Migraine isn’t Just a Headache… One Attack Put Me into A&E

Despite all the research, accessible information, and awareness campaigns, when most people hear "migraine", they think of an intense headache.

Some headaches may share the severe pain of migraine attacks, but a throbbing head is only one symptom of migraine. Every year, severe migraine attacks cause up to 16,500 emergency hospital admissions in the UK 01.

In today's article, Sarah Alexander-Georgeson shares her first migraine experience and why A&E needed to provide her with emergency care. 

Growing up, I was no stranger to the hospital. By the time I was 13, I had broken both my legs (at different times) plus an ankle, shattered my heel, fractured my elbow, had my tonsils removed, and doctors had placed a pin in my hip.

My clumsiness, which we found out when I was 19, was due to hypermobile Ehlers-Danlos Syndrome and meant I had a lot of accidents.

I'd trip up the stairs or fall down them. I'd often fall over my feet when walking in a straight line (nope, I'm not kidding. My ligaments are so loose, I often feel like I'm made from elastic). PE at school wasn't fun, as I racked up multiple injuries playing sports. My body was unpredictable, and I spent a lot of time with various bones in plaster casts. Sitting in an emergency waiting room was something I was very used to.

I knew my headaches were "more" than typical head pain

When I was fifteen, my headaches turned into the unbearable agony of migraine attacks. They were something I couldn't manage, something that interfered with school. I spent days in bed; my room turned into a dark cave I tried to survive in.

Sleep sometimes helped, but other times, I found myself balanced in some strange sort of limbo. I was between wakefulness and sleep. It felt like something was clawing at the back of my eyeballs, but I was too unconscious to move.

In my semi-dream state, it hurt. My head pounded and felt too heavy to lift. My head was crushing my shoulders and neck, yet I couldn't lie on my pillow. The pressure of the weight of my head on the pillow felt like it would explode. It intensified upon moving, sitting up, and opening my eyes. I was nauseous, I was vomiting, and I couldn't eat.

I was missing too much school. I was missing my friends. I was missing everything.

These migraine symptoms refused to go away

I thought the unbearable agony in my skull would magically disappear. After a few weeks, I couldn't handle it anymore, and I let my mum make an appointment with my doctor. I don't know why I was so naïve to think the headaches would vanish. I was already living with chronic pain, but I didn't want to believe something else was wrong with me too.

When I visited my GP, he examined me and told me I was having migraines. It wasn't a shock as I'd witnessed my mum struggle with them for years. He explained that he was reluctant to put me on more medication, as I already took so much due to my chronic pain. Instead, he wanted to refer me to a neurologist to see if anything else was happening.

I left the doctor's office feeling quite deflated. I had to wait up to three months to see a neurologist. In the meantime, I was expected to deal with the throbbing migraines like I had been doing. And, let's face it, I wasn't dealing with them well.

I didn't know what helped, I didn't know what triggers to avoid, or how to forget the pain for just a moment – I didn't know much about migraine at all. I only knew what worked for my mum. So, we tried that.

Without treatment, the migraine attacks were getting worse

When my next migraine attack happened, we ensured my room was completely dark. Mum placed a bucket next to my bed, a cold compress on my head, and chilled water on the bedside table. She rubbed me for hours, trying to keep me calm.

It didn't help. None of it worked. Closing my eyes was torturous; opening my eyes was worse. I was vomiting and choking, and the agony was so intense I wanted to smash my skull against the wall. It was so overwhelmingly awful, and I couldn't stop crying. The crying only worsened my migraine, but I couldn't stop; it also hurt when I wasn't crying. It was a lose-lose situation.

I've never been the crying type. My mum always said I had a high pain threshold. When my femur slipped backwards from its growth plate and needed emergency surgery, I cried as the pain was indescribable. But although all my other breaks and fractures hurt, I never shed a tear.

So my whole family knew there was something wrong with me when I was crying because of a migraine attack.

I was rushed to A&E

My mum bundled me up in the car. She rushed me to the Accident and Emergency Department at my local hospital. We still hadn't heard from a neurologist and hoped my trip would hurry that appointment. But the main focus was to treat the anguish I was going through right now.

The car journey was horrendous. There was too much light, bumpiness, noise. I remember throwing up multiple times, gripping the sides of my head to relieve the pain.

We were signed in and told there was a three-hour wait. I was the only person in the waiting room crying into a bucket. I must have looked wild, but I didn't care – I needed help. The lights were too bright, and the room was packed full of noise. I hated it.

I felt drained, but the pain eased occasionally, and my tears lessened. I lay across two chairs with my head on my mum's lap as she stroked my hair. My mum got talking to another woman sitting close by with her son, who had been waiting longer than us. His name was called, and the woman insisted we go first as she could see how much I was suffering.

The attack required emergency treatment

A nurse moved me from the waiting room to a side room, and a doctor came to see me. My mum did most of the talking, and I lay curled up in a ball in the bed. I was given something for the pain and put on a drip to rehydrate me. As I was given this treatment, they told me I desperately needed to see a neurologist. Whatever they gave me helped relieve my symptoms, and soon my head no longer felt like a torture chamber.

I was discharged with a prescription for medication to tide me over if I had another migraine attack. I left the hospital feeling much better than I had when I entered.

How chronic migraine affects me now

I'm unsure why my first migraine landed me in the emergency room. My old remedies, like over-the-counter (OTC) painkillers, gave me no relief. I couldn't function properly and wasn't sure if it was a migraine or something else.

The first flares of agony with migraine attacks still often make me cry. But, nowadays, at least I know what's happening and how to treat them. Now I can manage my attacks with medication prescribed by the doctor, taken with plenty of fluids and, preferably, lying down in a darkened room.

I had some extra tests to rule out anything else, and my neurologist told me to wear a cold compress on my head and rest somewhere with minimal light. Unfortunately, this method has limited results, and my migraines are getting more frequent. My medication still helps somewhat, but I'm on another (long, long) waiting list.

I'm leaving this piece on an unsatisfactory note, but I don't know what migraine has in store for me. However, I will say this: if you have migraines and your symptoms change or get worse, please contact your urgent care team.

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Sources:

1. Back to contents.

   Improved NHS migraine care to save thousands of hospital stays,

   https://www.england.nhs.uk/2020/01/improved-nhs-migraine-care/. Last accessed: July 2023

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Date of preparation: August 2023
D: COB-GB-NP-00185 (V1.0) / T: COB-GB-NP-00225 (V1.0) / M: COB-GB-NP-00205 (V1.0)