Published
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?
Cathy
I second what jkaee has said. I get atypical migraines on a fairly frequent basis. Light is generally not a big problem for me, though sound certainly is. I also don't generally get nausea, though sometimes I do. When I am having a migraine I would usually rate my discomfort at about a 5 or 6. Because they are fairly frequent, I have learned that I can't just lay in bed, in a dark and quiet room trying to just sleep it off. I work through them. I deal with the kids through them. I eat through them. I talk on the phone through them. I laugh and joke around through them. Does that all mean I'm not in pain? NOOOOO. My freakin head hurts. Just because people don't do the same things you do when you are in pain doesn't mean their discomfort isn't real.
At the end of it all I must say that I believe that the majority really have pain. But some have learned strange ways to cope with their issues. Some that we have met have other things going on besides their pain. Some probably do not have pain. But the sad thing besides the crappy attitude we have adapted becasue of feeling abused is that these patients do not get the services they truly need. They do not follow up with pain clinics on schedule like we contract with them. They do not get the counseling they need to help with the social issues they are trying to escape with my drugs by lying to me and my doc. Their true needs are not adequetly adressed and this also feeds into our frustration- whether we name it or not. When this patient leaves we do not necessarily feel like we solved anything. - sometimes I do- sometimes I really feel like it is a person with a headache they cannot control themselves and we just got "her" over the bump so that the headache can be controlled at home. These people seldom leave with a zero pain rating- just enough better to feel like they have control. They are happy -so we are too. These do not always get or request narcs either. If is was an easy topic it would not have generated almost 10 pages of discussion. If my crystal ball worked so I could see what pain is real that would be the best!
And I agree that the fakers that inspire our doubt deserve a special hell. Telling the difference I imagine falls into assesment skills. We are trying to figure out what our patient really needs. Maybe it is not really drugs- maybe it is counseling. and maybe it is drugs and then it is sad when we cannot let the patient be an active part of the care planning team- because we have "learned" to question motives.
K
At the end of it all I must say that I believe that the majority really have pain. But some have learned strange ways to cope with their issues. Some that we have met have other things going on besides their pain. Some probably do not have pain. But the sad thing besides the crappy attitude we have adapted becasue of feeling abused is that these patients do not get the services they truly need. They do not follow up with pain clinics on schedule like we contract with them. They do not get the counseling they need to help with the social issues they are trying to escape with my drugs by lying to me and my doc. Their true needs are not adequetly adressed and this also feeds into our frustration- whether we name it or not. When this patient leaves we do not necessarily feel like we solved anything. - sometimes I do- sometimes I really feel like it is a person with a headache they cannot control themselves and we just got "her" over the bump so that the headache can be controlled at home. These people seldom leave with a zero pain rating- just enough better to feel like they have control. They are happy -so we are too. These do not always get or request narcs either. If is was an easy topic it would not have generated almost 10 pages of discussion. If my crystal ball worked so I could see what pain is real that would be the best!And I agree that the fakers that inspire our doubt deserve a special hell. Telling the difference I imagine falls into assesment skills. We are trying to figure out what our patient really needs. Maybe it is not really drugs- maybe it is counseling. and maybe it is drugs and then it is sad when we cannot let the patient be an active part of the care planning team- because we have "learned" to question motives.
K
Very well said. I love your compassionate candour.
Special dance for you!
Catherine
I get migraines but thank god usually only my vision is obscured for about twenty minutes if I go lay down in a dark quiet room. But I will comment on the subject of pain. I went to the ER several years ago. I had severe pain in my back, right side. I couldn't do anything to get comfortable at home so my husband drove me to the hospital. When I got there one of the triage nurses told me there would be a wait to be seen, did I want to register. I told him yes, I was having pain and didn't know why. I was diagnosed with a kidney stone the size of a marble in my ureter and it was moving according to my IVP, was I crying, No I was not. Did I have a lot of pain...Yes I did. So, everyone please be careful when passing judgement on a patient.
In Response to: athomas91 who stated that he has had to shake patients awake and seemed to indicate he did not believe they had level 10 pain simply because they were asleep.
I have seen my teenage son be given enough medication to put him deeply asleep and yet that pain still be there. I know for a fact that my son has a very high pain tolerance, but his migraines are so painful that even while in a drug induced sleep he continues to moan and fidget and even cry because of the pain. He often doesn't remember much about it afterward, but for those of us there with him it is a painful thing to watch.
Thankfully, his neurologist seems to have found a medicine that works (for him) and he only has to endure a severe episode now about once or twice a year, but for a while there it was several times a month and the only thing they could do for him was to give him enough medicine to allow him to sleep, but not stop the pain.
I think that pain is a very hard thing to define and how one person reacts or doesn't react doesn't necessarily indicate their level of pain. Yes I know there are those who "fake" it, and I can only say that I truly hope their bodies never decide to show them the real deal.
I've suffered from these for yrs --
When Imitrex first came out, tried it and kept ending up in the ED w/ SVT.
OK, can't use that class of drugs.
Fortunately, I have a dr. that works w/ me to tx the migraines to keep me out of the ED.
However, several yrs ago, had mild headache, severe visual disturbance, so dh took me to the ED (my dr said to go.) They called for a neuro exam, decided it was a migraine and gave me dilaudid -- which caused a worse headache and itching in throat and face.
Finally, after numerous students/residents/drs, I blew up and said I was no experimental rat for observation -- no one else in the room if they couldn't stay quiet and keep the lights off.
ED dr. gave me demerol and the nurse literally kicked me out of the ED - I could hardly walk, no wheelchair support, etc.
Saw my pcp a few weeks later and he said "Oh, that was you -- they gave me a name of someone I didn't know and I said you were not a pt."
Gee, if they called my dr., which is fine (tho outside of current guidelines) and the dr says I am not a pt., wouldn't it be the staff's responsibility to come back and clarify this for me??
I know now why I was treated like scum by this one nurse.
Why did she assume drug seeking instead of trying to help?
SJ
I suffer from migraines. I have since I was about the age of 12. I have Imitrex, and Vicodin and Torodal (sp?) at home. I can usually treat them myself. This year has been extremely bad I think with my back I am pinching a nerve which hasn't helped my migraines. I have been out to OP so much for them that I will not go until I have tried everything I can here at home and I have usually had it for a wk to 2 wks before going to emergency room. Don't want them to think I am a drug addict just wanting pain meds. When I get them the noise, lights, N/V, unable to eat barely drink. My Dr. has put me on daily medication Inderall 120 mg and Neurotin 900 mg daily and that has calmed them down. Not happening as much. Usually when they are that bad demerol is what i need to get rid of it, or stronger. I will consult my dr. before going to er.
The post above are right pain varies in different people. I for one am not able to tolerate pain very well. My husband can.
My daughter is 10 and is starting to have migraines. We see a neuro dr. in DEc.
Angelia
I suffer from migraines. I have since I was about the age of 12. I have Imitrex, and Vicodin and Torodal (sp?) at home. I can usually treat them myself. This year has been extremely bad I think with my back I am pinching a nerve which hasn't helped my migraines. I have been out to OP so much for them that I will not go until I have tried everything I can here at home and I have usually had it for a wk to 2 wks before going to emergency room. Don't want them to think I am a drug addict just wanting pain meds. When I get them the noise, lights, N/V, unable to eat barely drink. My Dr. has put me on daily medication Inderall 120 mg and Neurotin 900 mg daily and that has calmed them down. Not happening as much. Usually when they are that bad demerol is what i need to get rid of it, or stronger. I will consult my dr. before going to er.The post above are right pain varies in different people. I for one am not able to tolerate pain very well. My husband can.
My daughter is 10 and is starting to have migraines. We see a neuro dr. in DEc.
Angelia
I had fairly good luck w/ Topamax decreasing migraines by about 50% -- and nice weight loss too -- but had to d/c because I couldn't concentrate to study...
Now the migraines and weight are coming back.
My 8 y/o has migraines -- I know they run in families, but she is not my bio daughter...
SJ
Oh Topamax! That's a fun drug, NOT! My Neurologist (I was referred to her by a BLESSED ER RN who was my nurse when I visited the ER for a horrible, horrible 3 day migraine that would not stop) prescribed for me as one of the things we tried to reduce the 9 or 10 migraines a month I was getting. After we had ramped up to the full dosage (can't remember exactly, perhaps 75mg daily) for about 5 days, I lost complete and total sense of smell. Well, that is not accurate. I could not smell any normal smells at all, I could only smell a wierd "chemical" smell that was very strong, and very, very awful. We discontinued it, and thank God, my normal sense of smell came back after about 5 days.
Finally, after I had my hyst. and went on hrt, my migraines have slowed to perhaps one a month or less. Evidently (my gyne and I ) figured out that having an estrogen level of 20 (that's what 70 year old intact ladies have) was a major factor.
I now only get one if I forget to stick a patch on.
BTW, after the Topamax fiasco, and before the hyst, we were trying botox to see if that would work, and it did, but the migraines would come back in 3 months, like clockwork, so that was only masking the problem. Also, lots of migraine patients call Topamax "Dumbamax". It's great for lowering your IQ.
I know this thread is old, but:
I went through a time where i constantly had migraines. I know a few people have asked how someone eats and drinks while having one, but quite honestly, i would have starved if i waited until AFTER the pain was gone. Not to mention i have to eat something when i take any painkiller, anyway.
My point? Don't assume anyone that eats and drinks with a migraine is a faker.
louloubell1
350 Posts
I second what jkaee has said. I get atypical migraines on a fairly frequent basis. Light is generally not a big problem for me, though sound certainly is. I also don't generally get nausea, though sometimes I do. When I am having a migraine I would usually rate my discomfort at about a 5 or 6. Because they are fairly frequent, I have learned that I can't just lay in bed, in a dark and quiet room trying to just sleep it off. I work through them. I deal with the kids through them. I eat through them. I talk on the phone through them. I laugh and joke around through them. Does that all mean I'm not in pain? NOOOOO. My freakin head hurts. Just because people don't do the same things you do when you are in pain doesn't mean their discomfort isn't real.