Friday, April 18, 2008

(IV) drugs? yes, please

This week was rough, even by my high pain tolerance standards. I started the week with a bout of depression, which isn't unusual for me. Migraine and depression are comordid conditions, meaning the two often exist together but one doesn't necessarily cause the other. In my own experience, I tend to have mild depression when my migraines are out of control, with occasional more severe depression.

That's what happened earlier this week. Depression bad enough I didn't even want to get out of bed and go to work. I knew it was the migraine beastie, zapping my serotonin levels, but knowing it doesn't ever make it go away. It mostly passed by Wednesday, just in time for a couple nights of severe pain.

Both Wednesday and Thursday nights the pain was bad, up to an 8 out of 10, and with some bad dizziness and nausea. I had exhausted my week's allowance of Imitrex, an abortive medication, which my doctor has me combine with ibuprofen to increase its effectiveness. I can only take
Imitrex two to three times a week before I risk medication overuse headache (MOH). Because my pain is daily, I have to carefully track when and how often I take any abortive medication. So I was stuck with nothing but my comfort measures - ice pack, essential oils, Altoids. I also have promethazine (generic for Phenergan), an anti-nausea med, that I can take.

This morning I called my fired specialist's office to see if I could get in for an IV infusion treatment. I had tried this once before earlier this month, and while it didn't get rid of my pain (nothing has), it did get it down to a much more tolerable level. The first time, I had DHE, Toradol and Reglan for the nausea. The Reglan gave me awful anxiety, and made me woozy.

My appointment was scheduled for 1:00, but they didn't take me back to the exam room until almost 2:00. Let me pause here to say one of the things I hate most about this clinic is that there are fluorescent lights everywhere. Being in the architecture field, I can understand more than most why this clinic would have ended up with them, but they haven't done anything to mitigate the problem. At the very least, they could have put some desk lamps in the exam rooms or something. Nope. Instead they will turn off the lights for you if you ask, but then they have to leave the door open so it's not pitch black in the rooms. (HIPAA issues, anyone?)

This time I made sure to ask for a different anti-emetic, and they gave me Phenergan. I didn't get the anxiety, but the wooziness was worse and it actually made me more nauseous. So they tried Zofran, a med usually used for chemo patients, but with a much better side effect profile. Bingo! Now I know which one to ask for. I also got Toradol and DHE, same as last time. The nurse who did my infusion this time was much more experienced than the one who did it last time, so she infused the meds more slowly and with more time in between than the first time I went. I napped for a little bit while I was there, since the Toradol and Phenergan both made me sleepy. I didn't leave there until 4:30.

DBF was kind enough to come with me this time. He sat with me the whole time, talked with me, and held my hand. He went to find a nurse when the side effects from the Phenergan were making me feel sick. When we came home he got me settled on the couch in the living room and sat with me for a few minutes until I fell asleep, and warmed dinner up for me.

My pain isn't gone, of course. It never is. But it is down to a 2, which is lower than it ever is on its own, and lower than I can get it with any of the meds I have on hand. I think I may talk to my new specialist about injectable DHE as an abortive option. (I'm putting it on my list of questions right now.) I have a new Relpax prescription waiting for me at my pharmacy that I will also be trying next week.

It's nice to have some relief tonight, after a particularly tough week of depression and severe pain. I don't know how long it will last. Last time I only got about 8 hours, but even that was a nice break. I'll be seeing my new specialist in about a month, which, all things considered, isn't too far off.

That's all for now. Here's hoping for a low-pain weekend.



Anonymous said...

Hi MJ - A big welcome to the blogging world! Great to see your blog. I'm so glad the iv experience was better this time. One more thing to learn to manage, I guess. Before you're done you'll be the world's greatest expert in being an assertive patient. If only we could make a living at that!

Maybe we need to take a tip from you and add a little portable incandescent lamp to our "bag" to take with us for iv's, etc.
- Megan

MaxJerz said...

That's not a bad idea, Megs. I may have to find a portable lamp to bring with me in the future. I did have my big celebrity sunglasses with me, which helped while they had the lights on sticking me with the needle, but that's certainly not a perfect solution by any means.

I do have a camping lantern that might just do the trick. I'll mention this to DBF so he can help me remember for next time. Thanks for the tip!

- MJ