drugs, drugs, drugs, part 1

Catchy, but a bit oversimplified. I think I knew this even in the 80s. Now I can’t even get clear cut solutions from my fantastic cutting-edge brain scientist doctor, let alone mom and dad.

It seems that us chronic painers have endless decisions to make about drugs, and not usually easy ones. While having access to a plethora of medical options is certainly something to be grateful for, it’s sometimes a catch-22. Often the only method to weigh potential negative side effects with potential benefits is to just try a drug, and often this goes badly. With off-label this, new trial that, and drugs to counter the side effects of other drugs, some of us end up with meds coming out of our ears, and consequently, more health problems than we started with. After being burned by narcotics and triptans that (unbeknownst at the time to my GP and me) dragged me down the hole of medication overuse pain, it seemed like Western medicine was not on my side.

So I’ve been holding back in the meds department this past year. Call me a granola hippie, but I have been diligently entertaining the idea that my body, if given the right time, space, and lifestyle parameters, can function optimally without added chemicals. I’ve got knowledgeable, talented alternative healers in my camp on this one whose treatments have been some of my most helpful (if expensive) tools so far. The problem with this plan is that it’s just not enough right now. I need to get up and go to work in the morning. Sometimes I would even like to watch tv or go out with my friends, or listen to music, and yoga and acupuncture just don’t cut it for these beloved activites. For the most part, these activities require drugs, drugs, drugs (yes, at least three kinds).

I started with an antidepressant, amitriptyline, used as a preventative drug that supposedly works by regulating serotonin levels. This has helped me get to sleep at night, and I think has helped decrease the severity of the migraines, but I’m not sure.

I added BOTOX to the mix, trying to overlook the fact that it is relatively new to the scene (so while researchers know a bit about its efficacy, I’m sceptical that they have conclusive evidence about long term effects) and that it is also, according to Wikipedia, “the most acutely lethal toxin known.” I worry that any relief brought by the botox is a band-aid solution, and that I will have more pain and tension in the long run as a result. My forehead is immobile and smooth as a baby’s bottom, which makes for a cool party trick, and I think it has helped decrease the severity of the migraines, but I’m not sure.

Most recently, I’ve started on a low does of topiramate, a medication that changes brain chemicals that send signals to nerves (whatever that means). Apparently it can be quite effective if your body can adjust to the side effects. Depression, exhaustion, and an unattractive zombie-like quality is the current menu, but it’s getting better. I think it has helped decrease the severity of the migraines, but I’m not sure.

Occasionally, when I’m feeling a bit desperate, I throw an abortive pain medication down the hatch. While I’ve been assured that these things can be used responsibly, I’m super paranoid that each one I take somehow causes more pain, or hinders my body from healing itself naturally. Sometimes these drugs decrease the severity of the migraines, but other times, I’m not sure.

GAH!!!!

While all of this is frustrating to no end, there are a few reasons why I think this treatment plan process is still such an elusive thing:

1) Chronic pain flare ups and symptoms can be irregular and unpredictable, making it difficult to track “improvement”.

2) Despite labels assigned to various conditions by western medical institutions, each person’s experience is unique. Ex. I know a fellow migraineur whose diagnosis and symptoms are the same as mine on paper, but we respond to certain treatments very differently.

3) Despite chronic pain costing the Canadian economy more than cancer, heart disease, and HIV combined, it is still one of the most under-treated, under-researched , and disbelieved afflictions (Shannon Kirkley’s Chronic Pain Series). So as a society, we just don’t know or care very much about it.

4) Big Pharma. This is a kettle of fish I don’t even understand, but I distrust new, powerful drugs, proven to be only slightly more effective than placebos, that are marketed as gold, and cost more than your first born child.

5) There is a grand canyon of confusion between western medicine and “natural” or “alternative” medicine. More work needs to be done to bring these sciences together, because feeling torn between the two is an added stress that makes finding a balanced treatment plan all the more difficult.

At the end of the day, I think finding the right treatment plan is about

research-Txt

and Patience

…. as well as trusting your gut,

and reminding yourself every morning and every night to never give up.

Anna

(“research” image by Fritis)

3 comments

  1. I’ve never suffered from depression (I’m an irrepressible optimist), but when I was on topiramate I was the most the most unattractive exhausted zombie there has ever been. Currently I’m not on any medication, and I’m no worse off than when on any of the twenty plus different medications I have been prescribed over the years.

    I agree that it’s very difficult to determine progress, or lack there of, as symptoms vary so much from one attack to the next. This seems to be a factor that so many in the medical profession don’t seem to take into account. I wonder how many migraineurs don’t fit neatly into the “official” migraine classifications. I would wager a great many.

    I count myself lucky in that nausea and severe head pain are symptoms that are relatively uncommon for me, although other symptoms are just as debilitating. For me it’s cognitive and motor skills that are affected severely. Fortunately (see, always the optimist) the “brain fog” which always accompanies a migraine to some degree, means that I am seldom distressed during an attack. I’m also fortunate in that I often have little or no recollection of the most severe migraine attacks, although those around me find them quite distressing.

    You’re right that patience and never giving up are two of the most important aspects of coping with chronic migraine. And I wonder why so little funding is available for migraine research.

  2. […] drugs, drugs, drugs part 1, I wrote about my frustrations with trying to devise an effective treatment plan. In the land of […]

  3. Well put, Anna! As someone with chronic migraine (every day) I always need to be on top of my treatments and my body’s reaction to them. Unfortunately, so often my broken brain is so caught up with its daily pain, it’s nearly impossible to think of anything beyond getting through the next hour. Or half hour or 15 minutes.. Or minute. One bad flare up can result in feeling like there had never been any improvement, and there never will be. When sanity resumes, it’s easier to believe relief or effective pain management is possible, but in the throes of a flare up, all hope escapes out the window. Linda .

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: