Migraine, Narcotics, and Taiwan's Hospitals

Life Health & Fitness
21

My point in the original post, (which was a bit lengthy, I know), was first to illustrate the difficulty in getting narcotics at all in Taiwan for a legitimate condition. I am allergic to most of the medications that would otherwise be prescribed here. That, or the drugs that are used have so many side effects thatI would rather not take them.

My second point, was that not only did they previously only prescribe 12 pills (already demeaning), but now I only receive 8 pills and I need to document my use of these drugs as if I am a child. This is a new policy for all of Taiwan(so they told me).I have had migraines for 20 years, and I have never been treated in this way before.

Has anyone heard anything about this new policy?

Personally, I could care less that these drugs are addictive. They work for me, they take away the pain, and I have no side effects from them. As well, I have no interest in taking them outside of the times that I am in pain.

In relation to migraines, I don’t really buy into the doctor based hegemony over the masses. As someone who has had them for a long time, I know what works well for me, and as someone else said, I don’t need a 25 year old kid lecturing me with his textbook medical ethics. These drugs are barely narcotics, and if I wanted to get high, it sure wouldn’t be on Codeine.

As to what this has to do with some woman in Africa, I have no idea.

I guess ultimately, it is hard enough for me to find the time go there once every 4 months, let alone once every 2 months. Note that the first post was done in a Migraineur state of mind, and as a result, sounded rather pissy. thus is the nature of the beast I suppose.

And what happens when I want to travel for any period of time? When I lived on other continents, I would have a prescription for at least 30 tablets for going to other countries. That way if a migraine attack occurred, I would be covered for 3 or 4 attacks. With the present situation, I don’t really know what I should do.

Anyways, thanks for the input.

p.s. - Stray Dog, most of your posts had a decent point in there (perhaps you have a “bone” to pick? :discodance: ). But please do not refer to migraines as “headaches”, they are not the same thing. :no-no:

p.p.s. - A friend of mine had a 36 hour horrible labour for her first baby. She also suffered from bad migraines, often which lasted for 3 days. When I asked her how they compared (for relative pain level), she said that her labor was easy compared to her migraines. I asked her why, and she said, “With the labour, the pain stopped sometimes”. Just to give you an idea.

22

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.[/quote]

Hey thanks Sandman. I would be very interested in that. I am not sure when I could afford it, but it would be great to be rid of migraines forever. PM me if you find the info.

23

[quote=“Huang Guang Chen”]I would just add that codeine is often contraindicated for migraines, as it can actually cause them.

HG[/quote]

For some people this is the case. But triggers can be a tricky thing to pin down. And for me, it has never really been an issue, and with my wide range of allergies/drug sensitivities, it is the safest bet.

24

[quote=“the chief”][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.[/quote]

:slight_smile: its just nice when you are recognized simply as “tommy” now instead of “tommy525” . Yes keyboard on auto as usual :slight_smile:

Yes and apparently, migraine is one of those mysteries of medicine. Very hard to treat, with highly individual results.

I hope u get way better Noel.

p…s. When i was last there in 1999 one could get just bout anything at the local drug store. Is there a lot of control now?

25

Thanks for seeing it the way it was intended but failed to be. I’ve just gone cold turkey to cure a twenty-year addiction to sugar, so maybe I was too blunt in my communication. :ponder:

26

[quote=“Stray Dog”][quote=“Noel”]

Thanks for seeing it the way it was intended but failed to be. I’ve just gone cold turkey to cure a twenty-year addiction to sugar, so maybe I was too blunt in my communication. :ponder:[/quote][/quote]
Sorry for having a go at you, Mr Dog, but I’ve butted my head against Taiwanese doctor morons too many times. Fer Chrissake! Codeine?! OTC in virtually every country. I refuse to be treated like a child. I want morphine? I need morphine? Gimme farkin morphine. Easy to differentiate between a junkie looking for an easy scrip and someone in severe pain who needs relief. The power relationship between doctor and patient is crap. I am an educated person who is quite capable of self-medicating. I don’t need some fool on a moral high ground with the power to write prescriptions to make judgements on my ability to handle habit-forming substances.
I wish I had the time to do a degree in medicine, but I don’t. Therefore I am perpetually at the mercy of the ivory tower wankfucks who dispense to the lesser mortals at their whim.

27

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

I really have no idea what you’re talking about, but what motivates you to post such mean-sprited stuff? You’re a nice guy, and have made great contributions to this website, and to lots of people’s lives in general in Taiwan. Your posts in this thread are completely out of character, that’s all. I take exception to your posts here because getting decent pain control is a real problem in Taiwan, I have had personal experience similar to the OP’s, and it’s very understandable that people rant about it.

Can we have a discussion about pain control in Taiwan without a flame war?

28

Marijuana is the only thing that works for me. I also get the flashing lights thing about three hours before the migraine is due to start. That and a weird hissing sound and tunnel vision. Regardless of what I am doing or where I am, as soon as the warning lights come on, so to speak, I drop everything, go home, roll a spliff (if available) and go to bed. If can get to sleep within those three hours then all is well and I wake up six or so hours later with nothing more than something that feels like a bad hangover. Otherwise, a migraine can lay me flat for up to three days with feelings of nausea and a pain in my head so bad all I want to do is stick a knife in my palm to distract from it.

BroonAnalgesic

1 Like
29

To the OP:
Interested in learning what you have tried over the years. Ergotamines are old meds, there are better, newer medications. Narcotics, like codeine, are scheduled drugs in the U.S. where I have been in practice with a neurologist for the past 2 years. We typically use them as “rescue” medications, i.e., when other reasonable abortive medications have failed. They basically knock you out, and by the time you awaken, you’ve slept off your migraine.

I empathize with you. We do have some patients with whom we’ve tried all other options, and the only effective medication is an opiate [be it codeine, hydrocodone (synthetic opiate often in combo with tylenol and known in US as brands Lortab, Lorcet, Vicodin), oxycodone (synthetic opiate often in combination with tylenol and known in US as brands Percocet, Tylox), morphine or a partial opiate like tramadol].

Just curious. Have you tried any of the following? Stadol, Fioricet (butalbital, caffeine, tylenol), Axert, Amerge, Imitrex, Treximet, Maxalt, Zomig, Relpax, Duradrin (tylenol,dichloralphenazone/isometheptene), Frova, Migraten. Many of these belong to the Triptan class of drugs, but if one is ineffective or causes intolerable side effects, we will try another as failure with one doesn’t equate to failure with another.

In the US we are suspicious of folks who routinely go to the ER for migraine headaches (unfortunately, for some there is no other option because they lack medical insurance). THe ER, as the OP has noted, is a sucky place for someone with a migraine. Usually, folks who go to the ER routinely, for for migraine treatment are flagged at some point as narcotic seeking (migraine is not an emergency, and is best dealt with in a clinic by family physician or neurologist). At some point, they are refused treatment with narcotics, are given non-narcotic treatment, and told to follow up with a neurologist.

UNfortunately, healthcare providers DO have to worry about diversion. And in some instances, there are protocols that must be followed in order to prevent it. In the US, some providers are prosecuted for prescriptive patterns that indicate diversion . One way to avoid suspicion is to prescribe in small quantities, the lowest effective dose, and least potent yet effective drug. Usually abusers are not interested in small quantities, and insist upon larger and larger amounts of pills, and/or higher and higher dosages.

Good luck to the OP.

Bodo

30

I have only had one migraine in my life, which was more than I would wish on anyone. Far, far, far worse pain than anything I could have imagined. Blind, puking, unable to touch ANYthing, skull far too small for contents, yeah, all that. Thank Ch*** I haven’t had another. I have immense compassion and sympathy for chronic sufferers. When people mention the word migraines, I sit up, pay attention, and do everything exactly as they ask as quickly and quietly as possible.

Thrice I have been in the mountains or really remote places with people who either got or had the warning signs they were about to get a migraine. Scary, scary stuff. Stop talking, get the medication fast, dim the lights, and combine caffeine with the drug to help the sufferer actually digest the medication. One of these times, we only had only 2 tablets. The first didn’t work, so the sufferer had to take the last one. I was (obviously) concerned about the possibility of another migraine and no drugs. That is a reason why the 8 at a time raises my eyebrows. They (the meds) are emergency first aid that need to be taken immediately. With something that important, I think an adequate backup supply is essential.