Picture this: You’re in the middle of the worst migraine attack you’ve ever had. You know how severe your migraine symptoms usually are thanks to careful tracking, so you’re certain that this attack is on a different level.
Do you take an extra triptan or NSAID and hope it’ll be enough to get you through this? Or do you risk a trip to the emergency room for faster, more effective treatment?
That’s a tough call to make when you’re in excruciating pain, and it’s even tougher now that you also have to consider the potential exposure to COVID-19, assuming you haven't already gotten a COVID vaccine. To make sure you’ll be prepared if you find yourself in this situation, we got Cove Medical Advisor Dr. Philip Bain’s advice on how to decide when to seek emergency care for a migraine attack.
What happens when you go to the emergency room for migraine?
The most important question to consider before you head to the E.R. is also the most obvious: How will they treat your attack when you get there? After all, there’s no point in traveling there if they’re just going to give you the same medication you have at home.
Luckily, emergency room staff are unlikely to just hand you a painkiller and send you on your way. Because your digestive system slows down during a migraine attack, medical workers won’t give you a pill or tablet at the E.R. Instead, they’ll infuse an acute treatment via IV, which works a lot faster. They’ll also use an IV to keep you hydrated. (Remember, dehydration is migraine’s best friend.)
After visiting the E.R., you should contact your primary care doctor (or migraine doctor if you have one) to go over what happened. You’ll want to identify any triggers that might’ve led to a more severe attack, and consider making changes to your treatment plan if you need to.
What are the downsides of going to the emergency room for migraine?
So, we know E.R. staff will be able to treat your migraine attack faster and more effectively than you could at home—and when you’re in debilitating pain, the only thing that matters to you might just be making it stop as soon as possible.
But if that’s the case, you should also take into account the amount of time you might spend waiting before you get that treatment. There’s really no way to know how long you’ll have to wait, and the emergency room is the last place you’d want to be during a migraine attack.
Why’s that? “Well, the emergency room is often a very loud, bright, chaotic place that treats a large number of patients with a wide range of conditions including heart attacks, strokes, and drug overdoses,” Dr. Bain explains. “To put it bluntly, migraine patients are rarely a priority in the ER.”
And in the times of COVID-19, those other patients aren’t just another source of unbearably loud sounds. They’re also a legitimate risk to your health—and if you have COVID-19 and don’t know it, you could be a danger to them. You shouldn’t let the fear of coronavirus exposure stop you from seeking emergency care if you need it, but you should consider whether the treatment you’ll receive is worth the risk you’re taking.
Oh, and one more thing to keep in mind: “The bills from an E.R. visit can be astronomical,” Dr. Bain says. In an ideal world, you wouldn’t have to consider your financial situation before seeking the care you need, but it’s an unfortunate reality that you should think seriously about before you find yourself in the middle of a severe attack.
Are there any signs that I should go to the emergency room anyway?
Just because there are legitimate reasons not to go to the emergency room for migraine doesn’t mean you should rule out the option entirely. In fact, certain symptoms should be taken as a sign that what you’re experiencing isn’t a migraine attack, and might actually be a more dangerous type of headache.
One clear sign is that your headache is very different from your usual migraine attacks, especially if it’s much more severe and starts suddenly. If you have any of these symptoms in addition to head pain, Dr. Bain recommends that you seek emergency care:
- coughing
- facial drooping
- fever
- seizures
- slurred speech
- stiff neck
- weakness in one arm or leg
It might also make sense to go to the emergency room if your typical treatment routine doesn’t work and you’re still in pain after a few hours, if you don’t have access to the medications you need, or if you’re vomiting so much that you’re dehydrated or can’t keep oral medications down.
What can I do now to avoid having to go to the emergency room?
You might think that there’s not much you can do now to prevent a potential emergency situation, but you’re probably already doing many things that can save you an avoidable E.R. visit. If you have a migraine treatment plan that works for you, you’ll usually be able to get an attack under control before it gets so bad you need to head to a hospital.
What does it take to figure out a migraine treatment plan that actually works? First, you’ll need to find a doctor with experience treating headache disorders like migraine. “Spoiler alert,” Dr. Bain says. “Not all [of them] do.”
Then, you’ll need to work with your doctor to find the right treatment plan for your needs. Dr. Bain recommends including a pain reliever (such as Migraine Relief), a migraine-specific medication like a triptan, and an anti-nausea medication, if needed.
Of course, the journey doesn’t end there. To make sure your treatment plan is working, you’ll want to track your attacks. You should also make sure to keep your medications on hand so you’ll always be prepared for an attack.
We know all that might sound a little overwhelming, and we’re here to help. Our online consultation was designed by migraine experts to help identify the right treatment plan for every sufferer’s needs. Complete a consultation to get a personalized treatment plan recommendation from a licensed Cove doctor today.
The emergency room could be the right place to get treatment that’ll rapidly relieve a severe migraine, but it’s far from the best place to wait out an attack. And when you factor in the cost and potential health risks, you’ll probably want to avoid going there except under the most serious circumstances.
As always, an ounce of prevention is worth a pound of cure. Finding the right treatment plan for your migraine is the best way to prevent a trip to the emergency room.
The information provided in this article is not a substitute for professional medical advice, diagnosis, or treatment. You should not rely upon the content provided in this article for specific medical advice. If you have any questions or concerns, please talk to your doctor.
