Question about refills on meds

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baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/15/2007 8:56 AM (GMT -7)   
 
Hi everyone.  I had a problem yesterday that I want to ask y'all about.  As I have posted before, my neurologist has put me on a regime of meds to help abort my migraines.  Well, thankfully, it has been working wonderfully.  His instructions to me 6 weeks ago were:  at the first sign of any headache or when you see on the weather that there will be a high pressure system moving in, take 1 Relpax, 1/2 prednisone, 1 zofran 8mg ODT and 1 2mg Dilaudid.  If this seems to be working but still have headache, repeat the Relpax in 2 hours and the Diluadid every 4-6 hours until headache is resolved.  Well......it has done great.  I haven't been to the ED since starting this 6 weeks ago and that is a record since my migraines started last summer.  I was feeling great about the whole situation.  My only complaint has been that the Relpax makes me sleepy but if I can rest for 2 hours, I am fine - even the Dilaudid doesn't make feel like I am drugged or sleepy or anything.  I am able to function without having to go to bed for 3-4 days!  So, everything should be great, right?  Not so fast.  When the doc wrote the scripts, he wrote 6 refills on all.  When I had them filled, the pharmicist told me that docs arene't allowed to write refills on Dilaudid.  I called the doc's office and told his "nurse".  She said that he should have known better.  I told her that I just wanted to let them know so that when I needed a refill, they wouldn't think I had already had it refilled 6 times.  Understand that every prescription he writes is copied and put in my chart before I leave the office so that anyone who looks in the chart will know what meds he has prescribed.  Anyway, last week, I called and told the "nurse" that I had 3 Dilaudid left and that we were expecting bad weather over the weekend.  I did'tn want to get stuck without any.  She said that the doc was out until Monday and that although she could write the script, for Dilaudid, she didn't like to.  I said that was fine but could she call me on Monday after speaking with the doc.  Well, she never called so yesterday afernoon, I called her and she was not nice.  She told me she would have a script for me but I would have to come pick it up.  I told her I understood and would come by the office.  She then asked me what mg of Dilaudid I used and I told her they were 2 mg tabs but sometimes I took 2 -3 (not at one time but spread out every 4-6 hours).  Well.......she informed me that I was not allowed to do that and that if I did that, they would not refill my scrip early.  So...what is early?  I thought I was doing exactly what the doc told me.  I told the nurse that the ED usually had to give me 8-10mg Dialudid to resolve the pain.  She told me that was the ED and that I was not allowed.  So, when I went and go the script, guess what?  She had only written it for 6 tablets.  So now, I don't know what to do.  I guess I will reserve them when the pain is at it's worse - that is exactly what the doc told me not to do - he said never to wait until the pain was bad or this regime wouldn't work.  What should I do?  This "nurse" made me feel like the biggest piece of drug seeking garbage in the world.  I am scared to call the doc and complain - first, she probably won't let me talk to him and second, if I complain, she will never, ever, help me again.  What do all of you think?
 
Thanks for listening (reading) - sorry this is so long!


DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/15/2007 9:00 AM (GMT -7)   
Oh, and one other thing - the script says 1 tablet Q day - instead of the 1 tablet every 4-6 hours like the original script.  So now, should I take it only once during a headache?  Thanks.
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


Rhoda
Regular Member


Date Joined Feb 2007
Total Posts : 55
   Posted 5/15/2007 9:23 AM (GMT -7)   
Glad to hear you found a combination that works for you.....my husband and I have not been so lucky yet, but we are working on it.

When is your next doctor's appointment? Maybe you could make an appointment to see the doctor and have him clarify everything in writing and get new scripts at that time. Just a thought.

Good Luck! Rhoda

Smiley1
New Member


Date Joined May 2007
Total Posts : 9
   Posted 5/15/2007 12:08 PM (GMT -7)   
Yes, the "gatekeeper" is on a power trip and way overstepping her bounds. I would go in during office hours, be oh so pleasant, oh so calm and controlled, but loud and resonant with while I explained my predicament. I suspect this would get you results and the respect you deserve.

tysmyboo
Veteran Member


Date Joined Dec 2004
Total Posts : 921
   Posted 5/15/2007 3:03 PM (GMT -7)   
Right! Just keep in mind who is the doctor and who is the "nurse"
 
Schedule an appointment WITH THE DOCTOR, state your concerns and be calm, sounds like nursey nurse is stirring up drama. I had this type of situation once where the nurse mis-relayed information and the doctor refused to treat me any longer...after talking to the doctor and getting a chance to hear what I really had said it was a different story.
 
Stand up for yourself, no one else will!
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baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/15/2007 4:30 PM (GMT -7)   
Thanks to all of you.  I had the same thoughts as all of you but just needed to hear it from someone else.  I will call and make an appointment or ask for a return phone call from my doctor tomorrow.  Now...if I can only get past the nurse.
 
Hope all of you are having a wonderful evening.  We have rain moving in and of course, my head is pounding.  On my way now to pick up the 6 tablets that I was prescribed yesterday.  I am going to try to only take one but we will see.  My prayer is that I haven't waited too long and that I don't get myself into a mess and to the ED.
 
THanks again, everyone.  You are all such a wonderful support group.
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 5/17/2007 12:03 AM (GMT -7)   
WHOA there Baseballmomof3,
 
First of all, your doctor prescribed a whale load of drugs for you to take, especially heavy on the narcotics.  The normal procedure would be to just take one Relpax when you felt a migraine coming on.  It is an "abortive drug" which is normally a "stand alone" medication.  If it is augmented at the beginning of a migraine, it would by an anti-nausea medication like phenergan. 
 
The narcotic medications, like the Dilaudid and Lortab, are considered "emergency" meds, to control the pain ONLY if the abortive (Relpax) fails to work.  Narcotic medications usually cannot be prescribed with refills.  A refill authorization can't be made prior to the timeframe the original prescription was written to cover.  For instance, if you are prescribed 1 Lortab to be taken every 6 hours, and the prescription is for 28 pills, you can't get a refill authorized prior to seven days from the date the original prescription was filled.  If you try to get it filled to early, it is interpreted that you are taking the medication more often than prescribed.  That's the quickest way to get labeled as a "drug seeker".  And as bad as it is to talk with someone other than your doctor, you have to be careful, because if some medical personnel thinks you are drug seeking (for recreational purposes) they can put it in your chart and you can be permanently screwed with that doctor's office, as far as getting additional narcotic medication...EVER! 
 
What also struck me as way off the scale is when you said that you get 8-10mg of Dilaudid at the Emergency Room.  The absolute max I've ever had a doctor prescribe its 2-3mg of Dilauded, and I've had migraines for 34 yrs, since I was 8. 
 
The 1/2 prednisone, 1 zofran(?) 8mg ODT(?) are baffling to me.  Can you check the names of those medications?  I haven't heard of them before.  I'm clueless as to why your doctor would prescribe a steroid (the prednisone) to take at the beginning of a migraine, since its purpose is to reduce inflamation in joints and muscle tissue, not an occurrance that just "pops up" at the beginning of a migraine.  I also saw that you have Lidocaine Nasal Spray prescribed.  What are you using that for? 
 
Since you have only been having migraines for eleven months, I am flabbergasted by this "drug cocktail" that your doctor has prescribed for you.  Compared to every other migraine sufferer I've ever come in contact with, you seem to be way over-medicated.  Please don't take this as personal slam.  Your post explaining your treatment just threw up so many red flags that fly in the face of normal migraine treatment, that it just really concerns me, especially since you haven't had to deal with this for very long.
 
This can be really serious, because you can get into a cycle of "rebound" headaches from taking too much medication too close together.  This results in having a permanent headache that nothing will make go away.  You shouldn't take migraine medication more that one or two days a week, or the rebound cycle will start.  The only way to get rid of the "rebound" is to go cold turkey on all pain medication, prescribed or "Over-the-Counter" (OTC).  This is not a pleasant thing to deal with.
 
My gut instinct keeps telling me that you should get a second opinion by a Neurologist not in the same office as your doctor.  Migraines are nothing to fool around with, and the medication can really screw with your system.
 
Please keep us updated on your status.  Posters here really care about each other, and I can be a big spaz when I'm concerned about someone.  Please post again.
 
Leigh Ann cool

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


baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/17/2007 7:26 AM (GMT -7)   
Cranky:  First, talk about running someone off rather quickly - when someone starts a reply with "Whoa", it is a pretty quick way to alienate anyone.  Second, as far as the Relpax is concerned, I have done plenty of research on the med (am probably ahead of the curve since my husband works for the manufacturer of the drug):  "Most people get migraine pain relief after taking one tablet. However, if your migraine improves and then comes back after 2 hours, you can take a second RELPAX tablet" and the instructions are to take no more than 2 in twenty four hours with most doctors prescribing it once and then if no help, again in 2 hours.  Just FYI, Zofran is a wonderful anti-nausea med - it works beautifully and does not make you drugged out and sleepy like Phenergan.  I have seen it used in chemo patients (both adult and pediatric) for years and we have started using it exclusively in the pediatric ER/Trauma Center where I work for anyone with vomiting.  It can be given IV or by mouth and actually comes in a dissolvable (ODT) form which is what I have.  If any of you are still taking Phenergan, I would strongly suggest asking your doctor about Zofran - it is very expensive, but in my opinion well worth the cost.  If I take Phenergan, I lose a day or two of my life being drugged feeling.  Now, in some cases, that might not be bad.  There are some migraines that I get that all I want to do is get to sleep and sometimes the Phenergan will help that.  Just a matter of personal preference.  As far as the steroid is concerned:
 "When the blood vessels leak a protein fluid during an extended full blown migraine attack, a considerable amount of inflammation develops along the blood vessel. Sometimes the body does not clean up the inflammation from one attack when a new attack develops. In this way, the inflammation from the new attack piles on top of the inflammation from the previous attack , this prevents a break between attacks. Even though this is theoretical, the use of steroids seems to be of benefit in this situation." - this from the Kirchner Headache Clinic among others.  I will tell you that even my ER gives steroids for migraine pain as part of their protocol - not just one ER but every one that I have ever worked in or had to visit for this. 
As far as the refills on scripts, I am fully aware that a script cannot be refilled early - that wasn't the point.  By no means was my script early - I had taken 7 (2mg) pills in 7 weeks - the doctor had written for 1 every 4-6 hours as needed.
 
As for the Dilaudid - the only time I am given 8-10 mg of Dilaudid (usually over 6-8 hours at 2mg intervals) is in the ER where it is given IV.  I have had kidney stones for years and that is what I have always been given and that is what they have used for migraines.  In some instances, I might only have to get 4 mg but my problem is that I usually wait until I am in such bad shape that it takes more meds to get my pain under control.  The ED is always running to get my pain under control because when I have this, my blood pressure shoots through the roof - the last time I was at 210/143.  I do not have high BP but my pain causes it -  no pain, BP is normal.  The Lidocaine NS is something that is fairly new, I believe that my neurologist is trying with me - I have to get it filled at a small pharmacy that still mixes their meds.  He says that it works in about 50% of patients - so far, it hasn't done much but I am willing to try it.  It basically numbs up the front part of your head (which my pain is usually in the center, behind my L eye). 
 
I appreciate your statement about getting a second opinion - already in the process.  Actually, my doctor is working very closely with a headache specialist and that is where all these things are coming from.  I saw my doctor yesterday and he was not happy that his nurse had treated me like she did - he wrote my script as he had originally ordered and apologized.  He told me that I was doing exactly what he had prescribed and since it was working, to keep doing it.  Please understand that I only have do take this "cocktail" maybe every other week.  So, in my opinion, that is better than living in the ED.  My grandmother, mother and baby brother have suffered with migraines for years so I have researched this thing to death, seen many doctors with each of them, etc.  I truly thought I had escaped the "Beast" since I am 41 years old but.....my goal is to live my life without constantly being interrupted with a migraine.  That is why my doctor has done everything he can to keep me from living in the ED. 
 
Hope I haven't offended you but there probably was a better way to approach your reply than starting out with "WHOA" and then saying you were "baffled".  Also, I am surprised that if you have had migraines for 34 years you haven't heard of the prednisone, zofran or the Relpax being given.  They all seem to be fairly standard meds (at least on all the info I read).  I realize that sometimes in the written word, things come out a little differently than we would like, but.....now, I know I am the "new kid on the block" here and apologize if my response has offended anyone but I certainly didn't appreciate you making it sound like I was a "blind sheep" being led to slaughter by my doctor.  This doctor has gone out of his way to refer me, to speak with different docs in the "migraine" field and to follow what all of the new research is saying.  He certainly hasn't had any issues with getting 2nd and 3rd opinions and has spent numerous hours working to find a solution.  So far, I feel like he has been successful - yes, I still get the headaches but am not "disabled" and unable to function as wife, mom, friend, nurse, etc. like I was just less than 2 months ago.  My post was to ask how to handle a "nurse/medical assistant" in this case - not to be criticized for what meds I was taking.
 
Thanks and have a wonderful, blessed day.
 

CRANKY 1
Veteran Member


Date Joined Aug 2005
Total Posts : 616
   Posted 5/17/2007 7:16 PM (GMT -7)   
Hey Baseballmomof3,
 
I'm sorry if my post came off as harsh.  You obviously have considerable medical knowledge, which wasn't apparent from your first post.  I am well familiar with Relpax, but it didn't work for me.  The steroid information was interesting, but it isn't used in my area, or the Zofran for that matter.  The Phenergan works well for me because it help to knock me out and I sleep off the migraine, with the help of the Dilaudid. 
 
Your ED apparently works a lot different than mine.  The typical treatment is to get the meds in shot form and go home.  Only one doctor every treated me by IV.  My ED is more of a "treat 'um and street 'um" attitude.  I think I've only seen the same doctor once, so every time its someone new.  Contrary to you, I have very low blood on a regular basis (100/60), and actually drops when I get a migraine.  After receiving a shot, it drops even lower, like 85/54.  One doctor wouldn't let me leave because my pressure was so low.  I had to get an IV bag of fluids before I could go home.  My ED is also the one that couldn't revive Jerry Falwell on Tuesday, so who knows how up to date they are.
 
The main reason I was so alarmed by your post is that our Medical community is mostly associated with one Health Service, which shares information in a central database.  I'm a hard patient to medicate, as I am resistant to many pain medications.  I don't even feel Demoral or Morphine which means lesser strength pain meds are useless.   Heck, my dentist usually needs to use this "super novacaine", and it take four tries before I get partially numb.  I never get totally numb.  Anyway, the point I was trying to make is that when I'm explaining this to a new doctor, I sometimes come across as knowing too much pharmacutical information.  A strange doctor that doesnt' know you can lable you as a "drug seeker", which gets into the big database, then you are screwed.  Especially if you are getting pain meds from more than one physician, people misinterpret the information.  I was just concerned for you falling into this trap.  I've been in and out of it on a rotating basis, and it is frustration beyond belief if you are in pain and the treating doctor thinks you are a junkie and faking it just to get high.
 
I didn't address the nurse with the GOD complex as well as I should, and I am greatly sorry for that.  Your treatment was just so different from all the treatments I have received from various doctors is the past.  Your cocktail would probably work well for me, minus the Relpax, but no doctor around here would ever prescribe it.  I also misunderstood that you were getting that high amount of Dilaudid via IV over time.  That makes so much more sense.  It sounded like you were getting a shot with that much, which would probably not be a good thing. 
 
Stadol Nasal Spray worked well for me, in place of the Relpax as an abortive.  I used it for a couple of years, but a new doctor I saw as a walk-in, in my doctor's office, decided that I had been on narcotics for too long, which she wrote in my chart.  The administrator insisted that I not be given or prescribed any narcotics for an extended time.  I'm still fighting to get that reversed.  They also sent a letter stating that I was not to be treated with narcotics to all the local walk-in clinics.  Thus, my only emergency option is the Hospital ED.
 
Luck for me, on one of my trips to the ED, I was given DHE as part of my treatment.  I did some research on it since it worked well for me.  Thus, my new abortive is MIGRANOL Nasal Spray.  It does the job most of the time.
 
Anyway, coming from my longterm treatment history, your post just sounded scary to me.  I apologize that I came across so strong.  I hope you can understand I was just concerned.
 
Hope you are well.
Leigh Ann cool

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


baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/17/2007 10:47 PM (GMT -7)   
Thanks Leigh Ann for responding back.  After hearing what you have been through, I certainly don't blame you for wondering.  I can only say that, so far, knock on wood, I feel fortunate to be where I am.  I am sure that can change, however.  It bothers me terribly that there is anyone out there that is not able to get treatment for their pain.  I try to explain to others all the time (that are not migraine sufferers) that a migraine is not "just a headache".  I truly wish that all in the medical community could learn that.  It makes me terribly angry to think that just because you are in pain with a migraine and try to get treatment that you aren't treated the same as if you had, say, cancer.  It doesn't seem fair. 
 
It also appalls me that the hospital you are using still uses IM injections for pain and not IV - I truly thought that had gone out with the dark ages.  I spoke with someone not long ago that told me that they used to get demerol shots for their migraines and they would help for an hour or two and then the migraine would increase.  I truly believe that the treatment I receive in the ED works best as a combo - not just the narcotic - I get the steroid, the zofran for nausea, the dilaudid and also at least 1000cc (and usually 2000cc) of IV fluid.  Sometimes I think the IV fluids help as much as anything (especially when I have been vomiting).  If you have ever been even slightly dehydrated, you know how that in itself can make you feel horrid.  Maybe the hospital you use will eventually get with the program.  Also, I must say, I think you are a brave soul to fight that administrator regarding your meds - hang in there and fight for your right to be treated with dignity.  The reason I go to the ED instead of the Urgent Care any more is that the Urgent Care only stocks Demerol and Phenergan (they do give both IV) and besides the fact that the Demerol doesn't work nearly as well on the headache, both of those drugs just make me drugged out for a couple of days and I absolutely hate that feeling.  In all honestly, the Zofran and Dilaudid do not make me feel like I need to take 2 days and stay in bed.  The Urgent Care, though, has always been wonderfully when treating me - they just can't stock the meds.
 
Anyway, I am going to say a prayer that a hopsital or somewhere close to you will make some changes and will treat you with the meds that work and with the best route (IV).  I have to believe that someone will realize that there is a better alternative for you than giving you a shot and sending you on your way.  I have to say, though, even the short time that I have been fighting this, it always worries me wondering what people think when I walk in the ED with pain (headache).  How do we all balance the need to be treated with being labeled?  I wish someone had an answer.  I did print off the ED form that Sarah has on all of her posts - I will ask my doctor to fill it out.  Has anyone used it with much success?

Leigh Ann, thanks again for caring.  Take care, have a great night and we will chat again soon.
 
 
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/24/2007 12:16 PM (GMT -7)   
Katelyn:  I wish I could help more - I am fairly new to all of this - for one year now.  I do know that my neurologist had me trying Midrin for a little while  (told me that his wife uses it and it sometimes helps) but I didn't get any relief at all.  I have posted several times about the regime of meds my doc has me on - a quick synopsis - at the first sign of any headache (big or little) or when weather is changing, I take Relpax, Prednisone, Zofran and 1 Dialudid.  This seems to work beautifully - haven't been to the ED in 8 weeks which is a record.  There are times that I try taking a Lortab instead of the Dialudid but that usually doesn't work as well.  Anyway, I realize this is a pretty strong regime but, knock on wood, it is working.  I am living my life again.  Let me know if I can help and good luck.  I truly think the key is finding a good neurologist or pain doctor (I guess pain doctor's treat migraines).  I feel very lucky to have found mine! 
 
I just have to fill all of you in, though, on the ongoing saga of my prescription.  Remember, I told you that when the nurse finally wrote my script for the Dilaudid, she was ugly and only wrote for 6 - take one every day.  Well, it so happens that I saw the neurologist last week with my mom (who also sufferes with this) and told him what happened.  He was upset that it had happened and wrote me another script right then.  When I got home, i realized he had written for 1 mg tabs so I thought,  I will just take two and not bother him again.  I went to the pharmacy with it day before yesterday and they said that it doesn't come in 1mg so they called his office, and, we are still waiting.  The saga continues.....
 
THanks for listening to me vent.  I am so frustrated, I could scream.  Why does the doctor tell me to do one thing and then, when I do it, his staff makes me feel like some crazy drug addict????????
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/24/2007 6:50 PM (GMT -7)   
Hey Katelynn:
 
Hey - I loved that Cranky responded back in kind after my marathon response - seems very sweet.  I have decided most of us on this board are probably grouchy a lot of the time (okay, no one get offended) because of these stinkin' headaches.  I have had one today (not horrid as I have been able to take care of my kids) but enough to make me so "cranky" with my kids, friends and hubby.  When my head hurts, I just can't take all of the "normal" life things.  I HATE THIS!  So...my point is that I am very understanding with anyone that is just having a bad day - many of mine seem that way since these headaches started- although, much better in the past 8 weeks.  Now...here is the stupid part.  I have felt this headache coming all day.  I haven't taken any meds (even after my lecture to everyone here about taking your meds before your head gets bad) because I just flat out didn't have time to sleep for several hours.  So....guess what?  Now it is getting very bad and I am so nauseous I don't think I could keep anything down now if I tried.  WHEN WILL I LEARN??????
 
Happy weekend to all!  Someone remind me to take my own advice!!!
 
 
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray


bdr1
Regular Member


Date Joined Aug 2005
Total Posts : 121
   Posted 5/27/2007 2:36 PM (GMT -7)   
hey ---

unfortunatley, the pharmacist is correct. dilaudid (hydromorphone) is a schedule-II control substance and cannot be refilled. also, at least in the state where i practice, schedule-II drugs are not allowed to be called in. you'll need a follow-up apppointment with this physician every month for a new prescription.

also --- always follow the advice of your physician - as they are ultimately responsible for your care.

baseballmomof3
Regular Member


Date Joined Apr 2007
Total Posts : 189
   Posted 5/27/2007 4:58 PM (GMT -7)   
ckgMD - thanks for getting back to me.  You are exactly correct - the pharmacy called the neurologist's office and then, the assistant at the neurologist office called me and told me to come pick up an new script.  I dread going there - the last time I had to do that, I felt like everyone was looking at me like some kind of druggie.  It makes me want to scream because I even asked the neurologist last week if I was doing what he had told me to do and did he want me to continue and he said yes.  But.....his office staff still treats me like I am doing something wrong.  Anyway, I think I am approaching week #9 without going to the ED which is certainly a record so I am going to continue with this regime.  I feel like I am between a rock and a hard place - I hate having to take heavy duty meds but when I do, they work.  If I don't, I end up having to take them IV so..... what is the answer??
 
Thanks for listening to me vent one more time.  I am thankful that I now have found some place to do that - I was beginning to feel very isolated!
 
Happy Memorial Day tomorrow!
DX:  Migraines since June, 2006, kidney stones
 
RX:  Daily - Verapamil, Trileptal
PRN:  Relpax, Prednisone, Dilaudid, Lortab, Lidocaine Nasal Spray

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