Migraine, Narcotics, and Taiwan's Hospitals

Life Health & Fitness
1

I have had classical migraines for most of my adult life. i see flashing lights (an “aura”) an hour or so before the attack, and I sometimes have numbness in my arms, legs, etc. . It is not “just” a headache, but a condition that can lay me out flat (for at least a day, if not more) at its worst. I was diagnosed around 13 years of age, and they have come and gone in frequency. Sometimes I am plagued by them (several a week), but more recently (thank the Gods for this), it is more like once every 4-6 months.

Chinese medicine has helped. but I don’t recommend it unless you have a TCM practitioner who is a bit above the normal grade. They need to really pay attention to your symptoms, not just the assembly line treatment we see at most clinics here.

As a result of all this, I have tried many western medicines. Far too many to count. In my teenage years I honestly felt like a guinea pig for experiments. After a decade of bullshit, I finally decided that basic narcotics worked the best. I take it, sleep, and the pain (mostly) goes away. I also have quite a few allergies (NSAIDS {aspirin, ibuprofen, etc.}, ergotamine {which is a common migraine medication}, and others). As a result this has made my life in Taiwan, and my relationship with its doctors difficult at best.

So, my first visit to the emergency room here was interesting, to say the least (note that this was about 7 years ago). At first they wanted to admit me to one of their ER beds. It is in a glaringly bright room, with incredible amounts of noise. No fucking way!! Next, they tell me that Taiwan does not have codeine, and that I will be given a demerol shot, and that I have to stay the night. Well, I knew for a fact that wasn’t true, having done my research on available drugs at Taiwan hospitals beforehand. I got into a nice argument with him, and insisted that he call down a Neurologist for a consult.

The Neurologist came down, and basically backed me up completely. (Very cool). He said that I had a letter from my Canadian doctor stating my condition (which I did), and that it stated clearly what drug had been used to treat me effectively, and that they should follow that. As well, he berated the ER doctor for not listening to me - he said that migraine sufferers (especialy for one of over 15 years) generally know their condition better than most doctors, and that he should listen to one who obviously isnt a fraud.

The Neurologist still wanted me to stay, but I explained to him why that was not going to happen (bright lights, noise, etc), and he finally agreed. He did say it would be best if I visited the out-patient clinic so I wouldn’t have to deal with this shit at the ER everytime I had a migraine. He also said that he would give me the largest prescription that he could give - of course, only 3 days worth. I though, ok, not bad, that should be about 30 or so pills (same as I would get in Canookland)… but no, only 12!!!

(this next part is the actual reason for this rant)

So, flash-forward 8 years or so. I have been seeing the same Neurologist as an out-patient for a long time. I only get my prescription filled every 4 months or so. 12 pills for 4 months is not really a lot right? Well, I go in last night, and the rules have changed. Now no-one is allowed more than 2 days of narcotics at a time (like 3 days wasnt bad enough) !!! My doctor actually looked embarrassed. As well (to add insult to injury), you have to fill out a daily narcotics usage form! WTF!!! What am I, a fucking junkie! I take this for an actual condition, and once every 2-4 months? This is bloody ridiculous. If this happened in Canookistan, I would probably just end up buying them on the street. This is ridiculous. For 8, (8!!!) pills!

Mind you, I don’t have much choice in the matter, so other than just rant, I will probably dutifully fill out the insulting form, and now waste even more of my time going down there every 2 months, rather than the once every 4 months I had been doing up to now (or the once a year I would have to do in Canada). This is not a comparison thing, it is more that this whole thing is insane!!!

It is hard enough to try and find a doctor who doesn’t treat me like a pariah every time I step into his office. Now I actually do feel like one, even though my doctor is great. Does Taiwan have that big a problem with drug addiction? Or does anyone know if this has anything to do with the recent WHO bullshit??

Rant complete.

2

Taiwan, like several other Asian nations, has a serious problem with its understanding of the nuances of narcotics use in genuine therapy. The lack of pain relief following orthopaedic procedures or dental surgery is one example, and you have just outlined another serious failing of the system here. Taking minor opiates like codeine does not make you a junkie, especially if you take it for something debilitating like a migraine. Junkies don’t take codeine, anyway. Codeine is far more useful as a cough suppressant and an anti-diarrhoeal anyway, so you should really be having a drug like tramadol or similar if possible.

Good luck bashing your head against the system. It sucks for those reliant on chronic pain relief.

3

There is a thread here somewhere on pain control in Taiwanese hospitals. At Taipei Medical University Hospital there is a pain clinic run by the chief anaesthesiologist (sp?) and he is authorised to hand out anything he likes, including sustained-release morphine (MS Contin). Maybe you should go and see him?

I think his clinics are Tuesday afternoons. The details are below:

Li Yuanwen, Chief Anaesthesiologist (Mazui Ke Zhu Zhi Yishi), Taipei Medical University Hospital (Taibei Yixue Daxue Fushe Yiyuan)

252 Wuxing Jie

Tel. 2738 0032

tmch.org.tw

Good luck. I got post-op morphine from this guy after a week of indescribable pain after an operation in a completely different hospital when all other doctors I saw couldn’t or wouldn’t help. I was sent out of the OR with paracetamol. Can you believe it???

He said Taiwan does not have a range of narcotics, it seems to go from codeine to oxy- or hydro- something, and then the next step up is morphine. I found the former two drugs useless and the morphine to be an almost instant relief from pain. This guy, obviously as a Ma Zui Yishi (Anaesthesiologist), knows his stuff and specialises in terminal cancer pain and that sort of thing. A nice sympathetic, knowledgeable doctor. I don’t know if he speaks English - I spoke to him in Chinese. Well, I didn’t. I was in such pain I couldn’t speak at all. My wife spoke to him in Chinese.

4

Lucky you, I say, that all you have to rant about in life is having to fill out some forms so you can otherwise easily and cheaply get the medication you need to make your life more comfortable.

Others out there die for want of the simplest of medical treatment.

Not being mean to you; rather just encouraging you to realise that your glass is almost entirely full. Best of luck with your condition.

5

[quote=“Stray Dog”]Not being mean to you[/quote]But you are.

6

Agree. Being left short on medication when you suffer migraines is up there with waterboarding in my book.

HG

7

I suffered from classic migraine from adolescence, along with my dad and two of my sisters. Went through the whole gamut of treatment options in the UK, including some very powerful analgesics and narcotics. They helped the pain – as you noted, usually they just knocked me out until the pain was gone, so I’d have a few miserable days of come-down and that godawful ennui that lingers for a day or two (in my case, at least) long after the pain has gone.
I brought about a year or two’s worth of UK meds when I came to Taiwan but once they were gone I was fucked – you can’t really argue with a doctor coherently when you’re in such distress that you literally can’t see, hear or speak properly. You also can’t really make an appointment with a doctor when you DON’T have a migraine – what are you going to say?
“Hey! You! I want to tear you a brand-new arsehole!”
“What’s wrong?”
“Well, nothing right now, but…”
“???”

Anyway, long story short, I found a Chinese herbal/acupuncture bloke who cost me a bloody fortune – I think around NT$10,000 per round of treatments and I needed three, as far as I remember. I wouldn’t let him stick me as I’m a chickenshit pussy, so it was filthy Chinese medicine gloop that I had to boil up in a special kettle-thingy and drink three times a day for a month at a time.
Point is, my man, this took place about 12 years ago and I can honestly say that I haven’t had a SINGLE episode since.
The caveat is that it costs a lot, doesn’t work for everyone, and there’s no NHI. but my GOD! It worked for me.
If you want, I can find out the bloke’s address from my wife, who unlike me always keeps business cards. It’s right near the Chiang Kai-shek MRT stop.

8

I would just add that codeine is often contraindicated for migraines, as it can actually cause them.

HG

9

[quote=“Stray Dog”]Lucky you, I say, that all you have to rant about in life is having to fill out some forms so you can otherwise easily and cheaply get the medication you need to make your life more comfortable.

Others out there die for want of the simplest of medical treatment.

Not being mean to you; rather just encouraging you to realise that your glass is almost entirely full. Best of luck with your condition.[/quote]

What a phenomenally asshole-like response, my good friend.
Did you get one of those newfangled tommy/Satellite TV computers that allow your fingers to directly type without your brain being involved in the process?
Just saying is all.

10

The guy gets his opiates, dirt cheap, and is complaining at length, as far as I can tell, about nothing more than having to fill out a few forms every two to four months. They’re limited for good reason (abuse/addiction prevention). But he gets his meds.

I just read an article about a woman in an African country who collapsed after giving birth for something that is easily treatable in the West, and in fact at her nearest hospital. But all the car drivers and motorcycle riders who tried to help her kept running out of petrol. They got her to a clinic about halfway to the hospital, but the doctor had long since quit because of salary disputes, and the clinic was lacking the equipment and medicines that would have saved her.

As I said in my previous post, I see little to rant about. Filling out a form every two to for months to help ease your headaches? Again I say, lucky you. I find it difficult to say poor you for nothing more than having to write a quick list every now and again – which is probably valuable data for those prescribing the drug. Look on the bright side is what I’m saying. If that’s phenomonially asshole-like to you, the chief, then I envy the amazing world you must live in.

11

Maaate, that’s like saying stray dogs in Taiwan have it real good, I mean you should see what their kin have to put up with in Iraq! It’s clearly pointless and silly.

And as an aside, opiates should be cheap, because they quite literally grow on trees, or rather hardy little shrubs.

HG

12

If the stray dog who posted here was getting treated for his ailment but ranting for nothing more than having to go to the vet every three months, then I’d say the same to him. Then I’d compliment him on his computer and literacy skills.

13

guy wants to rant let him rant…hell if we stopped everyone ranting in here there’d be no posters left…

14

Anyways, from your perspective, wouldn’t it be that the toilet bowl is half full rather than half empty???

15

Jeez. You guys are giving me a headache. Pass the codeine!

16

Ah! Prescription envy! :laughing:

By the way, you can get codeine over the counter here in HK, not legally, obviously, and damn those farkers charge an arm and a leg for it.

HG

17

[quote=“Stray Dog”]The guy gets his opiates, dirt cheap, and is complaining at length, as far as I can tell, about nothing more than having to fill out a few forms every two to four months. They’re limited for good reason (abuse/addiction prevention). But he gets his meds.

I just read an article about a woman in an African country who collapsed after giving birth for something that is easily treatable in the West, and in fact at her nearest hospital. But all the car drivers and motorcycle riders who tried to help her kept running out of petrol. They got her to a clinic about halfway to the hospital, but the doctor had long since quit because of salary disputes, and the clinic was lacking the equipment and medicines that would have saved her.

As I said in my previous post, I see little to rant about. Filling out a form every two to for months to help ease your headaches? Again I say, lucky you. I find it difficult to say poor you for nothing more than having to write a quick list every now and again – which is probably valuable data for those prescribing the drug. Look on the bright side is what I’m saying. If that’s phenomonially asshole-like to you, the chief, then I envy the amazing world you must live in.[/quote]

Assinine, childish, and above all, irrelevant. Dear oh dear. How’s the moral high ground? Lonely up there is it? Why not start your own thread entitled “Sob Stories I Have Read About” instead of hijacking this thread?

18

Project much, LL? :laughing: That has to be the most ironic post I’ve seen this year. Well done! :bravo:

19

Come on, Stray Dog. I have the utmost respect for you and what you do but your contributions to this thread have been rubbish. People in need of narcotics should be given them in abundance. WTF? 10-12 pills of pussy morphine per month?!
Farkin’ respect! I know when I have incurable pain. I know when I need pain relief. No twat-assed Taiwanese pseudo-doctor is going to tell me otherwise. Am I a junkie? Possibly. Am I causing anybody but myself harm? Highly unlikely.
We should be thankful that the Lord Jesus in all his mercy in collaboration with the National Health Care sysem are looking out for us? PsssHaaaw! I know when I’m in pain and no 23 year-old fresh out of med school twat filled with bogus morals and fake scruples is going to tell me otherwise.

20

Get real. Read the OP. His rant is about having to fill out a form. That’s what I responded to. It seems like some here are reading something else into this. He didn’t write about how his migraines are ruining his life, or how he can’t get what he needs, or anything else worth any sympathy. His rant, as he put it himself, is that he has to fill out a form. But I guess there are some migraine sufferers here who need to find someone to aim their frustration at.

He doesn’t like filling out forms to get his meds. I said he should look on the bright side that he can still get them and wished him all the best with his condition. That’s what you’re all mad about?

Or have I missed something here?