Walking into the ER with a Migraine (Part 1)
Last updated: October 2022
Let me set the scene for you.
It's day 5 of an earth-shattering migraine, and you're lost in the sea of emergency medicine and other abortive techniques you've collected over the years. You have only left your bed to use the restroom, the curtains have been drawn tight, the sounds reduced to silence, and yet all you can think about is the debilitating pain and nausea you're experiencing.
The focus is on migraine
Nothing can divert your attention because you can't look at anything, listen to anything, or be with anyone. Your thoughts are running rampant, you're desperate for relief, and what you have on hand isn't doing anything to improve your migraine.
What choice do you have?
Going to the emergency room
Last year, before switching to a migraine specialist who has a neurology infusion suite located inside their office, my only choice at the above moment was to walk into the emergency room for help.
Vulnerable during the pandemic
We were still very much in the height of COVID, so I had to go in alone. My husband dropped me at the door and wished me luck, and I knew that I needed more than that. As an autoimmune disease patient who is immunocompromised, I felt particularly vulnerable during this season, and exposing myself to the additional germs of an emergency room during the pandemic while struggling with an awful migraine caused some very real anxiety.
Overwhelmed and overstimulated
The harsh fluorescent lights overwhelmed me from the moment I opened the doors. Machines were beeping, radio buzzing, a commercial on the TV hanging on the wall, several people talking, and the phones ringing. I had to grab the wall beside me to steady myself. At that moment, I felt like I was going to crumble.
Sitting in the waiting room
I found my way to the desk up front, checked in, and sat down in the furthest corner of the waiting room I could find. I was wearing a baseball hat, and I kept my hand over my face to block out as much of the light as possible, but it was a lost cause.
The three hours I spent sitting in that spot were so much more agonizing than the five days I'd been locked in my bedroom - but I knew that the chance for relief still existed on the other side of those triage doors. So I waited. I cried silently, and I waited.
Explaining everything that was happening
When the nurse finally called me back, we came across the first challenge - getting vein access to insert an IV. Next, communicating the level of pain, the history of this migraine since its inception, and what I'd already tried at home felt like an eternity. Having someone else to advocate for me at this moment would've been immensely helpful.
Trying to break the cycle
Finally, we began the first set of recommended medications to break the migraine cycle - IV fluids, Benadryl, Reglan, and dexamethasone. When that didn't work, we tried Toradol. Finally, the doctor recommended ketamine. I was desperate for relief, and that last attempt allowed me to exhale for the first time in five days.
Is there a better way?
When I finally was discharged several hours later, I was exhausted. My ears were still vibrating from the post-migraine fallout, and my body felt like it had fought a war. The whole time, all I could think about was how there had to be a better way. There had to be a better place, a better scene, a more helpful option for migraine patients to get access to IV treatments.
Stay tuned for part 2!
In the second part of this article, I'll share a pleasantly contradicting experience of being treated in an infusion suite at my neurologist's office, and how I would never recommend a migraine patient walk into the ER unless it's the only choice they have.
Have others downplayed your migraine pain?