It’s started as any normal headache. Aching in my forehead and temples, but then my left eye kicked in. I get migraines and when my left eye starts hurting and I get nauseated, I know what’s going to happen.
I usually have something at home for the migraine. Something for nausea, something for pain and until my by-pass surgery I had something specifically for migraines. Now I can’t take that. I took what I had and unfortunately it came back up. When this happens I have two choices. One is to try and make it through the pain and nausea. If you’ve ever had a migraine you know that’s not a choice. The other is a trip to the emergency room. I hate going to the emergency room because it’s like a crapshoot.
When you see an emergency room physician for a migraine there are usually three types. It has been my experience that since they can’t measure pain, they veer on the side of the least is best.
The first doctor will believe you are lying and only trying to get some pain medicine, so they do the least for you they can, in which case you spend an extra 3 to 4 hours in the Emergency Room while they experiment with different drugs to stop the migraine. Through the pain you can tell them what works, but that’s the worst mistake you can make. A lot of doctors don’t like to be told how to apply treatment, especially when it comes to administering a pain medicine. If you mention any medicine by name, you’ve lost the battle and your migraine will just get worse while you are in one of the most stressful places you can be.
The second doctor is more sympathetic and want’s to know all about it. That doctor will listen to you and find out what works. Sometimes I think there are two types of this doctor also. One does care and wants to help relieve your symptoms as soon as possible. The other just wants to get you out of the Emergency Room to lighten their patient load or make room for other patients.
The third doctor just doesn’t care and you can hurt forever. This type of doctor will give you ibuprofen and send you straight home.
Anyway, with the last migraine I had to take the second choice and go to the Emergency Room. This is a brief story of what a bad emergency room visit can be like.
When the pain starts to become unbearable I have my brother drive me the 35 miles to an Emergency Room. During the drive my blood pressure and heartbeat are high. With each heartbeat my left eye feels like an ice pick is being stabbed into it and the left side of my head pounds. I’m past reasonable thought. I’m starting to panic because the pain is so bad and getting worse. I hold my breath and strain. This gives just a little bit of relief, but it’s better than nothing. I have a small trashcan in the car with me because of the nausea and vomiting. By this time I’m just dry heaving and actually I look forward to this. Each time my body convulses from the nausea there is a second of freedom from the pain. Now and then I hit my head against the car window. That also brings a second of relief. That one-second is all I can think about.
Of the three major hospitals in the city, I use one where my doctor works. This time the parking lot is full and I know besides the one to three hours I will be in treatment; there will be an additional one to two hours to get into the treatment room. So my brother drives me to another hospital’s Emergency Room.
We go to the second hospital and actually get in fairly fast, about forty five minutes. Once inside I wait another 30 minutes until the doctor comes in. He begins by asking me what’s wrong and whom have I seen for this before. I give him the name of my doctor and the hospital he works at. He asks why I didn’t go to that hospital and I told him about the ER parking lot being full. All of a sudden I know I have the first type of doctor. He tells me he’s going to call the other hospital’s ER. I don’t care what he does just as long as he stops the pain and the nausea. I can’t hear him call the other ER, but I do hear him later talking to someone outside the room. All I can make out is “This guy with the headache.” A nurse finally comes in and takes my blood pressure and pulse and it’s very high. The doctor comes back and starts talking to me. By this time I can barely understand what he’s saying. I’m in a world of pain. The doctor’s voice, the noise of people outside the room, the light in the room are overwhelming. I catch high blood pressure and I tell him it always shoots high when I have a migraine. That once the pain is gone, the blood pressure will go down. He leaves.
A nurse comes in later with a syringe and gives me a shot. I ask him what it is. I just made a mistake! If you ask what treatment you are being giving it solidifies in their minds you are seeking something other than pain relief. The nurse tells me it is a narcotic and something for nausea. I don’t really care what they give me as long as it stops the pain.
Thirty minutes later the nurse comes back and asks how I feel. When you have a migraine it’s about pain reduction. I tell him my headache is still where it was and I’m still nauseated. He takes my blood pressure again and it has jumped up 20 points on the top and bottom numbers. He leaves. He comes back later and gives me three pills. One is for blood pressure and two are for nausea. By this time I’ve been in the ER for over three hours. In that time my migraine is getting worse. The nurse asks me what is usually done and I tell him once the pain is under control, I’m given something for sleep to take as soon as I get home and something for pain for later. I just made another mistake! The doctor is already treating me like a drug addict. I shouldn’t have said anything. The nurse comes back after another 20-30 minutes and gives me prescriptions for sleeping pills, a sedative combined with Tylenol, and pills and suppositories for nausea. I still have no relief from the pain. The nausea is better. It after 10:30 pm and my brother and I leave and go to a pharmacy to fill the prescriptions. I take one of each pill hoping to stop the pain. On the drive home I can only rock back and forth from the pain.
We arrive at home and I go to my bedroom, sit, and rock. I can’t lie down because it hurts worse. That one-second is all I want. The sleeping pill doesn’t put me to sleep and the sedative with the Tylenol doesn’t stop the pain. I have another full day of pain and nausea and in that day all I want is just one second.
After having migraines for over twenty years you learn about ER visits. There are certain things you expect, don’t expect and that are a total surprise. There are certain things you do and don’t do.
These are some observations:
- A migraine is pure unadulterated pain. There is nothing brave or noble about trying to take the pain. If an avenue of pain relief is open to you – take it!
- An ER migraine visit is a crapshoot. You might leave the ER in less pain or much worse pain.
- You never go to the ER when your migraine is just starting. Unless you are in obvious distress most doctors will be very skeptical of you when you are in low to moderate pain.
- Most doctors and nurses are there to help seriously ill or life threatened patients. Most of the time your migraine will be viewed as minor compared to other people’s ailments. Be prepared to wait and make no demands.
- You can’t take your treatment into your own hand or suggest any treatment. You’re at the mercy of the medical establishment.
- You can’t ask what treatment you are being given. This adds to the doctor’s skepticism and that will temper any further treatment they give you.
- If your doctor wants to experiment with different medicines, agree. You might get lucky and one works. If not, by disagreeing or telling them you’ve tried it before and it didn’t work, the skepticism factor goes up. Know during this experimentation that the pain will get worse.
- Whenever you go to an ER with a migraine don’t take for granted that everyone there will want to help you. To some ER workers you are just another body.
- If you have a doctor that treats you like a drug addict or simply doesn’t care, get out of the ER as soon as possible. You’re in a very tense place and you don’t need anyone’s arrogance or antagonism. You need a quite relaxing place. Get home ASAP.
- As with most migraines there’s no telling when they will strike. If you have a choice go to your regular doctor. They treat and have been treating you for this. They have the drill down and you save yourself from much more pain. If you have no choice, go to the ER. You might end up with the same bad doctor, but at least you have a chance of another doctor being on duty that might be sympathetic.
- First and last understand that you don’t have the luxury of finding another doctor or another treatment. You are stuck with what you were given. At the worst, be prepared to suffer longer and more intensely. At the best, you will be treated by caring individuals who will undertake to quickly relieve your pain.