Good appointment with pain dr.- finally.

Hi All,

I saw my pain management dr today and it actually went pretty well. I expected to have to fight for some relief, but didn't this time, which was kind of nice. I told him that the Morphine was no longer working at all. He did not want to increase the dose- because apparently I am too young. He did offer methadone, but that did not work well for me in the past. Several weeks ago, I had a really bad case of strep throat and my internist prescribed some codeine cough syrup. In desperation, a few nights ago, I took it and it helped the headache. So he prescribed tylenol 3 for breakthrough pain and kept the continuous morphine at the same dose. THis is great- at least something will help.

I know it sounds strange, but the only two medications that have continuously worked for my pain have been Tylenol with codeine, morphine, and dilaudid. ( I always took the dilaudid as needed. ) However, he did not want to prescribe it because it is only for post-op pain and I am young.) So at least we have something that will help.

Sometimes, I wish there were pain physicians who were not that afraid of treating migraines or of treating younger patients. Sometimes, I feel like my pain is not treated adequately because of my age. (I am 29 and have been living with this since3 age 17) Does anyone know why this is? Why is my pain or management therof dismissed because of age?

I know this post is a little heavy on the pain control issue, but it needs to addressed occaisionally.

Pain free days,
sailingm

SM,
I'm a bit surprised that age is an issue, mainly because I was diagnosed when I was in my mid-20s, and my neuro at the time put me on what's considered a strong painkiller for migraine, Stadol nasal spray, and I was younger than you are now. Weird.

I don't have any knowledge of morphine or codeine though. Stadol is a narcotic-based painkiller. Have you ever tried that? It's worked really well for me.

It is just his bias, Sailing Muffin.

Due to different circumstances, Anna has had five doctors treating her the past seven years. She moved to Chicago, we picked a new neuro there, he changed careers, we got a new neuro, she moved back home, we went back to our G.P., and since then we sought the advice of a new neuro and brought on board a pain doctor/anesthesiologist. But for the most part, her G.P. has been prescribing since 2004, based on what these other doctors recommended.

All these doctors, without hesitation, prescribed or recommended certain meds. Her age didn't matter.

I know many (truly many) children and young adults who are on high doses of opioids for intractable head pain (most have Chiari/PTC/leaks).

Cheryl

So glad to hear, Muffin!

I'm always amazed at how vastly different our response to med's is. Codeine for me? Blistering rebound headache the next day.

I'm glad your Dr recognized and listened to what works for you.

Charlotte

At least you used the word "good".
I do agree. Whats age got to do with it??

P

Glad it went well.

It is my understanding that folks below 30 to 35 have a tendency to develop tolerance to medication very quickly. Old folks like me can stay at the same dosage for decades and still get relief. But the young need to upthe dosage regularly to achieve relief. That is my understanding. I saw this principle at work with teens when I was a probation officer. What took years for an adult alcoholic to be able to consume, a teen progressed in their alcoholism at alarming rates.

But SM, you have aroused my curiosity on this matter. Ask your pain manager what difference age makes and ask your folks. I will be interested to hear what they say.

From my reading, Richard hit the age issue on the nose. I've seen several reports on this issue.

Seems like another prejudice to add to the migraine list of prejudices (it's just a headache, take an aspirin and get on with life; etc.).

Becky

Hi All,

For the past 12 years of dealing with chronic intractable migraine/New daily persistent headache, I have seen literally dozens of doctors and specialists. All have had thier own syle and opinions. However, I do not remember age being a huge factor in treatment.

I am not sure if his opinion is based on reports that young people are more tolerant to medications, or that he is a little biased. I do know that I am probably the youngest patient he sees. I also know that my neurologists were usually more willing to treat my pain. (For several years, I was on as needed dilaudid. It was only after some trial and error, once the dilaudid stopped working that we found that morphine did work.) In many ways, I think it must be both a personal bias and a worry that the medications will hurt me later in life. All I know is that I hate to have to prepare for battle in order to get good relief from pain. I am glad this works and hope it continues to work.

I also asked my parents. Both say that they are concerned about some long term damage. I just want to be able to do things, to live life, and to live that life with as little pain as possible. Is this unreasonable?\

Well, I'm just glad something is helping.

Pain free days,
sailingm

Glad to hear it is helping

Cheryl

I know it sounds strange, but the only two medications that have continuously worked for my pain have been Tylenol with codeine, morphine, and dilaudid.

Not at all to me- the only pain meds that worked for me were codeine, barbiturates, injectable Demerol and Percocet.
Morphine alone worsens my HA for some reason. well, perhaps in massive doses...?

Sometimes, I wish there were pain physicians who were not that afraid of treating migraines or of treating younger patients. Sometimes, I feel like my pain is not treated adequately because of my age. (I am 29 and have been living with this since3 age 17) Does anyone know why this is? Why is my pain or management therof dismissed because of age?

Perhaps you are being too nice, undemanding ?? I had drs from whom I practically had to claw the Rx out. And I can't remember the details, but Vicky wrote once something about young people reacting differently to analgesics or narcotics than older adults. So in that matter, it's definitely not you. Shes' back so why not ask her.

I am happy for you that otherwise your appointment went well.

Risa

Ok, I understand the age prejudice a bit more now that it's been explained, and I guess I even understand the logic, but to me it's up to the dr. to treat your pain, and to monitor your reactions to the pain meds - including if you're developing a tolerance to it. Of course, the dr. can only adequately treat you if you're honest with him or her - speaking from experience, I know I'm reluctant to tell my dr. when I am using higher doses of my meds because I don't want them to tell me "oh, it's not working any more, you must've built up too hight a tolerance for it, we'll have to switch to something else!" LOL

All joking aside though, no matter what your age, you've got to get treatment for your migraine pain. Period. I hope you can convince the dr. of this.