Something a little different for you folks to gnaw on today.

Migraine is real and horrifying, but it is also invisible...so too many doctors and nurses think migraineurs are faking pain in order to get a shot of demerol or morphine.

We are not faking it. This woman's ultimate solution to end the pain is a solution that we migraineurs think about way too often.

http://headaches.about.com/od/advocacyi ... e.htm?nl=1

Why did this young woman come home from the ER and commit suicide?
Janice (not her real name) had been corresponding with me via email and talking with me on the telephone for a few months. She and her fiancé James (not his real name) had moved into their new apartment, but placed their wedding on hold until her Migraines were better controlled because they wanted to be able to better enjoy the wedding and honeymoon.

Janice was doing everything "right." She was seeing a neurologist, taking preventives, using triptans as soon as a Migraine attack began, using rescue medications sparingly when triptans failed. She was waiting for an appointment with a Migraine specialist. Still, about once a month, even with her triptans and rescue medications, a Migraine would spiral out of control, and James would take her to the emergency room.

James is what I'd call a model partner. When he and Janice began dating, and he learned she had Migraine disease, he told her he wanted to know more about it so he could help her. He had read books and articles, the emails between Janice and me, and had emailed me himself. We had also talked on the phone a couple of times.

More than once, Janice had expressed to me what many Migraineurs do -- the frustration of being treated like a "drug seeker" in the ER. Although she'd been treated with suspicion and disrespect, by the end of each visit, she had been able to convince someone to call her doctor, and the visit was resolved with her Migraine treated appropriately.

Unfortunately, there came that horrible morning when I got a phone call from James. Janice had committed suicide the night before while he slept. She'd had a Migraine that didn't respond to her triptans or rescue meds, so he'd taken her to the ER. They immediately encountered a problem when, because he was neither her spouse nor medical power of attorney, he wasn't allowed to accompany her to the exam room. They decided not to push the point for fear of seeming "difficult." James told me he was, "shocked beyond words when she came back out in less than half an hour."

Sadly, she didn't come out so quickly because she'd gotten quick and effective treatment. On the drive home, she told James that a doctor she'd never seen before had treated her. He'd come into the exam room, checked her reflexes, and told the nurse what kind of injection to give her. Janice told him another doctor there had tried that before, it didn't work, and asked him to call her doctor, who was glad to receive such calls. The ER doctor replied, "I'm not calling anyone. I know how to treat people like you." By that time, the nurse was back, and gave her the injection. Both the doctor and nurse left. The nurse returned with Janice's discharge papers.

When Janice objected to being discharged because she felt no better, the nurse left, and the doctor returned. He told her to "vacate that bed for people who really need it" or he'd call security.

After they got home, Janice and James went to bed. Janice got up and went into the bathroom. James heard water running into the bath tub, and thought Janice was going to soak in a nice, hot bath -- something she often did when she had a Migraine. He drifted off to sleep waiting for her. In the morning, he awoke, and instantly knew something was wrong. Janice was not in bed. He found her still in the bath where she had consumed a couple of glasses of wine then slit her wrists. He called 911, but the bath water and Janice were both cold already. It was too late.

As he told me what had transpired, James sobbed. He sobbed out of grief, anger, and guilt. Obviously, he's grieving losing Janice. He's also angry, but he's not entirely certain with whom he should be angry. He knows he's angry with the ER doctor, but feels it goes deeper than that. He's angry with the true "drug seekers" who make it difficult for legitimate patients to get care, the U.S. House of Representatives because the National Pain Care Policy Act of 2003 is still sitting in committee, with DEA scrutiny that makes some doctors afraid to treat patients in pain, and with a society that apathetically allows all of this to continue. He feels guilty because he wishes he'd tried to do something at the hospital and because he fell asleep and didn't check on Janice while she was in the bath.

Janice's family and James want to retain their privacy in this time of grieving. Knowing the generous and supportive spirit of the About community, however, they did agree to setting up a special email account for any of you who may wish to email them with condolences or prayer. Please don't expect them to answer everyone. You may email them at janice.family@gmail.com.

I'm not going to add much commentary to this, but leave it to you to think about. I just want to say this suicide was senseless and preventable. Our system is very dysfunctional and needs to be fixed.

g., i'm shocked. really. maybe you migraineurs could create a national association or something like that, something that could reach the US Congress, call the public's attention to the problem, change the law. i don't know. i'm really sorry. i pray that you never go through something like that. wish you pf days forever.

I suffer from migraines from time to time, but have never once considered suicide.

There is more wrong with these types of people than mere migraines. Sure, it plays a role, but it is not the defining factor in why someone would kill him or herself.

I agree that there must be more going on. i know someone who lives with a bleeding ulcer and he has never thought of suicide.

What I find sad is the lack of communication between the girl's doctor and the ER staff. If the doc didn't mind being called by the ER, why couldn't she just call him first and say, "I'm having a bad one, I need to go to the ER. Can you call ahead and let them know what's going on?"

If I were this girl's fiance, and the story is true, I'd hunt down and kill the ER doc. Slowly.

--PunkDavid

I'd rather have a bleeding ulcer.

Okay, I did not think anyone would respond to this...I just hoped that you would read and understand. But you don't understand.

Migraine headaches are not something that can be gotten rid of with some aspirin or some meditation. They fucking HURT, they throb, they pulsate, they make you vomit from your toes, and they blot out your senses.

When we are finally at the end of our ropes, we go to the ER. Most unfortunately, a migraineur in a severe attack presents the same exact symptoms as a drug addict in withdawal...the vomitting, the the sweating, loss of motor control, the crying, the begging for relief...

But you know what? We are not drug seekers, and sometimes if an ER doctor just took 5 minutes to call the patient's neurologist (I always have my neuro's number in my wallet) then that patient will be given the right medication and sent home nauseous, dehydrated, but finally pain free.

That woman who committed suicide, she must have had "other issues"? Her only "issue" was that she had debilitating illness that hijacked her life and left her in abject pain the majority of her waking hours.

I am not being dramatic here, folks. I lived it, I was almost this woman.

http://mymigraineagony.blogspot.com/200 ... eyard.html

Migraine is a chemical imbalance, like epilepsy. Would someone with uncontrolled seizures be turned away at an ER? Fuck no. If someone who has to experience several severe seizures a day committed suicide, would you think that this epileptic had "other issues"?

*takes deep breath*

rant over

My husband almost decked a doctor in Urgent Care...and he would most certainly hunt down any doc who refused to treat me...but he would never let me leave the ER without treatment.

No that's not it at all. Thank God you don't have really bad migraines! They are one of the worst things I've ever seen. I sold a drug to treat migraines and got to study at migraine centers. Before I went I was sure that migraines were just a bit over blown. That's not the way it is at all. These people have head pain like you have no idea.

A migraine that bad basically causes swelling of blood vesseles surrounding your head. The swollen vessels press on your nerves and cause severe pain. The nerve sends a signal that there is pain. The signal induces even more swelling and the cycle worsens. People have jaw pain and eye pain and facial pain along with them. It's sooo bad people really want to cut their head off, no joke.

it ain't no joke and sure isn't a psychological disorder. In fact it causes psychological problems because of the way you have to walk through life on egg shells always fearing your gonna get one.

I whole-heartedly disagree. This is not the movie Pi folks.

And yes, I have suffered from very severe migraines and have done so since I was in middle school. I take a prescription drug when one occurs, which thankfully has not in over two years.

She had an additional disorder to migraines. I don't buy the story.

Uh, yeah I do understand. I have had ALL of those symptoms.

You're not the only one who understands what migraines are like, but you are one of the few who think that it was migraines alone that made this girl commit suicide. I agree that they contribute, but she was obviously suffering from massive depression/anxiety in addition. She should have been treated for BOTH migraines and mental disorder.

It should not have happened, no one is arguing that.

But you need to realize that you are:

A.) Not the only one to understand migraines

B.) Not realizing that it is highly likely this girl was disturbed in addition to the migraines

And to top it off:

Even in the midst of one of my worst migraines, where I vomited, lost vision, and had numbess in my face in addition to the jackhammer pounding my brain, I NEVER ONCE, EVER considered killing myself.

That is fucking ridiculous. There are medications and treatments available. This was not her first migraine.

You blame the system, I blame her and her family and friends for not being more persistant with medical care. There is care available...FIND it, PAY for it, and feel better.

And why was she consuming wine to boot....that is a major no-no for migraine sufferers as it is a common trigger.

She and her family did not get her proper care. The ER was inept...but there are countless neuro-specialists (one I can recommend right now) that CAN help.

I don't buy it.

You need to be an ADVOCATE for your own care.

I think what I'm having a problem with is the fact that you're labeling your migraines a condition, something that is outside your control. For this lady, you're making it about her mental state.

You also said you didn't have one for 2 years. I've met people who have one every other day for their lives. Blinding pain for a period of time every few days. The ones that are treatable talk badly enough about them and there ARE a small percentage where NOTHING works.

Ah, so in your logic, since there was nothing that could be done, it was okay for her to kill herself?

I didn't think so.

There is more to this story than migraines and the system is not to blame either.

I agree. I think it's too easy to blame things on "the system".

I've never had a migraine, but my mom has them all the time. I understand that there are extreme cases, but a migraine can't possibly be enough to drive someone to suicide. I agree with you kiyo. There must have been other circumstances involved to lead to such drastic measures.

Respectfully, Tsunami:

Yes there are medications and treatments available, but they don't work for everyone. Then that migraineur has got to go through YEARS of trial and error with nasty medications in order to get some semblence of control over the migraines.

And then when that does not work? Pain every day, all day, until you want to kill yourself.

Tsunami, you said "in one of your worst migraines you never once thought of killing yourself"... now think about that pain and consider how you might feel if that pain came 14 days out of every month.

Now think about that pain and consider how you would feel if every time you went to the doc, they said, "try this new drug" and it did not work. Now think about that pain and consider how you would feel if that went on for 5, 10, 15 years.

Now think about that pain and consider how you would feel if this monster in your head made you postone your wedding or having children, or if it prevented you from going to grad school, or if it made you lose your job.

Now think about that pain and consider how you might feel if you had tried every drug on the market, every herbal remedy, every relaxation technique, every physical therapy and nothing helps it...some things make it worse, and you drag your ass from doctor to doctor looking for the solution.

And then when you are finally at the end of your rope with that blinding pain that has lasted for 10 days straight, you go to the ER and the doc, who is supposed to help sick people, brushes you aside.

Now think about going back home with that monster pain, knowing there is no end to it, knowing that if you go back to the ER you will be brushed aside again, KNOWING that you will never, ever get rid of that beast in your head.

This is not clinical depression. This woman, if anything, had "situational depression". The situation was terrible, she had horrific and uncontrolled pain. But since it is migraine pain, that woman must be nutso.

If she had cancer and needed pain treatment, the doc would not have hesitated to give her a shot.

But migraine is all in our heads.

I get awful headaches that make me completely unfunctionable. they will hurt for up to 3 days and get steadily worse the entire time. I can't move, I can't sleep, I can't do anything. I get sick to my stomach. Eventually, I have had to go to the ER on many occassions, because I just couldn't take the pain.
The first time or two, they gave me dilaudid. It worked great. It lasted about 10 hours, which is necessary to completely get rid of the pain and be sure it doesn't come back when the meds. wear off. Since then, they give me toridol which does nothing but make me swollen the next day. When I tell them just give me dilaudid, they do indeed come off like I'm some drug fiend. Hell, they are the ones who introduced me to it. And it is made for pain, so what the hell, use it as such@!!@!
I have taken out my IV and walked out of the hospital on a few occassions because of their ignorance.
My neuroligist just says that ER doctors are good for emergencyies, but not really equipped to treat these headaches.
I, also, tell these dr's to call my dr. , but my dr. doesn't always call back in a timely fashion.
Because migraines are chronic, I can see where one would get tired of not being able to get treatment, although treatment is so readily available. And getting tired of being treated as a drug addict. I don't know about going so far as suicide, but it is an illness that dr's need to take more serious than they currently do.

Dilaudid works great to stop these headaches in their tracks. It is a pain reliever. So, they need to just give it and stop worrying about drug addiction so much. It isn't like I'm hospital jumping, or getting it anywhere else. They know how much and how often I'm getting it and are way, way too cautious.
By the way, I'm state certified as a substance abuse counselor, and because of that, I know when they start asking certain questions exactly what they are implying.

Argghhh...

we live in a society where everyone thinks they are their own doctor. "Give me this, it works better" is great. Now imagine every person coming is saying "This works better". So after the ER doc discharged her... why didnt they call their own doctor then? go to a different ER? Ask a nurse to call her doctor?

I have a problem buying this story.. as the only "evidence" is heresay from the doctor/patient/Fiance/Writer... There is no way enough evidence to say the doctor fucked up- we dont know what happened in that room.. the only side presented here is what a woman in pain, who didnt get what she wanted, said to her finace... who is looking for someone to blame (which is natural)....who then presented the story to a writer with an obvious agenda. Doesnt make it false, just im not prepared to condemn a doctor over this.

And i think what Tsunami is saying is that there are thousands of people who have terrible migraines that don't kill themselves... so there obviously was something else wrong with this particular woman... Doesnt mean the migranes arent horrible. Doesnt mean that she didnt need more drugs... but to take the step of killing yourself.. But i dont beleive that ONLY physical pain can cause someone to kill them self...