M still bad after IV, dreaded ER question- need some help here- voo doo chickens etc

Hi All,

I had an IV or Depakan yesterdayat the IV center. I get fluids, followed by IV Benedryl and Phenergan, hen the Depakan goes in over an hour, and then toradol and morphine. It usually works wonders. But the pain level has been really high lately (around a 9-10) for a week. The IV brought it down to a (9/10) But this is still way too high.

I spoke with my neuro and am now on a course of steroids- his PA said that if it doesn't improve, I should go to Urgent care for a toradol injection. Toradol helps some, but I am not sure if will help this one. I did call the Urgent Care to make sure they did this kind of treatment and surprisingly, they do. I hate to even consider the ER. Mostly because there is the waiting, then you never know what what they will do- will they give meds that work, or not. I am just not sure right now.

I don't know what to anymore. All I want is to curl up until this is over.

I am on tramadol 200mgs ER for pain, Pristiq, zanaflex at night, tramadol 50mgs for breakthough, Tylenol#3 for breakthrough and Klonopin 1mg (up to four a day. I have had to use the as needed meds- tramadol, T3, Klonopin a lot lately. I don't know if I should try to taper them off some or what. (I doubt it is rebound.) I know I am grasping at straws here. Need opinions/advice.

I am just scared, On top of this, Dora won't be back till next Friday. I am hurting badly- and sometimes when this happens, I lash out. My roommate who has aspergers, is scared of this, so I tend to hold things back until I explode. ok, well I haven't been holding much back lately.

Anyway, I'd love any ideas or advice.

Pain free days,
sconesail

Scone, I will shake some voodoo chickens for you. If I were you, I would go the the ER. I find it is not usually as bad as I think it will be (never easy though:x ). I also think that your plan has not been working for quite a while. Every time you post you are at a 9/10. So, I doubt the stimulator or your preventatives are really doing much for you.

Also, having Dora is nice to keep you safe, but you need to continue to search for a Dr. who can find the reason for the fainting. Yes, it is hard when you have little emotional support. It is easy to settle in when you feel better, but that is the time to press on. Hope this makes sense as I too am having a long lasting bout of pain. Hope you get to the ER for help.
Hugs,
Cindy

Scone
Toradol is only an anti inflammatory, it helps the inflammation from migraine but won't do anything for pain. Morphine actually has a nasty side effect of causing headache and migraine.

Dilaudid is a much better pain medication and it will help you rest too, its IV or IM (injection), most docs won't write a script for these in pill form. The problem is getting a doctor to LISTEN to you regarding what's NOT working and be willing to change things up.

I have never heard of using Benedryl, an allergy medicine for migraine. The Phenegren is just a nausea medication, again, neither of these will do anything for pain.

The Depakan (Depakene) is the same thing as Depakote, a medication for seizures but used as a migraine prevention medication. This will do NOTHING for pain. Looking at all of this I can see why you are still suffering.

Tramadol is notorious for causing rebound migraine. Tylenol #3 doesn't work well and the migraine will come right back.

I think you need to admit to the hospital and IV something to break the pain. That would probably include Dilaudid, toradol, phenergren and the steroids. Are you taking Depakan daily as a preventative? If you are and its not working, get off that crap. It will cause your teeth to rot, your gums to bleed and swell, besides liver function can go critical. It's a bad medicine and if it isn't working, get off it.

My other suggestion is a sedative like Xanax. I recently got mine back and when I can't break the monster after taking Relpax, which is an abortive medication for migraine, I will take 2 mgs of Xanax and a Percocet. That and an icepack to the cold, dark, quiet room with a fan running and wait it out. Normally this cocktail will at least let me rest and sleep.

I am not sure if its the weather change or what, but recently I went through a very rough time. September and October were really bad and a few days this month too.

(((Hugs))) Trinity

Trinity

Hi All,

Thanks for the advice.
t
I ended up going to the ER today. I went to the same ER I have been to in the past and have usually had an ok experience-not so today.

First of all, the nurses were incompetent and couldn't get a line- they didn't even listen when I suggested which veins worked best. So, no line. I have only had trouble like this once- when I was severely dehydrated and then they gave IM shots and followed by successfully getting a line. So no line.

Also, before they even got in to talk to me, I got up to use the restroom, fainted on the way back, and then the nurse got mad because she said she had to do a three page report because I fainted. Did I mention, I was brought back in a wheelchair and had verbally told them of the fainting problem?

So they did IM injections. they gave me benedryl, Zofran, and Mophine. This took the pain down some, but not much. The nurse did check back and asked what else worked. She suggested more morphine and a steroid shot. I said this was ok, but could they check and see if something else could be done if this didn't work? She said she would ask, but didn't think so. So I got the shots. Then started dry heaving from the decadron. Someone came in with discharge papers, got the nurse, who did give me more Zofran before I left. They gave me prescriptions for Bupap(butalbital), and oral Phenergan and told me to follow up with my doctor.

I am home now. I now know why I haven't been to the hospital for three years for migraine or fainting. I was worried about going because they usually freak out about the fainting and everything. They didn't, actually, I don't think I even saw the ER dr. I suppose I was in the charge of the Nurse Practioner. But this concerns me now that I think about it.

I don't know what to do anymore. Obviously IV Depakan, which has worked for ten years isn't working. I went to the ER to avoid having an emergency visit to birminhaam next week. But I may have that anyway now. I do not want to be hospitalized as one has never really helped me. But if I have to be, I will.

The neurologist in Birmingham is new and has been helpful. He has pushed for Botox injections and they work for about two months. He is also trying to figure out what I haven't tried or what can possibly be added to the mix. I may call and talk to the on-call dr about what I need to do should I feel the same way tomorrow. (Even if it means meeting him in Birmingham and being seen at either his office or having him meet me at the ER there.)

As to tramadol- it works as well as Morphine did for me as a long acting medication. I don't know why, but it does. I will see if my pain dr will give morphine for breakthough rather than Tylenol 3.

I have been given benedryl to help the medications work for years. At one headache clinic, they gave it round the clock and it did help the headache.

Klonopin is in the same class as Xanax. Xanax makes me a little crazy and klonoping doesn't. It has been shown to have some nerve calming effects in dysautonomia- so I am on that and that does help.

I haven't given up on finding someone who can treat the fainting. I know it has gone by the wayside a little recently- I have been trying to work around it.

So I guess all there is to do right now is to rest. Call the Birmingham Neuro tomorrow and see if it would be best to be seen by him on Monday or see if it possible to meet him or have him admit through office or ER. I haven't been at this point in years, but maybe it is time?

Pain free days,
sconesail

Scone
So sorry you are going through all of this. Try to rest and I will send up prayers for you tonight.
Trinity

Hey Scone,

Sorry to hear about the brain pain. Hope you can things to calm down soon.

Take care,
PF.

I'm sorry things have been crummy for you lately. I hope Dora comes home soon, and retrained.

Trinity- There are many IV meds that I've seen given with IV benadryl, either before or after. I had a nurse 'forget' the benadryl on me once, and I could see the entire vein, bright red from the IV site (back of my hand) to my armpit. After getting the benedryl in the IV the redness faded pretty quickly. I figured I'd explain, forgive me if you already knew it.

Oh, I feel bad now for telling you to go to the ER (even though you didnt have a lot of options). I really hope you get some better treatments next week.
Get as much rest as you can until then.
Hugs,
Cindy

Hi All,

Well, I decided to call my neuro today. Fortuately, my dr was the on call dr and he called me right back. I told him what happened and he wasn't happy with the situation either. I also said that I really didn't know what to do right now. He said that he felt like he needed to see me in the office and maybe some of the medications they give in the office would help or, he would admit me. The one drawback is that he is located in a city about 90 miles away, but that is ok. He told me to come up tomorrow morning, they would work me in, and see how things went.

In many ways, this makes me feel a whole lot better. At least there is now a good, concrete plan. If they do admit- I hope it wont be for long or that they can do IVs in the office, Still. I feel better about the whole thing. My wonderful roommate is going to drive me up there. If admitted, one of my parents will come. But I just feel better especially since nothing here is working. I will keep you updated.

Pain free days,
sconesail

Scone
I am so glad to hear that your doctor will see you in the morning, hang in there!

Trinity

I hope everything goes well for you, and they find a better solution long term. 
Hugs, Cindy

Hugs, and the chickens are out in force for you from my neck of the woods. Let us know how things are going, and take care!

Any news? I'm hoping that the silence means you're inpatient and away from the internet while under treatment that's helping, but I figured I'd throw this out, just to check up with you.

I'm hoping your lack of update means you are still getting treatment. I'm sending positive thoughts your way!!!! (And shakin the voodoo chicken)