Do You Have Any Tips for a Respectful, Effective ER Visit?
Over the last few years of writing for migraine.com and engaging with you awesome community members, I’ve noticed something that I find so disheartening: it seems that many of you have been treated as drug seekers when you’re seeking proper care for your migraine, and that makes me so frustrated and angry.
Reapeatedly refusing morphine
My most recent migraine-related ER experience (which was more than three years ago, thank goodness) was sort of the opposite of what many of you describe. I repeatedly told the doctors and nurses that my pain wasn’t too bad (it was mainly the nausea, the migraine’s duration, and the dizziness that caused me to go to the ER in the first place—I thought they could interrupt what may have been status migrainosus). Despite my telling everyone that I did not want any morphine, it was brought to me three different times. I repeatedly refused and informed them that research suggests that morphine isn’t actually a good migraine treatment for ER care. When I was feeling better, I dropped by the checkout office and said, “I have a feeling I’m going to be charged for morphine, but I refused it multiple times and it was never administered to me. I just want to make sure it doesn’t appear on the bill.” The woman working assured me it’d be fine.
Guess what? I got the bill a couple of weeks later and—you got it!—morphine was on my bill. It took me months to fight it.
So many migraineurs in the ER are refused drugs that will actually help them, drugs they’re actually rightfully seeking under a specialist’s care. They’re treated as addicts, as seekers who will perhaps even fake a migraine in order to get high on drugs. Here I was in the total opposite situation. Even in my migraine-induced stupor, the irony wasn’t lost on me.
Feeling helpless at the ER
This is not to say I haven’t been treated as a drug seeker in the past. As a very well-informed migraine patient, I have to speak up for myself while being aware that the doctor(s) on duty may not welcome the input of someone without a medical degree. Thankfully, it’s been awhile since I’ve had a migraine that required emergency intervention, but I do feel a little helpless on that front. I have friends who are RNs and nurse practitioners who claim that even if I bring a note from my neurologist saying exactly what emergency treatment she recommends for my migraine, the ER doctors will ignore it. Perhaps they’re jaded, perhaps not. Unfortunately, the only way to test their theory is to get to the point where I need to head to the hospital, letter from my neurologist in hand.
This question is for those of you who have mastered the fine art of seekingmigraine treatment in the emergency room. How do you make sure you are treated with respect and integrity? For those of you who carry around a letter containing specific orders from your migraine specialist, how do hospital staff react to that letter? Do the doctors and caregivers give you the important care you deserve? Any tips you could share with me and our community about how to navigate the ER would be so helpful to us all.
How much has your migraine disease changed or evolved over time?