a classical or common migraine attack.
Basilar migraineThis usually occurs in young women. The headache is commonly over the back of the head and, besides nausea; the symptoms may include giddiness, double vision, unsteadiness, and slurred speech. Perhaps the most alarming symptom is loss of consciousness. These symptoms are due to a diminished blood supply to parts of the brain supplied by the basilar artery, a blood vessel at the base of the brain which goes into spasm to produce an attack.
Hemiplegic migraineThis is a very rare form in which there is a paralysis of the arm and leg on one side of the body. Fortunately the paralysis is temporary but it may be repeated. There is often a strong family history of similar attacks.
Ophthalmologic migraineThis, too, is rare and occurs particularly in children. During the attack, the eyelid droops, the pupil dilates, and the eye squints outward. Again these features are temporary and usually go when the headache stops.
Abdominal migraineThis occurs more commonly in women and its onset is usually in childhood. The pain is often over the upper part of the abdomen and lasts a few hours. The diagnosis is revealed by the family history of migraine and the occasional attacks in which the pain is preceded by about an hour of migraine, more commonly classical than common.
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Intramuscular morphine injections should be given for the relief of acute or severe pain when intravenous access is not available. There is no place for continued intramuscular injections and either oral or subcutaneous treatment should be used for continuing therapy.
Rectal morphine-Morphine suppositories are available in some countries and can easily be manufactured by a pharmacist. The recommended dose is the same as for oral administration although absorption may be slower and variable. Oral controlled-release MS Contin tablets are effective when given rectally but absorption is less predictable than by the oral route. They can be used to tide a patient over a short period of vomiting, but are not otherwise recommended.
Spinal morphine-Spinal morphine therapy provides improved pain control for selected patients with severe pain. The indications for this treatment and the optimal mode of administration for patients with advanced cancer remain to be defined.
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Any woman who has suffered for any length of time from the sharp pain of the cramps or the prolonged difficulty of the aching miseries, will tell you that she’s had to organize her life round her periods. Whether we like it or not, the majority of us aren’t such free agents as men are. There are lots of times when a woman can live and work as she pleases, but for anything from a couple of days a month to nearly half of her life, she has to plan ahead, restrict her activities and make choices. There are also choices to be made when it comes to treating the symptoms, as you may have noticed already.
Dragging pain and fatigue-You may find that the two exercises you have been practising to ease the pain are just too exhausting when you start to lose your energy. I certainly wouldn’t recommend you even attempt dry land swimming when you’re feeling tired, because that is exhausting in the best of circumstances. But you might find that you can manage the pelvic rock providing you don’t do it for very long. Stop as soon as you are tired and rest afterwards. In fact, several short sessions will do as much good as one long one. But if your fatigue is extreme, and even getting up in the morning is too much effort, then you might decide to try to ease your pain with relaxation, hot water bottles and rest rather than activity.
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