"You have chosen not to be admitted; therefore you should resume your outpatient medications. Good luck with your migraine and merry christmas."

I didn't have the energy to be angry. This was the third ER visit well within a week, and no one seemed willing to do what usually works for me--giving me 8-10mg of IV dilaudid in reasonably short order (less than an hour) and sending me home to sleep. They spaced the dilaudid out, or wouldn't give that much, or just something.

So a 9 headache would go down to a 7, I'd go home, go to sleep, and wake up with an 8.

I didn't want to spend all of Christmas eve in the ER, but I was trying to avoid going back to work on Boxing Day looking like the recently dead.

So much for that plan. They offered to admit me and give me 2mg every 8 hours. And then they treated it like a bargaining table. And brought DHE infusions up again, despite them never having worked. I don't get it.

I have no idea what to do next. I've sent an email to my GP (out of office until the 3rd) asking for a referral outside of UCLA, to Cedars-Sinai, and left a voice message with my migraine specialist asking him why all the ER stuff went down how it did--he was paged for two of the visits, after all.

If the meds I used to get will kill me, someone needs to tell me. If this level of pain is something I'm supposed to keep functioning with, someone needs to look me in the eyes and say that to me.

Get to us earlier!

Easy for you to say, Mr. Migraine Specialist Man. When I go to the ER after four days of the same migraine, I feel like I'm folding early. That's what I did this past Friday, but instead of decreasing in intensity (either much or little) it decreased and then spiked.

Which meant they transferred me from that ER to a hospital where the specialist has admitting privileges and I got the DHE flush again. Tiresome, boring, cold, hot, just...not a fun way to spend your weekend.

Does it work? Hard to say. Lying down for two days has its own minimising effect on my migraines. I was discharged at about noon, and got my next migraine by six. But it was small and mostly responded to Maxalt.

Mostly.

The upshot of the visit:
a) He wants me to ping him (how? he's so very unavailable) before the ER to see if we can do the DHE as outpatient before dilaudid, etc come into the picture
b) Namenda again
c) Increase Depakote to 1750mg/day

We shall see. My fingers are crossed Namenda-wise, and I'm back on the Mg and the riboflavin, just to see how things go.