HELP!! I can't take it anymore!

Hi-

I am a 41year old female with Migraines since I was 14, have been to more IM/Neuro's than I can count, and also have a large venous angioma on my left frontal lobe.  I have been on many beta-blockers and am currently on one now, take Topamax, and all anyone wants to do is throw narcotics down my throat to get me to shut up. 

I take or have taken Fioricet, Norco, Darvocet, Phenergan, Zofran, Stadol Nose Spray, Imitrex (which made me have chest pain and palpitations), Lidocaine Nose Spray (which works very well, but only for a short time and also your nose and throat are numb and you can't swallow), Ergostat, 2 different beta-blockers, Topamax, and God knows what else!!

I am a Registered Nurse and a department head in a large Dallas hospital, so I have a very high stress, demanding job. I HAVE to be there...literally. I cannot take any pain medications before or while I am at work otherwise I could not function.  So I have been going with headaches, nausea/vomiting, sensitivity to light, high blood pressure (from pain probably) and visual disturbances.  I have had many MRI's/MRA's, the only thing found was the angioma, I had paralysis in my right hand,arm and leg for almost 4 months and fell all the time or dropped everything.  I even passed out at work once. I had an EMG at that time, was told it was O.K. (It was totally humiliating, I had to be naked and they put needles down my entire right side and then did little mini shocks...not fun)!  Was also told that the angioma may make my headaches worse, but they have a venous function, so it was something I would have to get through.

I am at my MAX, or past........

Suggestions?  Please! Does anyone know of a good, reliable MD in or around Dallas who will actually listen to me!

Thanks-

Ali (Pronounced Allie)