My Pain Plan

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From back to front –

white tablets = paracetamol – red capsules = ibuprofen – orange tablets = aspirin

As someone who has suffered from Migraines for as long as I can recall, it is super important to me that I have a good pain management plan..

When I was younger it was actually easier to get the stronger drugs like Panadeine Forte than it is now. Because of that ease I would tend to default to the strongest drug I had as soon as I got the headache. These days, there are two problems with the plan of take the strongest drug I happen to own.

1. The more often you take a strong drug, the less effective it tends to be.

2. I want to save those now more difficult to get stronger drugs for occasions when I truly need them.

Nowadays, if I take two Panadeine Forte, within about 30 minutes, I can’t feel my head, arms or legs at all. It is like I am a torso floating on a fluffy cloud. That state of being is not especially conducive to getting shiznit done. :) But it does certainly get rid of the headache quite effectively.

Believe me, actually trying to do anything in that torso floating on a cloud state will result in An Incident Occuring. It is bad enough trying to coordinate a walk to the bathroom, let alone doing anything useful.

My doctor and I sat down a couple of years ago to work out a new plan, and I was surprised to find out that this plan works for me. Here’s what I do now when I feel a headache coming on.

Stage 1

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I begin by taking paracetamol and ibuprofen together but it *must* be taken with a cup of strong tea (two teabags of Australian Afternoon) or coffee, and a block of dark chocolate. I like 70% plus and find it to be more effective.

Chocolate always makes me feel better but the caffeine in the tea or coffee and chocolate helps the drugs to work faster. That is why they sell panadol with caffeine though it is obscenely expensive at around $8.99 for 40 tablets so I prefer to keep that purely for my handbag and emergencies when I could not get a cup of caffeine to go with my tablets.

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If it feels like it is going to be a bad headache I will take three kinds of tablets together – paracetamol, ibuprofen and aspirin but I usually take the paracetamol first with coffee/tea and make sure to have eaten at least a bowl of cereal before taking the other drugs. This is because two of the three drugs are not good on an empty stomach.

I can tell the difference between a headache that requires two drugs vs one that requires three drugs. The worst headache I tend to get is a hormone related migraine and that is always a three drug headache. Those headaches always appear on a specific day and so I know approximately when to expect them.

Three drug headaches are usually once a month happenings at most and they start from the moment I wake up, which is the reason for the cereal.

I’ll then wait to see what happens – if the headache goes away, epic win. If not, it is time for..

Stage 2

If the headache does not go away, I need to start thinking about what might be causing it. The two main causes for me are sinus and hormones. If it is sinus, I might try a couple of cold and flu tablets next but I need to wait at least 4 hours as those have paracetamol in them as well as pseudo-ephedrine and codeine phosphate.

If it is hormones, then it is time to bring out the big guns – I have 3 choices at this point.

1. A headache tablet with some codeine phosphate eg Nurofen Plus or Mersyndol Forte. This will be the choice if the headache is not too bad. However if we have got to this point chances are the headache is pretty bad and these drugs won’t help much.

2. Panadeine Forte which is paracetamol with a stronger codeine phosphate. Taking this drug means it is bedtime, at least for a couple of hours, because it does tend to knock me out or at least make me feel like I am floating with no arms and legs attached.

3. A Maxalt Wafer. These are not cheap at $11 per wafer. However they do work fast and if I am feeling any nausea this is a good option because it melts under the tongue and I don’t have to worry about keeping the drugs I took down. These do work very well for me, but they are a last resort due to their price tag.

Stage 3

Getting to this stage is pretty rare but it does happen from time to time – if a headache is not resolved by stages one and two, then I need to get a shot from a doctor or to head off to hospital. It has been a long time since this stage was needed thanks to the careful pain planning my doctor and I worked out together. :)

Nausea

When I was growing up, from age 15-17 I had nausea and dizziness on a daily basis for a couple of years. It was dreadful and we are still not sure what caused that, though there is a suspicion it may have been hormonal. I lived on Stemetil for those two years which is an anti-nausea drug.

Now the drug of choice for nausea is Maxolon. It is rare that I have to use them now. In fact it has been a couple of years since I last got a script for it, but I just used up my last tablet and I have a doctors appointment this week, so I will be asking for a new script.

Ocular Migraines

Have you ever had a kaleidoscope appear in your field of vision? I have. It is Not Optimal at all. It makes it impossible to read, drive, watch tv, basically, to see in general. These are called an Ocular Migraine – once again we have zero idea what causes this for me.

About 45 minutes after the kaleidoscope arrives, the headache sets in. And this is a terrible headache, a Panadeine Forte right off the bat headache.

However, the happy news is, after many experiences and trying out different things I have made a discovery. If I take paracetamol and ibuprofen with coffee or tea and chocolate at the moment the kaleidoscope appears, the headache does not arrive anymore. I have to go and lie down with a flannel over my eyes until the kaleidoscope goes away, but that is nothing compared to having to suffer through the headache that would always arrive.

Over to you –

How do you manage pain?

Do you suffer from migraines at all?

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8 thoughts on “My Pain Plan

  1. No migraines here, in fact, it’s rare that I get headaches at all. (grateful for that because I have never heard of most of these meds) Unless I have tweaked my back (which I did in December because of the dumb tree), I don’t take any pain medications at all. It is great that you have this plan with back ups so you don’t have to suffer as much as you did in the past.

  2. I had “migraine-like” headaches in college, which were most likely stress related. IIRC, they were best served with ibuprofen and a dark room. I sometimes get a quite bad headache but it’s not a migraine, for which I’m grateful.

    But I know what you mean about having a plan for pain management. There is only one opioid, a synthetic, that I can take without getting sick. So I take as little as possible and I probably have a pretty high tolerance for it. There are nights that I really wish for a stronger drug. I’m off my fibro meds at the moment (they took me off in the hospital) and I may or may not have had a reaction when we tried to add them back in. Will talk to the pain doc next month.

    Oh, I do have ocular migraines. Lucky me, they are the pain-free kind. They don’t presage a regular migraine for me, or even a headache, and I’m told that they don’t usually do so. I’m so sorry that they apparently trigger (or something) your migraines.

  3. I get the occasional migraine, but they’re much more rare now that I’m not working. The most common cause is an untreated sinus headache, hayfever based and was most often from having to work at a checkout near the flowers stand when the oriental lilies were blooming. If the buds were still closed, I was fine.
    These days I take antihistamine when a hayfever headache starts so the migraines rarely eventuate. When they do, I eat a sandwich, have a coffee and two of the “Chemist’s Own” brand of panadol/codeine, it’s the same as Panadeine, but cheaper. Then I go to bed and sleep it off.
    I’ve read in the papers here that because of codeine abuse, any tablets containing codeine may be moved to prescription only :( That won’t work well for us migraine sufferers.

  4. I do get a lot of migraines, or rather I DID. I take Pizotifen daily to keep the buggers at bay and they’re a life saver. I still get the occasional migraine and it’s usually brought on about by stress or exertion. The worst one in recent times was when I got a headache and thought I’d be fine to do a punishing yoga routine at home. Uh no, doofus!. Cue 3 days in bed trying desperately not to vomit all over myself. Sleeping for 15 hours a day is kinda fun though, just not the hideous nausea.

    If I feel a bad headache coming on (start to feel light/noise sensitive, nauseous etc) I lay a cool flannel on my forehead and lay down in a cool, dark room with my eyes shut. No phone, no tv on in the room, nada. I can sometimes avert a migraine if I listen to my body and act in time. If I ignore my body, I’m going to be in a world of pain. Coconut water seems to help stave a migraine off too.

  5. I used to have migraines a lot. It seems like when I got pregnant they got better. I would end up going in for a shot because they would get so bad. Maxalt is wonderful! I used to take Imitrex and it worked but for about 30 minutes after taking one I would actually feel worse. If I am at home I take Percogesic when I feel a bad headache coming on. It is over the counter but it does make you sleepy so I try to only take it at home.

  6. My pain plan is out the window now, I need to reassess and regroup. I have the Maxalt wafers now, haven’t tried them yet.

  7. Hello,
    That’s good you have a plan for treating your migraines.

    I have migraine headaches too. Recently it does happen frequently. In some cases I can find the causes for that but unfortunately 90% of my migraines attacks are starting at midnight so I don’t have any idea what is the cause of that.

    When my migraine starts I’m taking 2 Panadol Extra if the pain is not relief I am taking another 2 panadol extra after 4 hours or 2 Aspirin (aspero) and again if I didn’t get rid of the pain I am taking one Maxlat wafer and definitely it gets better in half an hour. (At 50% of cases it gets better with panadol or aspero).

    The question that I have and I can’t find answer for that is; is this correct to take 2000 mg of those pain killers and then take Maxalt or it is better to take Maxalt once the migraine starts. which one is better?! the reason for taking 4 tablets before Maxalt is that to prevent over-use of Maxlat. Before Maxalt I was using Relpax and I ended up with headaches of over-using it so that’s the reason for trying panadol and asprin befor taking Maxalt.

    • I would recommend speaking with your doctor, re this. My pain plan is simply that – mine, which my doctor and I sat down and figured out together.

      Are you getting enough water each day? :)

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