The dreaded ER visit last night.

Just couldn't take it anymore.

Migraine for 3 days and it just wasn't responding to any of my meds so I made the dreaded ER trip.

Of course they were really busy, which is par for the course.

Then they sent in some med student that questioned me for a half an hour.

He suggested that maybe I should have the Fire Dept come over and check our Carbon Monoxide levels even though I told him we have a carbon monoxide detector that plugs into the outlet near the furnace.

Several of the answers I gave him, he actually said, "Really, your migraines are that bad?"

I wanted to punch him right in the face.

Finally the PA came in and told me they would give me what I had last visit which was Dilaudid and Vistaril.

After the nurse gave me the shots, she said something about Nubain.

I said, "You didn't give me Nubain did you?"

"Yes," she said, "that's what the Doctor ordered."

Then I informed her that I told them up front that I was on MS Contin and the Nubain was going to throw me into withdrawals!

She called the Doctor in and she told me that it shouldn't be bad but yes, they are two drugs that will compete with each other in your system.

So, I had no choice but to go home and see what happened.

Was up half the night in withdrawals.

Couldn't get warm, shivering like crazy, vomiting, muscle aches and anxiety with restlessness.

In a word, AWFUL!!

Decided to call the ER this morning and let them know.

Talked to the Doctor from last night and she apologized and said she would notate in my chart never to give it to me again.

The funny thing is that she says notation on my last visit did show that I received Nubain that time and that is totally untrue.

I distinctly remember asking the nurse what I was getting before she gave it to me and she said 2 of Dilaudid and 100 of Vistaril.

Now tell me how does that happen??

I will never let them give me anything without being 100% sure what it actually is.

That's a pretty big screw up in my opinion.

What if the Nubain had been something that I was allergic to or something?

Wow, I am going to be really careful from now on.

Oh, and the only reason I did call this morning was because I knew if I just waited til I had to go to ER again, they would just think I wanted something besides the Nubain.

You know how you read that Drug Seekers go in and claim to be allergic to everything but their drug of choice.

Anyway, thanks for reading this.

Cindy

Maybe you should have stayed in the ER and let them actually observe your withdrawals, so that they could see for themselves that you were serious.

Very frustrating! If you are having a migraine that bad the last thing you should have to be doing is QC on the doctors. It does sound like a screw up of some kind. Your recommendation to ask before the nurse administers each drug is good one. Especially if you know you have trouble with any thing. I hope you are feeling recovered.

My goodness that is horrible. So sorry you had to go through that on top of the migraine.

It sounds like the nurse lied to you when you asked what you were being given? That or completely wasn't paying attention. Serious omission to not see you were on MS Contin and to even give you Nubain too.

Shouldn't they be required to confirm you hadn't taken any opiates? Wow. It actually wouldn't be surprising for a migraine patient to have taken opiates if they get attacks severe enough for the ER.

Plenty of folks are on them for chronic pain too. Nowadays, shouldn't the computer tell them what they ordered is contraindicated?

I freak out whenever they try to give me any medication without telling me what is it, let alone what the potential side effects and risks are, or what it is specifically for.

Surprised you even made it home before the withdrawals started. Its too bad they don't have something to reverse it, but I guess it is a reversal med already.

Definitely get a letter from your doctor in your file stating your history and what you should be given in that situation so you can skip the questioning and withdrawals! Or better yet, a rescue med at home (something injectable or suppository).

I'd actually file a complaint with the hospital too, to make them aware of the incident. As bad as it was, it could have been even worse, as you said. Best wishes.

I actually did think about staying to see if the withdrawals started but you know how they are so anxious to get you out of there so I didn't even bring it up.

Also, I thought that if it was true and they DID give me Nubain 2 months before, I was on the MS Contin then and I had no problems after that visit.

That's how I know for sure that I didn't get the Nubain on that previous visit.

Trust me I would have known it.

I think most of us know what the withdrawals feel like and there is no mistaking them.

And I have been on the MS Contin this time(been off and on it many times in 20 years) for the last 9 months.

They have always given me either Fentanyl or Dilaudid and it works fine in pretty small doses with the Vistaril.

Oh, that was something I forgot to tell you.

They had to give me 100mg of Benadryl because, once again, there is a nationwide shortage on Vistaril.

Sorry, I think I said they gave me Vistaril, but they didn't.

I was really upset when I was writing that first post.

My question is this:  Every one of those Doctors know that Nubain and Stadol are mixed agonist-antagonist drugs and compete with just about all the opiates.  Why would they EVER give either of these to someone who might have any opiate left in their system?

I remember my MD that I lost a year ago telling me not to ever let them give me Nubain or Stadol because it actually will strip the opiate off your receptors and that's why you go into withdrawals.

Now that doctor last night told me that was not true, but I know what I went thru last night and I am siding with my previous MD on that one.

I just don't know what to do.

I know if I see that Doctor again, she will probably just give me whatever I say works but if I get stuck with someone else, they may not.

Have an appt with my Pain Management Doctor on the 26th and she has migraines just like I do but not quite as severe.

Maybe she will have a suggestion because she and I have talked about what goes on in the ER when it comes to migraine patients because she has worked in several and also been a patient and they don't treat her any better than they do some of us.

Anyway, thank you guys for your support, it is much appreciated.

Will let you know what she says after I see her on the 26th.

Cindy

PS...Forgot to tell you too when that student was questioning me, he asked why I was on the MS Contin.  I told him and his response was, "Morphine for migraines?  Kinda overkill isn't it?"  I seriously wanted to punch him!

Sounds like you did not get a terribly knowledgeable doctor. Seriously, ER doctors are there to stop immediate death from happening (usually trauma, heart attack, stroke, etc...). Their job is to stabilize the patient until some other doctor takes over. They really get very little training in something like chronic migraine. That is why people's experience in ERs is so hit or miss. Best to get a letter form your doctor stating what you are taking and what procedures work for you. None of us are in the best shape to be arguing with doctors when we are in that condition.

Thank you all for your replies, they are much appreciated.

I am seeing the PA at Pain Manangement tomorrow at 2:40.

Will post when I get home and let you know what she says.

It took me a full 24 hours from the time I got that shot to really feel normal again.

Hope they give it a second thought next time and this doesn't happen to someone else.

Speaking of asking the nurse what's in the injection they are giving, I once had to use a different doc at my clinic because my doc wasn't in and his nurse refused to tell me what she was giving me.

Needless to say, I didn't let her give it.

They weren't too happy about it and obviously have never been in my shoes before.

Withdrawal symptoms are just not worth the risk.

Cindy

Praying it goes well for you and that you get some real help. As for the nurse refusing to tell you what was in the injection....Ekkkkkkkkkkkkk. Not even legal for her to refuse at least in NY. Not sure about other states but likely the same.

Sorry this is so late!

Had do some other errands after the Doctor visit and had to spend an hour at the Doctor because it was UA time and for the first time ever I could not pee!

Had to drink two bottles of water just to get enough for them to test.

Anyway, she could not believe that they gave me Nubain after me telling them I was taking MS Contin.

She has worked in this ER and a few others and said personally she rarely gave Nubain and didn't know any other Doctors who gave it very often either.

She thought my idea of just never allowing them to give me a shot without knowing 100% what is in it was the best way to go but wants to be sure they notated my file not to ever give it to me again.

She said they should never give Nubain unless they are certain the person is not currently taking opiates of any kind.

She also said instead of just telling them I can't take Nubain (where they might question me as to why)just tell them I am allergic to it because she says in that case they will make SURE you don't get it due to liability on their part. In other words they would be scared of a lawsuit.

She said she did remember a Doc giving Nubain to a pregnant girl and then it ended up that she had been taking opiates not prescribed by a Doctor and withdrawals put her baby at risk.

She said she was not aware that it was being used much anymore.

Anyway, she made me feel much better and gave me another script for the Dilaudid pills which do work 99% of the time if I take them soon enough.

I was also pretty happy because we have had so many Holiday goodies around between friends and neighbors bringing stuff over, that I was afraid to get on the scale, but I only gained 3 lbs.

Kem10: Thanks for your post. I can't believe it would be legal not to tell a patient what you are giving them but my sense in this situation was that they didn't want to give me my usual Demerol shot and were probably going to give me Toradol and see if I could tell a difference if I didn't know what it was. As if after 22 years of some sort of narcotic, Toradol has a chance in hell of working for me! I am going to check our State laws and see if they can get away with that. Would be nice to know.

Thank you everyone for your posts.

I don't get here often anymore but I can always depend on you guys for any help or support I need.

Will be checking here daily now because I realize that I need to give that help and support when YOU guys need it. Please forgive me for not doing that in the past. Sometimes I can be rather selfish and not even realize it.

Cindy

If you can't make it daily, don't worry over it. I try to hit all my regular websites a couple of times a week. I know people here understand that we all aren't up to being on here daily.

Thank you Sara79.

I will get here as often as I can.

Cindy

Cindy, I'm sorry that you had a bad experience at the E.R. I've had many bad experiences at the E.R., so I can relate. So many of the doctors and nurses seem to have no clue as to how to properly treat migraine.

I don't always get to post as often as I'd like, either. I just wanted to let you know that you've always been kind to me in your posts, and I thank you for your kindness. I've been posting here for years, and it's okay if you don't remember me. I just wanted to thank you for always being nice to me. I wish you all the best in the New Year!

Best Wishes,
Brenda

I just wanted to add that at the E.R. I've also been given shots and never even told what was in them. Every single time I've had to ask them, "What is this?" when they go to give me the shot. Who wouldn't want to know what drug they are being given? I can't believe that the doctors and nurses don't automatically tell the patient which drug they are being given. It certainly seems simple enough. Glad the worst of your withdrawals are over.

Brenda

I will admit, as a member of the healthcare community, I do tend to simplify things...I'll tell pts that 'Hi, I'm Sara with Respiratory, I've got your breathing treatment' rather than 'I've got your albuterol/atrovent' simply because most of the pt's I work with take these medicines at home.  If I know it's a new therapy for the pt I'll explain more, but many of the pts I'm giving this to take the same medication in the same form at home, and often know it by a trade name, rather than it's chemical name (example-Aleve, rather than naproxen sodium).  

However, I've been to the ER where I work both as a caregiver and a pt, and there I've always explained things more fully to my pts there, and had them explained to me in great detail too.  We do that because in the ER people won't always know the medications we're giving, or have never had them in this format (IV vs oral, or in my case nebulized rather than inhaler [nebulized -a fine mist of the medication over 3-5 mins rather than 2 puffs- easier for the drastically short of air])

I went in to my work ER due to dehydration, and was getting things explained in much too great (if simplified) form than I needed.  I finally told them that I knew I was in shock from volume loss, feel free to cut to the chase and start the IV, because I know it'll help the most, and I HATE needles, so lets get that part over with.  They laughed and stopped explaining in as much detail, but still kept me in the loop, just in a 'shorthand form' that cuts the explanation back to just what someone who works in the feild needs, rather than the non-medical form that they are used to needing with the general population.

Please do not ever hesitate to ask for an explanation of any procedure or medication from any healthcare professional involved in your care.  The only time I've ever seen a caregiver unable to explain immediately is when the pt is in such dire straits that the help needs to begin NOW, or they'll have a much sicker or possibly dead pt.  Even then they'll typically have someone there to explain things to the pt or family as everyone else is doing what they have to do now.  

Just last night I was involved with a pt who was fighting an infection (probably H1N1 flu), and we had to put them on a ventilator.  The hands on team was so busy trying to do their best for the pt, but their family had questions and concerns, and we needed their consent (pt was a minor), so there were others not involved in hands on care helping the family and explaining everything being done as well as getting needed supplies and tending all the other pts who needed someone.  I ended up being extra hands at one point, and I saw that the father had gotten upset enough to cry, so I brought him a box of tissues, because I had the time, and I would want someone to do this for me if I were in his shoes.

This is more how a good team provides health care...but I do know that there are hospitals that choose to have fewer staff and then stretch their staff so that they are not providing their best care.  I may not like everything about my workplace (who does), but I am proud to say that we work as an amazing team, and do everything we can to give pts the best care we can.

Sorry I seem to write novels explaining how the other side of the hospital bed works...If you're like me you'd rather have the novel, since it makes thing clearer.

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As a final note-PLEASE, please get your flu shot if you're able.  This has been a horrible flu season, especially in my area, and it's been particularly bad year for the atypical person to have trouble.  Most years the flu hits the very young and the very old the hardest.  This year's strain is hitting the mostly healthy adult the hardest, and they usually either do not get the flu or recover quickly and fully.  It's not too late, and I'd hate to hear that anyone here was battling it.


Also, if anybody here is immuno-compromised, please be careful. Wash your hands frequently, and try not to touch your face while out in public. The flu can live on a non-porous surface (shopping cart handle or door knob) for up to 72 hours.

Cindy,

I totally feel your pain I went through the same thing the other night. Kind of... From a previous visit to an ER I found out that I am allergic to NSAID's and was hospitalized with a GI Bleed and three colonoscopies to boot. So whenever I go to the ER I have to inform them that I am "Allergic" to NSAIDs and have had the nurses frequently over the years come in and tell me, "I am here with your pain shot." To which I reply, "What are you giving me?" About 5 times over the years they have said Toradol, which could kill me, so now I make it a habit of saying, "I'm sorry, could you say that again?" Because I don't want some nurse who didn't take the time to check my allergy/contradictions on my chart to kill me or put me in the hospital because they don't believe in the migraine fairy. Make them repeat it to you. Then repeat it back to them and force them to acknowledge it. If you have never heard of the medication ask about it, what is it, why are you giving it to me what does it do what are the possible side effects. Otherwise you might think your dying when everything is fine, like I did when they gave me compazine. Boy do I dislike most ER Doctors/Nurse practices. It really does make me sick to read this stuff. I'm so sorry to hear about your experience Cindy, just know most of us have been through this. Don't give up they aren't all like that. Also, file a formal complaint with the hospital they actually take that Very seriously.

BrendaL,  I remember you and so glad you are here!  So glad that I have been some help to you in the past, it really makes me feel better to hear that when I can't get here that often.  

Sara79, Thanks for your post.  I really don't fault the nurses and MD's because I know they are stretched thin and extremely busy.  I try to be understanding but it is difficult when you are in pain and just want a little relief.  Your post helps though.

Painsux, Thank you for your post too.  I will not let them give me an injection every again without knowing for sure what it is.  I cannot take companzine either.  It gives me a terrible reaction that is like a severe panic attack(I know there's a name for it but it escapes me right now) and I feel like I am going crazy.  Can't stand still, feel like I am dying, horrible.  Reglan, Phenergan and Ativan do it to me as well.  That's why I always get Vistaril.  They always give me Cogentin and 4 of Xanax when this has happened and it works really quickly.  Just looked it up, it's Akathisia.  I really need to write that down so I won't forget it.

Thanks everyone.

Cindy