Migraine

Food for thought:

Like many people on here, I had a bad experience with the local ER today. I'm not going to go into detail about it since that's not the focus of this post. I can say that it's a very similar story I've read about before on here. ER doctors not wanting to listen to your listed treatment plan from your neurologist/headache specialist and esentially listing me as a drug seeker becuase I was at the ER with a migrain.

I've had issues with this hosptial in the past but it's the closest one to me. Rather than contacting the hospital and listing my complaints, I'm thinking about contacting them from a more educational approach. I believe that by listing my concerns on a more educational level with information about migraines, I may at least provide the opportunity for one person there to understand what we all go through every day.

Just starting with the act of letting them know I had a migraine rather than what the doctor and staff kept referring to as a "headache." I will let everyone know how far I get with this.

Good luck. I'll be interested in your outcome.

I've gone the complaint route before and never had much come of it so I decided to direct my energy in a more positive fashion. I will let everyone know how it goes.

I am so sorry. I was turned away untreated by an ER in 1995 and haven't been back for a Migraine attack since.

Honestly, if I were an ER doc, I'd be loathe to give a migraineur any treatment that their own physicians won't give them.

Why won't our doctors give us what we need?

If I were having stroke-like symptoms and breathing difficulty (like I was in 1995) or had been told by my physician to seek emergency care immediately (like I had been in 1995--my doc told me to call 911) but still had a bad experience, I wouldn't go back.

Our doctors shouldn't refuse to adequately prepare us for unexpected pain. ER docs should realize that out-of-the-ordinary attacks could be strokes and evaluate us for neurological accidents.

And our docs should understand and accommodate us at their offices during normal office hours if they won't give us ahead of time that which we need.

Ok.

quote:

Originally posted by MedievalWriter:
I am so sorry. I was turned away untreated by an ER in 1995 and haven't been back for a Migraine attack since.

Does that mean that you haven't been in Status since 1995? I hope that's what you meant when you wrote that. I know that some ERs are awful, but not being treated when you're in status is dangerous. Can you go to another ER? I'd hate to see anything happen to you now just because you had that bad experience over 10 years ago!

In my situation I attempted several times to have the attending physician contact my neurologist. It was only after I made a very strong insistance that the doctor finally called. Now, I understood that on a Sunday at 6:00am my doctor may not be on call but there are close to 30 neurologists at the office I go to. Someone could assist with my care.

I also believe that no doctor would ever refuse any care to a diabetic, an alcoholic, someone with MS, or anyone else with a debilitating form of disease.

I'm sending out my letter to the hospital tonight along with copies of the ER forms from this website to show that there are options besides labeling people "drug seeker."

I can relate unfortunately to people's bad experiences in the ED. I have no abortive treatment options available since I have exhausted them all. I am not on any painkillers for my migraines. When my headache gets to about a 9 I know a trip to the ED is in my near future. The last hospital I went to would only give me narcotics and would not listen to my suggestion regarding previous treatments. They refused to call my neurologist or one of their own on-call neurologists. They gave me fentanyl even though I told them that doesn't help. When they wanted to know what narcotics worked I let them know that they don't help, but for moderate relief Dilaudid works. I was briskly told that that medication was only for cancer patients. As I was getting ready to leave (still having a headache) the ED MD came into my cubby and told me that migraines are a chronic pain problem and the ED is not the place for chronic pain treatment. He then gave me a list of pain clinics. When I arrived hom and was able to look at the paperwork the next day- the booklet was not on pain centers, but a list of AA,NA, an inpatient treatment centers for narcotic/alcohol abused. Needless to say I was fuming, this was the 1st time I've encountered this type of treatment. I am not sure what I could have done differently, but I am tainted towards the medical community now and how migraine patients are treated. I am still really bothered by the stigma that is attached to me and I am not sure how to overcome this feeling.

I cannot say that anyone at the ER has ever given me any information for AA/NA or any form of substance abuse treatment. Being that I'm certified in substance abuse and I have training in assessing substance abuse disorders, I would be absolutely FURIOUS. At that point I think I would have went back to the ER and told them how many different ways they could stick their information.

Personally, I've had more good experiences at the ER than bad. I am very realistic when it comes to my healthcare and fully understand that the guy dying of a gunshot wound is going to take priority over me. However, that being said I don't think that means my care should be neglected or my suggestions not heard.

Every where you turn you hear from the medical community or through patient rights acts (and things like that) that patients need to speak up and take more control of their healthcare and yet my experience has been many times when you try to do that you're met with attitudes.

I am lucky in that my one ER migrane experince was good. I was pretty new to migranes and they immediatly put me in a quiet dark room. Within 20 minutes I saw a doctor who gave me an Imitrex shot (which I did not have at home yet) and an antinausea shot of some kind and gave me an IV because I was dehydrated. He said if that did not help he would give me pain meds and try other things in half an hour and left me in the dark room. Thankfully my headache got better and I stopped vomiting.

But ERs are a mixed bag and do not necessarily want to call your Doc regardless of your problem. I was once sent by my Gyn to the hospital with a suspected ectopic pregnancy. Unfortantly I went to the wrong hospital so the OB floor sent me down to the ER. They were called CITY GENERAL and CITY CITY HOSPITAL and I was new to the area, they are 10 minutes apart, but off the same exit, and needless to say I was very upset, and my hubby was an hour and a half away.

The ER told me that I could probably get the ultrasound faster if I went to radiology directly. I am crying "My Doctor was supposed to call! She told me to come here!" "Call my doctor!" This was during the day so she was at my office. They sat me in the waiting room for about a half hour.

The triage nurse rolled his eyes (literally!) at me and almost put me back in the waiting room until he took my BP. Even the doctor was dismissive, when I reported that I did not have much pain, so he asked why I thought it was ectopic to which I repeated "MY DOCTOR SENT ME HERE! My Doctor was supposed to call! Call my doctor!" Around then my husband called my cell and said "Where are you?" I said in the ER. He said I was not becasue he was... That is when I realized I went to wrong hospital!

So I told them. I wanted to leave and go to the other hospital but my hubby said no stay there. They FINALLY CALLED my Doc(about 2 hours later)! I was sent for a Stat Ultrasound. When I got back down to the ER the attending came in with the resident and within an hour I was in the OR. I had started to bleed internally by then, so I was lucky.

The doctor from my practice who I was supposed to see drove over from the other hospital to do my surgery, thankfully she had privelages at both. My practice had actually started to call around becasue they were worried that I didn't make it to the hospital when I did not show up within an hour.

So I guess my point is that ERs and ER docs can be clueless jerks or helpful professionals and it does not matter what your problem is. If you don't come in with chest pain, unconscious, or bones sticking out it is a crap shoot as to the care you will get.

Sad but true.

I remember when I was younger and Migraines weren't a well known disease and the doctor's answer to my pain was to dope me up and send me home. The only thing I could do was go home and go to bed for the rest of the day. Thank goodness those days are over!

Nowadays, I have a letter from my doctor that states what works for me (IV Magnesium and Decadron) and I just bring that with me to the ER. Works like a charm!

Here are some forms you can bring to your doctor's office that can be filled out in advance of an ER visit so that you can avoid any hassles at the ER:

Emergency Migraine and Headache Care - Forms To Help

quote:

Originally posted by JamieHOST:

quote:

Originally posted by MedievalWriter:
I am so sorry. I was turned away untreated by an ER in 1995 and haven't been back for a Migraine attack since.

Does that mean that you haven't been in Status since 1995? I hope that's what you meant when you wrote that. I know that some ERs are awful, but not being treated when you're in status is dangerous. Can you go to another ER? I'd hate to see anything happen to you now just because you had that bad experience over 10 years ago!

Oh, if my former-ex-used-to-be-a-Migraine-specialist-now-turned-just-headache-doctor is to be believed, I've been in status migrainous twice in the two years that I saw him. He said it was mild and would not require hospitalization. First time he switched my preventative meds around and sent me home. Second time he switched my preventative meds and gave me a toradol IV. And no, he's not my doctor anymore.

I'm wondering if your question is whether I should have demanded that he hospitalize me? Or if I should have diagnosed myself and sought treatment outside his office in disgust?

I'll die at home before I ever go to an ER for treatment of a Migraine attack. If dying at home was good enough for my father, it's good enough for me.

Dr. Breathtakingly Arrogant and I did not discuss this, but he would have had to call an ambulance himself or agree to admit me before I would cross the threshold of an ER for Migraine. The only reason I got treated for the two allergic reactions I had to MRI gadolinium dye was because the radiologist called the ambulance both times.

This topic generates tremendous emotion in me. I usually avoid threads about ER experiences because the subject upsets me so.

I guess I should avoid them in the future too. I'm the Lone Ranger in my believe that we migraineurs should not be responsible for solving the problems that the medical community has with treating Migraine. I'm barely responsible for myself.

I apologize if my posting caused such a display of emotions for anyone. My point wasn't to stir up bad feelings it was more of just something for people to think about when they have a bad experience at the ER.

As a follow up to my posting, I sent the letter to the hospital early last week and have not heard anything back. If I do hear back from anyone I will post their response on here.

No worries. It's not at all your fault that there are good ER experiences as well as bad ones. You've got just as much right to vent about a bad ER trip here as you do to share the success of a good ER trip.

There is misinformation, as well as doctors not being adequately educated or trained in dealing with migraine. Unfortunately, we as patients often suffer because doctors aren't up-to-date with the latest info, and misconceptions help to color the way they view and treat us. Granted, that's not fair, and it helps lead to bad experiences.

Anyone that's had a bad, nightmare ER experience is going to cringe and shudder at the mention of the word ER. It's human nature that when we've been wronged, we dwell, and we get angry. We object on principle, because it's not right, and it's not fair. It's a natural, reflexive response. I think that's what happened here. We start thinking of our own experiences, get mad at the fact the system is not nice, and get fired up again on principle. Humans don't let go of stuff very well, particularly when what's wrong with the system is bigger than us. We get frustrated. And the thunder comes out.

I'm pretty sure that's what happened here with emotions. And that's okay. Everyone's allowed to vent, and no one has to stuff emotions. Everyone's entitled to feel.

So no worries about your post. No need to apologize.

I'll keep hoping that your letter gets a positive response. I'm rooting for you!

quote:

Originally posted by psk2250:
I apologize if my posting caused such a display of emotions for anyone. My point wasn't to stir up bad feelings it was more of just something for people to think about when they have a bad experience at the ER.

As a follow up to my posting, I sent the letter to the hospital early last week and have not heard anything back. If I do hear back from anyone I will post their response on here.

Here is my follow up from the letter I wrote to the hospital.

The "vice president of nursing" called me and spoke with me about the letter and the forms I had attached ot the letter. After going through the apologies she said she had talked to the medical director for the ER and that they were very impressed with the forms I had provided (thanks Teri). She said they were going to bring the forms up at their next physicians meeting and look at using the forms for patients that frequent the ER for migraines.

Hopefully this may have educated a few people there into the conditions we experience.

Way to go!