A Hospital Ward Dedicated Solely to Migraine Patients

I recently shared that at the end of last year, I was diagnosed with bacterial meningitis. This is an infection in my cerebral spinal fluid, which goes to the brain. I also had an abscess in my brain from the excess of fluid.

What was the experience like?

My symptoms started with an unbearable, earth-shattering, skull-crushing migraine and persisted to a high fever before I went to the hospital. It took 4 days to be correctly diagnosed and to start on the right treatment plan (heavy-duty antibiotics via IV 3 times a day), and I was in the hospital for nearly 3 weeks across 3 separate admissions.

The 8 weeks of IV antibiotics did help with the underlying infection and shrunk the abscess. But cognitively, I had a ways to go before I was back to myself when it came to listening, verbal processing, finding the right words, confusion, brain fog, and fatigue. Many of these symptoms overlap with migraine symptoms.

What did I try to get rid of my migraine?

To me, the more painful problem was the continuous, medication-resistant migraine I was experiencing (also known as continuous status migrainosus). I can't even tell you how many medications my neurologist and my migraine specialist worked to identify, prescribe, and get partially covered by insurance.

There were what seemed like weekly preventative migraine medications, and nearly every several days there was a change in my abortive medications. This is when I also tried an occipital nerve block. Unfortunately, it did not provide as much relief as we were hoping.

Regular emergency rooms and inpatient hospital staff often don't understand the complexity of chronic and continuous migraines. After 14 weeks of feeling this way, I decided it was time to escalate the situation to a headache clinic.

What did the headache clinic offer me?

The headache clinic I go to has an inpatient ward at a hospital in the city, about an hour from my house. The entire floor is migraine patient-friendly (dim lights and quiet). And the nurses were intimately familiar with all the different types of migraine medications, not just for my hospital stay but upon my discharge too.

When I decided to "check myself in," I was surprised to learn there were classes (migraine-specific, like how biofeedback can improve migraine pain) as well as group activities such as art and music therapy. For those interested, they also offered individualized medication therapy recommendations, psychological interventions, physical and activity therapy, patient education, meetings with staff pharmacists, medical detoxification, and alternative therapies. I loved the fact that all my providers could communicate daily and that it was easy to change abortive therapies when I needed more relief.

Which medication seemed the most promising?

The main reason I decided to go, however, was the potential of a new IV treatment (dihydroergotamine, or DHE) available in a monitored hospital setting. This medication is a migraine treatment that works by stopping the release of the natural substances in the brain that contribute to headache pain. In some studies, it has been effective in the treatment of migraine headaches and cluster headaches. DHE is a medication in a class of drugs called ergot alkaloids.^1,2

How did DHE work for me?

My protocol at the clinic was to dose 3 times a day for a total of 8 doses (almost 3 full days), and then to repeat the process if necessary. I found a little improvement after the first round of DHE. However, it was really hard on my GI tract, irritating my Crohn's disease. So, I decided not to pursue another round of treatment.

The team also used several abortive medications while I was there. They were able to prescribe a few of these as oral pills, and they have helped me maintain a tolerable level of migraine pain. It's now been about 2 months since my stay, and I'll tell you that the DHE did seem to break my migraine cycle – for which I'm extremely grateful.

Have you ever heard of an inpatient migraine hospital? Have you visited one? I'd love to hear your thoughts!