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Patient Perspective: Migraine and ER

Migraine Attack and the Emergency Room

You have that unbearable pain in your head, nausea, and maybe you can’t even see at this point.  During a migraine attack, when do you go to the emergency room and what should you expect? Some things may depend on the day, but there are some typical things to anticipate. I will share my story here knowing that each emergency room may take on its own procedure. There are some things that hold true for the majority.

 If you had asked me about going to the hospital early in my migraine journey I would have been surprised to hear that as an option.  However, I can now tell you after many years on this road I am a seasoned patient in the ER.  

While it is not where I want to end up, when I have exhausted all my other options I am grateful for the hope of relief.  However, I have to brace myself for the trip.

The ER is not the ideal place to go for someone with a migraine. It is full of bright lights and loud noises.  People are sometimes confused and can even be trying to start conversations in the waiting room.  

Patient Checklist

The best way to take on the emergency room is to be prepared.  Your must have checklist: 

  • ID
  • Insurance Card
  • Plan from your neurologist or other doctor if applicable
  • Know your medications and allergies
  • Have an advocate if you feel you will be too sick to speak to the nurse or doctor.  This can be a friend or family member.  Just make sure it is someone you trust who will make you feel more at ease.
  • Dress appropriately. Rooms are usually cold.  They typically give you a heated blanket, but even if it is 100 degrees outside it is usually cold in the hospital.

Next, be ready to cope with the conditions. The staff there may offer you a towel for your face or even a warm blanket depending on your facility.  Feel comfortable asking for the washcloth when you do the vitals check in.  

What to Expect

(Again this sequence can vary slightly depending on the day and hospital)

Front Desk: 

  • Give ID and health insurance card
  • State what you are coming in for
  • Get wristband and be sure to check for accuracy

Check in Room:

  • Called back quickly which may feel like false hope you are going to be seen
  • Vitals checked and answer a series of general questions:
    • What you are there for
    • What have you taken so far
    • Allergies
    • Doctor information
    • General Questions about personal safety
  • Sent back to waiting room
    • Great to ask for a washcloth for your eyes if you did not bring one. They may offer one.

Waiting Room

  • You may be there awhile so be ready to cope with:
    • Noise-lots and lots of noise. You could bring ear plugs. 
    • People possibly asking questions–feel free to say you aren’t well and not to engage in conversation
    • Bright Lights: You will want that cloth
    • Time: this will vary so be prepared for a few hours.  For me, a typical wait could be 3 hours.  I know others who have waited for much much longer.  However, you have to judge where you are and what help you need.  Sometimes you truly have no choice.

Patient Room

  • Nurse will see you and ask you same questions as in check in room
  • Typically they may start an IV if that fits with your health plan
  • Depending on regulations at the time you may be able to take someone back with you. 
  • Emergency Room care for migraines has changed for the better over the last several years.  Doctors are more focused and prepared to target the migraine.  
  • Share what works for you if you know.  Be your own advocate or have one with you.  

Treatment

This will vary depending on the patient, doctor, and protocol.  For the standard migraine patient there is a common migraine cocktail that may be administered.  If this path does not prove effective the doctor may choose to try some additional medicines.  Sometimes going home and getting rest followed up with prescription meds can also be helpful.  It is always important to follow up with your doctor or health care professional.  

Typically being treated in the ER will last a few hours depending on how successful the medicines are from the beginning.  I have been admitted, but that is not the goal or the norm in many cases.  So don’t be afraid to get the treatment you need.  

Experiences from My Journey

Mondays

These are super busy.  People can’t get into their primary care physicians yet typically and may be using the ER as the doctor’s office.  Be prepared to wait.

Middle of the Pandemic

I don’t remember how long I was at the hospital, but I do remember they were calling people back to recheck their vitals.  You need a current reading prior to being seen.  I knew that was a bad sign. 

 Nevertheless, I had to get help.  The staff was so kind to all.  They offered warm blankets and apologized.  My experiences are very positive.  I know not everyone’s mirror mine, but I do think we have many people out there who work hard everyday to provide the best care. 

Post Pandemic (kind of)

I waited for several hours in pain. Doubled over, nauseous, and miserable I counted the minutes. A lady looked at me and said, “Are you sick or contagious?”  I think she meant, “Do you have Covid?” I told her I had a migraine and was in a lot of pain.  I hoped the conversation would stop.  

She went on to ask if I had tried Tylenol.  Needless to say I was not talking to someone who understood migraines. I tried to remind myself that fortunately not all people know what a migraine is like or what it means to have one. 

After that wait time a nurse came out and called several of us at the same time.  This was an unusual practice. She then said we were going to hallway beds.  I tried to just be thankful I would be treated, but that meant no relief from the loud noises and bright lights. This might also mean my migraine would not improve at the ER.  When that happens I have been admitted.  

Back in the treatment area is sometimes even worse when you aren’t in your room.  The lights are truly like daggers and there are machines, sometimes you hear sirens, and the phone is loudly ringing.  So much noise!  You want to at least be in a room.

So as the nurse looked at her chart she looked at me again.  She said, “Oh honey, migraine. I am going to put you somewhere else.”  I felt bad for the others, but honestly was relieved.  I didn’t know if I should offer the space to someone else. The people going back were not seriously injured so I agreed to go.  

I was in bad shape for my pain level and this typically means my blood pressure is rising and I am experiencing a wide variety of symptoms.  The nausea, blurred vision, and sometimes inability to really function is just overwhelming.

Well, where I ended up was an old room they previously used to take x-rays in.  It had a gurney in it and no regular hospital bed.  This was only two days after I was dischared from a lengthier stay which I will be sharing more of soon.  So in addition to all the migraine symptoms I was feeling some anxiety.

However, I had to be thankful I had a room.  It was supposed to be quieter due to its construction so that was a blessing even if my conditions were not comfortable.  I was so dehydrated it took them hours before I got an IV and treatment.  They had to bring in an ultrasound machine to find my veins.  Perhaps this is why I was taken to that room.

That room was not stocked with any supplies and was not like a regular room. It was actually next to the break room and was confused for another type of room. At one point the police came in looking for someone. I am not sure what they were looking for, but I’m pretty sure I was not it.

A few more hours and I was able to go home after treatment with more meds.  Looking back I had no choice but to go there.  Sometimes, you must do what your body asks for and listen to what it is telling you.  

Hopefully the More Typical Expectations

Perhaps the regular visit when we are not in a pandemic or crazy times would sound a little different. Over the years I have been met with kindness and compassion. The typical treatment time involves a regular room and still takes at least a few hours for meds to work. The goal is to go home better and to continue to feel better after you leave. You still have to finish the migraine stages. I am always tired the next day as your body has been through a lot. However, I am also thankful to be past that point and moving on to living life again.

It has been consistent that I have had nurses and doctors who have been kind and focused on my care. They have asked what works for me and kept me until they found what did. In my other post I even share how it was the ER doctors who discovered hormones as one of my triggers. Even though the emergency room can have some unknowns I have always felt relieved to know I would get help.

Takeaways

The Emergency Room is no one’s dream place to receive treatment, but if you must go be prepared and listen to your body.  From experience if I know I need to go and I try to make it on my own that never goes well.  

Again, each person has to make the best choice for themselves. Stay in touch with your health care professional and reach out for support.

Thank you for being here.  Much more to come at migraineroad.  We will cover more of my journey and more topics will be added to our resources.  

Be a Part of the Community

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Also a shout out to all the hospital staff out there.  I have sure had some angels care for me over the years.

Disclaimer:

Although we strive to provide accurate general information, the information presented here is not a substitute for any kind of professional advice, and you should not rely solely on this information. Always consult a professional in the medical and health area for your particular needs and circumstances prior to making any medical or health related decisions. For your health related questions, please seek the advice of a licensed physician or any other qualified health care provider immediately..

11 thoughts on “Patient Perspective: Migraine and ER”

    1. Thanks so much for sharing this! In the past, I used to get at least 1 migraine a month. In recent years I don’t get them very often anymore. I was just having a conversation with a friend who brought up that someone had gone to the ER for a migraine and the thought had never crossed my mind in all the years I struggled with them! I have gone to the ER for many other things but it is good to know they can do something for you if you have a migraine. Good information to keep in mind about what to expect!

  1. Yeah in my journey with a migraines I don’t go to the ER anymore. They never take it seriously and because of this they consider it non emergency so if something more urgent comes in they bump me to the bottom of the list generally wait for me to get a bed or speak to a doctor is over 8 hours. So instead of going to the ER I tend to suffer at home and try and manage my symptoms the best that I can. I know it’s not the best but I just feel I get the care I need which is sad and disappointing

  2. I’ve been to the ER a few times and I must say, it’s not my number one choice but if I have to go, I always have to be mentally prepared for the long night or day ahead. It’s always a lot of waiting for me at the ER!

  3. Charlie-Elizabeth Nadeau

    I’m sorry you have to go through that but I appreciate your honesty. Your insight shared through your own experience will make many other feel more comfortable and it offers another option than suffering alone. I didn’t even know the ER offered help for migraines. Thank you for this and sharing great tips!

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