Into Hell

Into hell. That is where I went this weekend.

Those of you who've been around me a little bit understand that I suffer from migraines. A lot. Well, yesterday I suffered like I've never suffered before. It began in the morning with an unusual headache for me. Unusual, because it was *not* a migraine, rather it was a regular headache across the full forehead and seemed familiar to rebound headaches I have experienced from time to time. This headache persisted throughout the day until it turned into my old friend --a full blown head splitting migraine-- in the early afternoon.

Now, as I said, I am not unfamiliar with these. In fact, I have the pleasure of them every week. Sometimes daily. Sometimes making my life miserable for weeks on end... well, my life and the lives of everyone who loves and cares for me. Normally, I will take various over the counter analgesics to abort the pain. In fact, I take them so frequently that I am afraid of harming my liver and/or stomach depending upon which "proverbial poison" I choose at a given time: Acetaminophen or Ibuprofen. Another problem with taking abortive medicines so frequently to treat my migraines is that I run the risk of day-to-day rebound headaches. In fact, that is precisely what I have developed in the past. Anyway, back to the story. Into hell...

Towards the late afternoon my migraine progressed and the pain was getting worse and worse. I ignored it as best I could. Loathe to take any standard pain medication and fresh out of my prescriptions for triptans like Maxalt and Zomig (which wouldn't have worked at this late point anyway...) I really had no choice but to suffer. And suffer I did...

Until midnight when I could take it no more. The pain at this point was like none I had ever experienced. This was truly the most massive migraine I had ever known and I've experienced my share of doozies with this disease, mind you.

I could not think. I could not talk. I could barely stumble. My wife and my sister were with me and they listened to me wail and gnash my teeth in agony... tearing my hair out and contorting my head and applying pressure in every way imaginable posture looking for some tiny, miniscule form of relief or distraction.

They rushed me to the emergency room.

This was my first trip to the ER as a result of a headache. Needless to say, it was not a happy experience nor one I would ever wish on anyone. My wife let me out of the car as there was no place to park and I stumbled into the ER (bucket in hand for nausea) with the security guard leading the way as my legs buckled. The poor people in the waiting area and the reception desk returned my looks of desperation and agony with a mixture of shock and bewilderment. I must have looked such a sorry sight...

After about an hour and a half of triage, filling out forms, questioning and diagnosis they finally gave me an IV and an injection of something called Reglan. The intern said that this was the standard medicine the ER used to treat people with refactory migraines. He said it was an anti-nausea medicine, but should help the pain too. I never heard of it, but "should help the pain" was absolute nirvana to my ears. It was supposed to take effect within a half hour. One half hour later and I was still in horrible pain.

Next up, the doctor said we were going to try something called Ativan. He said this was a very nice drug that would make me sleepy. Whatever. I just wanted something that would make the pain go away. Well, at three in the morning --remember I arrived at the ER around midnight-- they still hadn't administered this Ativan. My wife stirred the pot and another doctor came to visit. She apparently was a resident or an attending. She asked another set of questions and finally decided she was going to prescribe something else. Dilaudid. I'd never heard of it.

I found out very quickly that this drug was very serious about relieving pain. Dilaudid is a narcotic. The nurse said it was more powerful than Morphine and would most certainly make the migraine go away. She was right. Well, for the most part.

At 4:30 AM I was released from the ER and my migraine was in submission. I was released with a system full of Reglan, Dilaudid and with fresh prescriptions for some more Zomig and now some Percocet too. I could still feel the migraine... but only barely. The narcotic had indeed knocked it out and was fast working on knocking me out. My wife drove us home and then... some unpleasantness happened. Let's just say that the combined nauseating effects of Dilaudid and my migraine had overcame whatever anti-nauseating abilities of the earlier Reglan.

My head hit the pillow around 5 in the morning and I was out of hell for a short reprieve.

8:00 AM. Dilaudid is gone. Migraine is back in full force. So much for that! At this point I am in just about as much pain as when I first needed to go to the ER the night before. Fortunately, it is Monday morning and at 8:30 AM the Cambridge Hospital Migraine Unit opens for business and with it my saviors.

You see, the Cambridge Hospital is home to Dr. Carolyn Bernstein and her team of nurses and reception and support staff whose primary purpose is to help people just like me. God bless them.

You see, Dr. Bernstein knows how I suffer. She suffers from migraines too. When I went into see her this morning everyone immediately recognized what was going on and there was no delay in putting an immediate stop to this damn migraine. The treatment was almost instantaneous and the folks there were so helpful and so obviously cared and wanted to help that it makes me cry.

There was no horrendous narcotics. There was no hours of questioning and waiting.

No, when I went in someone in the waiting room immediately said, "He can go ahead of me!" and then I was shuttled into a room where they turned down the lights and gave me icepacks for my head and neck. I was given some orange juice because of dehydration from the previous night's nausea. And then a kind nurse administered a single solitary shot of something called Toradol. This drug was a godsend. I noticed no side effects and it made my migraine go away. And more importantly, STAY AWAY. I also was instructed to drink lots and lots of fluids and eat plenty of protein as my body had been depleted by the other drugs and by the migraine.

The folks at the Cambridge Hospital Migraine Unit (I don't think that is the official title, but that is what I'm calling them ;) are special. At least to me. This is not to bag on the ER. After all, the ER has to deal with much more generic tragedies than mine, but what I went through last night was *very* serious stuff and I wish people were more aware of just how serious it can be. Migraine is a horrendously debilitating disease. Those of us who suffer from it not only have to put up with the pain of chronic severe headaches, but we also have to put up with all kinds of myths and misconceptions, deal with lost time to work and the ramifications that can have on our lives, and above all of this, migraine can be life threatening. Not to mention the pain and heartache this causes in the lives of those who care about us.

So, if you know anyone who suffers from migraines. Give 'em a hug.


*sigh* migraines suck. i have been in your situation before where a migraine was so debilitating and put me in the ER. its a very frightening thing to have your head so full of pain and not know whats wrong (or be able to do anything about it).

sometimes the only thing you can do is lay down in a cool, dark, quiet room and wait out the storm. other times you have to go to the hospital and get pumped full of narcotics. both suck.

By seele at Tue, 09/27/2005 - 03:20

sorry to hear about your struggles. glad you finally found relief.

i dated a girl for a couple of years whose father had nearly constant headaches that would regularly flair into disturbingly horrific migraines such as you describe. this (among other things) was due to agent orange exposure during his time in the vietnam war. having been around for more than a few of his bouts, including taking him to the hospital ER room on occasion and witnessing the same lack of expert care for this malady that you describe, i got to see up close and personal what this can do to a person.

my heart goes out to you ... hope you have a better rest of the week =)

By Aaron J. Seigo at Tue, 09/27/2005 - 07:06

As a fellow suffer, lots and lots of sympathy...

Have you spent much time trying to deduce what triggers an attack? I suffered for many many years (several attacks a month) until a couple of years ago I analysed the contents of everything I ate until I found a common ingredient..... cutting it out of my diet completely stopped the migraine attacks dead.
I only get them now if I accidentally eat something that contains it.
(am I still eligible for a hug?)

By ivor at Tue, 09/27/2005 - 08:26

I know how it feels. I've experienced what is know as cluster headaches, often described as one of the most painfull migraines available. The good part though is that they strike rarely. The worst part is most pain-killers don't work against it.

I have got some that does work now and almost instantly too, but at a price of 10$ per pill. The "drug-dealers" really know what you willing to pay to make the pain stop.

By Allan Sandfeld at Tue, 09/27/2005 - 10:25

In my planetkde blog near yours, I talked about being laid out with a headache all day on Sunday. Little did I know how good I had it.

I hope you're feeling better, and I hope that the new contacts you made in your post help you in the future if possible.

I haven't had migraines before, but I've encounters with severe back spasms in the past. Similar in the sense that people don't register how serious it can be. And you're left asking, "Then why was I crying like a little girl at 4 in the morning, getting carried into the ER by my family for a battery of xrays and tests?"

Well, best of luck.

By wadejolson at Tue, 09/27/2005 - 13:41

I have been suffering from migraine for a long time now though they are not frequent but very painful. I cannot stand light or sound. I cannot talk. I feel nausea. My right eye feels like its gonna pop out. Generally I just take a couple of Advil and retreat to a dark room holding my right eye. It is really bad...I won't wish it even for my worst enemies, not that I have any. That said, what you went through was many times worst than what I have been through ever. My heart goes out to you.

By floyd at Wed, 09/28/2005 - 14:25

That's an awful thing to deal with, indeed having such frequent headaches can drive you crazy literally. Isn't there a good cure for that? I really didn't know it can be that bad, I knew some people have pains like this I never suspected the gravity... no peace, no focus, no relaxing... I hope you find a solution to this as soon as possible, it's also recommended that you make some deeper medical research about it, just to make sure nothing else is wrong.

By gordman at Wed, 10/10/2007 - 15:23

I thought I had migraines worse than most, but your description of the "perfect migraine" was so accurate I could almost feel it! I've had long periods of suffering migraines like every seven to ten days, like clockwork. The frequency of yours are much worse than mine, I don't know how you can tolerate that many! I had migraines as a young child and remember getting a huge variance in treatment. One doctor prescribed cafergot. I once had migraine auras so badly as a child my parents took me to the ER. I vaguely remember the experience since it was quite scary, I thought I was going blind. I remember the doctor called me to walk over towards him, and when I managed to do so, avoiding various objects in my path, the doctor actually laughed at me and made it a big humiliating joke - meanwhile, I remained in agony. He finally told my parents it was "hysterical blindness." Amazing ignorance! I finally as an adult had a migraine very close to what you described, and I somehow managed to drive myself to an urgent care center where they eventually gave me an injection of Imitrex, then made me sit in a brightly lit waiting room for an hour - the migraine did not go away. I've found since then, if I take Imitrex (100mg tablets) at the first sign of migraine (and I believe all migraine sufferers know the sensations that come before each migraine has fully set in), it is almost 100% effective and will relieve the migraine within about 15 minutes or sooner. The trick is to take the Imitrex before the migraine has fully taken hold. I've found taking it after the migraine is going fairly strongly, there are few if no real results. Have you tried Imitrex? If so, how does it compare to Toradol? If you haven't tried Imitrex, maybe you want to ask you doctor about it. To me, it's a true wonder drug if taken soon enough, and has saved many lost days of work due to its effectiveness, at least for me. Sorry about the long post, but I know the pain, and I would welcome any helpful comments, so I hope mine can be of some help to you, or others who slug through all this text! Good luck, I hope you find something that works, but I would recommend you think about cutting the OTC drugs if they don't work, which they don't for me - it's not worth doing other damage when it doesn't work, but when in the middle of a migraine, I know I'll try almost anything to ease the pain. Again, good luck, I hope you find better long-term and effective treatments.

By primal1 at Fri, 05/02/2008 - 06:41