Wednesday, April 27, 2016

Migraines in Brazil

I posted before about visiting the clinic in Brazil to renew my migraine prescriptions - ones I had obtained in the States after fourteen years of visiting different doctors, neurologists, being poked and prodded, EKGs, MRIs, experimenting with different migraine medications (including an experimental pain killer that led to a very unsuccessful English literature discussion followed by a special one-on-one with my professor to justify my weird behavior oh boy). Anyway, after a two hour wait, I finally saw the doctor and was able to get my prescriptions renewed. Excellent, right!?

Except, when I went to the pharmacy to pick them up, I was told my three month prescription for anti-seizure medication would only be filled monthly and I would need to return to the doctor each month for a new prescription. They would also only fill it for one pill a day instead of the required two pills a day. Oh, and it cost R$26 for the 30 pills. So to actually fill my 60 pills a month, it would cost us $52.

The other prescription I take is Imitrex, which you might be familiar with. It's an abortive for when the migraines actually hit. The pharmacist told us there is no prescription needed for Imitrex in Brazil; it can be purchased over the country. Score! I couldn't believe how great it was that Brazilians could skip the medical circus the States require for an Imitrex prescription. When my US supply of Imitrex finally ran out and the next migraine hit, I set off to get some more of my miracle drug. Except, it wasn't available at the first three pharmacies I went to. At the fourth pharmacy, one I try to avoid because it's quite expensive (although ironically its slogan is "drogaria mais barata do Brasil" aka "the cheapest pharmacy in Brazil), I finally found it. I almost jumped over the counter and hugged the pharmacist, except you know, the lights were blinding me and the sounds were deafening  to me and I was dizzy and nauseous and all that accompanies a migraine. Give me your finest drugs, sir! "Sure, that will be R$26." Yikes, R$26 again. Well, whatever, I thought, I really can't survive without it. And then I saw the box. Dois cápsulas. I'm sorry, come again? Two pills for R$26. I politely declined and left, the sun blinding me on the walk home. Have I mentioned how god damn close to the sun we are?

Let me break this cost down for you guys. I need nine pills of Imitrex a month (R$117) and sixty pills of the anti-seizure medicine a month (R$52). That means to continue my medication, the medication that took fourteen years to identify as the right medication for me, it would cost us R$169 and include a minimum of a two hour clinical visit every month. That's more that my husband makes in a week and extremely our of our price range.

Two nights ago a migraine hit me with instant nausea and sickening pain. It felt like the front and back of my head were being compressed; the pressure was unbearable. One of my big issues with a migraine is that one side my neck becomes very tense and no position, sitting or lying down, will relieve the tension. So I spent the last two days lying on the ground, intermittently making sure the littlest expat was fed, changed, and entertained, and welcoming relief in any form. My husband suggested asking the pharmacist what they typically dole out to Brazilians and with that I picked up 12 pills of Migraliv for R$15 (and no prescription). I will say it has dulled the pain enough that I can function, but it's no substitute for my prescription. So the current verdict is for clinical care and classic OTC medicine (for fevers, pink eye, etc) Brazil takes the cake with their free visits and in-clinic pharmacy. For specialized medicine and treatments, the States has Brazil beat by a landslide.

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