Last month was my final trial month of the new med trial using a low dose of the anti-depressant nortriptyline as a daily preventative, with the abortive naratriptan to be taken as needed for severe migraine attacks. My results were…mixed. I had two weeks of no migraines at all – a new record since the spike in attacks back in 2018. The average number of attacks had lowered from three to two a week. However, the migraines I was getting were far more severe, enough so that I finally went to urgent care.
I would regret stepping foot in that office by the time I was through.
On the morning of July 2nd, I woke up at 8am in pain. I chugged water, sought out coffee, sipped a meal-replacement shake in an attempt to get something resembling nutrients down. I took an abortive and hoped it would kick in by noon. By 1pm, I was lying on the couch, clenching my teeth so hard my jaws ached, fighting not to just start screaming. I remember punching the couch cushions in frustration, and finally texting my housemate asking if we could go to the ER. I suggested a specific office of ReadyMed, recommended by my primary care as it had migraine abortives in-office and was covered by my MassHealth.
I was in too much pain to even think to check online what the wait times would be. I could barely walk to get into the car. The entire ride, all of thirty minutes, I was fighting not to throw up. We get there, sign me in, and the wait time is two and a half hours.
I wanted to just go back home and try to sleep it off, even though I knew sleep wouldn’t come for a long time. At least at home I can cry and punch my pillows in peace. By the time I was seen, the sharp edge of pain had lessened, and the barest amount of my motor skills had returned. I was incredibly slow on the reflex test, and the doctor knew immediately that I was still Very Not Well despite me nearly walking out of the facility. I was walked to an IV room, hooked up to bag of sodium chloride for fluids, and given injections of ketorolac tromethamine, diphenhydramine, and ondansetron. They were kind enough to call my housemate aka my all-homo/no romo life partner to come in and sit with me while we waited for the IV to finish.
It was my housemate who noticed that immediately after my arm was hooked up to the IV, it didn’t look right. She was very skeptical of how long they were taking to find a vein, as she works in medical and herself has what she jokingly calls “shy veins.” She said my arm looked swollen, and asked if it hurt. I told her I can’t feel anything, because during a migraine attack my brain is overloaded with pain. Unless I shatter a bone, get shot, or stabbed, I don’t feel a thing during an attack. I touched my arm and it felt ice cold. I asked her to touch it. She said that was all wrong and immediately pressed the alarm to call the nurse.
The nurse found that the IV solution for my dehydration wasn’t going in my veins, it was just draining into my arm. By some miracle, the initial injections of pain killers and abortives must have, because by the time they took out the IV and “flushed it”, the pain was gone and so was my nausea. I still felt everything else, the dizziness, memory loss, inability to stay warm, lack of motor skills, zero appetite. I only noticed the ice pick in my skull was gone because my arm hurt like I’d been punched. It was swollen and I could feel the fluid in. But the nurse rushed me out the door and sent me home anyway.
No longer in pain and throwing up, I was able to eat a decent dinner, and put myself to bed, listening to podcasts until I fell asleep. My arm continued to ache and the elbow joint felt wrong. As if the fluids in it weren’t settling right. I got no work done that day, but figured tomorrow I could give it another go and maybe work a little late.
I woke up the next day stoned off my gourd. Like I had woken up and decided to smoke a bowl for breakfast. All of my work requires a fully functioning brain, from social media management to website coding to client edits. Normally, even when I’m in total screaming agony, I wake up the next day foggy but good to go. I can do somethings if not everything. On July 3rd, I woke up too stoned to even answer my email. It was the painkillers in the IV I was given.
So between the body horror of watching my arm swell up with IV fluid, and the drugs causing me to take another day off of my work, I can tell you right now that I am never going to urgent care again. Which is not good, because severe migraines can cause you to crack your teeth due to clenching of the jaws (which I do) and can even trigger a stroke. But somehow that still seems better than fluid arm because without the IV, I can get back to running my company the next day.
My advice: check the times of the urgent care before you go. And if they aren’t great, maybe seek out a real hospital instead of a small immediate care facility. I would like to think they are all not as bad as what I went through, but seeing as I live in Massachusetts – the state with some of the most technically advanced medical practices in the country – I don’t have high hopes for it.