Migraine

Hi, I went into the ER this afternoon and it was an absolutely horrible experience. I feel confused, angry, and still in some pain. I was given dilaudid, benedryl, solu-medrol, and toradol. When I told the dr that I still wasn't feeling much better and that this has been going on for more that 2 weeks he told me that he doesn't believe that I have a true migraine. He told me that if I had a true migraine it would have gone away with toradol, compazine, and reglan. I had also told him that the only way my last 3 week migraine went away was being admitted into the hospital and given a hefty dose of steriods. I feel so confused are my migraine's really supposed to go away with those drugs? I have never been able to get relief from them since I was a teen. He made reglan seem like it was the cure-all, takes away nausea and controls the migraine. I was just wondering what everyone's input was. Thanks for looking.
Paula

Hi Paula, I am so sorry to hear you are still stuck with this migraine, and had a crummy ER experience to boot.

First let me tell you: any doctor that tries to diagnose a migraine based on its responsiveness (or unresponsiveness) to drugs doesn't know what they're talking about! So no, you are NOT crazy - just because that drug cocktail doesn't work for you doesn't mean you don't have a true migraine!

(There is one exception, which is hemicrania continua, a rare type of headache that is diagnosed partially based on its responsiveness to indomethacin, but this is the ONLY type of headache. Migraines are not diagnosed in this way!)

Reglan is definitely not a wonder drug for everyone. In IV form it gives me terrible anxiety and wooziness. Doesn't help my pain, either.

Paula, please don't let this doctor get to you. ER docs are not migraine specialists by any stretch of the imagination, and unfortunately for us, ERs are often a very frustrating place to try to get properly taken care of.

Can you just remind me - have you talked to your doctor about this ongoing migraine? Has he had any suggestions for you?

I wish you the best. I do hope you can get this migraine taken care of soon. Hang in there and don't let this ER turkey get to you.

I am so sorry about how your ER visit turned out, Paula. As MJ said, please don't let this doctor's attitude convince you that you don't know what you are talking about in your own body.

As soon as you feel you can discuss the event in a calm manner, you might contact someone at the hospital to make a complaint. This person might be an ER supervisor, or some type of patient advocate in the hospital; each hospital handles things a little differently. Letting someone know what happened--in a courteous, calm, but assertive manner--could help the next person who has to go to that ER with a migraine.

Have you discussed emergency procedures with your own doctor? Here are some forms which you and your doctor can fill out, which may make things simpler if you ever have to go to the ER with a migraine again:

Emergency Migraine and Headache Care - Forms To Help

Take care of yourself, and keep trying to get this migraine broken. Don't let this experience stop you from doing what you need to do for your own health.

I agree that you were treated by your extremely badly by that ER physician. And I agree that you should call Patient Affairs and file a complaint regarding his disregard for your needs and obvious inadequate education regarding migraines in general.

However, that being said, I would like to share my own very recent experience with you. I had an unusual migraine (I was unable to communicate clearly/much at all). Because of this different facet and because I was unable to abort with Zomig NS or sleep off with Alprazolam 1 mg., my husband took me to the ER. When we arrived we explained that this migraine was UNUSUAL and while not an 8 to 10, it was behaving weird. Dr Arrogant immediately said "I don't give pain meds for Headaches". At no point had I asked for pain meds (I have a bottle of Dilaudid 2 mg at home to take so I don't have to go to the ER for a bad migraine).

He proposed that he would give me toradol, reglan, benadryl, ativan and that would knock me out for 12 hours. I questioned this because reglan makes me psychotic but he insisted the benadryl would keep the reglan from doing that and that reglan not only is good for nausea but treats migraines. I am a pharmacist and KNOW this was an absolutely contraindicated idea, but I was so sick and confused with this weird migraine that I let him give it to me.

At first the cocktail seemed to work. They had given me 1/2 of the reglan dose. The doctor came in in about 10-15 minutes was very satisfied and ordered for me to have the second 1/2 of the reglan.
However in the 15 minutes between that time and the time the nurse came in to give me the second dose--the reglan psychosis hit.

I was wide awake--and all I wanted at that point was out of there. My husband requested that the doctor come in to see me again. HE DID NOT COME BACK IN. They pulled the IV and sent me home in the throes of an adverse drug reaction!!

I filed a complaint with patient affairs. After not hearing anything for 5 weeks, I finally called to find out where that complaint was, and was informed that the treatment had been ruled appropriate.
I think the other thing that really was unbelievable scary about that incident was that I presented with a complaint of migraine with UNUSUAL symptoms for me, and this doctor did NOT do a neural check. Nor did he pull out his stethoscope and listen to my chest. It turns out that this migraine had started because I was suffering from atypical pneumonia. But the treatment was appropriate!!!!!!

I will NEVER, EVER go to this hospital which prides itself in being one of the nation's top 100 hospitals again.

I lodged a formal complaint with my insurance company. And I am considering a letter to the Joint Commision on the Accrediation of Hospitals because I believe this matter was totally swept under the rug. Had I been having a stroke I most especially wouldn't like to be under a rug.

Paula.
Don't let this turkey get to you. They obviously don't know what they're talking about.

Next time, if you can, use one of the form that Nutcracker provided- they really help!

Hey tracie,
Sorry you had that bad experience- also with reglan. So i'm not the only one who could be clinically diagnosed with some psychiatric symptoms after Reglan? For me, it makes me acutely suicidal (yikes!)

When a doc tried to give it to me in the hospital ER- despite my shaking my head and saying that it was a bad idea because of known side effects, I said that I wanted it notated in my chart that I become suicidal from that medication, and otherwise, I am not suicidal, but under the care of a psychiatrist for depression, but stabilized. I also gave him the phone number of my psychiatrist to add to the record so that he could call her and see that what he was doing was going to make me come back the next day in a sorry state. I also wrote down his name and gave it to my husband to hold.

The resident backed off and asked me in the most condescending voice "what would her majesty prefer?" My husband said "my wife is in pain, and we know all about how to file a complaint at this hospital. She'd like..." I interrupted and said that "her majesty would prefer a magnesium drip with zofran. And a crown."

Same deal- top 100 hospital.

Now that I'm no longer a "frequent flier", they want to start out with morphine IV with zofran. I'm usually like "Nope- magnesium first. I want this thing broken!" It's amazing the difference that being somewhat controlled on meds makes in the number and quality of ER visits IMHO.

Did this make any sense? I'm in pain and letters are fuzzy...

I think many of us, including myself, have had bad experinces at the ER.

I believe that anytime you have experiences like the ones described on here, a letter to the Patient Affairs or looking up the Customer Service department in the hosptial is in order. I also think that if that if your concern is ignored, and the complaint is serious enough (like being discharged when having an adverse drug reaction), a letter or call to the Joint Commission would work to help solve the issue.

Like most of you I have had good and bad experiences with Er's. I never knew a thing about the drug Reglan. It was given to me for the first time in the ER. Afterwards I had a high amount of anxiety, I didn't know what was happening, I wanted to go home, right NOW, I wanted the IV, I didn't want to wait and was prepared to rip it out. I just was not myself. When I finally made a doctor/student tell me what the heck happened he then told me the Reglan side effects and how they can cause some "slight" anxiety issues! SLIGHT?? Yeah right! Anyhow, after that night its on my chart that I receive no Reglan!

quote:

Originally posted by hearts:
Like most of you I have had good and bad experiences with Er's. I never knew a thing about the drug Reglan. It was given to me for the first time in the ER. Afterwards I had a high amount of anxiety, I didn't know what was happening, I wanted to go home, right NOW, I wanted the IV, I didn't want to wait and was prepared to rip it out. I just was not myself. When I finally made a doctor/student tell me what the heck happened he then told me the Reglan side effects and how they can cause some "slight" anxiety issues! SLIGHT?? Yeah right! Anyhow, after that night its on my chart that I receive no Reglan!

"slight" - don't you just love when a doctor chooses to describe issues with a drug as "slight" or "mild." I had an ER doctor give me IV Companzine when I was nauseous and had been throwing up. Within 10-15 minutes of giving me the drug I was gripping the mattress, gritting my teeth and ready to yank the IV out of my arm. When I called for the nurse and she brought the doctor in he said "yeah, we sometimes see some mild anxiety issues with this drug." I wonder what he considers to be major anxiety issues?

First of all, Paula, I'm so sorry to hear about the rotten experience you had. ER doctors certainly aren't migraine experts, and how good, bad, kind, arrogant, knowledgeable, or not... they are, seems to vary widely.

Secondly, I think that the more of us file complaints when badly treated, the more likelihood that we may have some impact. There are a lot of ER's out there - it may take a lot of complaints to make a difference!

I've never been to ER with a migraine - never even realized it was an option. Since I've been on this forum I've realized that there were at least 3 occasions in the past when I should have gone to the ER! I've also been quite scared by many of your experiences! But I am clear that I need to work out a rescue protocol with my dr. and have that with me at all times in case I need to go to the ER.

And I think Jamie's crown is a good idea. I'd love to see it. Checklist for ER:

• letter from doctor
• list of meds that have worked for me
• crown so they know who the heck they're dealing with!

LOL!

- megs

I am new to the boards, but this just happened to me a couple of weeks ago. I probably go to the ER once a month for migraines. Toradol, Demerol and Phenergan is what I have been getting for years.

One doctor suggested something else once and it didn't work, which only gave me one extra hour of pain.....I was given fentynal (sp?) once and that did the trick, but I usually just go in and say what works, Please give it to me, I am dying.....(and it is sooooo obvious that I am dying..of pain)

Long story short, last visit was 3 times in one month.....typical migraine, 2 hours moaning and vomiting, laying on the cold bathroom floor, my husband peels me off and says, "LETS GO"....The kids are sleeping, its midnight, he walks me through the ER door, and tells me to call when I am done.

When the dr enters the room, he says, "I don't give out narcotics,..."no demerol, no dilaudid, no morphine, no blah blah blah" He TURNS the lights on ALL OF THEM and tells me to open my eyes and then asks me to open them wider. He tells me to follow his finger (this is a test to see if you are drunk or drugged - my husband is a police officer, this is how I know) so tell him I don't know of any other way to get rid of such a severe migraine ( I can hardly talk) He offers toradol.

I say can I please get something for the vomiting. He says yeah and leaves. I call my husband crying and he calls a neighbor over to watch the kids. My husband had to come in and talk to the doctor and tell him that I am not a drug addict and that I really needed that medication. It was awful. He ended up giving it to me, but I was horribly mistreated.

The doctor never did come back to ask how I was feeling after the nurse gave me the shots, either. I am still soooooo upset about the whole thing. Anyway, that is my story!!!!!! I called my GP and they told me to call them at any hour if there is ever a problem like that again and that they will tell them!!!!! I also will have them fill out Teris form that you listed here. That will be nice to have :-)

Hi Kduch!

Just wanted to let you know that I was the one who broke your post up into paragraphs so that all of our forum members could better read and comprehend what you were writing! Sounds like an awful experience! I hope you never have another one like it!

Take Care,