A hot topic just about anywhere Migraine is discussed is going to the ER for Migraine treatment. The discussions generally aren’t positive, and that’s not on the shoulders of the Migraine patients. They are simply trying to get help.
One problem that adds to problems with emergency room treatment is that too many people are essentially using the ER in place of their family doctors. Faced with a busy schedule, rather than take time during a weekday to go to the doctor, they wait and go to the ER. Especially during times such as flu season, this can mean that the ER is flooded with patients who could have been treated by their family doctors.
The goal of Migraine treatment should always be the best relief in the shortest time with the fewest problems. Thus, the ER is not the best choice.
There are many reasons to not go to the ER for 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 Migraine patients have been viewed as “drug seekers” when they go to the ER for Migraine. 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 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 of us with Migraine, 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 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.