Migraine Rantings
ERnursey was kind enough to allow me to hijack the comments to her excellent post about patient satisfaction scores (which evolved into a raucous discussion about the treatment of migraine patients in the ER), and then she came up with another brilliant post which explains how to tell the difference between a "migraine" patient and a patient with a migraine.
Good stuff.
Thank you ma'am. Sorry for the detour.
Good stuff.
Thank you ma'am. Sorry for the detour.
Labels: rants
posted by scalpel at 7:15 PM
17 Comments:
I know I'm on vacation, but that doesn't give you guys an excuse to neglect to email or otherwise contact me when there's a good flame war going on.
Unacceptable! ;-)
OY, I think I'm getting a headache now ;p
A call to action! I'm going to turn on all the lights and crank the music way up so they can't hurt me.
Anyone have a strobe light I can borrow?
No strobe, but I have 2 young kids that can make a LOT of noise! ;)
Who knew that migraine was the new fibromyalgia?
When I have a migraine I wouldn't even think about getting on the computer.
How is it that all of those "I have a 10/10 migraine every day" people are on the internet? Especially the one who says she's "in the middle of going on day 2 of a very high migraine attack"
Now I've got two groups to piss off when I feel like blogging again.
Sweet.
Hi, MonkeyGirl,
The people who post to that forum aren't they "typical" person with Migraines. They're Migraineurs who haven't found effective treatment yet, the ones who need information and support. They're working with doctors to find effective preventives and abortives.
I too have wondered how someone can be on the computer when they're having a severe Migraine. I certainly can't do it. In an attempt to address that issue and get people on the same page when using the pain scale, I contacted a couple of Migraine specialists for advice. Two things were pointed out to me. 1) When we attempt to quantify the numbers on the pain scale, what we end up with is a scale of how incapacitating the Migraine attack is, not the level of pain. Pain is so subjective that I gave up trying to understand how other people scale it. 2) Some people, even during a Migraine, are more functional than others. Especially those whose vision isn't affected by Migraines, try to do something to distract them from the pain and end up on the forum.
The comments on ERnursey's blog got a bit heated yesterday, but in the end, I think it was a productive discussion for some.
Teri
I agree.
As I've said before, treating pain is only an intermediate goal. Restoring function is the ultimate goal.
scalpel, I hope you aren't saying that migraines aren't really painful and excruciatingly so?
I haven't had a migraine headache in about 13 years. but, before that I went to the hospital maybe twice in my life with the worst headache i could imagine.
They came on quick, with no warning, and were almost immediately disabling. I could stand no noise and no light. I threw up almost non-stop and when there was nothing in my stomach then it was dry heaves. I could not even communicate effectively with people in the ER, that is how bad they were.
The strange thing is, in 1995 when I had a radical hyst for cancer, I have not had one of those type headaches since. I have to assume they were somehow hormonal, but I have no idea how that works. But, I do know what a horrible pain there can be with this kind of headache.
"scalpel, I hope you aren't saying that migraines aren't really painful and excruciatingly so?"
I'm not sure how you came up with the idea that I said anything like that. Because I didn't.
Hoo ah! All this talk of migraines is bringing on one of my own! I read the craziness on ernursey's site...what fun. It sure seems like alot of commenters there were trying to "out do" each other with stories of how painful/incapacitating their migraines are. Not that I think they were lying, I have migraines too, but it just doesn't seem like the best way to get the point across. And I really don't think any of the doctors/nurses involved in the discussion were trying to minimize the effects of migraine. Just my 2 cents...
But something else that made me think...seeing as some of the commenters had such debilitating migraines, sitting in front of a computer getting worked up over a blog post would NOT help the migraine!! =D whatever.
My initial comments were just intended to try to debunk some of the common migraine forum talking points. They like to say that they don't mind waiting to be seen and that they don't complain, but in reality everybody minds and many of them complain. They like to mention the stroke data to try to pressure us into seeing them sooner than we would otherwise, for example.
I admittedly was baiting them a little with the "candy" statement, which infuriated them, and then when I called "james" on his dubious assertions they didn't like that too much either. It seems to me that if "james" story were true then he would be posting that mean doctor's name all over the internet with gusto. Karma, right? I guess not.
Anyway, from my standpoint, I basically treat the migraine patient and the "migraine" patient the same as each other and the same as every other patient. As long as someone doesn't have a potential life or limb-threatening condition, then they are just another low acuity patient. If they are vomiting, yeah, they get back faster. If they have a neuro deficit, they come back immediately. Otherwise, it doesn't really matter.
Since neither migraine or tension headaches are going to cause them any harm, my goal is just to give them relief and get them home as soon as possible.
Actually, if you read the article it says James isn't his real name. I'd put better than even odds that this James just saw the story and thought he'd adopt it to make a point.
I've been following these blogs over the weekend and this week. Scalpel, thanks for pointing out that "call to action" in that forum. Following that was even more interesting than following the blog comments.
Emily, people sharing their own experiences is hardly trying to "outdo" each other, and using a computer during a migraine doesn't mitigate its severity. Sitting at a computer isn't the kind of activity that usually intensifies migraine pain, and doing something at a computer can help distract one from pain. It's quite easy to dim a monitor so it doesn't hurt to look at it. Learn what you're talking about or don't criticize others.
As for Mrs. Robert recounting the story of "James" and "Janice," as Mrs. Robert pointed out, she could have used another case to make a point, but chose to use them as she had personally been in contact with them. Googling brings up, for example, another suicide she wrote about based on articles in the british press, a mother's suicide. For that matter, anyone who Googles Mrs. Robert and takes the time to read even a bit of her published material will find that she probably knows more about migraines than some doctors. In her place, I'd be suing you for libel.
Most interesting is that even though scalpel baited these migraine sufferers with "candy," "cookie," and looking for a strobe light, which is a trigger for some migraine sufferers, they didn't stoop to his level.
The have shown themselves far more mature and intelligent when they decided in their forum remarks that he is not worth their time or any more comments. In fact, it was theorized that he is an internet bully who would never have the balls (my word, not theirs) to say such things should he have to do so in person. Rich! Sweet!
Now that I've commented, actually for the benefit of reasonable people who might come across this discourse, I bid scalpel a not-so-fond adieu! Scoff at the karma comments if you will. I find them entertaining as I think of the karma he has engendered.
one more thing and you can go back to your 'rantings.'
some of the most cooperative patients we see come from some of those 'migraine forums' scalpel so disdains. the migraine patients who bother to pay attention and take responsibility for themselves instead of whining about it get some good out of those forums. at least some of the good ones that encourage responsibility instead of whining.
thanks for linking to one on ernursey's comments. that's a good one to recommend to pts.
michiganerdoc signing off
"Scoff at the karma comments if you will. I find them entertaining as I think of the karma he has engendered."
I did get a pimple yesterday. I guess we can call it even.
I don't know about those other people with migraines, but when I get one, I go home, turn off the lights (or use the window shades to block out light), crawl into bed (my cozy, comfy bed), with the AC on high and sleep it off. Isn't that what's going to happen in the ER, anyway (eventually)?
I've been fortunate that I've found the main cause of my migraines (MSG) and I can prevent them, for the most part. Besides, I never went to the ER because I didn't think there'd be anything they could do for me, anyway. Just time and sleep seem to be the best fixes for me. Too bad that doesn't work for everyone, migraine - 'migraine', or not.
I read some of the comments as I am writing a paper on migraines for my MSN/APRN. I also am a mom of a daughter who has had migraines since she was about 10. We have been to the ER several times. She has had status migrainous on a few occassions, stretching to 10 days ending with a grand mal seizure. Until you have a child, who is healthy and happy one minute and down and out with blurred vision, severe abdominal pain and headache you wont understand the pain. I too am a nurse who worked many years....tired of the back patients etc. I also never realized how truly disabling severe migraines can be. I realize their is quite an amount of variety between migraine patients. I only hope that after years of experience and your own life experiences with people that you truly love.....and realize how non-compassionate healthcare is....and hope that you will realize that some truly are in agony and have no where to turn but the ER. Thanks
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