Bad M after IV- dreaded ER questions- need help

Hi All,

I had an IV or Depakan yesterdayat the IV center. I get fluids, followed by IV Benedryl and Phenergan, hen the Depakan goes in over an hour, and then toradol and morphine. It usually works wonders. But the pain level has been really high lately (around a 9-10) for a week. The IV brought it down to a (9/10) But this is still way too high.

I spoke with my neuro and am now on a course of steroids- his PA said that if it doesn't improve, I should go to Urgent care for a toradol injection. Toradol helps some, but I am not sure if will help this one. I did call the Urgent Care to make sure they did this kind of treatment and surprisingly, they do. I hate to even consider the ER. Mostly because there is the waiting, then you never know what what they will do- will they give meds that work, or not. I am just not sure right now.

I don't know what to anymore. All I want is to curl up until this is over.

I am on tramadol 200mgs ER for pain, Pristiq, zanaflex at night, tramadol 50mgs for breakthough, Tylenol#3 for breakthrough and Klonopin 1mg (up to four a day. I have had to use the as needed meds- tramadol, T3, Klonopin a lot lately. I don't know if I should try to taper them off some or what. (I doubt it is rebound.) I know I am grasping at straws here. Need opinions/advice.

I am just scared, On top of this, Dora won't be back till next Friday. I am hurting badly- and sometimes when this happens, I lash out. My roommate who has aspergers, is scared of this, so I tend to hold things back until I explode. ok, well I haven't been holding much back lately.

Anyway, I'd love any ideas or advice.

Pain free days,
sailing

sailing, i always feel horrible for you, when you post something like this.  you have a highly complex situation going on, and have been around-the-block when it comes to doctors and meds.  

personally, i hate the ER.  you never know who is going to dismiss your pain, or fail to look at the details of your history in order to help you.

is it possible to see a new neuro; perhaps in a different city?  a fresh look at things might be helpful.  i doubt any of us here can give competent advice.

it would have to be a doctor with a huge interest in putting all the puzzle pieces together.  i know you'll be better when your dog is back.  please know we are thinking about you and hoping for better days ahead.  dianne

Hi,

thanks for the advice.

I am have been seeing a new neuro for about 6 months. He is the one who recommended Botox. This has helped some. He does know about the fainting and is looking into it. He is also fine with pain stuff.

The head is back to about a 9.5/10. I don't know what to do. I absolutely hate the idea of the hospital, but I think I may have to go. I am just not getting better here and I am getting to the point where I can't bear the pain.

I am going back and forth on the ER/Urgent Care thing. I know that the Urgent Care can do toradol, but I know it may take something stonger for this one. I haven't been to the ER in three years for a migraine. I have thought about going to the Urgent Care- but am afraid they will take one look at and send me to the hospital. I hate this whole situation. hear are the reasons I should probably go: nothing here is working. Pain in horrendous and I need help. Not to go: I hate the ER, might get a dr who doesn't believe me, and receive no relief. right now, benefits outweigh risks. I'd love for anyone to weigh in here.

Pain free days,
sailingm

Hi All,

Well, Urgent Care was closed, So I wound up in the ER. I haven't had to go to the ER for migraine for 3 years. I went to the same ER I used to go to, but did not have a good experience.

Here is how things went.

Signed in. Fainted, immediately put in wheelchair and sent to triage. Good Start. Wish it had continued.

Here is how the rest of the visit went:

Just after I changed into a gown, and registered, but before the nurses really came to talk, I got up to use the restroom, fainted on the way back, and then the nurse got mad because she said she had to do a three page report because I fainted. Did I mention, I was brought back in a wheelchair and had verbally told them of the fainting problem?

First of all, the nurses were incompetent and couldn't get a line- they didn't even listen when I suggested which veins worked best. So, no line. I have only had trouble like this once- when I was severely dehydrated and then they gave IM shots and followed by successfully getting a line. So no line.

So they did IM injections. they gave me benedryl, Zofran, and Mophine. This took the pain down some, but not much. The nurse did check back and asked what else worked. She suggested more morphine and a steroid shot. I said this was ok, but could they check and see if something else could be done if this didn't work? She said she would ask, but didn't think so. So I got the shots. Then started dry heaving from the decadron. Someone came in with discharge papers, got the nurse, who did give me more Zofran before I left. They gave me prescriptions for Bupap(butalbital), and oral Phenergan and told me to follow up with my doctor.

I am home now. I now know why I haven't been to the hospital for three years for migraine or fainting. I was worried about going because they usually freak out about the fainting and everything. They didn't, actually, I don't think I even saw the ER dr. I suppose I was in the charge of the Nurse Practioner. But this concerns me now that I think about it.

The neurologist in Birmingham is new and has been helpful. He has pushed for Botox injections and they work for about two months. He is also trying to figure out what I haven't tried or what can possibly be added to the mix. I may call and talk to the on-call dr about what I need to do should I feel the same way tomorrow. (Even if it means meeting him in Birmingham and being seen at either his office or having him meet me at the ER there.) I have never really been helped by a hospitalization. But the time has come to get some sort of treatment, cause this just isn't ok.

Advice and reactions appreciated. thanks for listening

sailing

Hi All,

Hi All,

Well, I decided to call my neuro today. Fortuately, my dr was the on call dr and he called me right back. I told him what happened and he wasn't happy with the situation either. I also said that I really didn't know what to do right now. He said that he felt like he needed to see me in the office and maybe some of the medications they give in the office would help or, he would admit me. The one drawback is that he is located in a city about 90 miles away, but that is ok. He told me to come up tomorrow morning, they would work me in, and see how things went.

In many ways, this makes me feel a whole lot better. At least there is now a good, concrete plan. If they do admit- I hope it wont be for long or that they can do IVs in the office, Still. I feel better about the whole thing. My wonderful roommate is going to drive me up there. If admitted, one of my parents will come. But I just feel better especially since nothing here is working. I will keep you updated.

Pain free days,
sailing

Praying for you today.

So glad that you spoke to your neuro and he is going to take action! Keeping you in my thoughts today. Is it possible that you can get a document from him that spells out your medical issues and which meds work and which do not when you have to go to the er? When my asthma was in full bloom and I was needing rescue shots of steroids my doc gave me a paper that explained my issues to help me convince the docs that I was not a steroid-seeker.

How are you doing today SM? I hope better. Was the nuero able to help?

Sailing, I have been thinking about you lately and wondering how you were doing.

Hoping to hear better news though.

I truly understand your feelings about the ER.

It absolutely makes me sick to have to contemplate a trip there.

Haven't had to go much because the Pain Doctor gave me a script for Fentora and most of the time with two doses it will kill the big ones, but there is always that one that doesn't respond to anything but IV drugs.

Went to the ER a few months ago and luckily they are doing things differently.

If you are someone they know and you need the same treatment as the previous times before, they now just take you into the triage room really quickly and let a PA see you.

Then he or she orders the meds, they come right in with them and as soon as you are done you can leave.

Used to take me several hours, but this last visit was about 40 minutes!

I sure hope they continue this practice.

Urgent Cares here can't help me at all because they don't have narcotic meds there.

Anyway, I am glad you have a Doctor trying to get to the bottom of all this.

I will keep you in my prayers, you have been through so much.

Sorry those nurses treated you like that because you fainted.

What are they thinking????

Take care.

Cindy