I was diagnosed with migraines long before I had any symptoms of ME/CFS, around 1999 or 2000. I'd say ME/CFS was in full swing by 2011 for me, probably triggered by an illness I had in 2006.. followed by some foot dragging by doctors about what it was that was making me feel so bad. The official confirmation of rampant EBV and CMV plus a couple of positive strains of Lyme, and a few others (we did a lot of tests)... that confirmation didn't come until last fall. Each fall I have a recurrence of a series of infections and I sometimes don't get off of antibiotics until March or April. That's been happening since around 2002.
Anyway, when my neurologist diagnosed the Migraines, what he said was that anyone who gets 4 or more headaches a month, headaches that interfere with their life, not just "oh take an aspirin and it goes away"... should ask to see a neurologist, if their doctor hasn't already referred them.
My type of migraine can cause damage at the base of the brain, the area controlling motor function. One of the first effects I noticed is a significant increase in how clumsy I am. I play a lot of reaction-time types of games. My performance is no longer superb, but I'd call it more "normal" now. I really want to avoid it becoming "poor." I also put ice on the back of my head during any headache. I've been diagnosed with more than one type of headache.
In the past few years, I have a new symptom... I often can't talk during a phase of the migraine. And the right side of my body becomes weak and nearly paralyzed. The diagnosis has now changed to "hemiplagic" migraine. It makes communicating with nurses or EMT's a real bother. Since that type of migraine is not common or even well known (ie. it's not routinely taught to EMT's and etc.), I'm frequently accused of faking or drug seeking. This is despite my telling them (when I can talk) that opiates make it worse but that toradol and saline IV help a lot.
I think it's a false equivalence to say that people who are dehydrated should drink water and that's just as good as an IV of saline. I have gut issues and kidney issues so my body doesn't process water "normally" I think. Why not be better safe than sorry, and give me an IV? It's doubly infuriating when they accuse me of drug seeking in the same breath as deny me a simple saline IV. Even my cat got sub-Q fluids. But we let humans suffer because of this false equivalence: drinking water =/= saline IV.
I no longer go to the ER. It's simply not helpful, though it could be.