I went to the ED once because of a problem (my meds had made me really sick, they weren't sure which one, so we had taken me off them....not a good idea after all!).

The ED doctor knew what TN was. He gave me IV valium, IV benadryl, IV toradol (like a liquid aspirin, but works GREAT), and IV phenergan. This cocktail worked wonders. He also gave me a script for valium to take home. If a doctor is unfamiliar with TN, he really isn't going to just go off a letter from your doctor. He will go look it up (I work in healthcare and have worked in emergency departments). He has his license to worry about. He may call your doctor, but trust me, you don't want to wait that long for meds!!!!