First, don't confuse it with an OTC migraine supplement called Migranol - they are not the same.

Migranal is not a pain medication. It is a migraine medication - a derivative of ergotomine, and while it works similarly to triptans, and has similar efficacy to Imitrex, there are different side effects, warnings, and potential drug interactions associated with it (some as long as 14 days apart):
http://www.healthcare.com/medication...asal-16497.php

You should get/have gotten a drug information sheet with the prescription; read it very carefully, and if you have any questions, consult your doctor or pharmacist.

I'm not finding the usual PubMed page on this medication; instead there is an archived drug label at:
http://dailymed.nlm.nih.gov/dailymed...archiveid=7093

The Wiki page is severely lacking, but I do find a MedLine page:
http://www.nlm.nih.gov/medlineplus/d...s/a603022.html

More can be found on the web; google: dihydroergotamine nasal spray

Doc

thank you so much for you help.. i have a new problem. i went to my pain management doctor today and told him how the surgeon recamended a different pain med for me since the vicodines stopped working. he told me that he doesnt do precscription drugs that he only does the shot into the spine. i thought this was rather odd. he tried to tell me that the surgeon passed me off to him. but what the surgeon told me was to finish my pain management then come back and see him when the doctor couldnt do anything more for me. well the pain man. doctor got mad at me. then i told him about this lump that has started at the base of my neck,.. he then toldme thats from the cortizone shots i was getting inmy lower lumbar and was too much to quickly and that he cant touch my neck till its gone.. then he said since your gonna go with surgery you mind as well do that instead and released me as his patient told me to get into the surgeon as quick as possible gave me a script for percocet 7.5 and told me he wont refill my script. he also told me he only does shots and doesnt handle the med portion of pain management.. is that what hes for i am so confused .. i thought pain management is what is says

Unfortunately, it can get complicated. Some approaches to pain management include prescribing pain medications and some do not. Those that don't are sometimes referred to as Interventional Pain Management (IPM).
There's nothing wrong with IPM. It's a good way to go at first, but it can also be confusing to patients who haven't received an adequate explanation of what's going on and why. It also seems a bit hypocritical to me that they won't prescribe pain medications, but they'll perform an invasive procedure and implant a pump that delivers the same medication.
(I'm avoiding the political issues here or I'll be up all night.)

The problem comes if/when the procedures that IPM doctors practice don't work for a patient (for whatever reason) and medication is the only avenue left. Instead of going that way, they just throw up their hands and... well... tell that patient left in pain to go someplace else. Cuss you very much (to those doctors).

It appears that you got caught between two doctors with different theories about pain management and the result was you got dumped. It happens. I'm guessing the guy didn't treat you all that well to begin with, but that's neither here nor there.

I think you need to call your neurologist/neurosurgeon (are they the same guy?) and let him and your PCP know what has happened. Your PCP may or may not take up the slack (prescribe) until you can research & decide about the surgery or find another pain management doc/clinic. I also think it would be a good idea to get copies of all your records, especially from the PM doctor.

If you want to pursue getting another PM doc/clinic, your other doctors may be able to help (recommend/refer you), or your insurance company may have some ideas (they have lists of the doctors who accept their insurance), or your local hospitals may have clinics, or there are articles and sites online that may help you in the search.
Google: finding a good pain management doctor

Whatever you decide, I think it's important that you move forward (I don't mean rushing into anything - develop a plan and pursue it) and let your doctors know that you are going to move forward. You may need time to do some homework and decide what the best course of action (surgery, no surgery, pain management) is for you. PLEASE don't rush into anything or let anyone bully you into anything you don't understand or are unsure about. You want to be as fully informed as possible; this is your body that you'll be in for the rest of your life - you want to do the right thing for it.

We'll be here.

Doc

I am unsere what to do .. if i should find another pain doctor or if i should just move ahead with the surgery. I do want to have my neck done i cant take the pain.. and i dont like being medicated. What does cervical fusion entail

Yes, I sense that. It's because you are unsure, in pain, and don't understand these procedures and options, that I suggest you consider undertaking some pain management long enough to:

1. Get your pain under enough control so you can comprehend, think, and decide clearly and rationally,
2. Learn about the procedure and all of your options,
3. If appropriate, research and choose the right doctors/surgeons, get multiple opinions, or research/explore other options.

That might take some time. (Weeks - Months?)

I'm not suggesting pain management/control as a permanent solution at this time; just as a stopgap to buy some time until you can get your wits about you, think about and devise a logical course/plan of action, and implement that plan. Most people cannot do that while in that much pain. I know I couldn't, and many doctors would agree.

If you undertake pain management and later decide that surgery would have been better, you can always have the surgery.

OTOH, if you undertake surgery and later decide or find out it was unnecessary or a mistake, that can NOT be undone, and you may have no other choice than to enter pain management on a more permanent basis.

If it were me, given the risks and outcome statistics of cervical surgical procedures, I would want to keep as many options open for as long as I can and learn as much as I can in order to make the best possible decision for myself.

You have definitely decided to go through with surgery without even knowing what it entails? Is that what you're saying or am I misunderstanding?

NOBODY in pain likes being medicated. NOBODY. However, it's the only way some people can function and have any quality of life at all, and it's the only way some people can think, evaluate, and make rational informed decisions. After your surgery, you're going to need some medication for post-surgical pain, and possibly for several months to a year after that, depending on how your healing goes. Possibly indefinitely. Surgery can fix what's physically wrong, but it may not fix damage to nerves or end the PAIN. That's an important question to ask the surgeon: "Will this operation definitely cure my pain?" If he says, "Yes." he's not being candid.

You can learn what cervical fusion entails far better than anything I could describe by googling: cervical fusion

There are a lot of variables, and possibly some options/alternatives, surgical and otherwise.

Doc

That is because there is a mutual disrespect between surgeons and PM docs. It's the rule, not the exception. And ironically, you will find that many PM docs will not issue scripts for narcotics opting for more invasive procedures. Get a new PM doc (unless you are HMO; could be difficult)...

I kind of got caught up in my own issues. I have my house on the market, and not much time to look up things. sorry if I let you down. after re-reading the post, I do know that you have mulitpal issues going on. There was only one place in your spine however, that seems severe. Can you go get another opinion? Because you trouble is so spread out, I am not sure that surgery would be a good option. May I ask where you live, and if really good neruosurgeons are around you?. PM me if you want. I will try to get back on line. ginnie

For sure you need a new pain management doctor. Not all doctors do just a shot in the spine. he should have recognized that you have problems in more than one area of your spine and had some more compassion. do find another pain doctor. He handed you off to the surgeon, and is trying to force you into surgery. My pain mangement did the same thing. he told me he couldn't help me anymore after Two injections. He sent me to my second neuro surgeon. I had the C3-7 done. I was FORCED to do the surgery, but even after that, I now have trouble and more pain. I am not having any more spinal fusions. I found a new pain specialist, and I am hoping that she will not hand me off to another surgeon for both my neck, and my ankles. Pain management does hand off to surgeons. Patients find themselves not wanting to do surgery, but have to in hopes of reduction of pain. I am not sure of anything anymore, and I worry about the same issues as you do. Please keep going to find new pain management, and don't get forced into surgery at all, unless you are confindent in your surgeon and the decisions that are made. This is way to important to be rushed into a situation, that may or may not help you. Keep in touch, I will be here as much as I can. I have second opinion tomorrow for ankles. My foot colapsed more or less. I do wish you all the best. Just keep going, and trying to get another pain doc. that has compassion. ginnie

i went to the surgeon today he is concerned my neck is too damaged to operate on. the are going to do a myeloscopy to see how bad the discs are and if he can actually do the surgery. could you tell me about this.

Hi, of course I am concerned about you. If your surgeon is really worried that you are too damaged to operate on, I can't see a point in doing that test. I avoid those kinds of tests like the plague, unless there was hope that the diagnosis would lead to helping you. It is a painful diagnositic test. Usually with the MRI they don't have to do this test. He is trying I suppose to see just how far your damage is, and if there is hope for surgical correction. Because you have mulitipal areas effected, I would choose pain control with the very best pain specialist you can find. Ask your surgeon why this particular test is so important to him, and what the purpose is, if he doesn't want to do surgery anyway. I am so sorry that you have this condition, and I do know how scarry it can be. Weigh all your options before you choose anything. Definately ask your surgeon about this test. I avoided the EMG and the test he wanted to do to you. My surgeon was able to get all he needed from the MRI. I had also had a CT scan at one point. Please let me know what you decide. I sure will support what ever decision you decide upon. Google up that test for a description, it will tell you very clearly, how the proceedure is done. You are in my prayers. ginnie