Need advice re: ER visits

  1. I hate to be a bother, but I need y'all's advice!

    I have a KILLER migraine (nausea, feel like aneurysm pain, etc). I was in the ER Friday night & Saturday morning with the same pain. They gave me a shot of Dilaudid & sent me home. Saturday, Sunday & Monday I had a dull headache, but now it is back in full force.

    My question is: if I go back today will they think I am just drug seeking? I really don't want to give that impression. I would rather stay at home. I am just hurting, and I want it to stop!

    Thanks!
    Last edit by rn2b_moni on Jul 1, '03
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  2. 18 Comments

  3. by   moni rn
    I'm sorry, but I have got to get some relief. I just hope I don't hgive the wrong impression. It justs hurts too bad.

    Sorry, I couldn't wait.
  4. by   ERNurse752
    I hope you feel better soon...I know how much they hurt!

    I had the experience of going to the ER for a migraine for the first time in May...luckily I work in the ER, I went in on my normal shift time, and my favorite ER doc was on, who hooked me up with a lot of good drugs!

    Did they give you any Rx meds to go home on? Did they give you a referral to a neurologist? If not, hopefully they will today...sounds like you could use one if they're coming back.

    I don't think anyone will think you're a drug seeker.

    Good luck, and keep us posted on how you're doing! :kiss
  5. by   Audreyfay
    My hubby used to get terrible migraine headaches. He was finally diagnosed with TMJ and got a little plastic guard to wear at night, which help to relieve the pressure on that nerve. Guess what... no more migraines! Doesn't help you now. Better to bear the humiliation than the pain.
  6. by   SmilingBluEyes
    YOU are legit. and NOT drug-seeking. get help!!!! I wish you well.
  7. by   atownsendrn
    Hope you feel better soon. It sounds like you need to see a neurologist.
  8. by   NRSKarenRN
    In this type of situation it's best:

    If no hx of migranes:
    1. Call Primary care physician/NP to see if they can intercede with ER staff.
    2. If no PCP, go back to ER NOW.
    What type of workup did they do previously??

    If hx of migranes:
    1. Still do the above
    2. Followup with PCP as soon as possible and get orders for what to do with severe migrane attack, recomended drugs, etc, emergency RX---if your PCP allows them.

    Each patients pain experience and drugs offering relief is different.
    Be aware that you have to take pain meds AT ONSET of symptoms to allow for drug absorption (ususally 20-30 minutes)---thinking pain will go away only worsens pain and makes higher doses usually necessary as playing catchup.

    Iv'e had ONE medication induced migraine ---9/10, just underneath C Section pain. Son has had them since teenage growth spurt.

    Nursing school certainly accentuates most triggers. Good luck and hoping you find relief.
  9. by   nursebitty
    Hope you're feeling better by now- I'm surprised they gave you a narcotic right away, rather than try something like Toradol first. Dilaudid does not last long enough...Also, was this migraine diffferent from your previous ones? If so, although it's possible to have an occasional "atypical" migraine, I'd push for a CT-scan. Why take chances?
  10. by   hogan4736
    nobody answered the question...

    "will they think I'm drug seeking?"

    Yes they will...

    Is this appropriate? Don't know...

    We have yet to invent an absolute OBJECTIVE pain measurer...

    Will I give you the meds? Yes!

    Are there patients who get relief from a (non-narcotic) pain clinic?
    Yes

    Are there patients who only get relief from Demerol/Dilaudud?
    Yes

    Who the hell knows what's the right answer...
  11. by   krispynurse
    Go back to ER now...Sounds like you need some more working up and a trip to a neurologist. Boy, NRSKarenRn I really like the way you think. Been at this a long time haven't you? Are you a teaching nurse? Why is it that nurse's are always scared that they will think we are drug seeking when we go into a health facility complaining of pain? Sad isn't it?
    Last edit by krispynurse on Jul 2, '03
  12. by   moonshadeau
    We had a girl at work that began to complain of severe migraines on a pretty consistant basis. They were severely debilitating and she frequented the ER. Morphine was the only thing that gave her even the most minimal relief. She knew that the ER was thinking that she was drug seeking, but when you are in that much pain, she just didn't care. Fast forward about 5-6 months after many, many ER visits, she was diagnosed with an anerysm that required immediate surgery. She even had a family history of sudden death r/t anerysm. She attempted to return to work afterwards but could not due to neuro damage.

    Not saying that you have an anerysm or anything that severe, but just a story to remind us all that even "drug seekers" have real problems too. You shouldn't worry about being labeled, you should worry about getting effective care.

    Just my two cents. Hope you feel better.
  13. by   robred
    Have u had a Head CT or MRI done? If not, u need one asap to r/o other pathology. if this has been done, have you been prescribed meds specific for migraines, i.e. dhe? Take Care....Hope u feel better!
  14. by   hogan4736
    moonshadeau...

    A thorough history by the ER doc on the FIRST visit would have bought her a CT...

    Last month in our clinic, a 24 year old c/o headache and told me (in triage) his mom died from a brain anyuerism...He had a CT scheduled within 30 minutes...

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