[embodiment] !!!
Dec. 2nd, 2023 11:17 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
kaberettRealisation while wrangling laundry, presented as a series of facts:
- I have both migraine and endometriosis
- migraine means that I am limited to 6 days (or 8 if I push it and am willing to stare down my migraine team) of painkillers (which includes paracetamol, NSAIDs and codeine, as well as triptans) per month
- a thing that Mostly works to head off incipient breakthrough migraines is The Frovatriptan Protocol, which consists of frovatriptan + mefenamic acid (an NSAID) + paracetamol (optionally) + (in my case) prochlorperazine (definitely)
- each time I use The Frovatriptan Protocol I use up one (1) of my Six (6) Days Per Month
- migraine is. not. my only source of chronic pain.
- but I'd rather deal with endometriosis- and joint- etc etc etc-related pain than migraine fuckery, so I am currently significantly undermedicating my non-migraine pain
- BUT
- ON THE 14TH OF SEPTEMBER, NICE APPROVED RIMEGEPANT FOR ACUTE USE
- rimegepant, as the name suggests, is not a triptan -- it is a gepant
- this is a class of drug that works on the same basis as the stabs I'm currently using and responding generally pretty well to -- it targets CGRP signalling/pathways/thingy
- crucially, it has been conclusively demonstrated in clinical trials that this medication DOES NOT contribute to so-called medication overuse headache, so taking rimegepant does not count toward the six-day budget
- my next headache clinic appointment is on the 18th of December
- which is more than 3 months after the NICE approval was issued
- so I will theoretically be able to switch from The Frovatriptan Protocol to rimegepant, thereby freeing up all my six-day painkiller budget for managing non-migraine pain
AT WHICH POINT I might even be happy cancelling my pain clinic referral? We'll see.
(no subject)
Date: 2023-12-02 11:18 am (UTC)why yes I have spent the last two days not medicating period pain, why do you ask
(no subject)
Date: 2023-12-02 11:21 am (UTC)Ooh, that sounds hopeful!
(no subject)
Date: 2023-12-02 11:32 am (UTC)If they're willing to switch me over from galcanezumab to rimegepant wholesale that would be even better, but even this swap has the potential to make a massive improvement in my quality of life!
(no subject)
Date: 2023-12-02 11:44 am (UTC)I'm sorry, did I just read that your migraine team doesn't allow you to take paracetamol, or any other painkiller, on more than 6-8 days per month?
That's just. *helpless fury*
I hope you get your painkiller budget back.
(no subject)
Date: 2023-12-02 02:05 pm (UTC)This is in fact a standard migraine thing, yes - a lot of preventives won't be prescribed unless you've been down to that level of usage for at least three months, because headache genuinely is weird in that for a significant proportion of the population (by which I mean "somewhere around 50%, depending on the study") taking more painkillers than that really does both make pain worse and render at least some preventive treatments less effective.
Pretty sure that's not a factor in my case! But them's the rules of the game I'm playing, and yeah, it is... not great.
(no subject)
Date: 2023-12-02 12:30 pm (UTC)https://www.bbc.co.uk/sounds/play/w3ct4wdw
[I’m a big fan of The Inquriy which discusses everything from big up-to-the-minute international affairs stuff, important background science and environmental themes to more esoteric topics like “Will the Dali Lama reincarnate?” And because it’s aimed at people who often have English as a second language it’s good at explaining terms etc without treating its audience as stupid.]
(no subject)
Date: 2023-12-02 02:20 pm (UTC)(no subject)
Date: 2023-12-02 04:02 pm (UTC)(no subject)
Date: 2023-12-02 04:13 pm (UTC)But the new thing does sound hopeful. Good luck!
(no subject)
Date: 2023-12-02 06:25 pm (UTC)I was mostly already expecting the pain clinic to just say "yup, sucks to be you", given the constraints, and probably to have not spotted this option themselves (notwithstanding the doctor I appear tohave, er, got moved to them from the headache service...). But! We shall see. I don't even have an appointment date yet...
(no subject)
Date: 2023-12-02 05:11 pm (UTC)(no subject)
Date: 2023-12-02 06:18 pm (UTC)(no subject)
Date: 2023-12-02 07:33 pm (UTC)(no subject)
Date: 2023-12-02 08:03 pm (UTC)(no subject)
Date: 2023-12-02 08:11 pm (UTC)(no subject)
Date: 2023-12-02 11:21 pm (UTC)though, tbh, I'd cover my ass and keep the referral anyways.
(no subject)
Date: 2023-12-03 12:39 am (UTC)Possibilities abound!
(no subject)
Date: 2023-12-03 08:48 pm (UTC)So I hope that your appointment goes well and they allow you to switch!
(no subject)
Date: 2023-12-03 09:27 pm (UTC)