I’ve had migraines around 4-5 times monthly for about 10 years now, no aura, single side, set off by smell and pressure changes. I’ve been working with the same Neurologist that entire time who specializes in migraines.
I’ve tried literally every combination of daily and abortive treatments (over 40) including combos thereof. The only one I currently take is Toridol, which can lower the intensity and length from 24-48 hours to 6-12 and pain at maybe a 7 instead of a 9. As this causes potential kidney damage I use it very sparingly.
My main question is around painkillers. It’s obviously a very touchy subject in the US, but I’m at an en passé and want advise. The problem is a combo of general tolerance over time and a genetic resistance of 80% requiring larger than normal doses to begin with.
I started with Tramadol at larger and larger doses 10 years ago starting at 100mg and moving to a dangerous 300mg before finally moving on when even that dose had no effect on pain. I used Stadol next for several years and had some luck with it over a couple years, but eventually I only got the dysporia and strange thoughts with no painkilling effect.
I Then moved to Vicodin and eventually Vicodin HP which I take 4 at a time. The acetaminophen is dangerous at these levels and even 40mg of Vicodin is not even allowing me to sleep or work when I have a full blown attack. I’m sure this sounds like an addiction story, but we did 3 months off the Vicodin to see if my tolerance waned and what side effects I had, and all I had was a bit of diarrhea and sweats for 2 days, no dramatic cravings or massive DTs. The biggest side effects was I had to use all my sick days at work and couldn’t leave bed or go to work during attacks.
My neurologist has suggested likely need the stronger opiates, but is unwilling to take the risk of prescribing them as he says in the current climate it’s far too much trouble.
Based on my history should I pursue the stronger options? And if so how do I approach it? A family member with a chronic pain issue suggested a pain mgmt clinic as they are better setup for it. With monthly drug tests to ensure you are following their protocol and using only their Rx’s.
Sorry for the long post but I just wanted to make it clear I just want relief. Without working painkillers I’m bedridden and have issues working steadily. With them I’m fully functional and am productive and don’t live in fear of the next attack. Thanks in advance for your help!!