PAIN MANAGEMENT FOR FULL-BLOWN MIGRAINE ATTACKS

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CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 1/25/2006 12:55 AM (GMT -7)   
Ok, Folks...
 
I've had migraine attacks now for about 33 years, and it has been increasingly hard to medicate me for pain.  I am at the far end of the scale when it comes prescribing pain medication or giving me an injection for pain.  Nothing less than narcotic pain medication works on me now, and then only selected ones work for me.  For instance, Nubain and Dilaudid work on me fine, but morphine and demerol do absolutely nothing.  All the doctors are so paranoid about the narcotics, I have a difficult time with some doctors who refuse to work with me to relieve my pain, especially ER doctors.  One actually had his nurse give me a shot of BENEDRIL(called it by its pharmacutical name) and put me on oxygen for a while, I guess to try to fake me out that he was actually treating me.  He didn't even tell me what he was going to do, he just mumbled that the nurse would be back with something for my pain.  No information, no discussion, nothing.  I never saw him again.
 
SO......
 
MY QUESTION IS....
 
WHAT PAIN MEDICATION DO YOU TAKE FOR A FULL-BLOWN MIGRAINE ATTACK, and do you have trouble with any doctors providing you with adequate pain management?
 
Jest wondrin',
Leigh Ann cool
 
BTW- My mother has convinced herself I'm hooked on the drugs, and I need to go into rehab somewhere. tongue

"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett


purplegdaisy
Regular Member


Date Joined Feb 2005
Total Posts : 242
   Posted 1/26/2006 9:17 PM (GMT -7)   
When I get a migraine that won't abort with the axert, Imitrex injections or Florecet with Caffeine I end up in the ER and get:
4mg Diluadid
25 mg phenergan
Benedryl (Diluaded at that strength makes me itch)
and DHEA. Or could be DEHA ?? It is the active ingredient in Imitrex (I have no idea what that stands for but it makes the blood vessels contract and dialate so that the migraine stops.)

When given these four medications my migraine has always stopped. I always go to the same ER and they know me by sight at this point. I have been in about twice a month for the last 7 months. I tried going to a different ER last weekend (Saturday) because my usual ER had about 45 people waiting to be seen, and ended up getting just the diluaded and phenergan and still had the migraine the next day. We went back to the ER on Sunday and I got the usual cocktail and all was well in about 15 minutes. I ALWAYS make them start an IV and give the meds that way instead of muscular. I have never left the ER with a migraine if they do it that way.

I actually got lucky and my Neurologist was on call last weekend when I was there and he stopped to see me. He told me to be firm about what works, and tell them what I need. If I have any problems they are to page him immediatly...
I was on a cruise last week and got a migraine and the doctor on the ship gave me a shot of morphine in the rear which did nothing for me either. When you find something that works for you, stick with it, Talk to your neurologist about it and ask if a problem should arise in the ER, can the doctor call him/her for validation...


Hope this helps you some.
Tracy
Diagnosed UC october 2004
Currently in remission.... no blood or D...
lower back causing me tons of pain from car accident in July
DDD L4-S1


tysmyboo
Veteran Member


Date Joined Dec 2004
Total Posts : 921
   Posted 1/29/2006 12:27 PM (GMT -7)   
You are right Cranky1, most doctors now are so overly cautious that they will not prescribe necessary pain medications to people who need it. I had lortab...and my doctor refused to prescribe them, now...I have only taken 20 since August 29th. It wasn't like I had been through 3 bottles this month or anything...
Needless to say, it is time to find a new doctor- one who knows what they are doing and believes me...and it worried about adequate care and not how many prescriptions they write.
Sara-Migraine/Headache Forum Moderator
 
Thanks for Visiting HealingWell.com


purplegdaisy
Regular Member


Date Joined Feb 2005
Total Posts : 242
   Posted 2/8/2006 9:25 PM (GMT -7)   
Ok, I went to see my Neuro today and told him that I had been to the Er twice since I saw him at the ER 3 weeks ago. I told him of the trouble I had been having in those visits with getting the attending doctor to use the right combination of meds administered the right way to make my migraine go away.

He wrote on a prescription pad that I (name) had been diagnosed and was under his care for migraine headaches. We have tried several medications and the only ones that stop a full blown attack are 25 mg of Phenergan for the nausea, 45 mg of DHE and 4 mg of Dilauded, all administered IV.

He signed this and said if there were any questions to please call him. He addressed it to All ER Physicians.

I am going to keep it in my purse at all times and the next time I go in to the ER, show it to the doc so I can get the right combination of meds and be out of there in an hour with no more migraine. (fingers crossed that they will do what he has asked)

Has anyone else tried this? I am ending up in the ER 2 to 3 times a month with a migraine that will not respond to any of the meds I have at home, and I am not going to lay here and suffer with them if I can make them go away.

My heart goes out to everyone that goes through this daily, and with no relief from meds. Talk to your neurologist.... see if this is something that might help you. (I have great health insurance that allows me to go to the ER, but I have been in the opposite situation with no insurance at all and could not afford to go to the ER. I think that is what makes me go now. Too many headaches I had to suffer through for days on end.

Tracy
Diagnosed UC october 2004
Currently in remission.... no blood or D...
lower back causing me tons of pain from car accident in July
DDD L4-S1


Mary-Anne
Veteran Member


Date Joined Nov 2004
Total Posts : 508
   Posted 2/9/2006 9:58 AM (GMT -7)   
I hear you loud and clear about docs being so darn careful for what they give patients these days, it's as if those that do abuse the system and try and get lots of drugs hurt those of us that truly need to take them
I have had migraines for years, and was dx with lupus and fibro over a year ago - that changed many things for me, but I still have these headaches, and it's a coin toss as to who is going to deal with the headaches and prescribe the meds. My PCP thinks I need to take something on a daily basis to get stop the headaches from coming, so I've tried many things from trycyclic anti-deps to bp meds and so on, his latest was depakote. THAT was horrid, I couldn't hardly walk down the hall, my head was so off kilter.
I do have Zomig, but with that med, you trade one set of symptoms for another. Before that I had Imitrex, but at the time was on Paxil and suffered from serotonin serum sickness (no kidding). so we found Zomig and I got off the paxil and all anti-deps... I also have 10mg tabs of phenergen when the headaches are bad. That's it - and I can't take motrin because of the lupus...I do take ultram for pain with the fibro, stress make it worse, I can then take more ultram, but we are to the point that the ultram doesn't touch the migraine.
What works for me...I found through my mother, the 5mg of Zomig (sometimes another 5mg 2 hours later, but that's all that is allowed in a 24 hour period) and 2 500mg tabs of hydrocodone (she has back arthritis and has had this prescribed for her). I sleep like a baby for a while, sometimes (more often than not) the 2nd Zomig is taken, and then I finish the 24 hour period with 2 more hydrocodone and then tylenol. It eases the pain, but the migraine is still thre, I can just move around a bit.
My PCP says the next step for me is topomax or neurontin -well, they had huge side effects too, but he is adament that he will prescribe NO narcotics.
My rheumy says if that's what works for me, then I should take htat, but she doesn't prescribe it either, so I don't have it AT ALL, and now I am out.
As for going to the ER, that's a big deal when you are in the military and the pay and all that stuff...going up to the pos is an option, but it's over 30 miles away...
I usually wind up curled up in my bed waiting for a break from the pain. I've had a serious headache for day #3 now, out of other meds, one more Zomig but I don't want those symptoms either, so I am taking tylenol like candy. I see the rheumy on Monday and am hoping for a referral to a pain management specialist. It's such a drag for docs to take so long to treat the issue at hand.
Blessings, Mary-Anne
"Even though I'm walking through the valley of the shadow - I will hold tight to the Hand of Him who's love will see me through... And when all hope is gone and I've been wounded in the battle...He is all the strength that I will ever need, He will carry me..."
 
dx lupus, FMS - 2004
sjogrens - 2005
RLS, Anxiety, Migraines, Allergies, Carpal Tunnel Syndrome, IBS
meds - Plaquenil, Zelnorm, Klonopin, Seroquel, Zomig, Ultram, Zyrtec, Flexeril
 


tysmyboo
Veteran Member


Date Joined Dec 2004
Total Posts : 921
   Posted 2/10/2006 6:05 PM (GMT -7)   

There is a form I posted that you can have your doctor fill out ahead of time with current meds, and how they want you to be treated (what medications, dosages etc) when/if you go to the emergency room...

 

It is a wonderful idea to have this "gameplan" in place so you are prepared and have less likelihood that the docs are going to give you lip!!! lol

 

Sara


Sara-Migraine/Headache Forum Moderator
 
Thanks for Visiting HealingWell.com


CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 3/13/2006 2:35 PM (GMT -7)   

I just got a summary bill for my last several ER visits for migraine attacks.  The doctors all spent the same amount of time checking me out (three or four minutes).  Then they would mumble that the nurse would be back with something for my pain.  I would always explain my standard pain shot, but they would give me whatever they decided I should have for my migraine.  The truely maddening thing other than lack of control over medication, is that the doctors are charging two different rates for my treatment (doctor's bill only).  Some charge twice as much as others.  I guess I'm going to have to ask what trauma level visit I am being charged for and why.  So, not only do I have to fight for the correct medication, I have to be auditor and accountant to make sure I am being charged correctly.  What fun when I'm in the throws of a migraine attack.  This is especially essential since my only source of income is Disability, and my Medicare isn't in effect yet.  OK, enough whining for me today.  Anybody else have this problem?

Leigh Ann cool


"The weather is here, I wish you were beautiful."
                                             - Jimmy Buffett


philski
Regular Member


Date Joined Dec 2005
Total Posts : 34
   Posted 3/14/2006 7:46 AM (GMT -7)   
imitrex shot, nothing else works. Don't even bother trying anything else anymore. And if the shot doesn't go through just go to bed cause the day's a waste.

I've tried prettymuch every oral abortive available as of 2 years ago and imitrex nasal sprays. They just don't work for me.

-philski

JenMcD
Regular Member


Date Joined Dec 2005
Total Posts : 42
   Posted 3/22/2006 10:53 AM (GMT -7)   
I have been suffering from chronic migraines, anywhere from 2-4/week, for over a year now.

We have tried several antidepressants and preventatives and so far nothing has worked. My pdoc has recently prescribed Depakote (why on earth hasn't my neuro at least tried this yet???) for a bit of (hypo)mania that I have had for little over a month - I am Bipolar II also. It may be working a little bit, maybe we will up the dose next time and see. Luckily I haven't had any trouble with it yet. Just a little 'stupids' but nothing like the Topamax.

I am totally allergic to any and all triptans! I would rather deal with the pain of the migraine than deal with the nausea, stomach cramps, etc from the triptan - I rarely throw up from a migraine.

So the only thing that I can do is take a painkiller to try and ease the pain off so that I can sleep. I started off taking Percocet (Fioricet, Fiorinal, Tylenol #3, and numerous others have not even touched it) and now am on Vicoprofen, reluctantly prescribed by my neuro (he doesn't believe in pain meds! wth?!?). At least my old neuro took the position of 'lets keep you out of the er'.

As my neuro explained to me, alot of docs are scared of the DEA. Supposedly they are watched like a hawk and he doesn't want to loose his license that he went to school for, for years. Pain Management Clinics can prescribe high doses, so maybe that will be an option for me until we can get this thing in control.

The last time I went to an Urgent Care (the hospital was FULL) all they would give me was Toradol - you had might as well been giving me Benedryl.

The worse thing is that no on believes you. What are you to do if you think that your docs don't even believe you?
Please be nice to me, I'm a blood donor (conquering my fear of needles one pint at a time).

Dx: BPII (and everything that comes along with it), BPD? (pdoc trying to figure that out), Chronic Migraines (that means 2-4/week)

Current Rx: Lamictal, Lyrica, Depakote ER, Seroquel (prn), Xanax (prn), Vicoprofen (prn), NuvaRing

Past Rx: Prozac, Paxil/CR, Lexapro, Cymbalta, Ambien, Wellbutrin XL, Effexor/XR, Topamax, Neurontin, Trazadone, Klonopin, array of triptans (allergic)


Jahero
New Member


Date Joined Feb 2013
Total Posts : 1
   Posted 2/16/2013 2:27 AM (GMT -7)   
Hello. My name is Jahero. Im 22 years old as of this year and I have been labeled with CM. I have hit my breaking point in which I cant manage the pain with simple will power anymore. My head hurts 24/7 I cant sleep I can barely eat anything or keep it down. When they get really bad I spike a fever and it hurts to breath. Pain shoots all over my body and all I want to do is shoot my self in the foot in order to re leave some of the pain with in my head. I've lost jobs etc because of this and I just want some help, I dont know what to do. Everyone says its in my head but your body wouldnt let you put its self in that much pain, I dont want the pain or the meds. I WANT IT TO STOP! i feel like im at a dead end what should i do now?

kmigraine
New Member


Date Joined Mar 2013
Total Posts : 2
   Posted 3/14/2013 11:35 AM (GMT -7)   
I was getting 3+ day migraines 2X a week. I tried so many things, neurologists that put me on Nadol which worked to keep the migraines away but my pulse was at 42! I was taking Vicodin long term for daily headaches and back pain, but that was of no use for a migraine. Then I went to another Neuro who put me on Topomax which I didn't want to go on since my daughter who has Bipolar had been on and I had seen the cognitive dulling.....but I tried. No help and cognitive dulling and awful diarrhea! Now I'm on Depakoke at 750 mg a day. I went 4 weeks without a migraine! Now we are going to add botox to the depakote. I'm scared but whatever, I can't be a mom and wife spending 3 days a week in bed 2-3 times a month. It's sad. I've been homeschooling my son for 7 years but had to put him in school cause I had too many days where I couldn't work with him. My husband is being pulled away from work to take care of our kids. I've never been this helpless.

Anyone tried botox? I'd like to hear about it.

enigma1
New Member


Date Joined Mar 2013
Total Posts : 2
   Posted 3/25/2013 8:26 PM (GMT -7)   
Hi kmigraine I saw your post and wanted to tell you my opinion about the botox. I'm 24 and I have had migraines since I was 10. I also have a lot of other medical conditions, but I have tried what seems like everything for migraines. I have been getting botox injections and it doesn't help. The first injection feels good for about 2-3 days but then the pain comes back at what seems like full strength and with out warning. I tried a few more injections, I didn't want to just stop on the first one, and for sure it is the botox injections making my migraines stronger. I do believe things are different for everyone I think you should at least try it once. I hope it helps and I hope that this was helpful. If you have specific questions about it feel free to ask =)

enigma1
New Member


Date Joined Mar 2013
Total Posts : 2
   Posted 3/26/2013 11:01 AM (GMT -7)   
Hi kmigraine I saw your post and wanted to tell you my opinion about the botox. I'm 24 and I have had migraines since I was 10. I also have a lot of other medical conditions, but I have tried what seems like everything for migraines. I have been getting botox injections and it doesn't help. The first injection feels good for about 2-3 days but then the pain comes back at what seems like full strength and with out warning. I tried a few more injections, I didn't want to just stop on the first one, and for sure it is the botox injections making my migraines stronger. I do believe things are different for everyone I think you should at least try it once. I hope it helps and I hope that this was helpful. If you have specific questions about it feel free to ask =)

Ouchymama
New Member


Date Joined Feb 2014
Total Posts : 1
   Posted 2/2/2014 9:38 AM (GMT -7)   
I was given hydrocondone for tooth pain (which turned out to be a nasty sinus infection, but that's another story...). It killed the tooth pain, but I immediately had one of the worst migraines of my life.

My doc tells me narcotics are a known migraine trigger. So, not a good idea.

Am on imitrex now, it barely works, and I have all of the nasty reactions that others note. Daily topamax worked for migraines, but gave me full blown panic attacks. Relpax works, but at $200 for 9 pills, (and not covered by my ins), that's out. Zooming works, but knocks me out for at least 12 hours.

I think I'm headed back on topamax and just practice breathing through the panic attacks. Better than losing days every month in pain.

I really hate this crap.
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