Personal Perspective: Have you tried to get assistance with a migraine attack while in the hospital for a completely different reason?
Continue to educate your own medical personnel about migraine and its complexity.Be prepared to be a real advocate for yourself and your medications. A 19-day migraine is far too much to withstand. A 19-day migraine following major surgery for an external tibia/fibia break, and complex tibial plateau break is offensive and frightening.
On December 17, 2024, the very day I wrote my last post for Psychologytoday.com, I had just taken my puppy on a hike and was working to lure her down a very open stairway that led to my office. I had a piece of chicken, and she tentatively placed her paw on the second step and then brought it back. I coaxed her further, and she made a mad dash to the bottom of the staircase. At the same moment, I instinctively moved to the right to get out of her way and must have thought I was near the bottom step, as I planted my left leg, which ended up taking the full blow of a twelve-step fall. After being rushed to thehospital, I had my first major surgery, leaving me 12 weeks non-weight bearing and six months of healing ahead. The first setback was that the bones stopped healing at four months, leading to another major surgery to remove and replace the rod and hardware, with the goal of stimulating healing. Four days after the second surgery, just as I was being transferred to a rehabilitation facility, I felt the beginnings of a migraine attack: “Case studies have proposed that general anesthesia and opioids may be related to the development of postoperative migraine headaches” . At first, I wasn’t given my migraine medications at the facility, as the personnel weren’t familiar with administering them. When I could, they put me in charge of my own migraine meds, while every other After four days taking everything I could, I realized I was risking “rebound” and asked the floor doctor to contact my headache specialist, who recommended I go on my Medrol dose pack . Before going ahead, the doctor then contacted my surgeon, who basically told him steroids would stop or slow the healing of my leg, and I would be responsible should that happen. I was in a quandary. Live with the migraine indefinitely or take my risks with steroids; I couldn’t risk another healing stoppage. On went the migraine, though none of the rehabilitation doctors and nurses were familiar or comfortable with how to help and support me. In fact, in many of their minds, I had a “bad headache.” Watching me try to move from a bed to a wheelchair, being taken for excruciating physicalfor my leg, and struggling with all of the migraine symptoms, many wanted to help but just couldn’t. Also, there were days I just couldn’t move, as much as I wanted the physical therapy., but this experience was a true wake-up call. These were very good doctors and nurses who were generally medically on top of my care, all except for the misery of my migraine and how to help: “Few physicians receive adequate training to effectively diagnose and treat migraine,” argue the authors ofabout the U.S. workforce gap in the field of headache medicine. “Most medical schools lack a curriculum in headache medicine, while most of the primary care physicians who provide first-line headache evaluation and treatment recommendations never receive formal training in this area either.” After day 16, I was able to get in touch with my headache specialist, who asked if there was any way the rehab center could transport me to her office for IV infusions. The doctor seemed absolutely mystified about what she was talking about, but arranged to get me there. I cannot tell you the comfort, the relief of being back in her care, where she administered a variety of medications via IV, gave me nerve blocks, and even prescribed a short-term additional medication.Two days later, my migraine lifted, and I immediately started making remarkable progress in my physical and occupational therapy. While always fearing the attack might return, it did not. I think I was actually able to educate some of the staff regarding migraine—what it really is and isn’t— and the varied newer methods of treatment. I felt good about that piece, though sad about how far we still have to go for many to understand and properly treat our disease.Olivia Begasse de Dhaem MD, et al. “Highlights Physician Shortage Ahead Of Headache On The Hill. Workforce Gap Analysis in the Field of Headache Medicine in the United States”.Liao CY, Li CC, Liu HY, Chen JT, Cherng YG, Chen TJ, Dai YX, Wu HL, Liu WC, Tai YH. “Migraine Headaches after Major Surgery with General or Neuraxial Anesthesia: A Nationwide Propensity-Score Matched Study”.Cut-offs cut deep and wide, their emotional impact reverberating far beyond the combatants. Because much of the suffering is hidden, repair is challenging for everyone, not least of all therapists.Self Tests are all about you. Are you outgoing or introverted? Are you a narcissist? Does perfectionism hold you back? Find out the answers to these questions and more with Psychology Today.
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