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        Cluster Headache Help and Support >> Cluster Headache Specific >> My recent trip to ER (RANT)
        
(Message started by: mynm156 on Sep 18^th, 2007, 3:33pm)

Title: My recent trip to ER (RANT)
Post by mynm156 on Sep 18^th, 2007, 3:33pm

It doesnt happen often, in fact it had been about two years. Yep two years sence I last found myself in that place. It took me six hours of futility and finally despiration for me to go. So I took my swollen face and agonizing head to the brand spanking new ER just one mile from were I currently reside. For those of you who dont know I work in Healthcare. I am a Respiratory Therapist And I take advantage of my working in the hospital ESPECIALLY Emergency Rooms to try and ENLIGHTEN any and all Doctors who cross my work path to the life and current treatment times of a Cluster Head.

So back to the ER I was in and Triaged in under ten mins. This was however my last bit of GOOD NEWS to share about this trip. They Stuck me on what we call The Fast Track. This is an area of the ER where you are expected to get in and get out in a hurry. I was set in small room IN A CHAIR in the dark to await the Physicians assistant. HE showed up to find me pacing the room and I BEGGED him for a Non Rebreather. Has said I thought you had a headache are you having difficulty Breathing too? Through clinched teeth I explained the Hows and whys. HE then took me to a room that no longer attempted to confine me to a chair but one of those examination tables. He handed me the NRB and left me there again in the dark to await a shot of everybodies favorite Toridol. I had reached the point of tears. You know not Crying but when you hurt soooo bad that Tears just spontainously flow down your face. and speaking of FLOW I COULD NOT GET ENOUGH FLOW into the NRB and I mean I was breathing SOOO Fast and Deeply that the meter could not keep up. This of course with my moaning and cryiing got the attention of the Nurse God bless her who brought me the Toradol. She however, didnt understand that I didnt JUST HAVE A HEADACHE she kept telling me to slow down my breathing and ease up she wanted to turn down the oxygen. I was again left in purgatory for 90mins to fend for myself. Remember this is one of those small examinating tables couldnt laydown in you wanted to. Then comes my nurse SO are you feeling anybetter? NO!!!!! 30 mins later she returns with another needle and says Here I have some Demerol for you. To which I replied No you dont and she seemed very perplex by this reaction of mine. yet there proudly attached to wrist is the BIG RED ARMBAND that say say in BIG LETTERS DEMEROL!. You see I and VERY Very Allergic to demerol almost quit breathing once because of a IV shot of it. When I told her that she left again. cameback within a couple mins and then said "Well what does help you, we are not sure what you want." My good Cluster brother Chris SUPERPAIN texted me and summerized my trip like this " ER waste of Time and MONEY" I left the ER after 4 hours with a Script for Stadol nasal spray Use one Spray every Three hours. HAHAHAHAA EVERY THREE HOURS!!! and an ICE pack. Well My Cluster Brothers and sisters just like the precious few moments you wont get back from reading this go nowhere rant of a tortured fried brain all I ended up with was a reminder POUND BALLS FLAT WITH WOODEN MALLET BEFORE GOING TO ER. This will be more effective in dealing with the situation unless you are one of my sisters then how about EpiLady your sweet spot instead.

GOOD VIBES AND LOTS OF CLUSTER LUV!!!

MYNM156 aka howard

Title: Re: My recent trip to ER (RANT)
Post by Bob_Johnson on Sep 18^th, 2007, 9:18pm

You are not alone--as too many messages here will attest. Only reinforces that docs get very little/no education in treating complex headache. Given our very MINORITY position in their lives (i.e., medical issues they will commonly see) it's not a surprise that the ER is not the place to go.
========
Treatment of Primary Headache in the Emergency Department

Harvey J. Blumenthal, MD; Michael A. Weisz, MD, FACP; Karen M. Kelly; Renae L. Mayer, MD; Jeffrey Blonsky, MS4
Headache 43(10):1026-1031, 2003. © 2003 Blackwell Publishing

Posted 01/06/2004
Abstract and Case History
Abstract
Background: Each year many patients present to an emergency department for treatment of acute primary headache. We investigated the diagnosis and clinical outcome of patients treated for primary headache in the emergency department.
Methods: Patients treated for acute primary headache in the emergency department completed a questionnaire related to their headache symptoms, response to treatment, and ability to return to normal function. These responses were compared to the treating physicians' observations of the patient's condition at the time of discharge from the emergency department.
Results: Based on the questionnaire, 95% of the 57 respondents met International Headache Society diagnostic criteria for migraine. Emergency department physicians, however, diagnosed only 32% of the respondents with migraine, while 59% were diagnosed as having "cephalgia" or "headache NOS" (not otherwise specified). All patients previously had taken nonprescription medication, and 49% had never taken a triptan. In the emergency department, only 7% of the patients received a drug "specific" for migraine (ie, a triptan or dihydroergotamine). Sixty-five percent of the patients were treated with a "migraine cocktail" comprised of a variable mixture of a nonsteroidal anti-inflammatory agent, a dopamine antagonist, and/or an antihistamine; 24% were treated with opioids. All 57 patients reported that after discharge they had to rest or sleep and were unable to return to normal function. Sixty percent of patients still had headache 24 hours after discharge from the emergency department.
Conclusion: The overwhelming majority of patients who present to an emergency department with acute primary headache have migraine, but the majority of patients receive a less specific diagnosis and a treatment that is correspondingly nonspecific.

Title: Re: My recent trip to ER (RANT)
Post by BarbaraD on Sep 19^th, 2007, 6:36am

Howie,

ER is definitely NOT the place to go unless you have a cigarette lighter and are holding the whole ER dept hostage in front of the O2 threatening to light it until the CH receeds (my favorite story on this board on how to handle ER).

The last time I was in ER (for an unrelated accident) my head was strapped down to a nice board and I got hit. I told the nurse to get me lose and what was happening. He told me he needed to ask some questions first and then he asked me if I was PREGNANT! My hands found his neck and I (loudly) gave him a class on CH while shaking the hell out of him. The ER doc (fortunately) had heard of CH and came running and my head was unstrapped (after the doc explained that I had to let go of the nurse's throat first) and my meds were given STAT and the ER settled down to quiet after a fashion. Sometimes ya just gotta explain it to them where they can understand it..... ;;D

And BTW - we're not laughing at you -- we're laughing WITH you -- almost everyone on this board has had a BAD experience with ER.

Hugs BD

Title: Re: My recent trip to ER (RANT)
Post by barry_sword on Sep 19^th, 2007, 7:02am

Howard, I have had a similar experience with the ER. I have made two trips to the ER for a CH. MY FIRST AND LAST! The Doc on duty was a total freak. He stuck the tubes in my nose with a flow rate of whatever and gave me an IV drip. I told him I had a bad night of hits and looks like I have hit my head during an attack. He did not even look at the back of my head.

He then proceeds to tell me he is a CH sufferer. WHAAAA!!!!
He say's whenever he gets this "thing" he drinks back an Alkselzer because it has Aspirin in it and stops his "headache right away. I played along with this nut because all I wanted to do was get away from the whole ordeal.

Since then I have o2 and the right amount of Verapamil so no more ER visits for me for a CH.

I am not knocking the ER, but our's does not know what to do with a CH sufferer when they come in. I tried my best to explain but it was a waste of time.

Barry

Title: Re: My recent trip to ER (RANT)
Post by cat1955 on Sep 27^th, 2007, 6:23am

I live in Las Vegas and have had to go to the ER twice in the last year :-[ I ....2 different ER's...both of them gave me IV meds for pain and nausea. I tried to hang in there and ride it out but after several hours I gave in and went. I previously had a 10 yr cycle with small PF breaks for a day or two every month or so. I guess from the chronic swelling of the blood vessels, I had a subarachnoid hemorrhage and aneurysms that required some brain surgeries. I have 6 titanium clips. These last 2 ER visits resulted in CT scans which were negative...so then they wanted to do a spinal tap. I drew the line there...signed myself out AMA...this is after telling them I was there for a CH and requesting an imitrex injection and some O2...I finally got my script for my imitrex at my last visit to a dr but not for the O2. Help please, I need a dr that will listen to me