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Dancing With The Devil (Read 31127 times)
The Mad Viking
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Dancing With The Devil
Nov 18th, 2008 at 4:22pm
 
Using Opiates Like Morphine to Treat Cluster Headaches

My history with morphine started some 5 years ago when I was forced to reduce my use of imitrex as an abortive for my cluster headaches.  It was becoming less and less effective, and top of that, I was having frequent attacks of chest pains due to angina as a result of a heart attack I suffered in 2001, when they implanted my first coronary artery stent.

My first line of defense up until then had always been O2 and up to seven imitrex injections a day, followed by a trip to the ER and morphine injections when that defense failed to stop the really bad attacks. The oxygen therapy available to me when I was first diagnosed was 7 to 9 liters/minute and although it worked for minor attacks while I was awake, that flow rate was useless when the attacks came at night while I was sleeping.  

Around a year and a half after I was diagnosed with cluster headaches, I was able to get the oxygen prescription changed to 15 liters/minute.  That proved to be slightly more effective during the day, but again, it was not effective in aborting the high Kip-scale night attacks.  On top of that, my cardiologist prescribed nitroglycerine for my angina attacks.  While the nitroglycerine was effective in reducing the chest pains, it was also an obvious trigger for more frequent cluster headache attacks and it made their onset even more rapid than they already were.

I didn’t know what to do so I finally asked my GP if I could try morphine injections at home because I just had to have something to take the edge off the pain of my cluster headache attacks.  I can remember my GP saying, “We have to be careful or we both could be in trouble.”  I felt the morphine injections “worked” as expected, but in reality, they only took the edge off the pain of my cluster headaches to make them more bearable and did nothing to abort the actual cluster headache attacks.  This treatment was neither good nor lasting, but at least I could function.  At that point, the morphine made me honestly feel I had control of my life again.   For the first time in years, I finally had a happy life again with my family, but the stage was set for a perfect storm and my dance with the devil had begun.  

In looking back with 20/20 hindsight and a clear head, I had become dependant on morphine in a matter of months after starting the injections.  Only Bente and my GP knew I was using morphine, but neither of them realized the extent I was using it to get through each day.  I had become a functional addict with a nearly unlimited supply of morphine.  In the beginning I was using one or two 1.5 ml morphine injections a day at 10mg/ml.  By the time I entered detox five years later, I was dosing with four to six 1.5 ml morphine injections a day at a concentration of 40mg/ml.

Shortly after I started the morphine injections, I suffered two more heart attacks in rapid succession over a five-month period.   At that point I was seeing my GP, my cardiologist, and my neurologist of over 20 years, but only my GP was aware of my involvement with morphine.

The sequence of events associated with each heart attack didn’t help.  What is the first that the EMTs give you when they respond to your call saying you’re having heart attack?  Morphine, even before they start checking you.  Then they take you to the ER at the hospital and what do they give you when you arrive in the ER?  Yes, more morphine.  And if they have to treat another higher priority case while you’re lying there, because you were not lucky enough to be first in line, they give you more morphine.

Then, when you wake up in the recovery room, what is the very first they give you?  Yes, more morphine.

And “lucky me”!  As a chronic cluster head, they gave me more morphine, several times a day.  Totally, up to 8 morphine injections a day.  While all this was happening, I still refused to admit even to myself, that I was addicted to morphine.

By the time I had suffered my third heart attack and had the third coronary stent implanted, I had become a master of disguise in hiding the fact that I was using morphine regularly each day from my friends and family.  I had also learned that if I ran out of morphine and the withdrawal symptoms started before I could get a refill, all I had to do was call the hospital and let them know I was having chest pains and the EMTs would deliver the morphine faster that the pizza man could deliver pizza.  At this point, not a day went by without morphine injections and each day revolved around them.  I had become a functional morphine user and was extremely adept at hiding that fact from everyone including myself.

I received excellent treatment at the two hospitals in USA when I was admitted for my fourth heart attack in July of this year, while staying with Pete and Joyce in Virginia following the conference in Dallas. Plaque had built up in the third stent I had been given to the point where arterial plaque was blocking 70% of the blood flow through my right coronary artery.  The before and after video the cardiologist sent me from the cath lab was sobering.  Although that heart attack was very real and very serious, I was still given morphine for my cluster headache attacks.

Throughout this five-year period, my cluster headache attacks continued, usually at a rate of 3 to 5 a day and some times higher.  During the 2007 Clustercompagniet Conference in Trondheim, Chuck made a presentation on the demand valve therapy he was using as a part of the pilot study Pete was running to determine it’s effectiveness.   Chuck’s description of this therapy was so convincing, I prevailed on our local oxygen supplier to loan me a demand valve system.  The demand valve and therapy Pete developed made a tremendous improvement in my ability to abort cluster headache attacks during the day, but some night attacks were still a problem.  Despite my claims to all about using oxygen as my first line of defense for my cluster headache attacks, it was morphine I reached for first when these attacks hit then the oxygen if I used it at all.

By the time Pete arrived in Oslo last September, I needed a morphine injection just to get to the airport to pick him up.  I even had to take a shot to be able to go to the store just to buy a pack of cigarettes.  That’s when it all started to unravel and the wheels began falling off my wagon.  I had run out of morphine the day Pete arrived, but was determined to make the trip to Haugesund without it.  I recall telling Pete the night before we left that I was afraid I had become addicted to morphine, but still clung to the story line that I only used it “as needed” for my cluster headaches.  I know that sounded like a good rationale to me, but it was clear from his comments, Pete wasn’t buying it.

Later that evening around 11 PM, the withdrawal pain had gotten severe and it became clear the trip to Haugesund would be impossible without morphine, so I called the hospital and told them I thought I was having another heart attack.  As usual, the EMTs arrived with the morphine injection and the withdrawal pains started to subside.  I received a second shot in the ambulance on the way to the hospital, and a third at the hospital while waiting for the cardiologist.  As the EKG revealed no sign of a heart attack, they assumed it was only angina and released me early the next morning.  The trip to Haugesund was uneventful, but after two nights staying with Ole Orre and his family in Sauda, I had again started into withdrawal.

By the time we arrived at the symposium site in Haugesund the next day, I realized what was happening and finally admitted to myself that I was no longer in control, the morphine was.  To make matters worse, on top of the withdrawal, I was sure I was having a nervous breakdown.  I begged a dear friend who suffers from migraines for anything that would help, and as it was clear I looked like death warmed over with a bad case of the shakes, she gave me six sobril and a couple valium tablets.  That helped calm my withdrawal symptoms enough so that I could at least perform my duties at the symposium as expected, but the cat was out of the bag, and there were now several people who knew just how badly I had become addicted to morphine.  

I took the opportunity to speak privately with Dr. Monstad about my problem with morphine while in Haugesund, but the combination of sobril and valium had masked my withdrawal symptoms so well, it must have been clear to him, there was no real sense of urgency.

Had I been smart, I would have called the pharmacy and told them to cancel the prescription, but NO – morphine was running what was left of my life. I did relatively well, while my dear friend Pete was with us after returning from Haugesund, but as soon as he left for the airport and his flight home, the very first thing I did was to go to the pharmacy to get even more morphine and started to shoot up again.

The next month was a rollercoaster of emotions marked with short euphoric highs from the morphine and bouts of depression every time I realized what had become of my life all spiced with moments of fear over the thought of going through detox.  I knew I had to do something.  After speaking with several of my closest friends who were aware of my addiction to morphine and who all said it was good that I wanted to go into detox, I scheduled an appointment with my GP in the hopes he would be able to have me admitted for detox.  

To my surprise, my GP passed me off to a pain specialist who I saw a few days later.  He sent me off with a prescription for oxycontin 80mg X 2+ cataflam 50mg X 3 to detox at home, but I had to wait for my disability check to arrive in order to buy the medications.  It seems that our method of social medicine here in Norway that is so good at collecting the tax to keep it running, and it will give you all the morphine you want, but once you become addicted to it, you’ve got to buy the detox medications out of pocket.

When I explained what was happening to Pete, Pål, and Oliver, they all told me in no uncertain terms, that this was NOT the way to detox, it cannot be done at home, and that I needed professional help by people skilled in working with people addicted to opiates through the entire detox process and follow up therapy.  They also called the pain specialist who had sent me home to detox “Dr. Feelgood” and quack, along with a few other names I can’t repeat.  What I didn’t know at the time was that these three were meeting on Skype at least twice a day along with Chuck and Michael to work out a plan of action to have me admitted to a proper detox facility.

They were right.  A few days after starting the detox process at home I was a physical and emotional train wreck in progress…  Somehow Pål managed to get hold of Dr. Monstad who agreed to see me the following day.   When I arrived at Dr. Monstad’s office I must have been a sad sight.  He took one look at me, shook his head in disbelief and said, “Jesus Christ, Svenn you really need help.”  The first thing he did, was write me a prescription for sobril and then he told me to stop taking the oxycontin and cataflam.  He also said he would have me admitted me to a detox facility as soon as a bed became available.  Three days later I was admitted for detox

The 2-week stay at the detox facility was something I would not wish on my worst enemy and I have learned my lessons.  As Pete kept most of you up to date on my status with daily SITREPS, I’ll spare you the details of my stay at the detox facility.  What I can say at this point is my recovery from morphine addiction is still in progress and likely to be so for some time to come.  Although I feel so much better physically, the memory of morphine still lingers.

There are several lessons to be learned from my story, but the most important is simple, opiates like morphine are NOT a medication for cluster headaches.  Obviously, in extreme cases, opiates like morphine, can be administered as a temporary intervention, but only under controlled conditions by competent medical professionals.  The frequency of cluster headache attacks and continued use of opiates as a method of intervention is a recipe for disaster with a very predictable end point.  Once your brain becomes dependant on opiates, words like control, strength, and will power are meaningless.  Your brain will make you do anything to get more.  I have promised myself NEVER again.

Opiates do NOT stop a cluster headache attack.  They only mask or take the edge off the pain.  

Oxygen therapy administered with a demand valve or with a non-rebreather mask at flow rates high enough to support hyperventilation is a very effective abortive if used early, properly, and there are no other medical conditions that interfere with it.  Oxygen therapy is also very safe and it can be used in conjunction with triptans to actually abort the cluster headache attack and stop the pain.

By telling my story I really hope you understand that opiates like morphine are not the medication for us, and not something you should play with.

Svenn


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« Last Edit: Nov 19th, 2008 at 10:41pm by The Mad Viking »  

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Re: Dancing With The Devil
Reply #1 - Nov 18th, 2008 at 4:25pm
 
Svenn,

Thanks...  I know that wasn't easy.  You've got a very powerful story a lot of folks need to read.

V/R, Batch
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Re: Dancing With The Devil
Reply #2 - Nov 18th, 2008 at 4:39pm
 
Wow Svenn! You have truly danced with the devil. I know all of our get tough, hang in there,  was meaningless at the time when morphine ruled your existence, but that was all that we knew to do, other than pray. I know your journey is not completed, but it appears that you have crested the top of the mountain and can now start the journey downhill. I think that it will be much easier walking.

Love you bro!
Jimi
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Re: Dancing With The Devil
Reply #3 - Nov 18th, 2008 at 4:46pm
 
I just want to give you the biggest Hug right now Svenn.  You are a very courageous man, and it's is a devine honor to know you, to know I have met you, and can call you friend.

Thanks again to Pete, Pal, and Oliver too.   Kiss
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Re: Dancing With The Devil
Reply #4 - Nov 18th, 2008 at 5:04pm
 
svenn:
i dont know you but we are brothers not only in ch but having danced with opiates myself.
my dance was with percocet and stadol , i thought most effective but they were only a trap. the dr's not knowing what to do pushed those and i was glad to get them.
after 4 years i was also faced with the fact of addiction. getting detoxed was an awful experience i wouldn't wish on an enemy.
now its imitrex and o2 with an occassional monster energy drink.
thank you for sharing it was tough i know but i can see your integrity and the tested man you are.
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Re: Dancing With The Devil
Reply #5 - Nov 18th, 2008 at 5:32pm
 
Thank you for telling your story Svenn.

I love you and you are so very important to me.  I just want you to know that.
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Re: Dancing With The Devil
Reply #6 - Nov 18th, 2008 at 5:42pm
 
I know that was a difficult story to tell, Svenn, but there will come a time when your story will save someone else here a great deal of pain.

Many thanks, brother, and welcome home.

All the best,

George
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Re: Dancing With The Devil
Reply #7 - Nov 18th, 2008 at 6:01pm
 
This is how it is and says it all.

Quote:
...each day revolved around them.



Sometimes it is not "wanting to" that can help overcome, the drug overrides that, but "wanting to" can be acquired. 

Quote:
...my recovery... is still in progress and likely to be so for some time to come.


You've very good friends to get you to this point, Svenn.

Stay very brave and don't hesitate to call another.  With you brother.
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Re: Dancing With The Devil
Reply #8 - Nov 18th, 2008 at 6:06pm
 
Good on ya my friend.

         Potter
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Re: Dancing With The Devil
Reply #9 - Nov 18th, 2008 at 7:02pm
 
Whew Svenn. I too know that was a tough thing to post but We're all proud that you've got a handle on this thing and know that it's a long struggle but manageable.

I didn't know the details until now but that post makes me even more glad to know you.

Hold on Svenn and thanks.

Charlie
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Re: Dancing With The Devil
Reply #10 - Nov 18th, 2008 at 7:12pm
 
Wow. Powerful is the correct word to describe that life story. I'm not sure if you had help (doesn't matter either way) with translation or not, but that was incredibly clear and cogent. Well Done!

Good luck as you go forward, my friend.
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Re: Dancing With The Devil
Reply #11 - Nov 18th, 2008 at 7:25pm
 
That was powerful Svenn and thank you for sharing it. You are one strong guy and I love you. Tell Bente I said you deserve a special massage for sharing that.  If it only helps one person on here .... well you know what I mean.

Love to you both and BIG HUGS from TEXAS

BD
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Re: Dancing With The Devil
Reply #12 - Nov 18th, 2008 at 7:43pm
 
Thank you for sharing your story Svenn.  Still sending prayers and vibes your way.
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Re: Dancing With The Devil
Reply #13 - Nov 18th, 2008 at 8:05pm
 
Dear Svenn:

Thank you for that testimony.  It's clear that opiates are a slippery slope to hell...

It must have taken a lot of guts to get through the detox and even more to tell your tale and withholding nothing from us.  Svenn, I wish you the best of the best and look forward to seeing you online.

Respectfully,

Ray
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Re: Dancing With The Devil
Reply #14 - Nov 18th, 2008 at 8:48pm
 
SmileyWe all stand with you my brother!!!
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« Last Edit: Nov 18th, 2008 at 8:49pm by N/A »  
 
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Re: Dancing With The Devil
Reply #15 - Nov 18th, 2008 at 8:57pm
 
Svenn, By now, you should know how very proud I am of you!
I know you are not done yet, but you have faced the very worst now....the only way is up!
I hope noone here ever needs your story, but I'm so glad you posted it.....I know that in itself was hard for you.
Some old clusterhead I know told me a time ago 'Life is good".......
I'm glad you concur..and now, ya grouchy old Viking, as we spoke, I am stuck up in your life forever..... you can't shake me out of it!!

I AM the big sister you never had.........and I loves ya, Bro!

Cathi Kiss
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Re: Dancing With The Devil
Reply #16 - Nov 18th, 2008 at 9:26pm
 
This message needs a sticky...  People and the Doctors that feed them opiates thinking they are the answer need to read this story.

Thanks for bareing your soul for the good of all Svenn.  I am proud to know you. 

Welcome to the rest of your life my friend.

-Dennis-
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Re: Dancing With The Devil
Reply #17 - Nov 18th, 2008 at 9:36pm
 
Svenn,  Smiley Smiley Smiley

Way to go!!! Cool Cool

B&A Smiley Smiley
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Re: Dancing With The Devil
Reply #18 - Nov 18th, 2008 at 11:09pm
 
Hi Svenn,

That was as powerful and compelling a confessional as I have ever seen. Your honesty is humbling. I don't think I could do that...and the writing, oh my...Dennis is WAY right, this really needs to be a sticky.

What you have done and said here is incredibly important for you...at least I suspect that (I don't really understand addictions, least of all my own) but I have no doubt you have saved lives with this.

AND...I thank God for your friends...you are a truly fortunate man to have been blessed with those like THAT!

You remain in my thoughts and prayers,

Best,

Jon
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Re: Dancing With The Devil
Reply #19 - Nov 18th, 2008 at 11:53pm
 
WOW

Powerful my friend; truly powerful.


I am indeed proud to call you my friend !!!!!!!!!!!! 

Again with this post, you continue to give help to others even in your time of struggle. Please know how much you're loved and an inspiration to many.


My thoughts, prayers and love remain with you friend.     Smiley
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Re: Dancing With The Devil
Reply #20 - Nov 19th, 2008 at 12:26am
 
Svenn my friend... thank you for taking the time to write this. I never for a moment doubt that you have what it takes to win the battle.

I am alarmed that they would prescribe oxycontin... my little town in western Pa has a huge problem with Oxycontin addiction. Be very very careful to not substitute a monkey with a gorilla.

with much love.. many prayers and

with warm regards,
Tony

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Re: Dancing With The Devil
Reply #21 - Nov 19th, 2008 at 8:57am
 
Svenn, as I have told you privately, and will tell you here publicly, I am SO proud of you, for grabbing a hold, and breaking this addiction!  Now, with this writing and publishing, I am even prouder still!

I am sure, anyone reading your sojourn through hell, will think twice before treading on this slippery slope!  I thank you for bearing your soul, in hopes of helping your fellow sufferer.  How just like you to do this.

Pete, Pål, Michael, Oliver and I are just glad that we could be there to lend the helping hand.  We spent a LOT of hours discussing how the best way to help you.  We were VERY glad that Pål was local, and spoke the language, and could get things done that the rest of us couldn't do.  He is a great person, and one that I am glad to know and have met in person.

All of us together could not do a thing, without your realization, and commitment to beating this.  You have done wonderfully, and we are SO proud of you.  We know the battle is not complete, but we are also very pleased with the progress you have made, and with our daily chats with you.  Yes you have your ups and downs, but, from what we see, there are far more ups, than downs.

And quit looking to the past, and the mistakes that were made.  Those are over and done with.  Learn from them, but don't dwell on them.  Look to the bright and wonderful future that you have.

Keep fighting the good fight, my friend.  Remember, you have many that are here for you, when needed, just as you have been there for us (me in particular) when we needed it.

Chuck
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Re: Dancing With The Devil
Reply #22 - Nov 19th, 2008 at 10:12am
 
Svenn,

thank you so much for sharing your story. I know it took guts to share it, as it took to fight against it, but I'm sure that it will help many others. I'm glad that you told your story.  Smiley Smiley Smiley

Sanna
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Re: Dancing With The Devil
Reply #23 - Nov 19th, 2008 at 1:53pm
 
  Yes, a very powerful testimonial that many need to read.

Thank you for your bravery in sharing this most difficult area of your life Svenn and in telling your story...quite possibly saving lives in the process.  

 You are to be commended.


Linda

edit to add:  Thank you DJ or Steph for locking this.
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« Last Edit: Nov 19th, 2008 at 2:06pm by Linda_Howell »  

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Re: Dancing With The Devil
Reply #24 - Nov 19th, 2008 at 5:17pm
 
Svenn, my brave Viking friend, we are so proud of you.
Your unselfish and well written post will save others from the hell you have lived for the past 5 years.  Of that I'm sure.

I know, from our conversations, how hard this struggle has been for you.  I commend you, sir, for a job well done.  Lesser men would not have fought the battle.

With Love & Respect,
Jackie
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