When To Go To Er For Migraine

“Migraines can be very debilitating, so it’s important that you know when to go to the emergency room for treatment. If your migraines aren’t responding well to over-the-counter pain relievers, or if they’re getting worse or last longer than 4 hours, then it may be time to see a doctor. However, not all cases call for an ER visit. In fact, many times, doctors will tell their patients to just take some Tylenol, wait until morning, and try to relax. This is because in most situations, it’s much more cost effective to treat minor headaches at home rather than visiting the hospital.
So what exactly happens when you have a migraine? A migraine attack involves inflammation of blood vessels in the brain which causes intense throbbing pain. The pain usually lasts between four and 72 hours with a peak around noon. Other symptoms include nausea, vomiting, sensitivity to lights, noises or smells, sensitivity to food, dizziness, fatigue, and sensitivity to medications.
It is believed that about 20 percent of people who experience migraine attacks also suffer from aura – visual disturbances like flickering lights, zooming spots, blind spots, tingling sensations, numbness or loss of movement control. These symptoms occur before the headache begins and can sometimes affect one side of the body more noticeably than the other. It is not known why this occurs but there are theories being researched by scientists. Some believe that the aura could be caused by electrical discharges within the brain while others say that these episodes are related to low oxygen levels in the bloodstream.
There are two types of migraines: 1) classic migraines 2) transformation migraines. Classic migraines cause only pain on one half of the head. Transformation migraines cause pain on both sides of the head. About 10 percent of those who have migraines develop classic migraines later in life.
Treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), beta blockers, calcium channel blockers, antidepressants and steroids. Acute care treatments may include intravenous fluids, IVs, medication injections, antibiotics and/or antiviral medication, and steroid nasal spray.
If you think you might have a migraine attack, here are some things to do to help get relief quickly:
1) Take any prescription medicine you are currently taking, including vitamins and herbal supplements.
2) Get plenty of sleep. Try to avoid alcohol, caffeine, tobacco and excessive amounts of stress.
3) Wear dark sunglasses to protect yourself from bright lights. Also wear sunscreen and lip balm to reduce the effects of sunlight.
4) Eat foods high in Vitamin B6, magnesium and potassium. Foods rich in Omega 3 fatty acids and fiber are also recommended. Avoid fast food or processed meals.
5) Drink lots of water throughout the day. Water helps dilutes toxins and clears out mucus, which reduces congestion.
6) Stay away from caffeinated sodas and alcoholic beverages. Caffeine constricts small arteries causing increased blood pressure and heart rate. Alcoholic drinks dehydrate and make dehydration worse.
7) Make sure you exercise regularly. Exercise stimulates production of endorphins which relieve tension and depression.
8) Do relaxation techniques, yoga, meditation, breathing exercises, etc. Yoga has been shown to improve circulation and relieve muscle spasms. Meditation is great for clearing your mind and relaxing.
9) Keep a journal where you track migraine frequency, severity, triggers and remedies. Write down everything you eat, how much you sleep, physical activity, mood, pain level, etc. Tracking information can give you clues into possible triggers or patterns.
10) Don’t smoke. Smoking narrows the blood vessels which increases risk of stroke, hypertension, coronary artery disease, diabetes mellitus, asthma, arthritis, osteoporosis, cancer and lung infections. Cigarette smoking contributes to plaque buildup inside blood vessels resulting in narrowing of the arteries.
11) Get regular checkups. Doctors recommend seeing your physician every six months or sooner if you have a family history of cardiovascular problems. Your physician should be aware of your medical conditions, current medicines and health status.
12) If your migraines become frequent or severe, consult your primary care provider. There are several different types of migraines and each type requires specific treatment.
13) Many people find acupuncture helpful for treating migraines. Acupuncture releases endorphins which block transmission of nerve impulses and decrease pain signals.
14) Massage therapy may be beneficial. Studies show massage therapy relieved migraine pain better than placebo.
15) Biofeedback therapy uses special equipment to monitor and regulate your heartbeat, respiration, and skin temperature. Therapy sessions involve learning how to slow and stabilize the heart rate, increase deep breaths, and lower blood pressure to alleviate headaches.
16) Chiropractic methods utilize spinal manipulation to correct misalignment of the spine, which may trigger migraines.
17) Hypnotherapy provides self-hypnosis training to learn how to cope with anxiety and stress. During hypnotherapy session, trained therapists guide the patient through various states of consciousness to achieve optimal relaxation. Patients report decreased number of migraines after undergoing hypnotherapy sessions.
18) Acupressure is similar to acupuncturing except using fingers instead of needles. It works on balancing energy flow in our bodies. When your qi (energy) is flowing smoothly, it prevents illness and promotes good health.
19) Herbs can provide temporary relief to migraine sufferers. Ginger, peppermint, valerian root, chamomile, kava and St John’s wort are popular herbs used to treat migraine pain.
20) Homeopathic remedies are prepared according to strict guidelines and contain natural ingredients. They work by stimulating the immune system and promote healing. Homeopathy is based on individual symptoms and characteristics.
21) Surgery is a last resort option for severely affected individuals. Surgery can stop the spread of swelling by cutting off cranial nerves and blood supply to the area. Another surgery called decompression removes bone above the skull thus reducing pressure.
22) Botox injections are performed to paralyze muscles involved in facial expression which results in less pain during migraine attacks.
23) Transcranial magnetic stimulation (rTMS) is another minimally invasive procedure that uses magnetic pulses to stimulate the cerebral cortex region of the brain. The goal of rTMS is to interrupt abnormal neural pathways that lead to migraine pain.
24) Medications such as Depakote, Dilantin, Depo-medaject and Zovirax can prevent migraine attacks. Anticonvulsants are also prescribed to treat epilepsy and seizures. Amitriptyline (Elavil) and Nortryptilene hydrochloride (Norpramin) are tricyclics commonly used for depression. Topiramate (Topamax) is an anticonvulsant drug which was found to be effective in preventing migraine headaches.
25) Stress management plays a major role in reducing the incidence of migraine headaches. Stress and anxiety aggravate premenstrual syndrome and migraines. Relaxation techniques such as yoga, meditation, biofeedback, guided imagery, progressive muscle relaxation, exercise and listening to music can help calm your nervous system.
26) Find alternative therapies that suit you best. You don’t need to always see a doctor for migraine treatment. Seek advice from friends and family first. Alternative therapies such as chiropractic, acupuncture, herbal therapy, yoga, meditation, Tai Qi, Reiki, Ayurveda, Traditional Chinese Medicine, Therapeutic Touch, aromatherapy, color therapy, art therapy, sound therapy, massage therapy, music therapy and spiritual counseling are just some of them. Talk to your doctor about incorporating complementary therapies into your overall migraine treatment plan.
27) Be aware of warning signs. Warning signs include:

Headache radiating beyond the eye socket

Sudden onset of blindness

Fever

Severe or worsening nausea and/or vomiting

Dizziness

Unable to walk

Loss of appetite

Neck stiffness

Slurred speech

Difficulty in swallowing

Double vision

Inability to move parts of your face

28) See a doctor immediately if you experience sudden change in behavior, speech, vision, hearing, balance, coordination, memory, sensation, mental capacity or personality.
29) If you have missed three menstrual cycles without improvement, see your gynecologist.
30) Consult your doctor if your migraines become extremely painful, last for more than 48 hours, accompanied by a fever, persistent nausea and vomiting, extreme sensitivity to noise, smell or touch, double vision, blurred vision, ringing ears, slurred speech, difficulty walking, poor balance, inability to stand or sit up straight, drooping eyelids, stiff neck, chest tightness, rapid pulse, shortness of breath, red streaks on gums, mouth sores, tongue lumps, involuntary movements, convulsions, unconsciousness.
31) Never take aspirin or NSAIDS for a suspected allergic reaction. Aspirin interacts badly with certain meds like clarithromycin,”