Headaches after skiing

[Rdputnam515]

Does this happen if you stay the night at alt or only when you travel back and forth?

when is the last time you went to see a dentist? Any tooth/jaw pain, sinus pressure?

I once did a little snorkeling and the pressure change pointed out a tooth issue, I though I was going to die. I’m wondering if maybe a bad tooth may be causing these issues for you? Pressure changes stirring up the bad and causing you to feel sick

 

[palikona]

Does this happen if you stay the night at alt or only when you travel back and forth?

when is the last time you went to see a dentist? Any tooth/jaw pain, sinus pressure?

I once did a little snorkeling and the pressure change pointed out a tooth issue, I though I was going to die. I’m wondering if maybe a bad tooth may be causing these issues for you? Pressure changes stirring up the bad and causing you to feel sick

I haven’t stayed at altitude overnight since June, so I can’t answer that.

Saw a dentist recently and have no issues. No sinus pressure.

Wondering if the pressure change is causing something though.

 

[pchewn]

You've addressed quite a few things except your eyewear/goggles/sunglasses. Have you tried out some different goggles that make you squint less, or are darker, or something like that? I'm thinking it might be some sort of eye related tension.

Maybe close your eyes and meditate on the lift to relieve the tension?

 

[Sibhusky]

Wondering if the pressure change is causing something though.

I've been tracking my migraines for years and my #1 trigger is barometric swings. But just the vertical drop of my mountain, even yo-yo 'd, wouldn't be enough to set it off. Combine it with a barometric change, maybe it tilts me over the age. But generally unstable weather means a lot of swings and there is a lot of unstable weather in the mountains.

 

[Doug Briggs]

Do you have a pulse oximeter? It might be informative to see where your O2 levels are before, during and after going to elevation.

 

[Rdputnam515]

I would should also ask about any edema?

swelling of feet legs?

 

[palikona]

I've been tracking my migraines for years and my #1 trigger is barometric swings. But just the vertical drop of my mountain, even yo-yo 'd, wouldn't be enough to set it off. Combine it with a barometric change, maybe it tilts me over the age. But generally unstable weather means a lot of swings and there is a lot of unstable weather in the mountains.

So for me, the vertical drop for the day ranges from Denver (5,280’) to the base area of a typical Summit, Grand or Eagle county ski area (8.5-10k’) and then skiing up to 12,500ish. Yesterday was just up to 9,700’ from 5,280’ and back. Maybe that’s triggering migraines? My symptoms yesterday were nausea and dizziness after getting back down to Denver. Today, some dizziness and I think a headache is coming on.
Do you take a preventative migraine medicine when dealing with barometer pressure changes?

 

[palikona]

I would should also ask about any edema?

swelling of feet legs?

No, no swelling.

 

[palikona]

Do you have a pulse oximeter? It might be informative to see where your O2 levels are before, during and after going to elevation.

I do. In Denver, it reads 95% typically. I’ll check next time.

 

[Doug Briggs]

I do. In Denver, it reads 95% typically. I’ll check next time.

I have a friend with pulmonary arterial hypertension. She learned a lot about her oxygen level by taking frequent readings noting location/elevation and activity.

 

[Seldomski]

Back in August, I after getting what had to be a migraine (I’d never experienced one but this had to be on, without aura), after mountain biking, and other headaches after exercise, I went to the doc who then sent me to the cardiologist, who found through testing that I have a small PFO in my heart. It’s a hole that usually closes after birth but 25% of people’s don’t and don’t even know it. And it usually doesn't effect those who have it. The cardiologist and I decided against the simple procedure to close the hole, because he was not sure it would help the headaches. Next up: the neurologist. I got an MRI done and it came back normal, but with some small bits of white matter, which I think indicates migraine tendencies. I’ll learn more next week during a telehealth meeting but it sounds like exercise for me can trigger headaches and migraines. Does anyone else deal with this? I have no idea what the neurologist will suggest moving forward in terms of treatments, meds, etc.

Reading back through this, maybe it's time to get a second opinion on the PFO?

Patent foramen ovale: A hole in the heart-Patent foramen ovale - Symptoms & causes - Mayo Clinic

Learn more about the causes and complications of this condition in which a hole in the heart doesn't close the way it should after birth.

www.mayoclinic.org

Maybe under the increased stress condition of exercise + altitude your blood oxygen level is dropping.

PS - I am not a doctor.

 

[palikona]

Reading back through this, maybe it's time to get a second opinion on the PFO?

Patent foramen ovale: A hole in the heart-Patent foramen ovale - Symptoms & causes - Mayo Clinic

Learn more about the causes and complications of this condition in which a hole in the heart doesn't close the way it should after birth.

www.mayoclinic.org

Maybe under the increased stress condition of exercise + altitude your blood oxygen level is dropping.

PS - I am not a doctor.

Yes, you may be right. I’ve been thinking about this.

 

[Sibhusky]

Do you take a preventative migraine medicine when dealing with barometer pressure changes

I have tried a raft of preventatives. Many have seemed to work for a while, but none have held up when a full year was compared to any other full year. I have not tried the CGRP meds yet because every time I look at what the higher insurance will be plus the non-covered part of the drugs $ plus finding a neurologist willing to go through all the hoops to get those drugs - which might not work after all that $ and effort - It's just easier to go to bed. I will admit that Topomax had some impact. But I was a loon to deal with plus being depressed and I decided that I'd rather feel great on the good days instead of depressed everyday.

Yes, I'm currently on a "preventative". It prevents nothing.

 

[palikona]

I have tried a raft of preventatives. Many have seemed to work for a while, but none have held up when a full year was compared to any other full year. I have not tried the CGRP meds yet because every time I look at what the higher insurance will be plus the non-covered part of the drugs $ plus finding a neurologist willing to go through all the hoops to get those drugs - which might not work after all that $ and effort - It's just easier to go to bed. I will admit that Topomax had some impact. But I was a loon to deal with plus being depressed and I decided that I'd rather feel great on the good days instead of depressed everyday.

Yes, I'm currently on a "preventative". It prevents nothing.

I just tried Nurtec for the first time today since I did end up with a headache per usual, the afternoon of the day after exertion, and it’s done nothing
I’m so down because I had high hopes for it.

 

[Sibhusky]

Good to know. Nurtec was the one I was interested in.

And I'm the same, it's DAY AFTER the exertion, not day of. But I wake up with it, so it's not like I can just ski each day to kick the can down the road.

And then suddenly, I'll have a week or two when everything is fine.

 

[palikona]

Good to know. Nurtec was the one I was interested in.

And I'm the same, it's DAY AFTER the exertion, not day of. But I wake up with it, so it's not like I can just ski each day to kick the can down the road.

And then suddenly, I'll have a week or two when everything is fine.

It may work for you though. My neurologist was able to get 16 pills for free for me to try. Also, you can go through the Nurtec website and get a saving card to give to your pharmacist once you have a prescription. At least that way, you can try it. I’ve also heard from some people that Nurtec doesn’t work for them but Ubrelvy did, so I may try that next.
I used Cambia last ski season and it helped half the time but now doesn’t seem to help. I tried Propranolol a few months ago and that didn’t help because I was on a low dose and felt like shit after two weeks.
Have any doctors figured out why you get your migraines?

 

[Sibhusky]

Have any doctors figured out why you get your migraines?

The neurologists I went to had no interest in the "why". All they cared about was testing drugs on me. I'm the only one worrying about the why. I stopped going to neurologists. (This isn't a metro area, there's not a lot of selection.) My primary can write presciptions.

I'm on Medicare, so I'm not eligible for almost all of those trial programs. Any Part D Insurance has been way higher than the one I use if they cover Nurtec. And the Nurtec copay was nuts. As I said above, the price in total was far beyond what I am willing to spend. My current plan is at least very permissive about the # of triptans I take in a month. The ones that covered the CGRP class of drugs were not. If we were working through trying Aimovig, Nurtec, Ubrelvy, etc. I would not only be dropping mucho $, but unable to get abortive drop in the qty. needed. I go through a lot of ice packs. They are cheap. If I had a job I had to show up for maybe I would drop the bucks. But I don't. So, going to bed is way cheaper.

I know @crgildart did well on Aimovig for a while, but the numbers just don't make sense to me, plus I hate needles. (I used to faint when I got a shot. Now I don't but when someone else is doing it, I don't have to see it coming. A bit different doing it to yourself.)

 

[eok]

I've been tracking my migraines for years and my #1 trigger is barometric swings. But just the vertical drop of my mountain, even yo-yo 'd, wouldn't be enough to set it off. Combine it with a barometric change, maybe it tilts me over the age. But generally unstable weather means a lot of swings and there is a lot of unstable weather in the mountains.

Barometric swings are often a trigger for us too. The more intense the weather front (pressure-wise) the more abrupt & worse the headache. Ironically, when significant low pressure weather systems move in, I'll usually get a migraine... and my wife will usually get a migraine when an abrupt high pressure ridge moves in afterward.

And let me tell you: central Oregon can get pretty extreme & rapid shifts in barometric pressure!

This doesn't keep us off the mountain though. Sometimes I can lose an active migraine after skiing for a while - which probably is no different than the good old method of taking a brisk walk to lose a headache. Anyway, skiing with a headache is - for me - better than not skiing at all.

 

[crgildart]

I know @crgildart did well on Aimovig for a while, but the numbers just don't make sense to me, plus I hate needles. (I used to faint when I got a shot. Now I don't but when someone else is doing it, I don't have to see it coming. A bit different doing it to yourself.)

I'm still using Aimovig monthly. Dropped off it for 2 months when COVID went through the house and efficacy went back up after that break. Been on it since March but I'm going to have to switch in January. My insurance is dropping it and picking up Emgality so I'll give that a try when we're back over our out of pocket max. When it's pay to play (copay like 20%) I just roll with the sumatriptan because it works well enough after an hour when they hit. But, Aimovig is the only thing in over 20 years that actually worked WELL to prevent them. I hope Emgality does too but not all that optimistic. Not paying $600+ a month for either though..

 

[Andy Mink]

No offense to anyone who needs these medications but who comes up with the names?