I find the same problem...its a shame that the "drug seekers" of the world have made it so difficult for those of us that are legitimately in pain to be treated with respect and to be treated with the medications that we deserve and that will give us the quality of life we need just to get through the day to complete or little tasks like getting out of bed, getting dressed and going grocery shopping.
This is when we need to get tough, don't give up...write letter to everyone...send them on to all the appropriate channels so that this problem is not ignored! This needs to be addressed...
Hang in there and do what you need to do to be treated with respect and treated adequately with the proper medications...((getting the step ladder to climb down off my high horse now!))
Your circumstances almost mirror mine. My family doctor was very understanding of the fact I needed pain meds and he did prescribe them. What I liked about him (he moved away over a year ago and I still miss him ) was he did not think I should settle for pain meds and try someone who could work on preventing them. He admitted he did not have much experience with controlling migraines and I respected him a great deal for that. He sent me to 5 or 6 neurologists. The first one pretty much "dropped" me after he found out I did not have a tumor he could operate on. He wanted to settle for pain meds so I moved on. It seems every neuro I went to was ready to give up after a couple of medication trys. My new family doctor (who continues to prescribe pain meds) sent me to a neuro he went to med school with. What a fiasco! He wanted to try a couple of different treatments (which involved painful injections) and I was willing to try anything. The pain clinic decided they could no longer prescribe narcotics so my family doc. continues to. No one told me that the insurance was covering only a small portion of the treatment costs and I did not get a statement from the insurance company until the treatments were finished. Now I owe the doctor so much money they won't let me go back until I get the balance paid down. I used to go in for the nubain/phenergan shots but they quit helping. The family doc switched to demerol/phenergan but they quit helping. Now I pretty much rely on the ER as well and if I am luckly I get a doc that will give me morphine, only about half of the ER docs will. I am to the point that morphine is the only thing that works.
Sorry, I did not mean for this to be so long. When I start thinking about the whole situation I just need to vent and this seems to be the only place I can do it.
Had A humdinger of a migraine on Monday afternoon. Had been fighting it off since Sunday afternoon. Went to my DR Office as a walk-in and it was standing room only. This was about 3pm, and I couldn't get in. Went home for a little while. I couldn't stand it anymore, so about 7:15, went to the ER. DIDN'T GET A FREAKING SHOT UNTIL 2AM!!!!! Needless to say, by then, I was dying, and my poor father looked like death warmed over. At least he got to watch the entire Monday Night Football Game. It's never taken half that long to get seen by a doctor before. The Doctor's choice of medication was, (are you ready for this now?) Thorazine. Two great big huge needles of the stuff. I looked up its uses, and it's primarily an anti-psychotic, but about half way down the list of uses is "intractable pain". I had to look up "intractable" which means stubborn or difficult. The shot didn't work particularly well, but nobody checked on me for an hour. By then, I just wanted to be discharged and go home.
I gotta work out some kind of deal with my doctor that they slide me in for a shot, regardless of what else is going on, and that I get at least a Nubain injection, regardless of what doctor is on duty. I'm sick of the doctor d'jour and the medicine d'jour. Especially when I know that I'm not going to get any pain relief from some weenie guy whose too afraid to prescribe strong enough medication.
So many doctors, so many medications,
During one of my trips to the ER one of the doctors finally told me it was possible for my doc to give the ER a standing order of treatment for my migraine. My family doctor did this and it worked great. Once I told the triage nurse I had a standing order I got right in. The doc was happy because he did not have to stick his neck out for the morphine it takes to get rid of one that sends me to ER. Unfortunately it seems to be difficult to find a doc willing to do that. My doctor moved over a year ago and I have not been able to convince my new doc to give me one. He will rarely stick his neck out for anything stonger than demerol which doesn't work anymore.
My best advise - talk to your doc about a standing order in ER or look for one that will do it. I am still searching.
If your neuro found a combination drugs that does a fairly good job of controlling your migraines you are fortunate. I have been to several and they have not found the right combination yet. There are many times I need to go to ER for pain control but just don't because of the hassle and financial reasons. All my neuros have seemed to think that Topamax is the current wonder drug for all. I know people it has helped and have to talked to people here it has not helped. The only thing I have gotten out of Topamax is bad side affects and I have experimented with high and low doses I have gotten better, through necessity, of hiding how severe the migraines are from my employer. The next time I go I am going to inquire about some of the meds you have found successful.
Has anyone heard of an extremely low white blood cell count being due to high doses of Topamax? The docs can't even agee on this. One doc thinks Topamax was the culprit and another thinks is was the Depakote I was taking right before I started the Topamax.
Propranolol...is Inderal (generic form) I take that daily and it helps some...not as much of a difference as Topamax, but I am taking it for blood pressure also.
The low white blood count, I have found more common with depakote than with Topamax (not that it is COMMON with either, but I had a doctor that refused to prescribe depakote for some of the side effects that were possible and I think that was one that he ran in to!)
Tell me what's been going on with you!!!!!!!!!
I read through the posts on the difficulty treating migraines and can sympathize. I've been offline for a week fighting a couple of bad headaches. I unfortunately know mine are rebound right know as I wean off painkillers. When they're really bad they trigger migraines.
It's tough because a good neurologist can be the best medicine for chronic migraines. I complain about mine occassionally but overall he is still very good at what he does and in partnership with my doctor does a great job.
I've had some great luck with melatonin and valerian root, two natural remedies. Melatonin helps me sleep and valerian root helps me with anxiety. These coupled with a pain killer and / or a muscle relaxant often work really well. I've got the medications I need to fix my headaches on hand rather than needing to go to an ER or clinic.
Hi Leigh Ann,
Thanks for the warnings about the herbal remedies. I check everything with my doctor before taking them and he's given me the okay. I also received some advice from a naturopath on the brands that are reliable concerning the makeup and concentration of the various herbal brands.
Have you considered trying another doctor? and then setting up a treatment plan? I have a plan in place with both my doctor and neurologist so that I'm not put in the situation that I'm asking for medications in the middle of the headache. I also keep track of all of my medications in a headache diary so that both doctors can see what I'm taking and how often and see that I am using my medications responsibly. Just some thoughts.
I looked up Stadol NS on many websites because I had never heard of it and it was often grouped with Tylenol with Codeine which is what causes me rebound headaches. Just a friendly question - is it possible that some of your headaches could be rebound if you're using a lot of Stadol NS? When I'm suffering from a rebound headache from Tylenol with Codeine, nothing works including Toradol except for a narcotic that is as strong or stronger. My rebounds can trigger migraines. I'm only suggesting this for you to think about.
Good luck - you'll figure it out.
Hi Leigh Ann,
this is my first post, so I do not know how to do the title thing -- bear with me. Regarding getting consistent care in the emergency department: I am an emergency physician (not practicing at the moment due to multiple herniated neck discs and [you guessed it - migraines]). Contrary to Sara's belief (although I know for a fact it is well-founded ) not all of us ER docs have a God complex. Formulating a care plan with your primary care physician and/or neurologist will provide guidance for the emergency physician when you present with a migraine. Speaking as someone who has been there, it is great to have background information and a plan in black and white -- something to do that will actually help the patient I am seeing. I was never one of those "weenie" doctors afraid to give narcotics. Quite the contrary -- I took pain relief very seriously and the nurses called me "the morphine queen"...So having a care plan on file in the emergency department could be very helpful for you. I would definitely look into it. If you have such a plan an emergency physician would have a hard time explaining why s/he did not follow it. Hope this is helpful.