Major RANT!!!

I just got back from my Pain Clinic appointment and I’m pissed.

I had a very bad week with headaches. I used more Norco than I normally need. So I’m explaining this to him, and I get the “It’s time to get you off of narcotics” speech. I tried to explain to him that Hydrocodone is the only thing that helps. I taken all kinds of other drugs and nothing else will touch these things. So what does he do?

He puts me on Ativan (lorazepam). Yeah, a benzodiazepine. That’s the last thing I want. I’ve heard many a story of people getting addicted to benzo’s and going through hell getting off of them. I’m supposed to take one every six hours. I’m not having headaches because of anxiety; I have anxiety because of these headaches.

But it’s like he had a predisposed opinion and would not listen to me. I just had PT today too so I know a strong headache is coming and I’ve left with only anti-inflammatories.

It’s a good thing I have Ativan because now I really need it!

Dan, I'm so sorry. I've gone through this too, and I know the absolute mortal terror the "time to get you off the painkillers/narcotics" talk strikes in a migraine patient. I'm not on regular narcotics, either, and never have been. But I am on stadol NS, a narcotic nasal spray, as a rescue med, which means I'm only supposed to take it when the triptans fail. I go through periods though when the triptans fail alot, and what else am I supposed to do? I am afraid to be honest with the dr. about how much rescue med I need because I don't want him to take me off it entirely and leave me without anything that works at all - the situation you find yourself in after the "time take you off the narcotics" talk.
Sadly, it seems a catch-22. Be honest and suffer, or calculate what the dr. needs to hear to get you the best results. They don't always want to treat the migraines, they just want to treat what they "think" is wrong instead of what is actually wrong.

I actually know several chronic "brain pain" patients on daily benzos as a preventative/abortive treatment. This would be as a "last resort" type of measure. Anna has three doctors in recent years who have been "for it." The three doctors include a board certified neuro and a board certified pain doctor/anesthesiologist.

Here is something you can read:

http://www.neurologyreviews.com/08apr/MigrainePrevention.html

Cheryl

I was on Ativan for just a couple weeks and started having complete memory blackouts. It was very disturbing to say the least. To have 12 hr chunks from the previous day just wiped away.

I use it only when I have to go to the dentist. I have such a fear of dental work that I need something to calm me down - way down. But when I get home, I'm too loopy to do anything but sit in a chair in the front yard. It makes me very stupid and uncoordinated. (Yeah, I know. I'm stupid and uncoordinated anyway but this is much worse.)

I can't imagine taking it on a regular basis and being able to much more than just drool.

Chris

My wife's grandmother is in an Alzheimer's care facility and goes completely bananas on it. She's Group Health so she gets many doctors and they seem to ignore the NO ATIVAN label on her chart. The last incident was her streaking through the dinning area. Then a year ago she threw a couch through the front window of the visiting area.

Granny provides the family with much entertainment these days.

Brent,

Thats so funny and sad at the same time. I don't get why doctors refuse to listen to their patients or the guardians of said patients. Seems that they know what is a bad idea for them and why.

I got that speech last time I told my old neuro that the amount of narcotics I had been using for the last SEVEN years wasn't doing the trick anymore.
And it Really wasn't that much. So, I found a near who was also certified in pain management and now have enough to comfortably make it through the month. It makes such a difference, Im not missing nearly as much work.

Good luck.

Charlotte

Dan,

I hope you sit down with this guy and ask him why he is doing this. Stick up for your rights as a patient. I am going on day 5 with this migraine and if I did not have something to kill most of the pain, I would be a wreck. When I take the drugs, I feel like Chris, loopy.

Hal

My PCP doc has never been been stingy on the narc meds. Never once has a refill been denied or even the "We need to see you again" line. It may be that she has someone close to her that also has migs.

All I can add is find another doc. These head monsters are bad enough even with a generous source of meds.

And as a side note when you are filing out the intake form for a new doc don't put down that you smoke or drink. There is no law that you have to tell your doc everything. You are in charge of your health history and you need to manage who knows what and when.

You do not want your doc to know that you have an addiction.

That has made a huge difference with so many people I know. 75% of the people I treat have been in car accidents. And far too many of them have been refused narc pain meds. Many of them smoke. And it's astounding how many change docs and leave out that they smoke and get some decent pain control meds.

You don't want to tell your doc you have an addiction and in the next breath ask for potentially addictive meds.

I know most of us here probably don't smoke drink a lot but it's a very important tactic to use if you do.

Brent wrote:I know most of us here probably don't smoke drink a lot but it's a very important tactic to use if you do.

Well now there's an idea. If only it worked to alleviate pain and not have an unpleasant hangover.

That certainly would be helpful if mig relief was just a drink or two away. Life would be so much easier if a little "herb" helped. Cheap, easy to get, no hangover and no freakin' docs to deal with.

I was glad to hear that quite a few cluster HA patients having been getting relief with hallucinogenic mushrooms. And they don't even have to use enough to trip. You can find them almost anywhere and even grow your own. I am sure it makes their life much less difficult. That and they can be broke with oxygen and cortical steroids.

It doesn't seam fair at all that migs which are usually less severe then clusters have fewer effective treatment options.

After receiving the "get you off narcotics" speech, I know he's tuning me out. I'm going on EIGHT years of this. I know what works and what doesn't work, and Benzo's that make me sleep all the time are not the answer.

This is ridiculous. I'm getting flack from my wife about sleeping all the time, my migraines are no better, and now I'm getting the feeling that the MD and the Psychologist (I have to talk to) are thinking this is all caused by anxiety.

NO DAMN IT, NO!

Dan,
if your're sure that benzos are not the answer, ask for a second opinion.
This doctor seems to follow protocols but he does not seem to follow DAN as a person who has his own characteristics and needs.
You - like most of us migraine sufferers - are surely more informed than the average of patients on drugs and you have already tried and experienced most of the available meds used for migraine.

You need someone who listens and who take you past experience and present symptoms into the right consideration.

Take care