First, let me preface this letter with a few thoughts: I have been reading some medical blogs lately. I swore I would never read them, as they tend to make me angry. But instead, I have found the doctor's point of view very interesting!!
Specifically, I've been reading to try to understand the doctor's point of view in ER treatment of migraine sufferers. I think I'm beginning to understand why some ER doctors are so suspicious of true migraine sufferers who come to their ER's for care! (I'm not saying they're right to be suspicious...just that I think I understand their point of view a little bit.) They see drug-seeking patients in the ER ALL THE TIME! I think if I were an ER doc, I might be suspicious of a migraine patient, too!!
BUT (and this is a BIG BUT) I do think that the difference between a "migraine" sufferer (someone seeking strong narcotics for a high) and a migraine sufferer (a true migraine patient in real pain) is VERY clear! For a good ER doctor, telling the difference really should not be a difficult task.
So, with these thoughts in mind, I wrote a letter I'd love to give to my ER doctors:
Dear ER Doctor:
I am a chronic migraine with aura sufferer. I have pain nearly every day but I struggle through it most of the time. Today, I have come to your ER for help. I am a REAL migraine sufferer! You can be certain of this because:
I am a patient at one of the best Headache Clinics in the USA! I'd be happy to give you an appointment card with my doctor's name and phone number if you wish to talk with him!
I take many medications: several preventatives, one abortive, and two rescue meds. I also receive nerve block injections (20 or so shots all over my head and neck) in an effort to control my pain. I DO NOT take narcotics for my daily migraine management!
I am willing to try almost any medicine you feel may help me to break this migraine. (Anything but compazine--I'm allergic to that one!) If you ask me what has worked in the past, I'll be glad to tell you. But I have NOT come to your ER seeking narcotics!! In fact, I'd really rather you didn't give me narcotics (which only cover up the pain for a short while). Instead, I'd really like to try something that might actually break the migraine cycle. But I'll try most anything you suggest!
I will NOT exaggerate my pain level! I've never had a 10 out of 10 migraine. Definitely not a 15 out of 10! If I've come to your ER for care, it's probably because my pain is a 7-8 and I've been throwing up for DAYS! If I get to this point, I am definitely not able to keep my medications down unless you give me some IV fluids and nausea meds to settle things down.
I also have a history of esophageal tear during migraine. I threw up so violently two years ago that I tore my esophagus and had to have it cauterized during an emergency endoscopy. My GP does not want this to happen to me again--so it's very important that we get my vomiting under control if we can!
