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Migraine and an ED visit

The Migraine World Summit is an annual event for migraine sufferers the world over. It is a forum where all the migraine researchers and clinicians come together to support those living with migraine and offer their latest understanding in the hope that it may help someone somewhere with this debilitating condition. This blog is taken from an email from the MWS and recounts the story of Jaime Sanders and her story of coping with daily migraine and how she prepares for a visit to ED.

"Most of us who experience migraine attacks have multiple treatments and medications at home to treat our attacks. But when those fail, and the pain and other symptoms overwhelm us, the only option left may be to seek treatment in the Emergency Room (ER). What can we do to prepare for a visit to the ER? How does having a written protocol help the medical professional who attends to you, and minimize the additional stress and potential challenges of an ER visit? Jaime Sanders is a true migraine warrior. She is a mother of three, has lived with migraine since childhood and manages multiple additional chronic conditions. She has become a powerful advocate who has helped countless others feel seen, heard, and inspired to improve their own outcomes. What is your home treatment routine to avoid a visit to the emergency room for a migraine attack? Jaime: Having multiple treatments, including neuromodulation devices, different varieties of the same medication, and having the right modality of treatment at home are all important. An intranasal spray, or being able to administer intramuscular injections yourself is really important because you need a fast delivery of the medication. Also, if you're vomiting or you have diarrhea you need medication that can bypass the gut because it's not going to get absorbed. How do you decide when a visit to the ER is the best option for you? What symptoms beyond the pain need emergency medical attention? Jaime: As someone who lives with daily migraine, it's hard to tell when it’s the right time to go to the ER. I have to look at the history of my migraine, how it shows up for me, and what my body is trying to tell me. When my resources at home fail to abort my migraine or decrease my symptoms, and the vomiting and diarrhea cause dehydration, then I know I need more intense treatment. And that's when I seek acute care in the ER. What do you do to prepare for an ER visit? What is a treatment protocol? Jaime: The protocol is an official document, a written prescription, on letterhead, signed by my headache specialist saying, "These are the things that my patient needs for treatment for her attacks." It states my history with the disease, what my current treatments are, and what has failed me in the past. I keep that in what I call my "migraine binder" which contains a list of all of my prescriptions, all of my allergies, my past appointments, my upcoming appointments, any surgeries that I've had. It validates my disease without me having to say anything. Now, whenever I have to go to urgent care or to the emergency room, I have a document that states what are the treatments I need and their doses.

Watch the full interview for answers to:

  • When should someone experiencing a migraine attack go to the ER?

  • What are some reasons people avoid the ER when experiencing an attack?

  • Beyond head pain, what other symptoms that accompany migraine might warrant a trip to the ER?

  • What steps can be taken at home to help avoid the ER during a migraine attack?

  • How can an ER visit impact one’s mental health?

  • How can we counter the perception that those with migraine are "drug seekers" when seeking emergency care?

  • How can we work with our physician to write a migraine treatment protocol to be used at the ER?

  • What information might this protocol contain?

  • Where besides the ER can an individual seek emergency care for an attack?

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