Those with migraines.....

[Tinythepanda]

Well after being migraine free since starting warfarin in October I had the mother of all episodes.

I got up yesterday morning and by 9 I could barely see out of my right eye, I couldnt walk with out gripping onto the walls for dear life because my legs were so weak and I was so unbalanced.

My mother in law called an ambulance and by the time they arrived I was unable to talk and struggling to stay awake. I was rushed straight to ct and thankfully no bleeds or clots. I was very confused and didn't know where I was for a little while. I was moved to the acute stroke ward to be observed for a few hours and was finally discharged and diagnosed last night at 7.

Today although my headache has gone my vision is still affected, my balance is stay off and I'm still getting a few words jumbled up. Is it possible to still have these residual effects after a migraine?

I was going to see how I am by Thursday and then if no better back to the gp for advice.

My INR was in range so I know this wasn't a factor.

[Tinythepanda]

* discharged and diafnosed with migraine.

[Manofmendip]

Hi

What is your INR at the moment? What you describe is what I had sometimes before I was anticoagulated and sounds more like a type of TIA.

I was migraine/TIA free for 7 years on Warfarin and 75mg Aspirin and then I started to get the migraines again, several a week. I was given low dose Amitriptyline to add to the Warfarin and Aspirin and I haven't had a migraine since 2010 now.

I am now on Fragmin instead of Warfarin.

Dave

[Lure2]

I agree with the others.

What INR did you have?

Kerstin

[Tinythepanda]

Thanks both,

My INR range is 3-4 and I'm pretty consistent.

My other TIAs were without headache although symptoms were very similiar.

I had the visual aura for a while and I'm still left with a blind spot. I did have my typical migrain type headache but also a pain on the back left of my head and neck.

What was different was the inibility to talk and the confusion and the weakness where I couldn't hold myself up. They did report I had left sided weakness.

My headache has gone but I'm left with still jumbling a few words, poor balance and bumping into things.

I'm wondering whether it is a migraine hangover and intend to visit the GP Thursday if there's no improvement.

Fingers crossed these nasty symptoms disappear. Is it naive to believe a good INR doesn't always prevent clots?

Thanks for your advice as always x

[Lure2 in reply to Tinythepanda]

What INR did you have when you had the suspected TIA/stroke?

As I selftest every second day i know too well how the INR changes from day to day.

You say your INR was in range. Was it over 3.2? It is quite possible to have a TIA/stroke with an INR of 3.2 as we have very sticky blood.

Kerstin

[margbott in reply to Tinythepanda]

Dear tiny the panda

i do think that we can clot even with an so called in range inr.

First clotting cascades are very complex. An inr tests for only a single aspect of clotting cascade an it is far downstream. Other factors such as X a which is what is sometimes used to evaluate resize to or need for enoxaparin/low molecular weight heparin (s) come far ahead of vit. K part of clotting cascade.

So absolutely a good inr doesn't preclude a clotting episode be it a minor sludge blood thing a Tia DVT stroke. Besides which who decides what a good inr number is for each individual? Some folks do ok at 3.5 others need more. Some also need to manage platelet aggregation which war far in does not do. That's why Some folks need aspirin or other anti platelet med. In addition to warfarin.

In my experience I had a 3.5 cm clot to my upper Cephalic vein (upper arm) with an inr or nearly 7. My target inr was between 4 And 4.5.

I had taken aspirin for a massive headache the previous day and had not been eating which was how my inr got up to 7. Afterward the university hematology dept declared me a Coumadin failure and I've been on enoxaparin injections twice daily since that time.

And yes I do still get that migraine boiling brain feeling with dizziness and speech trouble for which aspirin seems to be the only help. The hematologic to say that I can take up to 1000 MG aspirin in a day but not take it everY day.

I've also had several clotting episodes even on low molecular weight heparin plus aspirin.

I don't think you can get 100 percent protection for APS with any current protocol.

I hope you go back to your doc on Monday even if you are feeling better. We need to document the problems with APS. .. It's still too little understood and too many times people just don't get the preventative nor the acute care they need because docs don't know what to do and just dis count symptoms. I sometimes feel like I'm getting the blame for being difficult.

Best wishes

Margaret in Ca

[Tinythepanda]

Hi kerstin,

My TIAs were prior to warfarin. The hospital didn't say what my INR was simply that it was in range. I checked my yellow book thinking it would perhaps mention in there.

Thanks for all of your answers. It's just a bump in the road in this journey.

[MaryF Administrator]

I must say I agree with you, I would wish to go back and remain suspicious of such symptoms. MaryF

[Lure2]

I agree with APsnotFab, who knows this illness well, that you should do something at once!

Kerstin in Stockholm

[ledlegs]

I must say I have been on Warfarin for 26 years now after 3 DVT's and have always suffered with migraines. Lately I have been getting the visual disturbance I have always got before a migraine but don't get a headache afterwards and Prof. Hunt at St.Thomas' doesn't seem to be concerned so I just have to put up with it I suppose.

[Lure2 in reply to ledlegs]

Hi leighfarlow,

I also have the usul blind spot for some minutes and afterwards the the zig-zac patterns for some minutes. I never have headaches.

After I started warfarin I do not get it very often as before warfarin. I do not get worried because of them anymore either.

It is another thing to get a blind spot which remaines (!) and also difficult to speak and some confusion and weakness at one side etc. That is not migraine I should say. I have been told that is a TIA or a stroke.

May I ask what therapeutic level of warfarin your Prof Hunt has put you on? Is it stable?

26 years with warfarin is a long time but I know others on here have been on it even longer.

Best wishes to you from Kerstin

[Tinythepanda]

Hi all,

Apologies for going awol. I have spoken with my consultant secretary and I will be seeing her 25th June. She said she may want to schedule in an mri at some point in view of my recent epsisode.

I have also made an appt for Monday to see my gp to insist on a referral to the migraine clinic. If this migraine was the cause it needs investigating and with 2 children and being on warfarin I can't be worrying about collapsing.

I'm also going to the optician today to have a visual field test, retinal photos and good look at my optic nerves. 2 years ago I had inteacranial hypertension and can be a cause for vision loss so want those things checking too.

So it's been a few days of organising things and I'm feeling a bit more min control. You gotta love this condition for you giving you a kick every now and again to say I'm here don't get complacent.

In the meantime I'm trying to type and send messages which is fun when it looks to me as though the j is missing.

Thankyou all again for your advise and kind words. My family are wonderful but it's only those of us living it truly know the way we feel. Hope you're all doing as well as can be with your health x