Last Wednesday I encountered the reason for the sometimes crappy treatment I get in the ED concerning my migraines. I actually met a real life in the flesh migraine faker! :
I was waiting in the Ed waiting room, waiting for my boyfriend to get off work, and noticed a couple sitting across from me. They were chatting happily, laughing and pigging out on candy bars and chips and cokes. I noticed the hospital bracelet on the girl and after about 10 minutes, I couldn't help myself.... I asked her what brought her to the ED at 3:00 in the morning. She looked at me and says..."Migraine"
I'm in shock at this point but then I get angry!
I say" YOU have a migraine and you can EAT and DRINK? Isn't the light bothering your eyes? You do NOT have a migraine and you know it!"
I turn away disgusted. Well....guess what...she goes into "migraine mode". Gone are the chips, the chocolate and the cokes, and out come the dark sunglasses, the cold ice pack and she puts her head down on her boyfriend's shoulder and starts to grimace in "pain"
I start laughing out loud. :chuckle I could not believe it! I still can't!
I have to drag myself into the ED, feeling half dead, wishing I was, and I get the red flag because the staff encounters people like this girl!
When I finish nursing school I want to work in the ED and I'm guessing I can't do what I did Wed, but I think I'm going to have a hard time keeping my mouth shut.
Honestly, I never quite understood how the cynicism towards migraineurs came about until now. Another part of me can't see how the real thing can be confused with these obvious cases of faking it. A dilemna that shouldn't exist I suppose.
How do you handle people like this? Can you get your license taken away?
We have seen the whole spectrum of migraine complaints. But the sure sign there is a problem folks is this- if they get their shot and scoot immediately to the bathroom- to huff the air freshener- then we know there is a problem. Yep we did catch one. This Pt no longer gets narcotics in our dept. We spent time on the net and found that air freshener somehow makes the high better.
Yeah whatever.
We really try to believe what our patients tell us about their pain. and treat according to their complaints. I hate that patients like this affect the care of those who would never dream of abusing us.
Migraines are the worst... it's like having a kidney stone in your head!
I have been plagued with them for a long time and get frustrated too when I hear people who have a "headache" call it a migraine . However, I have to remember that I have managed to build up a hige pain tolerance level. What I go to work with might put another peson out for days! I try to be sympathetic and try to remember that even if they don't LOOK sick -- they feel it. (But any time someone USES an illness or injury to get drugs, attention etc... it sort of yanks my chain -- those of us who have to live with that kind of stuff ..try NOT to use it but function in spite of)
I avoid the ER with mine -- am tired of the run around.
Locally there is a computer bulletin board, that rates ERs and clinics and MDs On who gives the most pain relief meds. Hilarious to read. A pt in our ER gave the site to me and a password, hilarious.
I had a girlfriend that had migraines so bad that everytime she had one she would have me take her to the emergency room. They give her a shot and she would be totally out for the whole day. I used to get them too but I would hurry home and stay holed in in a quiet room until it passes. I don't know how other people can carry on like it doesn't bother them.
Deb: Same thing happened to me w/ my GB; boy, were they nice to me all of a sudden when the U/S results came back (funny how that picture of a honkin' big stone got me treated with compassion, whereas prior to the U/S no one wanted to be bothered).
I went in to the ED once with a migraine and my nurse was wonderful, bless her heart, but I'm sure the attendings were skeptical, since it was a friday night and maybe they thought I was a seeker lookin' for a fix. The nurse told me they were giving me toradol and reglan IV. I felt 10000 times better in about 30 minutes and after vomiting up the last contents of my stomach, I felt refreshed and ready to go home. When I asked to be d/c, the doctor and nurse both came into the room and they were like, "you feel better? really? great!" and I said to them- duh. I'm not a seeker. The Toradol was great. Please note in my chart that I was relieved with Toradol so that if I come back in the future, you guys will know that I'm not a seeker!
Deb: Same thing happened to me w/ my GB; boy, were they nice to me all of a sudden when the U/S results came back (funny how that picture of a honkin' big stone got me treated with compassion, whereas prior to the U/S no one wanted to be bothered).
I went in to the ED once with a migraine and my nurse was wonderful, bless her heart, but I'm sure the attendings were skeptical, since it was a friday night and maybe they thought I was a seeker lookin' for a fix. The nurse told me they were giving me toradol and reglan IV. I felt 10000 times better in about 30 minutes and after vomiting up the last contents of my stomach, I felt refreshed and ready to go home. When I asked to be d/c, the doctor and nurse both came into the room and they were like, "you feel better? really? great!" and I said to them- duh. I'm not a seeker. The Toradol was great. Please note in my chart that I was relieved with Toradol so that if I come back in the future, you guys will know that I'm not a seeker!
I went in to the ED once with a migraine and my nurse was wonderful, bless her heart, but I'm sure the attendings were skeptical, since it was a friday night and maybe they thought I was a seeker lookin' for a fix. The nurse told me they were giving me toradol and reglan IV. I felt 10000 times better in about 30 minutes and after vomiting up the last contents of my stomach, I felt refreshed and ready to go home. When I asked to be d/c, the doctor and nurse both came into the room and they were like, "you feel better? really? great!" and I said to them- duh. I'm not a seeker. The Toradol was great. Please note in my chart that I was relieved with Toradol so that if I come back in the future, you guys will know that I'm not a seeker!
Hee!
Friday, Saturday, 2 in the morning or 2 in the afternoon.....what time does it have to be so no one thinks you're drugseeking? I'm truly perplexed. I've heard referance to time as a red flag often and was just wondering. What if the migraine occured 56 hours before and you got fed up at 2 in the morning on a Sat? I'm really happy to hear that you got relief with what you got! I'm on that same regime but at home as to avoid going in at ANY time of the day.
I know adressing this topic is like beating a dead horses but oh well. Sorry guys!
UPDATE: I got an answer from my fiancee who talks with the nurses all the time or rather listens to them. It seems fishy when a migraine will come in on a friday or at wee hours of the morning because a Friday signifies lonliness and the wee hours says that you know precisly when its not busy and that you will be seen quicker. Whaaat?
KC, we used to have that problem until recently, when our entire hospital campus was declared a smoke free zone.
Now we can tell them that they can NOT go outside to have a cigarette while they are waiting to be medically cleared for admission to our psych unit or someone elses (rehab, etc) talk about mad, there are many of them who go AMA because of this...
back to the topic of Migraine sufferers, we have those (as I am sure you all do) who are allergic to: Imitrex, Toradol, Ibuprofen, Tylenol, Phenergan, Stadol, percocet, Vicodin,Midrin, Maxalt, Zomig, Compazine, etc etc... Of course they CAN take Morphine and Demerol!
when we start their triage, we can usually tell who are seekers and who are sufferers. I try to be very empathetic to either one, they usually dont require a lot of me, just giving the meds and discharge and actually it is kind of nice to not have a patient that needs the million dollar workup!
Have you ever had a shot of Imitrex for a migraine. It was useless for me and made my head burn. So they gave me another shot of it because the first didn't work. I get migraines and have been to the ER for them. I think I have went 3 times in the last 4 years. And believe me it is only after all of my options have been exhausted. Hot shower, dark room, meds and an ice pack. And truthfully I was treated crappy at the ER. To start with before I went I had tried Excedrin Migraine (which normally works miracles) and Tylenol is a joke when it comes to migraines. Not sure about the others. I will absolutely refuse Imitrex. The nurses should have realized I wasn't faking as I kept puking, right in front of them. I am not sure what they eventually gave me the first time after the 2 shots of Imitrex (which my doctor know informs me is contraindicated due to my medical history, which the nurse was told about by my dh) but it worked. The other time I remember as being a horrible experience they gave me demerol, as I told them my dr said no Imitrex and they could call her. It didn't relieve the pain but made me "out of it" Yet when I told the nurse this (and still puking) she said "Oh well, the dr won't give you anything else and he has already signed your discharge papers" So dh had to take me to another ER (they were very nice there) when they gave me compazine and something else (not morphine or demerol and it was a pill and a suppository) and it worked. So if I have to go in for a migraine again I will refuse the imitrex and demerol. Maybe that nurse had drug seekers before but I don't think she should make that judgement. I certainly don't look like one. Although I guess they come from all walks of life. I look like the middle class housewife(and nursing student) that I am. She actually refused to tell the dr it didn't work. My blood pressure was sky high and it is normally very low. Doesn't that signal pain? Dh had dropped me off (we had 2 kids and it was the middle of the night) and picked me up when I called that time or he would have raised a fuss. I was in too much pain to argue much. But it still pisses me off to this day. I actually fought the hospital with the copay and won. Tried to have the insurance company not pay them too but the insurance co refused to fight it. I also made a complaint to the hospital. I have been to that same ER for my kids, my son had stitches above his eye there and we just went Friday night because my 6 month old had a high fever that would come down (104.7 rectal) and it turns out he had the beginning of pneumonia. The nurses are usually great at that hospital (I had my kids there) so it must have been an off night for that nurse but I was in some serious pain. And I have an extremely high threshold. My labors barely hurt (except for #2 -- the induction). In fact I had no pain with #3 and only went to the hospital with #1 because I wanted to push.
I am not sure how I will be as an actual nurse but I hope I don't treat a patient poorly because I perceive them to not be in pain or lump all migraine suffers who go to the ER as drug seekers.
And there is a special place in hell for anyone who fakes a migraine. I wish many migraines upon them. Wish they drug seekers would find a different illness to fake.
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teeituptom, BSN, RN
4,283 Posts
Pain is the reality of the individual :rotfl: :rotfl: :rotfl: