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Emergency Room Chronicles of an M Worder: When All Else Fails

We’ve mentioned before that M Words can sometimes get so severe that they require an ER visit.

  • 1) How do I know it’s time to go to the Emergency Room?

We measure pain on this very annoying scale.  Here’s how I equate this ridiculous scale to the real world. 

0-2 = Headache/some tenderness: I take NSAIDS pills. I can keep working.

3-4 = Start of migraine/sharp pain on 1 side of head: I take abortive pill (Imitrex).

5-7 = Migraine, fatigue, nausea, sensitive to smells/sounds/light: I take 2d Imitrex or Zofran/nausea pill. REALLY need to lay down.

8-10 = Severe migraine symptoms: loss of vision, nausea, vomiting, extreme neck pain, fatigue.  I need 1-2 Imitrex injections; pills no longer work now.

                     Chronic Pain Scale

AFTER I’m at the highest pain level & I’ve tried pills and injections to no avail, only THEN do I go to the emergency room.

  • 2) How can I eloquently express that my head is going to fall off (and also I’m going to puke & can’t see out of my eye)?

You have to be a partner in your own health! Use pain scale numbers to describe your severity. Give full name/exact amount of every medicine, vitamin, & supplement you take & allergies to meds. (Go memorize these NOW if you don’t know).  You will normally have to repeat this 3 times (intake, nurse, doctor) so you better be able to do it in your sleep.  Request a wheelchair if you need to sit down (I do). Request a bucket if you, well, need it.

  • 3) What’s going to happen now? How many needles are they going to stick in me?

Even though this is the worst pain you may have felt, ever, you may have to wait hours before you get a room or an IV started.  Once I get there, I let them know which of my veins are better than others (sadly, I know).  Let your ER doctor know of any past treatments that have or have not worked before. They might do an MRI or CT scan to rule out anything besides a migraine.  Be honest about your pain levels as you progress through treatment.

                                   Me in the ER

That’s me in the ER during my back-to-back visits last August with my ridiculous brother (yes, he randomly opened his shirt to blow up a latex glove balloon to see if any of the staff would notice).  If you can take anyone with you, you should. Humor, friends, & family really take your mind off what’s going on in your body.

Warning: Because there is no way to tangibly measure pain, there’s a valid concern that people go to the ER claiming migraine just to get narcotics.  For this reason, make sure that 1) the ER is your last resort & 2) you know the full names & dosages of current & past medications. I’ve been told informed M Worders are much easier to work with!!


For more info:

  1. ER Series by Ellen Schnakenberg & Dr. Kyle Kingsley on MigraineDotCom
  2. Their Follow Up Interview, posted this week!
  3. If you’re as amused by my brother as I am, you can follow him on Twitter at @nguzan.

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