I have a friend who suffers from migraines (not Rep. Michele Bachmann, though I’m sure she’s a delightful person). The young lady of whom I speak has suffered from this condition for most of her life. Unlike the aforementioned Presidential candidate from Minnesota, my friend’s migraines are often debilitating. For years, she sought answers from Conventional Medicine, until she got some unusual advice in an emergency room.
The young lady in question recently visited her local emergency room twice in the space of five days for two separate migraines. On the first visit she was given a shot, often referred to as the “magic shot,” which consisted of Phenergan and “enough Demerol to bring down a bull elephant” — the words of the on-call physician. The shot made her fall asleep for about three hours, after which she awoke and suffered for an additional 26 hours before the migraine abated. All told, that migraine lasted for 72 hours.
On the second visit, she was attended by a nurse practitioner (NP). This man, she told me, was different. After she explained her current symptoms and related her experience during the first visit, the NP closed the door to her room.
“Do you want to have the shot,” he asked, “or do you want to get better?”
Taken aback, my friend replied that she wanted a treatment that worked. The NP then explained that, in the fast-paced world of emergency rooms, most medical professionals assume the people who come in complaining of migraines just want the “magic shot.”
“If they’re drug seeking, it’s faster to just give them the drugs,” he explained. “I never prescribe opioids for real migraines.”
In all the years my friend had been visiting emergency rooms, she had always received a shot. Sometimes it worked, sometimes not. Never, not once, had she been told that she was being treated like a mere drug addict.
It turns out, Demerol (chemical name meperidine) does not cure migraines, and hospitals know this.
“Despite guidelines recommending against opioids as first line treatment for acute migraine, meperidine is the agent used most commonly in North American emergency departments,” read a study reported in Annals of Emergency Medicine, a peer-reviewed medical journal.
The study concluded that: “Meperidine is less efficacious and associated with more side effects than DHE regimens in acute migraine headache. There was also a trend towards decreased efficacy of meperidine compared to anti-emetics… Clinicians should consider alternatives to meperidine when treating acute migraine with injectable agents.”
The NP instead prescribed for my friend what he called “the migraine cocktail” — Benadryl, Compazine and Toradol, given intravenously with a liter of fluids. This remedy contained no narcotics and was relatively mild as far as prescription drugs go (although prescription drugs should be avoided, of course). Because this treatment takes an hour to administer, emergency rooms rarely offer it, choosing to just give migraine sufferers the shot.
While I applaud the NP’s non-use of opioids, I would add that at least one study has found that a popular supplement, coenzyme Q10, may be successful in preventing migraines.
A 2004 study reported at the American Academy of Neurology’s annual meeting found that migraine patients who took 100 mg three times a day of CoQ10 — which acts as the body’s energy producer — had fewer attacks in three months than those who took a placebo. The participants taking CoQ10 also had fewer days with a headache and fewer days with nausea.
My friend’s migraine was gone within half an hour of being treated with the “migraine cocktail,” but when she spoke to me she felt sick — over the way she had been treated by the medical community through the years.