My comment about pain was merely to gain an understanding that this is true 10 pain. I'm not saying that she is not experiencing this sort of pain, just that I want to make sure this is the case. I have the CDH, I to know what H@#$ is like. I'm there, have been for a long time...
Anyways, I knew this might stir a little controversary I just wanted to make sure things are in perspective. Pain is a subjective experience and she may be to a 10, I am a blunt person, straight to the point, and I like to question everything. It doesn't mean that I don't believe. I don't mean to cause any offense either.
And no not all doctors believe in the rebound effect. In fact, I am one of them. I believe in withdrawal effect. Very different, 1 is medically proven with scientific evidence, the other is only ~50% of the time. Please research this, read articles in science journals not crap from Mayo Clinic, because they just say every medicine causes this effect to a migraine sufferer. I think each person is individualized and will react differently to different treatement plans. Narcotics are not for everyone, just as SSRI's are not for everyone. I myself have tried over 45 different prophylactics and have had little success with 97% of them. This is because pain can cause depression as depression can cause pain. But treating depression for a person that is not depressed is going to have some not so good side effects. As migraine sufferers, many of us are very sensitive to medications, which is inherently another issue.
Narcotics are definitely not the first line of defense, but in this case because she has had good reaction to the demerol she may have luck with a daily dose of an opiate pain reliever such as Hydrocodone, etc. This may reduce the pain and the frequency. I agree she needs to have a nuerologist or a pain specialist. She will probably have breakthrough pain. For this she may be able to take a triptan, NSAID or even a prednisone pack that might help. As with many of the migraine prophylactic treatments, there is the risk of withdrawal syndrome, which includes the risk of increased headaches, fever, chills, general discomfort, etc. Like I said, she also may find relief from an IV saline solution, I know this helps reduce the pain for me by 2 notches when they are really bad. I am lucky enough that I have a couple of saline bags at home, and I can just plug in and it really helps, and there's no side effects whatsoever.
Remember there is a big difference between dependence and addiction. An addict uses the drug to get a euphoric feeling. A dependent person uses the medication do continue a somewhat normal life. She may need this medicine to move forward. I hate to see anyone suffering this much because I myself have been there.