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Have you ever rushed to the emergency room for a migraine, hoping for relief,
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only to leave feeling frustrated and unheard?
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Migraine Heroes is a podcast for chronic migraine sufferers who've seen countless
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doctors with no results. Learn how to reduce your migraine attacks without endless medications
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or constant sacrifices. Hello, I'm Diane Ducarme. I've helped over 500 people
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break free from migraine, even after suffering for up to 60 years. My mission in life? To bring
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this relief to a million people using a unique blend of Eastern medicine and Western science.
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In this episode, you will learn why so many migraine sufferers end up in the emergency room
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and what the experience is really like, the benefits and risks of ER treatments,
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when they can help and when they may actually make your migraines worse,
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my most effective way to abort migraine attacks naturally so you can avoid repeated ER visits.
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If you've ever ended up in the ER for a migraine, you're not alone. In fact,
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over 1.2 million people visit the ER every year for migraines. Migraines are one of the top reasons
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for neurological ER visits. They account for a significant percentage of headache-related
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ER admissions. Some studies suggest around 1 to 2% of all ER visits. People with chronic migraines
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are two to four times more likely to visit the ER than those with episodic migraines,
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so less than 15 migraine days a month. Chronic migraine increases the risk of status
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migranosis, a migraine attack that lasts more than 72 hours and often leads to urgent ER care.
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Yet up to 70% of migraine patients report dissatisfaction with the care they receive in
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the ER, citing poor pain relief and lack of planning for follow-up. Let's delve into what
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to expect and the reality for migraine sufferers. If you've never been to the ER for a migraine,
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you might expect to go for immediate relief, especially if you're going through one of those
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status migranosis lasting more than 72 hours. Most emergency rooms follow a standard protocol for all.
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That standard protocol includes step one, triage. The nurse assesses your pain level and symptoms
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to determine the level of priority. Step number two, basic neurological exam. Doctors check for
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signs of serious conditions. Notice that here you are at a disadvantage already. Migraines can
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sometimes be mistaken for other serious conditions like stroke, meningitis or brain hemorrhaging,
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leading to extensive testing using CT scans, MRIs to rule out other causes. Those are very
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important yet absolutely exhausting for your body and brain already in pain. Step number three,
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medication administration. You may receive IV fluids, pain relievers, anti-nausea medications
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or migraine-specific drugs. Step number four, observation. They will monitor your response
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before deciding if further treatment is needed. Step number five, discharge. If no complications
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arise, you're sent home with a very undermining diagnostic of migraine. Sounds logical,
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reasonable and simple. Unfortunately, many migraine sufferers report very mixed experience.
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The ER is designed for medical emergencies and its environment can actually exacerbate the
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migraine attacks. Here are eight reasons why. Number one, bright overhead lights. Many ER rooms
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have harsh white fluorescent lighting that are not thought through for migraine sufferers.
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While they are very helpful to see what's going on inside a damaged body, they can worsen light
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sensitivity and intensify the migraine pain. Number two, loud noises. Beeping monitors,
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staff conversations, nearby patients in distress, crying, create a noisy atmosphere that can be
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overwhelming and migraine-triggering. Number three, high stress atmosphere. Being surrounded
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by medical emergencies, long wait times and the general anxiety of the ER can elevate stress
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hormones like cortisol, which can further intensify a migraine. Number four, lack of
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migraine-specific treatments. Many ERs still rely on non-specific medications like opioids,
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despite guidelines recommending migraine-specific treatments. A 2019 review found that only 37%
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of ER providers followed national guidelines for acute migraine care, which includes avoiding
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these opioids. Guidelines strongly advise against it because they can cause medication overuse
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headaches and migraine chronification. This mismatch often results in ineffective or temporary relief.
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It comes therefore as no surprise that a large-scale review found that only about
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half of migraine patients achieve significant pain relief within two hours of ER treatment.
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Number five, bias and stigma. Research shows that migraine patients, especially women,
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are more likely to be dismissed or misunderstood in ER settings. Some report being treated as
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drug-seeking or overly emotional, which can delay appropriate care. Number six, low rate of
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preventative care recommendation. One study in the US found that less than 20% of patients were
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giving preventative medication referrals or neurologist follow-up after an ER migraine visit.
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Number seven, lack of qualifications by the doctor welcoming you in the ER.
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A survey published in Headache, the journal of head and face pain in 2003, found that the US
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medical schools offered a median four hours of headache education during entire medical school
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and residency programs offered even less, especially in emergency medicine. More than that,
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the US qualifying exam for emergency medicine doctors include only about three to five percent
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of its questions on brain and nervous system topics. Within that small section, headache and
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migraine make up just a tiny portion lumped together with more urgent conditions like stroke
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and seizures. Number eight, exposure to germs. Sitting in a crowded waiting room with sick
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patients can expose you to viruses or bacteria, potentially triggering an immune response that
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worsens migraine symptoms. I recall the story of a woman with whom I currently work based in the US,
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one of, if not my most severe case, recommended by the office of a neurologist to migraine heroes.
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She had had an operation, actually 10 operations for her migraine to put an implant in her brain
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and ended up with a very serious infection in the last operation and needed to have it all
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removed to take care of the new disease at hand. So be mindful. And that is how we get to up to 70
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percent of migraine patients report dissatisfaction with the care they receive in the ER.
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Many describe the ER as a last resort when home and outpatient treatments fail, especially if they
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lack access to timely specialist care or preventative therapy. And timely as a word is
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really important here as we all know. So why going to the ER can be important? While it's true that
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many ER treatments provide only temporary relief, there are legitimate reasons to go,
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namely confirming your diagnosis. A visit to the ER can rule out dangerous conditions like stroke,
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meningitis and brain aneurysm, which can sometimes mimic migraines. And so therefore,
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it's really important. And also getting a short term solution for severe pain. If your migraine
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has reached unbearable levels, ER doctors can provide strong, very strong medications to break
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the cycle of pain. However, these should be seen as last resort, not a long term strategy.
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While ER treatments may offer immediate pain relief, frequent use of medications,
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especially strong painkillers, can actually worsen migraines over time. We've talked about
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medication overuse headaches. They are well documented and a topic on one of my previous
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podcasts. High doses of opioids or morphine can provide instant relief, but often lead to
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dependency and more frequent migraine in the long run. A medication cocktail may break a severe
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migraine cycle, but does not address the root cause of your migraines. And so roughly 30 to
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40% of patients return to the ER within six months, indicating that long term strategies
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are rarely addressed and that some of the treatment received actually could have worsened
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their situation. So how to avoid all of that and abort your migraines? Let's talk about that
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in a minute. Just now, I want to give you five quick advice on how to plan for your visit at the
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ER if you need to go. Number one, bring an ER migraine action plan. Keep a list of what has
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and has not worked for you in your past attack. Please give that list to your loved one. Chances
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are you might need to have them think of it for you. Number two, be clear and assertive. Let your
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doctor know that you have chronic migraines and what treatments have worked before or ask your
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loved one to be that way for you. Very demanding, very assertive. Number three, ask for a proper
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diagnosis. If you haven't been formally diagnosed with migraines, use that ER visit as an opportunity
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to rule out other conditions. Number four, say no to unnecessary pain killers. If you do receive
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strong medication, use it as a last resort, not as a long-term solution. Put that in your action
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plan as well, especially if you have medications that you know will cause problems but will
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actually bring you relief more than others. Number five, follow up with a specialist. ER visits should
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be a temporary measure. Work with a headache specialist or holistic practitioner for a long-term
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plan. Now is the time to demand that visit with the neurologist if you don't have one yet.
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So for me, you know, the real key to reducing ER visits is mastering how to abort them.
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So what's the best long-term strategy? Well, it is to learn how to abort migraines naturally.
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The real key to reducing ER visits is to master how to abort your migraine attacks. That's exactly
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where we created the Migraine Now button in the Migraine Heroes app. One of my clients said,
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oh my god, this is the best use of AI and I agree with her. Over the last five years and a half and
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the last three years, we've developed and we are at our third version of the Migraine Now button.
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We've learned that you can, you can not only prevent migraines, but in many cases you can
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stop them at the beginning or in the middle of the attack without medication. It's not magic,
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it's a skill and like any skill, it's learned and it's deeply
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personal because you matter, your dreams matter and your life matters.
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Found this episode helpful? Hit subscribe so you never miss an episode
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with the powerful insights and practical tips for real migraine relief.
