and today, the hangover
Morgan and I ended up in the ER last night.
Last night was not a great night. Morgan and I ended up in the ER due to a migraine that was really awful even by my standards. We held off on going for like two hours because I didn't want the lecture, but eventually I gave up and said let's go.
First they gave me Zofran and magnesium, but the magnesium and I didn't work well together - it made me really hot and flushed, and it made the nausea worse which made my migraine worse which yeah, not a good plan. Then they did give me Dilaudid and fluids and sent me home after, which was all I'd wanted.
We did get the narcophobe lecture from the doctor BUT in his defense he wasn't judgmental toward me at all and was very matter of fact about it. The reason I get the lecture every time I go to the ER is because WA state guidelines say you're not supposed to give IV narcotics for acute increases in chronic pain, which my migraines technically are. WA guidelines indicate that I should be treated with narcotics by my prescribing doctor and that's it. So before the doc gave me any pain medication, he went through my records and looked me up in the controlled substance prescription database. And yes, I have a lot of scrips for narcotics in the last twelve months. I've also had more root canals than I can remember plus my normal monthly meds. But the doc did acknowledge that there aren't really any other red flags in my file, because I'm not doctor shopping for scrips, I'm not ER shopping for narcotics, and I've had my routine with my monthly scrips and my doctors for a while now.
The problem is that my regular docs tell me to go to the ER when it gets that bad, and the ER docs tell me they're really not supposed to treat me. Note that while almost all of them have told me they're not supposed to treat me, with about one exception they all have, and the doc last night said he couldn't in good conscience let me leave without mitigating or reducing my migraine. I really have to give the ER docs credit for that, even though they're technically violating state guidelines by treating me. (I'm not sure if they're laws or guidelines or what the penalty is for breaking them.)
So I will be talking to my pain doc and my neuro in the next month about what I can do when my regular meds aren't enough. The problem isn't that they're not prescribing me enough oxycodone to get through the month, because they are. The problem is that I get migraines the oxy won't touch, or won't break, and in those situations the only thing I've ever found to work is IV dilaudid. But going to the ER every six weeks is unsustainable and I am so, so tired of the lectures.
For other options, the ER doc did mention things like DHE, but because my migraines come with a lot of neurological symptoms (that weirdly keep changing) it may be contraindicated. I'm not entirely sure about that but the doc didn't offer me a DHE option last night. The magnesium was supposed to help the migraine, because it does sometimes, but either it infused too quickly or it's just not a good option for me because it just made me feel terrible. I didn't say anything at first because I thought the nausea and the feeling hot was due to the migraine, but realized when I kept feeling really flushed especially in my throat that it was a magnesium side effect, so asked Morgan to go check with the doctor, who immediately sent in a nurse to discontinue the mag.
Also when they gave me the second dose of Zofran and the first dose of Dilaudid they gave me ice chips and oh my lord that may have been the best thing I ever had. My mouth was super dry and the ice was exactly what I needed. I ate ice pretty much all the way home and then drank water.
Morgan is home today because we didn't get home til like...eleven? I don't even remember. So he didn't sleep well and took today off. I wish I could have, but I need to be here for meetings and my (gulp) performance review at 3. At least the migraine is gone. I have a migraine hangover today, but it's not an actual migraine so I'm considering myself lucky.
This entry was originally posted at http://blueraccoon.dreamwidth.org/1365315.html. Please comment there. |
comments
Last night was not a great night. Morgan and I ended up in the ER due to a migraine that was really awful even by my standards. We held off on going for like two hours because I didn't want the lecture, but eventually I gave up and said let's go.
First they gave me Zofran and magnesium, but the magnesium and I didn't work well together - it made me really hot and flushed, and it made the nausea worse which made my migraine worse which yeah, not a good plan. Then they did give me Dilaudid and fluids and sent me home after, which was all I'd wanted.
We did get the narcophobe lecture from the doctor BUT in his defense he wasn't judgmental toward me at all and was very matter of fact about it. The reason I get the lecture every time I go to the ER is because WA state guidelines say you're not supposed to give IV narcotics for acute increases in chronic pain, which my migraines technically are. WA guidelines indicate that I should be treated with narcotics by my prescribing doctor and that's it. So before the doc gave me any pain medication, he went through my records and looked me up in the controlled substance prescription database. And yes, I have a lot of scrips for narcotics in the last twelve months. I've also had more root canals than I can remember plus my normal monthly meds. But the doc did acknowledge that there aren't really any other red flags in my file, because I'm not doctor shopping for scrips, I'm not ER shopping for narcotics, and I've had my routine with my monthly scrips and my doctors for a while now.
The problem is that my regular docs tell me to go to the ER when it gets that bad, and the ER docs tell me they're really not supposed to treat me. Note that while almost all of them have told me they're not supposed to treat me, with about one exception they all have, and the doc last night said he couldn't in good conscience let me leave without mitigating or reducing my migraine. I really have to give the ER docs credit for that, even though they're technically violating state guidelines by treating me. (I'm not sure if they're laws or guidelines or what the penalty is for breaking them.)
So I will be talking to my pain doc and my neuro in the next month about what I can do when my regular meds aren't enough. The problem isn't that they're not prescribing me enough oxycodone to get through the month, because they are. The problem is that I get migraines the oxy won't touch, or won't break, and in those situations the only thing I've ever found to work is IV dilaudid. But going to the ER every six weeks is unsustainable and I am so, so tired of the lectures.
For other options, the ER doc did mention things like DHE, but because my migraines come with a lot of neurological symptoms (that weirdly keep changing) it may be contraindicated. I'm not entirely sure about that but the doc didn't offer me a DHE option last night. The magnesium was supposed to help the migraine, because it does sometimes, but either it infused too quickly or it's just not a good option for me because it just made me feel terrible. I didn't say anything at first because I thought the nausea and the feeling hot was due to the migraine, but realized when I kept feeling really flushed especially in my throat that it was a magnesium side effect, so asked Morgan to go check with the doctor, who immediately sent in a nurse to discontinue the mag.
Also when they gave me the second dose of Zofran and the first dose of Dilaudid they gave me ice chips and oh my lord that may have been the best thing I ever had. My mouth was super dry and the ice was exactly what I needed. I ate ice pretty much all the way home and then drank water.
Morgan is home today because we didn't get home til like...eleven? I don't even remember. So he didn't sleep well and took today off. I wish I could have, but I need to be here for meetings and my (gulp) performance review at 3. At least the migraine is gone. I have a migraine hangover today, but it's not an actual migraine so I'm considering myself lucky.
This entry was originally posted at http://blueraccoon.dreamwidth.org/1365315.html. Please comment there. |
comments