Have I displayed drug seeking behavior??

[elthia]

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

[TiffyRN, BSN, PhD]

Drug seekers usually seek meds that alter their mental status; mostly narcotics and sometimes (not as frequently), phenergan. My husband and I both have migraines and I can guarantee we would never "seek" triptans, sometimes the side effects barely outweigh the benefit of getting rid of the migraine.

I think what may have happened with your prescription is that your MD originally ordered 30 (or whatever that number was) and the pharmacist under instruction from the insurance company had the prescription changed with an MD order to just 6, therefore the pharmacy did dispense all on the (new) prescription. If you had insisted when you dropped it off that you would pay for the remaining pills it probably wouldn't have been an issue. If this is true then when you called and begged the pharmacist for more, he probably was not following standard practice by dispensing more, just dispensing them out of compassion. He (or she) probably knew that people do not generally exhibit drug seeking behaviors in regards to triptans. But that is all a theory I have, not any real knowledge, just personal experience with insurance companies getting my prescriptions changed.

[Cindy1008RN]

Anyone that has had a migraine will tell you.........that is NOT drug seeking. I can take one look at someone and I will know if they have a migraine or not. I have never had just a normal headache. All of my headaches have always been migraines. Praying that you can't get control of these headaches very soon.

[rn/writer, RN]

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.

If you do end up having one and it's giving you these kind of symptoms, you need to see a neurosurgeon ASAP.....because when brain aneurysms do rupture, more than 50% never live to see a hospital and trust me when I say, the sequalae after a rupture is brutal!!

Need to rule out arteriovenous malformation along with the other things mentioned.

You have my utmost sympathy.

[EmmaG, RN]

I am so very sorry that you were treated that way by the ED. When you are better, please file a complaint. There is absolutely no excuse for what they put you and your husband through.

Do you work at this hospital?

I have migraines, but nothing close to what you describe. I can't even imagine...

[MiaKeaRN]

Although my situation is a little different than yours, it is similar in the fact that my insurance would only pay for 3 pills of Mefloquine at one time (in one month).....and the prescription was for 8 pills. To make sure I had adequate maleria coverage while on a mission trip, I had to pay the difference for the pills that the insurance didn't cover. I swear it took me an hour to get it through the pharmacist's head that I had the right to PURCHASE the total amount due to me, even if the insurance company would only pay for 3 pills. After going round and round with the pharmacist, I insisted that she contact my insurance company on the phone while I was standing there.....and they basically told her the same thing: They were paying for 3 pills and I could pay for the other 5 out of pocket. The pills were expensive and I would have preferred to have waited for the insurance to pick up the payment at the end of a month, but I was going to be out of the country and couldn't risk it. Insurance companies don't have any problem taking our monthly premiums, but it seems like they are paying for less and less services.

[SuesquatchRN, BSN, RN]

Well, you are seeking drugs, certainly, but so freakin' what? You need them.

[angel4gramma]

Im sorry you are going through this. I have dealt with migraines for many years. I get 10-15 a month. Some are not as painful as others. I have been lead to believe by my NP and neurologist I can only get 9 Imitrex a month due to possible severe side effects although neither can tell me what. They both give me samples when I run out and don't have a problem with it although their staff act like they are paying for it and try to tell me they are out of samples until I ask to speak with the Dr then they find some "way in the back"

[elthia]

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.

QUOTE]

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.

[CRNI-ICU20]

Oh I am soooo sorry for you....

My son gets these sometimes, and he even gets them so bad that he gets field cuts, or words will invert....he becomes disoriented and will sometimes not know familiarity....it goes away in an hours or so....he's been tested for all the TIA stuff, etc...it's just severe migraine like yours....

Have you been tested for environmental triggers? ie, air quality, sprays, etc..? Some places, hospitals, used harsh chemicals that linger in the air, or on surfaces and have been known to trigger severe migraine headaches in people....

I hope and pray you can get relief...and NO, you weren't seeking drugs...you were seeking relief....

blessings, crni

[EmmaG, RN]

Have you been tested for environmental triggers? ie, air quality, sprays, etc..? Some places, hospitals, used harsh chemicals that linger in the air, or on surfaces and have been known to trigger severe migraine headaches in people....

Excellent point. Our unit secretary got them from the stuff that was being used to clean the hallway carpets.

[sharona97, BSN, RN]

I really hope you can get a better handle on these nasty migraines. I sufferred for a long time (10 Years) with migraine HA's. Once I stopped Premarin my HA's went away.

I believe hormones can be one of the factors that could contribute. Do you have a family history of migraines? My Aunt who lived on a farm would have my Uncle give her injections of whatever the Doc had ordered. (Don't know what it was). She also had to use a heavy narcotic because of the N @ V named Stadol. It is a nasal spray that stopped her N @ V, gave relief from the migraine, and she also used Ibuprofen to help fight the residual pain.

I hope your Doc has taken some diagnostic tests, MRI?????..........

There is always a second opinion........

Hugs

[MA Nurse]

I just recently read a study that said they are finding out people who have migraines like this sometimes also have a patent foramen ovale.There was a woman who had the hole fixed and she no longer had migraines! I'm sure this doesn't apply to everyone, but you could certainly mention you want to look into this possibility! Sometimes it isn't diagnosed until you are an adult..usually this is something people are born with.