My next appointment with Dr. H. I told him in detail about my E.R. visit and reiterated that I had never really taken any heavy duty pain killers, except maybe while in the hospital. Trying a new approach, we agreed on continuing different preventives and using something less potent for breakthrough pain. He prescribed Depakote, which is used off label for migraine pain. Also Tramadol for breakthrough pain. I tried this regimine for a month, no relief, and horrible side effects from the Depakote. We tried Topamax, Cardizem, anti-seizure meds, anti-Parkinsons meds, and more that I can’t even remember. The Tramadol seemed to ease the pain somewhat, but I still needed a preventive. Dr. H. told me that the main difficulty in treating Chronic Migraine is that no two patients reacted the same to any one treatment. At this point, 6 months in, Dr. decided that preventives weren’t the way to go. We had tried every type available. You may be asking yourself why, by this time, I didn’t consider another doctor. I researched, in detail, as I tend to do, the doctors and treatment options available to me in my area. Pain management doctors were common, but most had horrible records of success. Some had legal action pending, and some were under review. My doctor specializes in Migraines, is a neurologist, which I prefer, and studied with the head of a prestigious clinic out West. They are still in contact and use many of the same methods. I asked my doctor what would happen if he ran out of options for me. He assured me that if that happened, he would refer me to his friends’ clinic for inpatient detox and treatment. At the time of this post, he still feels we have options not yet attempted. To continue, we tried nerve block injections to block the pain, which didn’t help at all. The next step was a long-acting extended release narcotic to try and keep the pain at an acceptable level, without spikes in which I would need the breakthrough meds. First one was Tramadol, since it seemed to help a bit and gave me little to no side effects. Turns out that Tramadol in my system 24/7 DID cause side effects. Onward, yet again.