Emergency Rooms and Migraine Headaches

The emergency room plays an important role in the treatment of migraines: it’s usually the place of last resort when your treatments fail and the first place you should visit if your migraines present unusual or alarming symptoms.

Even if you’re following your doctor’s treatment plan carefully you may find yourself with a migraine that doesn’t respond well to medication.  First understand that this occasionally happens with migraines and adds to the complexity of treating them.

Anytime you go to the emergency room or an urgent care center for a severe migraine be sure to follow-up with your doctor as soon as possible.  Your doctor will need to evaluate your treatment plan and any medications the hospital doctor may have given you.  Your doctor will want to make sure it doesn’t cause any drug interaction problems.

Many migraine patients may feel frustrated after visiting an emergency room because emergency rooms tend to be fairly busy and treat the patients they perceive need the most immediate attention.  Because a migraine sufferer may not display any outward symptoms of traume they may be forced to wait lengthy amounts of time before being examined.  Some patients report feeling as if emergency room personnel disregard severe migraines as true emergencies.  Instead, patients feel that they’re being bombarded with questions that may imply substance abuse.

You absolutely have the right to prompt attention from emergency room personnel.  However hospital personnel are frequently overworked and must quick assess the status of many patients, some of whom may be experiencing immediate life-threatening conditions.  They must responsibly administer medications which means they must be careful not to give narcotics to suspected drug abusers.  This occurs more in larger urban areas where drug users, unable to obtain drugs on the street, visit the emergency room and fake their pain in order to receive pain killers.

If you need to visit an emergency room it’s imperative that you inform the staff that you’re under the care of a physician for your migraines.  Give them the name of your doctor and suggest that they contact him/her if they have any doubt about your condition.  Another suggestion is that you keep a copy of your treatment plan, or a receipt copy of your last doctor’s visit.  You should also keep a list of your medications with you so hospital staff can safeguard against negative drug interactions.

Although rare, permanent disability or serious health conditions can occur as the result of a very severe migraine attack.

If a migraine lasts longer than 72 hours, seek immediate medical attention.

If a migraine is accompanied by frequent vomiting or diarrhea, seek immediate medical attention.

If you experience aura, confusion, partial paralysis, or speech impairment after the migraine attack subsides, seek immediate medical attention.

If you experience visual impairment in both eyes, gait abnormalities, weakness of the limbs and dizziness, seek immediate medical attention.  You may be experiencing a migraine-related stroke.

If you’re over the age of 55 and experience a severe migraine attack accompanied by aches in the body or extremities, and visual impairment, seek medical attention immediately.  You may be experiencing a temporal arteritis headache which could lead to a stroke or blindness.

The content of this article is not meant to alarm you - instead, it’s meant to educate you so you can make more informed decisions about your situation.  As always, please discuss matters of this nature with your physician so you can receive advice that’s geared to your specific situation.

Filed Under Migraine Symptoms, migraine treatment | Leave a Comment

Which Doctors Provide Migraine Treatment?

When looking for medical treatment for your migraines it’s good to know the different levels and types of care available to you.  Although most people begin looking for medical treatment with their primary cary physician you should know that it doesn’t end there.  There are lots of different doctors that can provide migraine treatment.  This article reviews some of the different types of doctors that may be able to provide help.

Primary-Care Physician

The primary care physician is the person that most people first disuss their migraine problems with.  This is primarily due to the fact that the patient is already comfortable discussing various ailments with that doctor.  Your family doctor is the person that usually refers you to specialists if they feel it is appropriate.

The primary care physician is usually a general practitioner, internal medical specialist, or family practitioner.

Pros:

  • The doctor knows your medical history.
  • The doctor probably knows your family medical history and may even be treating other people in your family.
  • You have probably established a long term relationship with the doctor.

Cons:

  • General practitioners are generalists, not specialists.  As such they may not know of the latest advances and treatments available for migraine sufferers.
  • Some general practitioners may be reluctant to refer you to a specialist because they believe the condition is something they’re qualified to treat.  This may result in lengthy treatments and considerable trial-and-error attempts before the most effective treatment is found.  If you don’t believe your doctor’s treatment is effective you should feel comfortable enough asking him/her to refer you to a specialist.

Neurologist

A neurologist specializes in conditions that affect the brain and is considered highly qualified to diagnose and treat headache and migraine conditions.  Many primary care physicians refer their migraine patients to neurologists for this specific reason.

Pros:

  • They’re likely to keep abreast of the latest migraine treatments and medications.
  • Because of their specialized knowledge of the brain and how it functions they’re likely to accurately diagnose the presence of neurological disorders that can cause migraine headache pain.

Cons:

  • Because neurologists deal with very complex brain problems they may not be willing to spend time treating migraine patients.
  • Some neurologists only deal with patients that have very severe and frequent migraine pain.  Infrequent sufferers may not be able to get an appointment to see certain neurologists.

Headache Specialists

A headache specialist is a physician that specializes in diagnosing and treating patients that suffer from migraines and other types of headaches.

Pros:

  • Headache specialists are likely to have th latest information on migraine treatments and therapies.
  • Because they treat people with different types of headaches they should be able to distinguish between a migraine headache and other headaches that have similar symptoms.
  • Because of their knowledge of migraine headaches they often provide cost effective treatments.

Cons:

The term “headache specialist” is not a certified or accredited medical sub-specialty so determining a physician’s qualifications may be difficult. Ask the physician if he/she is a member of the American Association for the Study of Headache (AASH), which is a professional group for physicians and researchers interested in the treatment of different headache types.  Because accreditation is not required it is recommended that you only visit a headache specialist as the result of a physician’s referral, or the referral of a trusted physician, friend, or family member.

Read the article “Questions to Ask Your Doctor About Migraine Headaches” for more information.

Filed Under migraine treatment | Leave a Comment

Questions to Ask Your Doctor About Migraine Headaches

When you make an appointment to see a new doctor about treating your migraines be sure to ask the receptionist to book enough time for you to ask questions of the doctor.

Here are some good questions to ask the physician:

In your experience, are migraines treatable? Your doctor should view migraines as a highly treatable (albeit not curable) condition, not something you simply have to live with.

In your opinion, what causes migraines? The doctor should have an understanding of the underlying conditions that cause migraine headaches.

Have you treated many migraine patients? The doctor should have some experience treating patients that suffer from migraine headaches and be familiar with the latest treatment plans.

If you prescribe something that doesn’t work well or that causes many side effects but helps the headache, what would you do? The doctor should be willing to try different medications until one can be found that reduces the side effects but is still effective. He should also be amenable to trying alternative non-drug treatments.

What do you do if your migraine patients don’t get any relief from your recommended treatments? The doctor should have some sort of escalation plan, such as referring you to a different specialist.

The doctor should be open to answering these questions and taking as much time as required to make you comfortable and confident that he/she is willing to help you.

See also: Finding a Migraine Doctor

Filed Under Migraine Therapy | 1 Comment

keep looking »