Have I displayed drug seeking behavior??

Nurses General Nursing

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I really scared myself today.

I've been having debilitating migraines, that last 5-10 days. Horrible, nasty migraines with dizziness, tinnitus, stabbing pains, photophobia, phonophobia, diarrhea, and intractable n/v. Yes, I have been taking my topamax. Yes, I have started seeing a neurologist, and he started me on elavil and doubled my topamax dosage. I am actually having almost daily migraines, and I take Axert, if the axert x2 doesn't work then the sucker last a week, give or take 3 days. Phenergan po or supp doesn't work, zofran po occasionally works, I've lost 8 pounds in the past month from n/v, I have NO paid time off left or sick leave left, I'm probably going to have to file FMLA if I want to keep my job.

Insurance only pays for 6 axert a month. that translates to 3-6 migraines a month. I am having almost daily migraines right now. So I got very panicky and had a complete meltdown when I ran out when my pharmacy was closed yesterday( my pharmacy has limited weekend hours). Axert is $21.00 a pill in the US. My script was written for 15 pills a month, insurance would only pay for 6, so the pharmacy only filled for 6, and when I called this morning and requested the other pills that I would pay out of pocket for, the tech said I would have to wait because it was 3 weeks too early to fill the scipt. At the time of the conversation I was having an aura, and I told her that. I called as soon as they opened. I almost had a panic attack, I couldn't get her to understand that if the script was for 15 and only filled for 6 then technically I was still 9 pills short for the month. Well I finally got the pharmacist, who allowed me to pick up 6 more pills, but too late. It took 45 minutes to get them, took one, then later took another. Went to work and had to leave early because I was dizzy and puking my guts out. My head is just killing me.

I was so terrified of having another full blown migraine, I didn't think I could lose my cool that way. I was almost yelling at the tech. I need to get off the computer, it's hurting my eyes, thanks for letting me vent

Specializes in NICU, Telephone Triage.
Not to get too nosy here....but have you had a CT (to check for any bleeding or tumor), and/or a CTA (CT Angio) done?? If not, and your symptoms are this severe, you NEED to have that checked. Many people don't often have a warning to the fact that they have a brain aneurysm....but those that do, it's often migraine headaches. Also, the migraine headaches beforehand can be a warning that it's going to rupture.

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I've had a CT done of the head and of both eyes, just because I sometimes lose vision in my R eye. I've been worked up for CVA at the ED. I haven't had a CTA or MRI done yet though. My grandfather and greatuncle died from ruptured brain aneurysms, but I'm told it's not genetic. The severe migraines are. it's believed stress is just really exacerbating the migraines. My father had migraines that would last for weeks also, my sister's more lucky, her longest was 2 -3 days.

Interestingly enough, I had small script of zofran po, just for breakthrough n/v. I took one a little bit ago, not only did it help with the n/v, but my pain went from 8/10 down to 4/10, from stabbing to throbbing. This is so much more bearable. I need to ask my neurologist for more. I wonder, is it the fact it's a serotonin antogonist? Thank goodness oral zofran has gone generic.

Everyone here who suffers from migraines: google patent foramen ovale and migraines and you will see these studies liking the 2 problems. Hope I've helped some!

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

My pharmacy insurance is through Medco and they interpret just about the same as yours. However, my doc has been successful in making appeals for a couple of expensive drugs. When you have such a history as yours, you are the exception not the rule and you deserve to be considered for an override.

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Specializes in IM/Critical Care/Cardiology.
Advil does not help with the type of migraines the OP has described--they are not typical headaches!

Ibuprofen has been used successfully in patients for RESIDUAL pain, no the migraine itself.

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Just got discharged from the hospital today. Was admitted by my neurologist for status migraine with intractable n/v. Given IV hydration, DHE, decadron, reglan, klonopin, upped the topamax again. Got MRI/MRA done. No aneuryisms, do have so microvascular changes in the brain??? Neuro says about 14% of the population have these changes, especially migraineurs. If I keep going into status migraine this frequently we're going to have to do a lumbar puncture to measure my CSF pressure. If my CSF pressure is to high, then we will have to change meds again. I was wrong, my admission weight was 12 pounds lighter than what I weighed in the clinic 2 weeks ago. I forgot to weigh myself at discharge to see if the hydration put some weight back on, :lol2:. Also had follow up EKG, just cause I keep having chest pain when I vomit, EKG was good. It just feels so good to be able to walk outside during the daytime without feeling like someone is stabbing icepicks through my R eye, to be able to concentrate well enough to drive a stick shift, to eat without puking my brains out. Honestly, I could live with the headache, it's all the other crap that happens with the migraine that I can't stand.

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Specializes in icu, er, transplant, case management, ps.
Just got discharged from the hospital today. Was admitted by my neurologist for status migraine with intractable n/v. Given IV hydration, DHE, decadron, reglan, klonopin, upped the topamax again. Got MRI/MRA done. No aneuryisms, do have so microvascular changes in the brain??? Neuro says about 14% of the population have these changes, especially migraineurs. If I keep going into status migraine this frequently we're going to have to do a lumbar puncture to measure my CSF pressure. If my CSF pressure is to high, then we will have to change meds again. I was wrong, my admission weight was 12 pounds lighter than what I weighed in the clinic 2 weeks ago. I forgot to weigh myself at discharge to see if the hydration put some weight back on, :lol2:. Also had follow up EKG, just cause I keep having chest pain when I vomit, EKG was good. It just feels so good to be able to walk outside during the daytime without feeling like someone is stabbing icepicks through my R eye, to be able to concentrate well enough to drive a stick shift, to eat without puking my brains out. Honestly, I could live with the headache, it's all the other crap that happens with the migraine that I can't stand.

I am so thankful I don't suffer from these types of headaches. In fact, I rarely have a headache.

Woody:balloons:

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Specializes in IM/Critical Care/Cardiology.

Welcome home! I'm glad you are feeling better.More importantly, I'm glad that you're neurologist hospitalized you and did a work up. I hope you don't need to have the sp.tap, but if it comes to that it tells me he is invested in helping you and is really appearing to be concerned, as we are!

Keep us posted, hope you can get full relief everyday!

Hugs

Sheri

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Thanks. It's just so nice to be feeling better.

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I'm glad to hear you're feeling better.

Please consider having your neurologist fill out the FMLA papers as soon as possible for you to protect your job. You don't have to take the full 12 weeks all at once. It can be in increments of a day (or days) at a time--- even hours if you can't work a full shift.

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Specializes in Adult Care- Neuro ICU, Ortho, IRU, Pedi.

Have you and your Neurologist every discussed Pseudo Tumor Cerebri? I was told I had a "migraine" for more than 2 years. No one would listen to me. They all thought I was a hypochondriac and I was beginning to beleive it too. It took me several doctors and losing my vision overnight for someone to finally listen. I thought I was going crazy when in fact my intracranial pressure was so high that I eventually lost my vision and I was scared to death. Maybe it's worth checking into if not considered already. And definately file for FMLA soon. I am in the same situation and a panic attack is always not far away if I don't get into the doc when I am having problems. I get very high strung when my pressure goes up and nothing makes sense. I get emotional quickly. My problems have resolved after really paying attention to the stress and lack of sleep. It is so difficult when nursing is your career to relieve those things. I have to work to keep my insurance to keep me on the meds and pay my bills. If I didn't have to work of course I wouldn't but it's not realistic. I do love my job but it just a constant catch 22. My vision is more important to me than what someone else thinks of me. It also helps to know that I have a diagnosis and although I feel I may die from the pain it really actually won't kill me and it will eventually pass. It just helps to know. No one knows what you are feeling only you know. I hate calling into work with a "headache" because it's not just that but because you don't have tumor growing off the side of your face doesn't mean you're not sick. Next time tell them you have a GI bleed with explosive diarrhea. That usually never get questioned! LOL. No you are not overreacting and don't feel guilty for trying to take care of yourself. It's just a curse of being in the medical field that you put others before you. We are taught as nurses to treat patient pain as reported but it's double standard when you complain of the same pain. DON'T FEEL GUILTY.

For more info go to www.pseudotumorcerebri.com and you can contact me through here if you have any other questions. Even if you really have migraines just constant education about your condition and current ways to treat it. Keep looking out for new things to make your condition tolerable.

Good luck. Jennifer

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Have you and your Neurologist every discussed Pseudo Tumor Cerebri?

Good luck. Jennifer

So far my eye exams have been ok, but that is one reason why we will do a lumbar puncture to measure my CSF pressure if I keep going into status migraine.

I'm filing for intermittent FMLA this week.

Good news is I've been migraine free for over 24 hours at this point, :yeah:

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I'm glad, elthia. Pain is the enemy.

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Of course you are not exhibiting drug seeking behaviour. You have a pain that you want to be rid of. A few suggestions. First I think you need find out what is causing the pain. Try keeping a foods diary and see if these migrains come on after you have eaten certain foods. Also if it persists suggest to your Doctor that they investigate it further. Your back could be out of alignment and that can cause one to have migrains. These migrains dont occur for no reason. Maybe a visit to a naturopath, good luck

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