Need advice re: ER visits

Nurses General Nursing

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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...

I doubt they will think you are drug-seeking. If I worked in that ER, my first thought would be that we failed at finding the cause and providing relieve for you. Get yourself back there right now and good luck!

nowplayingEDRN

799 Posts

Specializes in Step down, ICU, ER, PACU, Amb. Surg.

I am a migraine sufferer....

A) Go back to the ER

B) Make an appointment with your PCP

C) Make sure you get a CT or MRI and a referal to a neurologist

D) Talk about propholayxis(sp) treatment with your PCP. You should not be forced to run to the ER every time you get an attack.

E) Do start to keep a journal of what you do and eat so you can try and find the triggers to your headaches. When you regroup after a headache...write down if there was an aura and the S/sx you had. Take this long with you to the doc/neurologist so that they can see where these are going.

F) After 2 visits, I doubt you will be viewed as drug seeking. However if you keep seeking tx at the ER with out getting some follow up testing and care from your PCP. Yes, you will be labled drug seeking.

Good luck and warm thoughts and lots of prayers,

moni rn

297 Posts

thank you all for your responses! : ) i am going to try to answer all of y'all's questions.

1) yes, i see a neurologist. he does not refill prescriptions unless you are in for an appointment. my last appointment was scheduled for early may, but he ended up having to cancel due to ... heck i don't even remember his excuse. this is the 3rd time he has cancelled on me. the earliest i could reschedule was for in about a week (july 7th), and i just pray he doesn't cancel again. trust me, i have been tempted to go somewhere else, and i did, once! the 2nd neurologist said he would not give me anything stronger than maxalt, and he believed in "experiencing" the pain. so, no pain meds. he pretty much labeled me as a drug seeker & sent me on my way. i cried all the way home. my original neurologist is supposed to be the "headache guru" in town. he is not in a private practice, but does not like his patients to call the service & be handled by one of his partners. *shaking head in disbelief* i did that once, and boy, did i get in trouble!

2) i am on topamax 100mg bid, effexor xr 150 mg, imitrex injections and phenergan 50 mg im prn. i still get a migraine at least once or twice a week. the causes, that i suspect, are tmj and stress. i just got my braces off, that was supposed to "cure" my tmj (not!), and i do sleep with a mouth gaurd nightly. well, stress ... i am in nursing school! *lol* i did try inderal, but i gained about 15 pounds with it. also, i have tried zoloft & maxalt. for the pain, i was on percocet (stopped that, because i got to a point where i could take 3-4 with no relief) and stadol (stopped that, because my body adapted to that, too). i do not want to be dependent on any meds!

3) my last ct & mri was in march, i think, and that was during a trip to the er. it was all clear.

4) btw, i ended up not going to the er. i was so afraid that they would think that i was drug seeking, that i could not bring myself to go. i just took my phenergan, did some relaxation breathing & tried to sleep. however, now i have just a headache (4 or 5/10), instead of what is was (9 or 10/10). i am taking advil & excedrin migraine and toughing it out until my appointment. oh, i am also doing relaxation breathing, aromatherapy, yoga & meditation. in all reality, i hate taking medication of any sort. if i can take care of something through herbal tea, aromatherapy and/or meditation, that is what i do. the meds that i am taking now, i absolutely hate. obviously, they are not working. (well, imitrex sometimes works.) i would love to stop taking all of this cr*p!

well, now that you know my migraine history ... *lol* thank you for "listening"! again, thank you for your responses! *hugs*

Specializes in ICU, nutrition.

Sorry to hear you are having so many migraines and so much trouble seeing your neurologist. How frustrating. I'm not sure I could deal with a doctor with such a prima donna attitude "Do not call my service," etc. Bad enough we have to deal with jerks like that at work every day ("I like the lab work on the right side of the clipboard, and the med list on the left side") without having to waste time and money dealing with them as our physicians. Is he worth it?

I suffered from migraines once or twice a week for several months about 8 years ago. It turned out my stressful job plus the mold growing in my office equalled migraines. After I quit the job, my migraines decreased to 1-2 a year. Since I've been living in south Louisiana, my mold allergy has grown more severe and I now take daily Zyrtec and decongestants to keep from having migraines. I still sometimes get them if I'm under a lot of stress and it's really damp. I'm hoping after I move later this month I can quit taking meds all the time. When I get a migraine I take Zomig. I took Imitrex before but the side effects were terrible for me. I have also taken Midrin in the past which worked well for my headaches. Good luck to you and I hope you find the answer to help you control your headaches.

kids

1 Article; 2,334 Posts

Next time you get into a spot where you need to go to the ER for migraine (or need a repeat visit like this time)...take in all of your meds so they can SEE you have every non-narc method for treating at home and they aren't/didn't work...I've yet to hear of a drug seeker turning up in the ER with a bag full like you are listing.

sphinx, BSN, RN

326 Posts

I'm curious what kind of mouth guard you have. There are, as I'm sure you might know, a few different kinds. I used to use a soft one that covered all my upper teeth, but it didin't keep me from grinding or clenching so much, but protected my teeth from damage....so I still had terrible pain. I finally ended up getting an NTI splint, it just goes over your front top teeth and prevents your jaw from closing so you can't clench or grind, it forces your jaw to relax. It made a world of difference to me. Now I rarely have any pain.

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