Over the last week or so, I've seen several online discussions in which people were talking about having bad experiences going to the emergency room for a migraine and how much they hate going. Do you hate going to the ER for a migraine? If you answered, "Yes," to that question, I have another one for you. _Why _ do you go to the emergency room for a migraine? There are many reasons to not go to the ER for a migraine:
- It's difficult and painful to get there in the first place.
- ER waiting rooms can be full of stimuli that can make our migraine worse - noise, bright lights, and more.
- The wait the the ER can be long.
- ER physicians often don't have a lot of training or experience in treating migraines.
- Some migraineurs have been viewed as "drug seekers" when they go to the ER. This is largely because of the number of people who go to the ER claiming they have a migraine when, in fact, they do not. They actually _are _ "drug seeking." Unfortunately, there's no test that can be run to confirm migraine, so we can get caught up in this problem.
- For the most part, we shouldn't need to go to the ER for a migraine.
Any of us can get to the point of having to go to the ER with a migraine on rare occasions, but for most migraineurs, there's no reason to have to go even a few times a year if we have a good treatment regimen. A good treatment regimen has three types of treatments:
- _Preventive _: If we have three or more migraines a month, or if our migraines are especially severe or debilitating, we should be working with our doctors to find effective preventive treatment.
- _Abortive _: Unless there's an issue that precludes our taking them, we should also have abortive treatment. Abortive treatments aren't pain medications, which only mask the pain for a few hours. Abortive treatments stop the migrainous process itself, thus stopping the symptoms as well.
- _Rescue _: While rescue treatments generally can't abort a migraine, they can give us relief from migraine symptoms and help us rest. Some can help us get to a deep, restful stage of sleep, and that kind of sleep is the best "natural" migraine abortive of all.
The Bottom Line
Emergency rooms are great for emergencies such as injuries, stroke, heart attack, and many others. They are, however, not so great for migraine. The advice and care of our own doctors are far better.
Our doctors should be willing to work with us to make sure we have preventive, abortive, and rescue treatments. Even with rescue treatments available, there may be rare times when we need to seek care in an emergency room. Our doctors should also be willing to talk with us and tell us under what circumstances we should go to the ER for a migraine.
If our doctors aren't willing to work with us on a treatment regimen that includes rescue treatments, it's time for a new doctor. When seeing a new doctor for the first time, it's important to make a list of any questions you have for that doctor. When it comes to the doctor who will be treating us for migraines, it's perfectly all right and appropriate to ask the doctor's view on rescue treatments and what his or her patients do if they need help outside of office hours.
Obviously, we should treat our doctors with respect, but there's nothing wrong with expecting to receive the same level of respect as you give. Our first appointment with a new doctor is a great time to have a conversation about working as treatment partners toward the common goal of better migraine management. If you have an appointment coming up, take a look at Migraineur's Guide to a Successful Doctor's Appointment.
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