I have been at these dark places with migraines that I have considered going to the ER. What are your personal guidelines for your decision to go to th ER.
For me, it's about length and severity. I've had a migraine that was a good 9 - 10 out of 10 for 3 days, and I went to the ER every day. Nothing I had at home was touching the pain. I've also had migraine symptoms that resemble strokes, so when I get one with symptoms that feel different than usual (wrong time of day, wrong side of the body, etc) I go to the ER. I'd rather play it safe.
Last summer, I had a migraine that was a constant 8 out of 10 for three months straight, but it took me about a month to decide to actually go to the ER. I was working with my neurologist to find something to stop the pain, and she was urging me to give each new medication a good trial, so I felt less inclined to seek "emergency" treatment. I was a crazy person by the time I decided to go in. I had been in constant pain for a month, could barely get out of bed, and I had already been through 5 or 6 meds that hadn't touched the pain...or made it worse! I need relief that day, or the next choice would have been asking to be admitted for a 72 hour hold. I would have said anything to get them to give me something to knock me out.
The problem with going to the ER for migraine relief is that they're pretty much told not to give you drugs. Migraines, while a clear medical condition, are un-quantifiable. There's no way for them to know if your pain is real. It's quite common for drug seekers to go to the ER for their next fix and claim to have a migraine. It sucks for those of us who actually have the condition and need treatment, because I'm almost always treated as drug seeking. That alone makes me hesitant to go to the ER, because when I'm in that much pain, the last thing I want is a freakin' interrogation.
It's the same with fibromyalgia. I think one of the other reasons so many doctors are reluctant to give us a big old dose of happy no pain stuff is because they worry about bounce back pain. Nothing worse than being pain free finally able to sleep and then waking yourself up crying because your pain breaks through even into your dreams. I would rather live with a headache that is an eight than have a bounce back that soars into the clouds way above a ten.
Here are some links that you might find helpful for deciding when and how to use your local emergency department:
Why does the ER treat me like a drug seeker? https://migraine.com/blog/why-does-the-emergency-department-treat-me-like-a-drug-seeker/
Tips and Tricks for a Successful ER visit: https://migraine.com/blog/tips-and-tricks-for-a-successful-emergency-department-visit/
Migraines from an ER doc's perspective: https://migraine.com/blog/migraines-from-an-er-doctor-perspective/
An ER Doctor’s Perspective: Strategies for Migraine Relief: https://migraine.com/blog/an-er-doctor-perspective-strategies-for-migraine-relief/
Migraine and the ER: A Follow-up Interview: https://migraine.com/blog/migraine-the-er-a-follow-up-interview/
Forms for the ER: https://migraine.com/blog/emergency-migraine-treatment-forms/
When to go to the ER: https://migraine.com/blog/when-doctor-er-for-migraine/
Never...no nit really. But my most recent trip was definitely a wasted trip. Six hours later and I still had a migraine, that got as bad as before by the time I got home. Bummer🙁