thomas jefferson headache center in phila,pa

Well, on that topic, the THC was prescribed at a low dose, to treat nausea. It didn't get me high and unfortunately it didn't help my nausea. My pothead roommates in my second year of college thought I should try smoking with them "to help my head" (I think they just wanted someone else to toke up with them). Anyway, I've done it a few times and it's never helped, though I've heard some people say otherwise.

hey ben  ashley again you might have told me before but how old are you?

                                                                           talk to you soon

Jenn,
By the way, when I was in the headache center today I asked the front office staff about "Dr. Gregg". They said that the only Dr. Gregg that they know about is Dr. Greg(g?) Gardener (or Gardner, I forget), who was a resident there. He no longer works there but he does have a job at Paoli Hospital on the main line. Make sure to avoid it :p

Ben

BeenTreated,
I believe that if you reread Ashley's post you'll see that her mother was not upset because Ashkan-a-z-i wanted her to stay, but instead that he was going to discharge her even though she had not reached their stated discharge goal of 0 pain. What makes you think that he has poor bedside manner or would be inappropriate?

Ben

hey ben, its ashley how are you doing. im always saying how my headaches are and i never ask you how your's are. what do you do all day.  i dont remember if you said you had to stop school and work at this time. are you in pain all the time. well i got home tuesday oct 30th. they sent me home with topamax,minocycline, naproxen,gabapentin,and magnesium. oh yeah ultram, which does nothing at all for the pain.when my doctor discharged me i was about a 1. got home and guess what the headaches started on wed 31th around 8:00 pm. took the ultram of course did nothing. so on thursday i called the headache clinic around 8:30 at night and my own doctor was on call. dr a-s-h-k-n-a-z-i. i waited about 45 min and he never called back. so i called again. he never called. really pissed me off. i think he tired of me and my mother. she is very out spoken and asks them alot of questions. he doesnt like that too much. now he the other thing. the day i was admitted my doctor was away for a week. dr mamura, i am pretty sure he is a fellow,because he is always with my doctor all the time,he must be training under him. well they knew i was on percocet. i was in bad shape the day they admitted me because of the pain. dr mamura called in dr young and they both agreed to admit me right then and there as long as i signed a contract not to go back to using percocet after i got home. they asked me where i was getting it and i told them my primary in n.j.   they also said that after i got out they wanted me back once a week because of my headaches being so bad and that they would give me a urine test, and if they found percocet that they would treat me for a month and then let me go. this dr mamura is a young pompus guy. dr young also said i would be let go. dr mamura said he would fire me.  that really pissed off my mom. she said fire her, I'll fire you. he is very intimidating. while i was in the hosp he heard me yelling a couple of times and freaking out. he thinks i need mental help and also thinks that when i get out of control that its not normal. me and my mom yell alot but we dont mean anything by it. he has heard me and her go at it. my mother told him that if he thought this was abnormal he should come up to jersey and see how my entire family is. she told him he would have us all committed. maybe because we are italian,but thats just the way we talk. to us its normal. i dont like him at all. so now its friday nov 2nd and my head is killing me. so i went to my primary and got a scrip for the percocet. i had to. im not taking as many as i was before which was 10 per day 10mg each. i know that wasnt good. so now i try to take them every 6hrs. maybe take ultram in between. im so pissed off. im supposed to go to jefferson this thursday 8th for the first office visit after the hosp stay. im going to put it off until after the 15th. my mom made an appointment in nyc at columbia headache center for the 15th. just want to run all this by another doctor. see if he has a problem with the percocet. how many does dr nahas prescribe for you? so that means if i go back to jefferson and they find percocet in me , well thats it for me. i dont think that fair at all . dr a-s-h-k-e-n-a-z-i had no problem with the percocet for the 8 months i have been with him, now all of a sudden he agrees with dr young and dr mamura about the percocet. and after him not returning my phone calls on the night he was on call really pissed me off. oh yeah another thing , if i did go on the 8th for the office visit i would be seeing a nurse prac. i found out that my doctor would be there. wonder why im not going to see him. all i hear from my doctor is the minocycline seems to be working. is that why he told me when i was in the hosp that it could take up to 4-6 weeks. one minute he says one thing and then the next minute its something else. i figure that if columbia is goung to treat me the same way, meaning treating my headache with the same meds,or moving on to other meds its a shorter distance and less money my parents are going thru. i will let you know how my visit at columbia goes. i just applied for ssi, but thats going to take awhile. so i will continue to take the meds my doctor put me on, until i see what happens at columbia. let me know how you are doing. my mom could ring my doctors neck.if he would have kept me there for two more days, after he took out the lidocaine drip and whatever else, he would have seen what happened. oh well talk to you soon

                                                                                 ashley

Hi Ashley,

Wow. It sounds like you've been through a lot recently; I'm sorry to hear that. From what you've posted I can see that you're justly frustrated with the treatment you received. Let me try to give some perspective about the things that happened though.

I don't know Dr. Ashke**** well but it seems like your main complaints with him is that he changed his mind and decided that you should not be on percocet (while previously allowing it) and hat he did not return your phone calls. I can't explain why he wouldn't call back. In the past when I've needed something when the office was closed I've sometimes been in touch with him. I would think that there was some reason you were unable to get in touch with him, although this definitely should not have been the case.

As for the percocet, I went through virtually the same thing you did. For the first 4 months or so that I saw Dr. Nahas she allowed me to keep taking the methadone that I was on before I began seeing her. However, as time progressed, she began to worry (rightly so) about the amount I was taking and the possibility that it was exacerbating my headaches. I was honestly taking way too much methadone at the time so she had good cause to worry. I mean no offense by this, but the dose you were taking before you were admitted (10x 10mg/day) would worry any headache specialist. So, like you, I was admitted into the hospital with the condition that I stop taking the narcotics that I was on. Unfortunately, after two weeks the hospital treatment did not work for me, but I was sent home on multiple new medications (with orders to not take pain medication).

It certainly sounds like the resident that was seeing you was very rude to you and your mother. However, despite his rudeness (which is never justified), many of the things he was saying, as much as you may not have liked them, sound relevant and important. Although he was wrong to criticize the way that you and your mother were communicating, he may have been thinking that many migraine sufferers are in psychological distress (I wouldn't hesitate to say MOST are, even) and worried that this may have been the case for you. Obviously he should not have said the things that he said however.

In regard to your upcoming follow-up appointment, it's not uncommon to see a nurse for a follow-up visit. However, as you said, both Dr. Young and Dr. Mamura said they would not continue to treat you if you continued to take percocet (though it seems like Dr. Mamura didn't say this in the most respectful way...). Believe me that I know how hard it can be to stop taking what you feel like is the only thing that can help you. However, when you were admitted, you agreed that if they treated you (which they did do for a considerable length of time, with some success) you would stop taking your percocet. Honestly, this was a reasonable request because, as I said before, taking that medication can make your headaches worse (and almost certainly will at that dose) and will inhibit other treatment attempts. While it may seem unfair that one or more of the doctors told you that you should not receive pain medication, even in the ER, they were right to say so. It's a terrible idea for anyone who is recovering from taking a lot of narcotics to take any, in any circumstance that is not life or death. While they can't stop you from doing so, they can and will refuse treatment if yo violate the conditions they set for your treatment . You won't find his to be different at any headache center that you go to.

So, looking at your options, it seems like you can continue to get percocet for your pain from your primary doctor or you can stop taking the medication and seek a more effective and less neurologically damaging solution at a headache clinic that has fa more resources and experience with headaches than any family doctor. Please remember that te only reason that I am allowed to take oxycodone by the JHC is because I stopped taking narcotic painkillers for more than a year to try many, many other treatments and medications. I never violated their reasonable (although very hard at times) conditions for treatment. So please don't look at my case and think that you should be treated in the exact same way, because we've down much different paths.

I truly understand how hard it is to be in the position that you're in. If you feel that JHC has treated you poorly then perhaps another headache center is the answer. But part of this answer must also be that you follow the instructions of the doctor who specializes in treating the problem that you face. If you ever want to be free of your headaches you must seek specialized treatment and follow their instructions. Again, there is no excuse for the way that Dr. Mamusa treated you from what you report, but if you were frustrated because the treatment wasn't going the way that you wanted it to try to understand how frustrated the docor treating you would be, hearing your frustration, being frustrated himself that things might not be working like they had hoped, but even more frustrated that you would not follow the instructions that they gave, which may have been the cause of the treatment failing in the first place.

Again, I'm sorry to hear what you've been through, but I hope you decide to reconsider your choice and also reconsider the advice of trained specialists.

Ashley,

I'll be the first to admit that I had a very difficult time dealing with the pain. Right after I got out of the hospital, I attempted to go back to school (which I had been out of for a year, even on the methadone). I didn't have very much success. I had signed up for 4 or 5 classes but I was only (barely) able to complete one. In the year and a half since I detoxed from the methadone and was treated in the hospital, I've only completed that one class. Also, I've applied for social security benefits as you said you have because I also cannot work. I spent a lot of time sitting around my apartment trying to deal with the pain. I put on a lot of weight (mostly from the medications I was trying). My legs were covered in puncture holes from IM medication injections. I was very depressed at times. It's very hard to handle such great pain gracefully and I know that I certainly didn't.

I very much wanted to be back on narcotic painkilling medications, but Dr. Nahas was trying dozens and dozens of different medications and treatments, each of which had the potential to greatly decrease or knockout my headaches. I wanted to be on the methadone (or something like it) because I wanted to feel better. But I also knew that I would be a lot healthier if I could find some solution that wouldn't make me dependent on narcotics and susceptible to their destructive side-effects. It turns out that we've tried almost everything that they know of that could treat my headaches. I'm taking the many medications that I'm on because they're the best solution we've found so far. I don't get the worst possible headaches as often as I would without the medication. Also, my mood is better than it was before I started taking Emsam. I do my best and keep trying other medications (even though I have been prescribed oxycodone at this point) because I do not want to have headaches for the rest of my life either. I know that narcotics won't help me toward that goal. So I'll keep trying every medication that I can in hopes that something will stop the headaches. Even now, knowing that I've tried almost all of the medications that JHC has available to it and not responded to them, I know I made the right choice in trying them before going back to just treating the symptoms with narcotics.

As far as the CRPS goes, it stands for Chronic Regional Pain Syndrome, also know as RSD, or Reflex Sympathetic Dystrophy (http://en.wikipedia.org/wiki/Complex_regional_pain_syndrome). It's a nerve disorder that I developed after sustaining a stress fracture to my heel and tearing my Achilles tendon playing basketball. The cause of the disorder is largely unknown, but I was in intense pain at the site of the injury and all the way up to the knee all of the time and extremely sensitive to any touch. I couldn't walk for nearly a year. I was treated with Elavil at the time and regularly saw a pain specialist who also gave me lumbar nerve blocks (I had to be put under for these as they were injections into the spine with very large needles). I was also very depressed at the time. Eventually I got better after about a year, for no apparent reason, but it was a tough thing to go through at 13 years old.

what was it that was causing her headaches? was thomas jefferson the ones that helped her? what did you daughter exactly have that was causing her headaches