The Good, The Bad & The Ugly- Emergency Room Visits with a Migraine-Part 1

To a person who suffers from migraines, especially Chronic Migraines, like myself, a trip to the ER is a fairly common occurrence. Having had Migraines for over 30 years, I have experienced every range of visit from the Good, the Bad to the really, really Ugly! Unfortunately, the majority have not been very good. I choose to share some of my experiences, in hope to help others know that they are not alone, and also to share some ways we may be able to begin to find ways we can see more Good than Ugly.

Wheeled in by your husband or friend in a wheelchair because every step feels like an earthquake in your brain, sunglasses on and still the light is killing you, the drop of a pin sounding like someone dropped a tray of glasses, you check in. These people want to talk to you! TALK? REALLY? Your speech is slurred and it takes every effort to speak. Can you describe the pain? Ummm…. Hot pokers being pushed through my eyes! Jackhammer in my brain! Vice on my head! What is your level of pain on a scale of 1-10? You want to say 18 but know they will think you are over reacting.

Finally, back into a room, they take your blood, shine a light in your eyes, and want you to pee in a cup. (toxicology screen). Having done this for 30 years, you know what meds will usually break the cycle. Just FIX it you want to scream, but if you do, it will hurt your head!

The Ugly

In light of the latest Opioid “Freak Out” going on right now, and having no real diagnostic tool to SHOW a migraine is actually happening…  A migraineur shows up at the ER and the first thought on the ER staffs’ mind is that you are someone looking for a drug fix. That seems to especially hold true the younger you are as well. I have been told I knew too much about the medications required, I must just be looking for a fix! I have been left lying in a room for over an hour before any type of medication was administered, just to see if I really was serious. It took my husband getting upset at the ER Doctors to get them to act. Because of also having Parkinson’s, there is only one type of anti-nausea medication I can have and that is Zofran. After having repeatedly told staff this, we actually had a nurse try to dismiss this and give me another anti-nausea med. Every medication that is administered is now checked by my husband!

Just recently, we spent 22 hours (yes that is correct!) at the ER! 10 hours in waiting room/triage. At least the nurse was nice enough to allow me to come out of general waiting area to a quiet triage area. But, still, 10 hours with no food, no medication, and 1 bag of fluids. When we were finally called back to a “room” in the ER, it was more of a draped off area with a recliner, not a bed. You could hear EVERYTHING! Lights were glaring! I was miserable! No food or drink, as they assessed situation. They had my electronic records, they could see I have Status Migrainous – “The International Headache Society has classified Status Migraine as “A debilitating Migraine attack lasting for more than 72 hours.”

First treatment, Zofran, and Toradol. May as well have been shooting my IV with water. Another few hours down. Second round of treatment, Depakote &; Magnesium Sulfide and more fluids… Now if they had let me go with maybe a Morphine chaser and said “Go Home!” I may have been able to sleep it off, but they waited too long and we ended up back up level 10. So on to the last treatment, according to them, Ketamine drip. All in all, a very UGLY visit!

At best, you can hope to get out of the UGLY ER visit is a very long wait for medication and not the right kinds that will break the migraine cycle. You end up going home no better than you came, but you have a really special bracelet and a Band-Aid to show for your visit!

The Bad- (Well at least they tried)

I use the term BAD somewhat loosely here. At least they believe us we have a migraine! Some may not really believe our ability to actually function at a level 10 pain level, and that we are slightly exaggerating, but they are nice enough to keep the lights off in the room you are put into, unless they are doing something with you. We refer to these as the “Gee the Excedrin Migraine didn’t work?” attitudes. The problem with the “Bad” visits are that often times the ER has a single protocol for treating migraines and do not deviate from that protocol. This can be dangerous is someone is possibly having a stroke, or aneurysm or atypical migraine. Also one type of protocol does not always work for every person. I have found in these instances, general sympathetic ER staff, slight willingness to listen, but usually only a temporary relief to the migraine. It is like putting a Band-Aid on a sucking chest wound.

Part 2: Will look at The Good and ways we can get more Good visits!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

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  • Tamara
    1 year ago

    I’m lucky – so far ER I normally get seen by a doctor 2-3 hours (although the last one was 6 hours). But I have an amazing urgent care in my town where everyone knows me by name and look. There I get to lie down in a separate room, door closed, lights off – IV fluids and maxaran/toradol at the beginning and then will amp up with imitrex/zoning injections or morphine (also tried a few other things like lidocaine up the nostril, oxygen, etc). The one time nothing was working (day 6 of horrible pain and unable to keep much down – also took 10 tries to get an IV) I got transferred by ambulance to the ER and got in pretty much right away and was placed in this random hallway that was super dark – ended up admitted for 4 days.

    Last time I chose to call my mom and go to the ER because i had red flags – headache hit me out of no where ( I ALWAYS get prodome symptoms) – I actually fell to my knees it was so bad, I could have swore someone stabbed me in the eye. The pain also kept changing sides every 20 minutes which is ompletely new. And it was 5pm so urgent care is only open until 10 and I knew if it wasn’t listening to meds I would be sent home or the ER. Then I got to spend 6 hours in a busy noisy hallway …. got home at 3am. Did no testing what so ever, assumed it was a migraine and it did response to the usual – ketorolac and maxaran. The doctor came in and asked what I normally get so I told him and he ordered that.

    Soooo I will be going to urgent care first and then ER if necessary. But all in all I haven’t had that many bad experience. They just suck because it’s ER visit and yes we are not life threatening so we get pushed down the list. I do hate when it’s busy and they put you in chairs once you have seen the door. My migraine are caused partially by old whiplash injury so I need to recline at least to take the pressure off the ligaments – sitting makes it worse

    Sorry for the ramble, today is a bad pain day.

  • Macbeck
    1 year ago

    My worst ER visit (Only if urgent care is closed or I’m concerned it could be more serious than migraine) was really ugly. Dr’s argued with each other about who had to take me. When a provider finally came in to see me she said, “Well you’re not my patient but the other side refuses to see you.” What a great way to introduce yourself right??

    I have a “Migraine Treatment Protocol” book that states very clearly the combination of 3 meds that work to break my really bad migraines. She refused to even look at my protocol. Let me add that this is a NON-NARCOTIC protocol. She only gave me TWO of the three meds in my protocol, and I left with a diagnosis of “headache”.

    My best visit was to the urgent care. I got an older doc who truly listened and was interested in my protocol book. He did the exam he must do, apologized when he had to shine his light in my eyes, and asked enough questions to assure himself this was my “standard” severe migraine. He then checked to make sure they had the meds I needed per protocol and ordered the injections. I would also like to add he kept the lighting low as well as his voice.

  • ShakingthePainAway author
    1 year ago

    I really believe we need to advocate for greater education for ER doctors to understand the treatment of migraines! With the number of Migraineurs out there, this is so disturbing that we have evolved so little in the past 30 years of the time since my journey with migraines began!
    We should not suffer without an avenue for relief because there IS no avenue!

    Gretchen Church
    Author & Contributor~ Migraine.com

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