Monday, October 18, 2004

Sitting in bed with the laptop, as I usually am when posting here, watching TV (“Silence of the Lambs” on Skinemax; I’ve thought all of the movie adaptations of Harris’ novels have been well done, although, like all adaptations, they had to leave out a lot of the internal dialog that really makes his characters unique… I also thought Edward Norton was miscast as Graham in “Red Dragon”; what’s his face was a better Graham in “Manhunter”)… pretty much stoned out of my gourd on Stadol, the migraine medication I’ve been prescribed for several years. I hadn’t seen a doctor for migraines in a couple of years; figured I’d get around to it when the county settled their medical insurance mess. They have, and I had a migraine Tuesday night. The subsequent headache lasted well into the next day, so I bit the bullet and made an appointement with a new doctor in town; hadn’t switched doctors since the move to Braselton. I felt the beginnings of another tonight, hence the medication.

Now, when I talk about having migraines, I’m not talking about just a bad headache. I hate hearing someone say “Man, I’ve got a headache; I think I’ve got a migraine.” If you had a migraine, you wouldn’t have to think about it; you’d know. My migraines started when I was about 14, and weren’t all that frequent; once every couple of months or so. As I’ve gotten older, they’ve decreased in frequency to every six or eight months. They start with numbness in one of my fingertips, moving from finger to finger and sometimes to the end of my nose and lips. After the numbness, I get sparkles- sort of like an afterimage, like when someone shines a bright flashlight in your eyes- that start like annoying little specks in the corner of my vision and spread to the entire center of my vision. The sparkles shimmer as zigzag shapes, a herringbone pattern that flashes red and yellow. The sparkles, “scintillating scotoma” I think they’re called, move to the outer peripheries of my vision before vanishing. Then there’s waves of overpowering nausea that have me heaving my guts out. Following these precursors, which last 20 to 40 minutes or so, comes the headache. A headache for which terms like “crushing”, “pounding”, and “blinding” are inadequate descriptors. The headache lasts for several hours, and over the next few days, I’ll have a “regular” grade headache.

Not all of my migraines exhibit each of the precursors. Most of the time it’s the scotoma followed by the pain. Bright lights and loud noises seem to aggrivate the symptoms. I’ve never really figured out what triggers them, exactly; for a long time I was convinced that MSG and nitrates, like from a hot dog, would trigger them; but then I’ll eat a hog’s worth of weiners with no headaches. Sometimes stress with trigger one, sometimes not. Not having eaten for while seems to make me vulnerable to them, but I’ve never found any one thing. Science seems to be at a loss to explain what causes them, too; they’ve noted vasodilation (or constriction, I forget which) in the brain during migraines but feel these are symptoms and not causes. I’ve had a MRI that found nothing unusual; no brain tumors or anything like that. And as science progresses, I’ve tried each latest miracle drug- ergot based drugs like wigrain (sp?) and Midrin, the new tryptan drugs like Imitrex, Amerge, Maxalt, Zolmig… my last doctor had wanted me to try one called Frova. None of them stopped the migraines. The only drug that works, that stops the migraine within 15 minutes, is called Stadol.

The only problem with Stadol, otherwise known as butorphenol tartrate, is that it’s a synthetic opiate- a narcotic. It’s usually used as a painkiller, and is used as a veterinary drug. It’s also apparently abused for its narcotic qualities, and therefore restricted. It stops the migraine, all right; it also zonks me out to the point that I end up asleep and drooling. While I can’t do anything useful while having a migraine, I also can’t do anything useful while taking Stadol. It’s taken me the better part of an hour to write this (moving from “Silence of the Lambs” to “Futurama” on Cartoon Network); I have to chase my thoughts down from wandering all over the map and nail them down with the keyboard.

Speaking of which, where was I going with this blog entry? I filled in my new doctor with my past history; something that gets old after several new doctors and re-tellings. I mentioned wanting to find a medication other than Stadol, and that my last doc wanted me to try Frova. He made a couple of cursory notes and said that while he didn’t like to prescribe narcotics for chronic pain, my migraines weren’t chronic. He also said that if the other tryptan drugs didn’t work, Frova probably wouldn’t either; and gave me another prescription for Stadol. And here I am… the migraine’s gone, but so’s my sobriety. Not an unpleasant feeling- quite the opposite, actually. I can see why it’s addictive. Just not the worth turning yourself into a zombie.