A Guide for Migraine Patients When in the Emergency Room
When you are in the throes of a migraine attack, harnessing the energy to leave the house requires a gargantuan effort. So, you can bet that if a migraine patient presents at a local emergency room, it’s because they need help—although due to the ongoing stigma associated with migraine, many patients won’t receive the attention they deserve. If the pain you are experiencing prompts an ER visit, the following guide will help you ensure that your visit results in the care you deserve.
What to expect when you go to the emergency room for your migraine
Signs to go to the emergency room for a migraine
The reason most people with migraine end up in the emergency room is that they fear their symptoms may be a sign of another serious health condition or the pain has become unmanageable. If the pain begins suddenly, it is more intense than usual, causes numbness, weakness, visual loss, or any unusual or new symptoms—you need to get checked out by a doctor. Pain can be a frightening sensation because it can feel like you are out of control with no resources to improve the situation.
Prepare to face the stigma
Unfortunately, those who end up in the emergency room for their migraine are sometimes greeted with hostility instead of empathy and compassion. It is not uncommon to hear of migraine patients being treated disdainfully, as if they are exaggerating their symptoms. Their invisible pain is often not taken seriously—some are even accused of being “drug seekers,” inventing their condition to score medication. Don’t let this discourage you. Be your own advocate and remember: Migraine is a disabling disease, and you deserve proper support and treatment.
Know what to expect once you get there
The wait. You should expect a lengthy wait time when you arrive at the emergency room. You’ll have to be assessed and go through triage, and unfortunately, migraine is often determined to be a less serious problem compared to other conditions that present to the emergency department.
The waiting room. The hospital waiting room is the absolute worst place to be when your head is pulsating and your stomach and the room are spinning. It is often noisy, too bright, and has strange smells and beeping alarms—all of which can only make a migraine attack worse.
The examination. When you are finally seen by a doctor, your symptoms may make it difficult for you to give a coherent account of your medical history. Migraine hangovers, also know as the “migraine fog,” can make patients sound drunk or dazed, and can further raise suspicions that you are not legitimately unwell. If you are deemed to be truly experiencing a medical issue, you will most likely be given pain relief medication and sent home.
Items to bring with you
Aside from always having your migraine kit fully stocked and with you (acute pain medication, food, water, other medications, and anything else you need during an attack), you should also have the following items in one place and easily accessible somewhere in your home. That way you don’t have to look for them when you are in the grips of a debilitating migraine attack and need to get to the emergency room quickly.
- A letter from your headache doctor explaining your diagnosis, and a full history of your illness. Include your doctor’s contact information in case the ER doctor has questions for them. If you do not have a headache doctor, make sure the advocate who comes with you is prepared to vouch for you when you describe your symptoms and medical history. It is optimal if your physician documents in the letter what medications you have responded to and tolerated in the past and which drugs have been poorly tolerated or haven’t worked.
- A full list of your medications. Try to bring them with you as well.
- Your headache/migraine diary.
- An advocate. A trusted friend or family member has a dual role—they can care for you and ensure you get to the hospital and home again safely. But they can also ensure medical questions are answered fully, remember any important instructions, and can make sure you get the care you need.
Don’t forget to schedule a follow-up
If you do end up in the emergency room because of a migraine attack, be sure to schedule a follow-up appointment with the provider that normally cares for your migraine. If you currently aren’t seeing a headache specialist, search for one here. That way your medical records will be up to date and any changes to your medication schedule can be enacted. You will also be able to go over the details of your visit and relay any new information you received from the emergency room doctor.
Preparation is the key when it comes to living with migraines. By following the steps outlined here, our hope is that you receive compassionate, prompt, effective help should you ever find yourself in the emergency room for your migraine. For more information on whether your migraine symptoms warrant a trip to the emergency room, check out this piece from the American Migraine Foundation resource library. If you have questions and would like to speak to us directly, contact us here.
Reviewed for accuracy by the American Migraine Foundation’s subject matter experts, headache specialists and medical advisers with deep knowledge and training in headache medicine. Click here to read about our editorial board members.