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#1 loltex

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Posted 28 July 2013 - 07:12 PM

Hey guys,

 

My doctor has order an MSLT for me after having an overnight study that came back inconclusive. 

 

I've had severe migraines since I was around 10 years old. Over the years, I've found that the only things that even begins to touch the pain is smoking.

 

Of course this makes me nervous because I've heard that they often do a drug test in association with the MSLT to make sure that there are no drugs in your system that could make you sleepy. I've thought long and hard about telling my doctor about the migraines but had a bad experience with a neurologist in the past who refused to treat me after I told him the only way I knew how to control the pain. My current doctor is also somewhat straight-laced and again, I really worry about being dropped as a patient for a second time.

 

At this point, I've tried to stop altogether but there's always still the chance of getting another migraine and they make me want to blow my brains out the pain is so intense.

 

I've known I have N (with cataplexy, hallucinations, paralysis, all that jazz) for a couple years now and am desperate to get my life back.

 

My question is how many of you were drug tested when you went in for MSLT? Did anyone's come back positive?

 

Also wanted to say that this community has been a big help and has given me so much more hope than I use to have. Thank you guys. 



#2 jareblake

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Posted 28 July 2013 - 07:32 PM

I did have to take a drug test before my MSLT. Unfortunately, with the kinds of drugs that are prescribed for Narcolepsy (stimulants-xyrem) you will probably be hard pressed to find a Dr that will prescribe them to someone who uses illicit (I use that term loosely in your case) drugs. I'm sure smoking helps with your migrains but I can't imagine it helps with N. I certainly don't need anything else to make me tired.
Good luck.

#3 loltex

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Posted 28 July 2013 - 08:21 PM

Smoking helps only in the sense that it lets me pass out and gets rid of the nausea that comes with migraines. It was horrible when I realized that the only time I was fully awake was when I was having a migraine bad enough I considered going to the ER



#4 Hank

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Posted 28 July 2013 - 09:08 PM

I had a drug test as well before my MSLT.

Just out of curiosity, have you been formally diagnosed with migraines or is that your description of what you experience. I mention this because when I experience a severe sleep attack, I get nauseus with a brutal headache and hot flashes.

It is a good idea to be completely up front with your doctors. Your doctor may be reluctant to prescribe a controlled substance to a patient who has not been honest. I would think honesty is more important here than "self medicating",

#5 drago

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Posted 28 July 2013 - 10:46 PM

You can always ask what they'll be testing for. I recommend doing it BEFORE going to the sleep lab, where the technitions generally are uninformed about the tests run on urine samples. (One of the technitions that worked in the lab admitted to me that he didn't know exactly what they were testing for just "stuff that can make you drowsy." I couldn't tell if he was lying, but he told me without the test the entire MSLT/overnight test would be invalid.)

 

If your doctor doesn't want to answer your question about what's being testing for, just explain to him/her that you are concerned about your results. Certain drugs (smoked or otherwise) can remain in your system for a long time after you used them and the effects are gone, so the concerns are valid.

 

Also, always be honest with your doc about stuff that you ingest. Alcohol, smoking, etc. This includes prescriptoins that you get that you either don't use or have leftovers of and use later. For example, I was prescribed hydrocodone-acetemetophine for pain post-eye surgery. However, I only took a few pills and stopped, since the post-op wasn't that painful. I kept the leftovers, though, for a rainy day, which is a good thing, because I have a dying root (root canal!) toothache that wakes me up if I try to take anything less powerful at night. Technically, since the prescription was for pain post-op, and now I'm taking it for my dying tooth, it's considered "self medicating." It's important to tell your doc about this stuff because of drug interactions, side effects, etc.

 

You should tell your doctor that you've had a bad experience with another doctor (dropping you as a patient) before, and while you should definitely tell the doc about your migranes (because they could be related to your narcolepsy), do you have to connect the two? By that I mean, have you tried telling your doctor about the smoking without explaining WHY you do it? I only ask because many patients use recreational drugs, smoke cigarettes, drink too much alcohol, etc. and still receive treatment. If the doc asks, maybe you can elaborate, but the issue might be less what you do and more why you do it... If that makes sense.

 

For example, I drank two fingers of whiskey every night for two weeks so I could fall asleep -- for me, it was for my insomnia. When I told my neurologist that, she lectured me about how alcohol metabolizes and blah blah BLAH. Had I just said that I had an alcoholic beverage each day, she wouldn't have said anything -- again, it's not about what I was doing, it was why I was doing it.

 

Sorry you're having these issues. Is there some reason you're concerned about having a positive result turn up in your confidential medical records? I'm guessing that if you get a positive test for smoking that won't be bad if you disclose that you've smoked up front...

 

drago







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