Is expecting to be prescribed a migraine rescue drug unreasonable?
Dear Ms. Robert,
First, from the bottom of my heart (and my wife's), thank you for your ongoing work on behalf of migraine and headache sufferers. Your work has changed our lives for the better, and we will be eternally grateful.
Now, on to my question. Is expecting to be prescribed a migraine rescue drug unreasonable? A bit of explanation:
I am dual diagnosed with migraine without aura and migraine with aura. As I understand it, this is very typical for migraine sufferers. Although I have been dutifully trying preventive drugs, none have been found yet that help much. Zomig nasal spray does abort my migraines about 85% of the time. However, there is still that other 15% when it does not work, and I limit myself to using it two days a week only since learing about rebound from you, and I have three or four migraines a week.
I have now asked two neurologists about a rescue medication to take when Zomig doesn't work and when I've already used Zomig two days in a particular week. When the first neurologist refused, I took your advice and fired his "sorry butt." (Thank you for that too, by the way.) Now the second neurologist has also refused, stating that he "does not prescribe narcotics." I NEVER asked for narcotics. I asked for rescue, and I don't care what the rescue is as long as it works. I'd eat worms if they worked for rescue! Oh, I asked about Midrin, and he informed me (quite rudely) that it's a narcotic. I'm not an idiot, and am capable of reading about drugs. From my reading, Midrin is not a narcotic. Is that correct?
Is my request for a rescue drug unreasonable? I could see doctors being reluctant if I were unwilling to keep trying their prescribed preventives, but I'm being as cooperative and patient as I know how to be.
Please advise?
Gratefully,
Jon
Dear Jon,
Thank you for your comments. You and your wife are very welcome. It's gratifying to know that I've helped you.
You are right -- Midrin is not a narcotic/opioid. One of it's ingredients can make one very sleepy, so it is a DEA scheduled medication, but not a narcotic.
Your request for a rescue medication is quite reasonable, Jon. Proper Migraine management has five components:
1. Diagnosis and finding a doctor to work with.
2. Trigger identification and management.
3. Preventive therapies if needed.
4. Abortive medications.
5. Rescue medications to be used when abortives fail or when abortives can't be used.
Optimal health care can only be achieved when patients are educated about their health, and patients and physicians work together as treatment partners in an atmosphere of mutual respect. That's my philosophy, and I stand by it. It appears to me that you are doing your part in this. You're learing about Migraine disease and treatments, and you're working with your doctors to find effective preventives.
In your place, I'd fire this one's "sorry butt" too. Have you considered an actual Migraine speciaist? Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.
Jon, I'm proud of you for advocating for yourself so well. That can be very, very difficult. It's easier to advocate for someone else than for yourself sometimes.
Good luck, and please let us know how it goes?
Teri
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dvikib
Monday, October 26, 2009 at 12:00 AM
Jon - I really hope you find a good doctor soon. I love Midrin. Most of the time if I take it at the first sign of pain (I don't get auras), it aborts the migraine although not immediately (can take an hour or two). It makes me a little sleepy but I can certainly live with that better than a migraine. I am surprised you're having trouble getting a prescription for it - my gynocologist prescribes it for me! I can't take Imitrex - it paralyzes my swallowing muscles and didn't work anyway. Midrin comes in generic form and is fairly inexpensive even without insurance.