NeoNurseChic

Know what's great? On the horizon that is....CGRP inhibitors! Supposed to be ideal for those who can't take triptans. I keep my fingers crossed, but it's still, oh...probably a couple years out yet? Yeah the side effects are terrible for some of the meds! I think the meds I did the worst on were depakote, topamax, neurontin, and zonegran. Funny, but right now I'm on lamictal...and no side effects from that at all really. Dry mouth, fatigue..nothin new. :) In about 3 hours, I'm heading into the city for the 47th annual scientific mtg of the American Headache Society. Looking forward to learning what new things are on the horizon! :)

:) 5-HT1, I believe, right? I can't tolerate Imitrex because I have a big problem with tachycardia - the 'trex makes my heart beat wayyyyy faster than it should. I wasn't a fan of that! I use zomig NS and amerge...but for 2 different things. Zomig is so short-acting, but also works very quickly (esp in nasal spray), so I use it for cluster headaches when I'm away from my oxygen tanks. Amerge takes a long time to work, but it lasts much longer, and it'll knock my daily migraine down to a level 3-5 instead of 8-10, so that I function much better! Frova has the longest half-life, but it doesn't do anything for me, unfortunately! I see a neurologist at a top headache center, and in fact I used to work as a research assistant there for a little while. I went on to develop a rather lengthy project on improving the quality of migraine and headache education for nurses -- now if I could *just* use that to find something that helped ME, I would be golden!!! haha Something like 98% of migraineurs can find an effective preventative...and I've fallen in the 2% group for 4.5 years now...except for Kudzu. That would have been great if I hadn't hemorrhaged so soon after starting it! Therre are days when I get tired of being the guinea pig, but such is life, eh? hugz, carrie :Melody:

My first degree is a bachelor of music in piano performance. I graduated with that in May of 2004. 9 days later, I started nursing school. Graduated from my BSN program this past May. Seems like a whirlwind!! carrie :Melody:

Arg...that stinks. Hugz!!! I still use DHE...the good ole ergot derivative. It makes me sick like no other! The last time I used it was mid-shift working in the ER. I had taken 8mg of zofran about 45 minutes before I got the shot. I can't take reglan or compazine due to some pretty intense reactions, so Zofran is my one and only. Well, about 10 minutes after my friend gave me the DHE injection, I had to excuse my self from interviewing a patient with a nurse...ran back to the patient bathroom (ew) and threw up about 6 times. It was awful, but this seems to happen to me every time I use DHE. My neuro told me to cut the dose down to 1/2mg because when I have a level 10 mig and then take the whole mg and throw it up, it doesn't do much good! LOL I used to take Vioxx for orthopedic stuff. My current ortho gave me celebrex, but it didn't help, so I stopped taking it. Right now I take a combo of aspirin and naproxen daily for post-op prevention of clots and lessening inflammation. For me, though, I'm just trying to put off joint replacement. Wouldn't have ever progressed so quickly through Avascular Necrosis had it not been for headache drugs... I did take indomethacin for awhile, but it really felt like it was eating a hole through my gut lining. I quit taking it when it wasn't helping at all! One thing I've always detested throughout my headache/migraine treatment was having to take one drug to treat the side effects of another. The only reason I have a whole supply of zofran is because lithium and zonegran made me throw up every day. I also take concerta related to memory loss from topamax, which I never recovered from...even though I've been off the drug for a long time. That kind of thing is upsetting. They don't tell ya that when you sign on to take it. Hugz, carrie :) :Melody:

I didn't tell them about my disabilities until after I started school - just due to timing and my own personal choices. I was up front about it as soon as I got there, however. I met with the assistant dean of student affairs and the VP of the school of nursing, and they were very understanding. I had to get certain documentation (just a letter, really) from my neurologist, and then I had to put in writing what accomodations I would need. They then responded with a letter stating what accomodations they would offer, and on what conditions. It worked out very well. I did have some major health roadblocks in nursing school, but because I had set the foundation of being very conscientious about things and really worked hard to stay on top of my disability, they were excellent about it. The hardest part was the toll on me! But...if you are bound and determined to do it, then you will - just make sure you are not putting yourself at risk for injury with the physical side of nursing. That's something that you'd have to decide with a student health center, your own physician, etc. Good luck!

I think my migraines are worse when I have acid reflux than when I take my nexium, however. :) No can get off PPI's ever...thanks to biology and depakote (which I haven't taken since 2001!)... Lots of the headache meds cause very bad reflux, so it seems like everyone is on some type of PPI or H2 antagonist these days! If the nexium ever quits working for me, I'm in trouble!

Hehehe Yes I have heard a variety of explanations for what such Latin phrases mean. It always makes me laugh! One of my earlier jobs in a hospital was working in dietary nutrition...did it part time for 3 years, on breaks from school. So, that's when I learned what all of the typical abbreviations were that would be used in our area, including NPO and then supplements are also written in the same terms of BID, etc. Anyways...for that job, the RD we worked with did require us to know what the words were in Latin. Good call on his part! :)

I have insomnia, but from what, we have no clue! It seems to be very common among cluster headache sufferers. I have quite a few friends from nursing and med school who suffer from insomnia...in fact, at one point we were going to name the 9th floor of our apartment building the "Insomnia Floor." I sleep best from 5am - noon... I tried Ambien, but it did nothing. Ativan worked for a little while, but I was still able to stay up until around 3am without being tired. Then I took Klonopin. I could still stay up all night on Klonopin, but in addition I felt horribly tired during the day. I went off it last week. I had a sleep study in May, but all it basically showed was that I have problems sleeping! (Duh...I knew that already...hehe) One thing that I know helps many who have insomnia are the tricyclic antidepressants. But part of the problem with the TCA's is that they can cause a person to sleep too much. I know I can't use them for insomnia (or for anything) because even on low doses I can still sleep about 20 hours a day or so. The sleep psychiatrist wants to work with me on fixing my sleep schedule. I dunno about this....the cluster headaches are going to come, no matter how much I try to adjust my sleep schedule! So...I'm sorry I don't have really any better answers. My psychiatrist and I were going to work on switching me from Klonopin back to Ativan or Xanax because they are not so long acting. I guess we'll see! Would love to know if any major insomniacs have found success with anything!

That's nice to know. Wish we'd had that law over here when I got stuck!! I also work in the inner city. I love to work in the city, but at the same time...everything comes with a risk. One night I was working in the ER, and shortly after I left, 3 guys were shot up in the convenient store right across the street...I lived in the apartment building above that, which were student apartments for the university. Talk about timing...I'm lucky I didn't go in that store before I went upstairs, like I often did! Everyone thought it was rather mean that the guy involved in my needle stick refused to retest. The nurse who continues to do my blood work just keeps telling me that what goes around comes around, and he'll get his... True...at some point he probably will...

My stick was on March 1 of this year...as a student, nonetheless. I was working at a clinic in West Philadelphia. I, myself, have been taking injectible medications for several years, and I couldn't believe it happened, but...accidents happen... I was taking a patient's blood sugar. They don't use safety lancets out there -- cheaper to use the white ones that are supposed to go in the pen, except we don't use the pen because of cross-contamination. So, I twisted the top off and stuck the patient. The glucometer came up as an error, so the patient was frustrated. The needle box was far away, and I went to pick up my supplies and the lancet went into my thumb...I was still wearing gloves. Well...obviously I can't really get into all the details, patient history, etc. At any rate, I spent a month taking Combivir. I had my own preliminary screenings done, and I have been diligent about follow up testing. I haven't gotten the results of the 3 month check yet, but everything else has been in the clear. :) In my case, the patient actually refused to retest. He said it was my fault, so why should he have to? Well in some ways, he is correct...but I wouldn't really put fault on it. Accidents happen. (Even though the trauma book I used said that there are no accidents...everything is preventable! MVA into MVC...whatever...) An odd coincidence is that another student from my class had a needle stick there just a few months prior. He did not choose follow up with university health due to the circumstances of the situation. We both felt slightly crushed by the experience, but we bounced back okay in the long run. :) I *hate* that I have to worry until the 6 month testing goes all the way through. Even though the risk of getting HIV from a needlestick is very low, and even lower for a lancet...that went through a glove..it still makes me worry a little at times. I have a very busy personal medical history, and about 7 days after the needlestick, I had sinus surgery. I was throwing up blood for about 5 hours after the surgery, and at one point my mom said, "I have to go wash my hands..." I realllllly don't like putting my loved ones in that position where they feel even a little nervous. So...it happens! I talked to a LOT of people after that about their experiences. Almost everyone I talked to had a story about how they had a needlestick at some point. It helped me feel a great deal better! Hopefully that will help you, too. All we can do is learn from it... It's hard because you don't know how it happened. With mine, I do know...and I know the stick made me a lot more careful...even though I already was very careful about it! Hang in there, and know that you are definitely not alone. If it had to happen, I'm glad it was with a good family and that you feel safe about it. That helps a LOT, I do think!! Many Hugz, Carrie :)

For a TON of info on migraine and headaches, you can check out: http://headaches.about.com That way, some of the rationale behind things like giving compazine will make sense, even though it seems like a nothing drug to people who are not familiar with its use for headaches. Even for level 9 pain, compazine can sometimes help...all by itself. Now, if your pain was still there when you left, and they kicked you out, then you're talking JCAHO inappropriate management of pain type thing. On the about.com site linked above, there are also articles for JCAHO issues on pain. There is just such a wealth of knowledge there. I live with about an average of level 8-10 pain daily. It will decrease with the use of Amerge and/or Ultracet, but I'm limited as per my physician to only take these meds 2 days a week. I also have cluster headaches, for which I can use high flow oxygen (15 LPM via nonrebreather mask for about 10-20 minutes)...and there's no limit on the use of that. Thank goodness because I can get up to 6 attacks per day or night, and you can't lie down with them. I've probably tried over 75 different meds in the search to find something that will bring relief. To date, only the Amerge and Ultracet combo have been the most successful. The only preventatives I've found to be helpful were depakote (which I had to stop due to side effects) and Kudzu (root of an herbal vine). Kudzu was the best I personally ever tried, but I had a hemorrhage not long after taking it. Although I'm the only person who's ever had that experience on Kudzu, I have had 3 surgeries in the last 3 months, so we're waiting before attempting it again! Otherwise, they can use all classes of BP meds, antidepressants, antipsychotics, antiepileptics, and on down the line -- with varying rates of success with different types of meds. That has to be determined with a neurologist and by looking at established literature on headache and migraine prevention. Check out the site if you want to read and learn a LOT of great info. Hugz to you! carrie :Melody:

It actually can be given alone. Depends on how much it helps... It is often combined with a powerful vasoconstrictor, if you don't have any contraindications for it -- such as DHE (dihydroergotamine). Compazine for migraine isn't just intended to treat nausea accompanying migraine. It actually is one of the meds out there that has been found to treat the PAIN of migraine....along with most phenothiazines. Then again, don't give them to me...or I'll go into SVT and if I don't, then you'll have to pull me off the ceiling for the jitters. Headache medicine is an art.

My BSN degree was in a program for 2nd degree students. My roommate and I both attended Penn State for our undergrad degrees. Mine was in music, and hers was in industrial engineering. There were many nights when we both said we should have just stuck with our former careers. We thought we had made a mistake. But then there were many nights when I was glad I made the decision I made! Almost all of my plans had been uprooted at one point or another, and it definitely wasn't easy...but a friend of mine once told me to have "No regrets." I was, at the time, feeling like I should continue on in music - hadn't yet started nursing school. I had just finished an extremely successful senior piano recital, and I thought I'd made a mistake by giving that up. He said to me, "But you might also be a really great nurse. No regrets." Great advice!! It's not easy to make a big change like that...but change can be good. :) I'm glad I got my nursing degree (now that it's all over)!!! Hugz, carrie :)

I was in the hospital at one point and taking an MAOI for headaches. I had been on pamelor (nortriptyline) quite some time before that, and a new nurse came in and just handed me a pill. I asked her what it was (mistake #1...i had to ask what my med was). She told me, and I said I can't take that. She kept on insisting that it was prescribed and I should take it. Finally, without raising my voice, I said that combining a TCA with an MAOI can be fatal, and I will not take that pill. She said okay. :) The nurse she was working with that night is someone I've known for several years now. I called her in the room just to let her know what happened. I told her that I didn't want the newer nurse to get into trouble, but I just thought she should know...as an educational type thing. I remember being very stressed out that entire hospital stay because it was over New Year's and between new nurses and nurses pulled to our unit to cover during the holiday, it seemed like little mistakes were happening all over the place! Mistakes do happen....just very important to recognize them, make sure the patient is okay, and then plan what you will do to ensure that doesn't happen again. Scary world out there sometimes!

Nice words...I can also add a few choice 'quotes' to the list... In the ER, I overheard a nurse tell a neurology resident-friend of mine that she "wished all these migraine patients would just go home and go to bed." One night, a pool nurse on the tele unit and I were talking about her experiences in the pool. I told her that I wanted to work in headache neurology. She said to me, "Oh I could never do that. I have absolutely NO sympathy for those people." Those people???!!! Sympathy?? :angryfire I told her that I'd been admitted at that hospital 6 times alone for migraine and headaches. She just walked away. I've heard such a variety of comments - in the hospital working and also as a patient - it breaks me up. But now, instead of sitting silently, I use it as a prime opportunity to 'educate' -- and if education doesn't work, then at least it generally shuts them up - at least around me! I can't stand people who make comments like that. Obviously NOT working in a caring profession because they care... carrie :)