3/20/07 Podcast: When To Go To the Doctor Or ER

Patient Expert

The transcript of this podcast is below. If you prefer to listen to it, you can do so easily from the MigraineCast Web site.

Welcome to MigraineCast, the weekly podcast brought to you by MyMigraineConnection.com and the HealthCentral Network. With Migraine disease, one reason it's so essential that we're educated about the disease is that we can't call our doctors every time we have a Migraine attack. We have to make certain treatment decisions ourselves, such as when it's time to medicate and what to take.

Another vital decision we have to make is when we need to see our doctor or seek emergency care at an urgent care center or hospital emergency room. There's another misconception about Migraines that comes into play here, the old "A Migraine never killed anyone" misconception. Taken as stated, I suppose you could say that's true. But Migraine attacks can and have caused fatal strokes. To my way of thinking, that's the same thing as the Migraine attack causing the fatality.

So, just when should we make an appointment with our doctors or head to the ER?

If we're experiencing the worst head pain of our lives, be it a Migraine or a headache, we need to see our doctor or seek emergency care immediately. Actress Sharon Stone summed it up nicely on the Oprah show in 2004 when she said, "If you have the worst headache you've ever had, go to the hospital because by the time you get to the hospital, you're as far gone as you wanna be." She had experienced what she thought was the worst Migraine of her live, and had she not arrived at the hospital when she did, would have died from an aneurysm. The aneurysm wasn't related to her Migraines, but she had mistaken the symptoms it caused for a Migraine attack.

If moderate to severe Migraine pain lasts longer than 72 hours without at least a four-hour pain-free period while awake, it's termed Status Migrainous, and emergency treatment should be pursued. Status Migrainous puts us at increased risk of Migrainous stroke. Abi Smith was 21-years old and on day 7 of a Migraine when she had her first Migrainous stroke. She was hospitalized, thought to have recovered, and sent home. A week later, when a Migraine hit, she suffered a second stroke. This one was fatal.

Other reasons to seek emergency care include unresolved loss of vision, loss of consciousness during a Migraine or headache, and uncontrollable vomiting with a headache or Migraine.

There are also times when we need to see or at least check in with our doctors. Any time Migraine patterns change or we experience new symptoms that we think are Migraine related, it should be confirmed by our doctors. Just as Sharon Stone experienced symptoms that she mistakenly attributed to her Migraines, there are times when less severe symptoms that we attribute to Migraine may be something else entirely, perhaps something that needs to be treated. It's not safe to simply assume, we need to confirm. Some symptoms that should be discussed with our doctors include confusion, dizziness, fever, numbness, shortness of breath, slurred speech, stiff neck, persistent vomiting, unremitting diarrhea, vision loss, and weakness.

Other situations where head pain should be checked out by a doctor include headaches that are severe or come on suddenly, headache that persists and keeps getting worse, headaches or Migraines hat interfere with normal activates, head pain that began after a head injury or other trauma and continue, and when we find ourselves taking pain relievers or Migraine abortive medications at the recommended dosage without relief.

Yes, it's in our best interest to learn about Migraine disease or any form of headache disorder we may have. That educations will help us to make treatment decisions each of us must make for ourselves when we have a Migraine or headache.

When in doubt, it's best to err on the side of caution. Part of what sometimes makes it difficult to treat Migraine disease and headache disorders is that they can present symptoms that could mean other, sometimes serious conditions. Remember -- don't assume; confirm with your doctor.

After living with Migraine disease for over 40 years, I've come to realize that learning about Migraine disease can allow us to work with our doctors as treatment partners to gain control over this disease rather than the disease controlling us.

Please join us at MyMigraineConnection for information and support or for a transcript of this podcast. From MyMigraineConnection.com and the HealthCentral Network, this is Teri Robert reminding you that you can live well with Migraine disease and headaches.