migraines and nursing

Jen,SN · Feb 19, 2005

Thanks for all of the advice everyone.

First off, a little more history: I'm currently a jr. nursing student, with 2 clinical days, 2 class days, and 3 work days each week--I work evenings(can't really change shifts, and whoever said that Id have less work to do on nights...well, instead of 8-12 pts I'd have about 18, so...) Yes, of course stress is a problem--isn't it for every person trying to do school and work? I'm trying to manage it as best as I can, and my headaches don't really seem to correlate with stress that much. My main triggers seem to be art. sweeteners, flashing lights, inc. blood flow to the head(bending over), dehydration, noise from microphones, getting startled out of bed, and my period.

How does FMLA work? Do you just call in and say, "I'm taking a FMLA day?" I'm also looking into a temporary disability right now; by the MICAS profile I'm considered grade IV, seriously disabled. Also, disability pays...FMLA doesn't, right? And I am a starving student...

My current treatment regimen is 30mg Nortryptaline QD(at night), 50mg Topomax BID, 150mg Zoloft QD(both for this and for my bipolar), and a prenatal vitamin that actually doesn't list magnesium. My rescue plan is Imitrex SQ ASAP, 2-3L of water, another shot in an hour if needed, and fioricet(which I believe is similar to the duridrin someone mentioned, it's asprin, caffiene, codiene, and barbituates) if I max out of imitrex. If that doesn't work, head into the ED for droperidol(which I don't like), valproate(which I've never had), or dilaudid(which, at the fear of sounding like a drug seeker, I do like).

I love my job. I love what i do. I just can't handle these headaches, and I don't really know what to do the make sure I don't lose my job because of them...

z's playa · Feb 19, 2005

My pathophysiology teacher is an MD and he swears by a big bottle of gatorade to rid yourself of a migraine. I've never had a migraine so I haven't had the opportunity to try this. It's worth a shot though so I thought I would mention it.
Shel

:rotfl: I'm sorry....its funny to think someone's migraine is resolved with a big old bottle of Gatorade. I wish I was that lucky. Sure would be a heck of a lot cheaper! :)

( sounds to me like they probably suffer from headaches brought on by dehydration)

Gatorade is great for hangovers too!

deegale · Feb 19, 2005

I too get tension and migraine headaches I went from getting one every 2-3 months to weekly. I started seeing a chiropractor and was headache free for a year I just recently started getting them again and again started going to chiropracter. there is also a dr called a cranial/sacral therapist.

Just brainstorming, here are some ideas:
- get a second opinion from another neuro doc
- see a chiropractor
- see an acupuncturist
- see a naturopathic doctor
- consider finding a job with drug coverage
I do not have migraines, but am very prone to motion sickness and can get it from turning around too fast on a bad day. The lasting sick headache and nausea are miserable, although I'm sure nothing compared to a migraine. In any case, I am sympathetic.

vamclouky3 · Feb 19, 2005

...Get your eyes checked out could be major sensitivity to any light source. In the middle of cooking dinner for my boys...later!!! :coollook:

Thanks for all of the advice everyone.
First off, a little more history: I'm currently a jr. nursing student, with 2 clinical days, 2 class days, and 3 work days each week--I work evenings(can't really change shifts, and whoever said that Id have less work to do on nights...well, instead of 8-12 pts I'd have about 18, so...) Yes, of course stress is a problem--isn't it for every person trying to do school and work? I'm trying to manage it as best as I can, and my headaches don't really seem to correlate with stress that much. My main triggers seem to be art. sweeteners, flashing lights, inc. blood flow to the head(bending over), dehydration, noise from microphones, getting startled out of bed, and my period.
How does FMLA work? Do you just call in and say, "I'm taking a FMLA day?" I'm also looking into a temporary disability right now; by the MICAS profile I'm considered grade IV, seriously disabled. Also, disability pays...FMLA doesn't, right? And I am a starving student...
My current treatment regimen is 30mg Nortryptaline QD(at night), 50mg Topomax BID, 150mg Zoloft QD(both for this and for my bipolar), and a prenatal vitamin that actually doesn't list magnesium. My rescue plan is Imitrex SQ ASAP, 2-3L of water, another shot in an hour if needed, and fioricet(which I believe is similar to the duridrin someone mentioned, it's asprin, caffiene, codiene, and barbituates) if I max out of imitrex. If that doesn't work, head into the ED for droperidol(which I don't like), valproate(which I've never had), or dilaudid(which, at the fear of sounding like a drug seeker, I do like).
I love my job. I love what i do. I just can't handle these headaches, and I don't really know what to do the make sure I don't lose my job because of them...

RedSox33RN · Feb 20, 2005

don't mean to derail the thread here, but could someone explain how the fmla works? if you have to call off, as i have, once a week for the last four weeks for my migraines, do you just tell them you're taking a fmla day? i actually had fmla papers filled out when i need about two weeks off last fall, and am just wondering how to go about it....
i go back to my neuro the 23, i have been taking topamax and can barely stand it anymore, it makes me feel miserable and sure doesn't help my migraines. maxalt is my lifesaver, but very very expensive! i don't know how i would survive without it.
h

I've had migraines since the age of 3. I tried Topomax about a year and a half ago, and I couldn't get past the awful side effects to know if it worked or not. I finally am seeing a new Neuro, and he said that in his experience, it only works about 40-50% of the time.

I'm currently on Atacand for prevention, and Migranal/800 ibuprofen/fioricet/phenergan (though not all at once!) for treatment. About every 2-3 months I end up in the ER for demerol. I hate knowing that they think I'm a FF there, but because I'm also a Type 1 diabetic, if I can't get rid of my migraine within a few hours, I get really sick and my blood sugar gets either really high or really low from vomiting. I always ask them to try Toradol first, but they usually say that if I'd tried my "regular" regime at home and none of it has worked, Toradol probably won't. I at least TRY to give them the option of no narcotics, though I hate having to try to prove I'm not there for a high.

I've never figured out any food triggers, though an insulin-induced low (if I get below 60 or so) will usually trigger one. I know even a good stress headache, untreated, will give me one.

Anyone else using Migranal? All of the triptan-type drugs stopped working for me a few years ago. Migranal gets rid of mine about 9 times out of 10.

lazydaze22 · Feb 20, 2005

Yet another long-time migraine sufferer here. Since I was 12 my head has constantly hurt. I get the real bad ones daily, the really, REALLY bad ones a few times a week. I quit going to the ER because the lights and sounds there nearly paralyze me with the pain. Urgent care is quieter and quicker if I can get there during their hours, or my GP will give me a tordaol/phenergan injection. I'm in my senior year of nursing school (TOTALLY understand the poster who is trying to do work and school and deal with these migraines! I really feel for you!). I have also wondered what to do if/when the time comes that I am missing too much work, so the FMLA info is great. Thank you.

Sorry to detract from the OP, but any reccommendations for areas to work in from those who have migraines as well? I don't want to ask anyone at school because I don't want my grades to suffer due to someone else's judgment of whether or not I should be a nurse. I've had my share of nurses telling me I should never be a nurse and to just get my degree and find another job, so I'm not looking for that type of advice.

To the original poster, I have known nurses who were on disability due to migraines, but they all had to quit nursing and then fought hard to get disability. It breaks my heart to think of how many really excellent nurses are out there but can't work because migraines disrupt their lives and there is nowhere for them to go where people understand. It's not just a boss that understands or a job that can let you work flexible hours, but the need to work a certain amount of hours to earn money to put food on the table. It's all so frustrating and I'm sorry I have no ideas to help you. I hope you are able to solve this problem and that your head lets up and gives you peace this week.

rehab nurse · Feb 20, 2005

I've had migraines since the age of 3. I tried Topomax about a year and a half ago, and I couldn't get past the awful side effects to know if it worked or not. I finally am seeing a new Neuro, and he said that in his experience, it only works about 40-50% of the time.
I'm currently on Atacand for prevention, and Migranal/800 ibuprofen/fioricet/phenergan (though not all at once!) for treatment. About every 2-3 months I end up in the ER for demerol. I hate knowing that they think I'm a FF there, but because I'm also a Type 1 diabetic, if I can't get rid of my migraine within a few hours, I get really sick and my blood sugar gets either really high or really low from vomiting. I always ask them to try Toradol first, but they usually say that if I'd tried my "regular" regime at home and none of it has worked, Toradol probably won't. I at least TRY to give them the option of no narcotics, though I hate having to try to prove I'm not there for a high.
I've never figured out any food triggers, though an insulin-induced low (if I get below 60 or so) will usually trigger one. I know even a good stress headache, untreated, will give me one.
Anyone else using Migranal? All of the triptan-type drugs stopped working for me a few years ago. Migranal gets rid of mine about 9 times out of 10.

I've used all the triptans as well, though maxalt mlt works the best. imitrex nasal spray worked but the taste just made me vomit even more. my PCP tried me on verapamil pm (sp?) before i started seeing my neuro. i had a spell last fall where i had a migraine for two weeks (yes two weeks!) and the maxalt had stopped working because i used it so much. i know what you mean about hating to go to er, i sure hate strolling in there and asking for what works (toradol, dilaudid, zofran). last time i was in er, they gave me phenergan, decadron, and something else i don't remember but i remember after i got it all in a 10 second iv push and my hand was on fire...about thirty minutes later i was in an awful stupor, and at that point, even death didn't seem like a nice alternative to my migraine anymore. it took 16 hours for that combo to wear off. i hate going to the er, because even tho they will call my neuro and pcp and they tell them what works and give orders (toradol, dilaudid, zofran!) they still give whatever they feel like. ugh.

i've never figured out any food triggers, either. what sets me off are bright lights, some sounds, severe stress, and my periods.

i also work rehab/subacute full time, go to school, and am a single mother to two toddlers. i know how it feels to have to juggle it all, and sometimes its hard not to have help, boy do i know. i feel for everyone here! hugs!

h

rehab nurse · Feb 20, 2005

Thanks for all of the advice everyone.
First off, a little more history: I'm currently a jr. nursing student, with 2 clinical days, 2 class days, and 3 work days each week--I work evenings(can't really change shifts, and whoever said that Id have less work to do on nights...well, instead of 8-12 pts I'd have about 18, so...) Yes, of course stress is a problem--isn't it for every person trying to do school and work? I'm trying to manage it as best as I can, and my headaches don't really seem to correlate with stress that much. My main triggers seem to be art. sweeteners, flashing lights, inc. blood flow to the head(bending over), dehydration, noise from microphones, getting startled out of bed, and my period.
How does FMLA work? Do you just call in and say, "I'm taking a FMLA day?" I'm also looking into a temporary disability right now; by the MICAS profile I'm considered grade IV, seriously disabled. Also, disability pays...FMLA doesn't, right? And I am a starving student...
My current treatment regimen is 30mg Nortryptaline QD(at night), 50mg Topomax BID, 150mg Zoloft QD(both for this and for my bipolar), and a prenatal vitamin that actually doesn't list magnesium. My rescue plan is Imitrex SQ ASAP, 2-3L of water, another shot in an hour if needed, and fioricet(which I believe is similar to the duridrin someone mentioned, it's asprin, caffiene, codiene, and barbituates) if I max out of imitrex. If that doesn't work, head into the ED for droperidol(which I don't like), valproate(which I've never had), or dilaudid(which, at the fear of sounding like a drug seeker, I do like).
I love my job. I love what i do. I just can't handle these headaches, and I don't really know what to do the make sure I don't lose my job because of them...

I feel for you about the job. I too am struggling on a thin line with losing my job because of absenteeism. It is hard for me, as I have to work a minimum of four days a week to be able to get health insurance for me and my kids, at the cost of 300 bucks a paycheck. i have so many health problems right now, it's a joke. i have lupus, migraines, two herniated discs in my lumbar spine and the chronic pain that goes with it, endometriosis and pending surgery for that (when/if i can afford to take the time off for recovery). i juggle school (i'm trying to get my RN after being an lpn almost 10 years), work, and my two toddlers. i struggle. right now, i just don't know how much more i can take. i really feel for you. i don't know what the solution is. i don't have understanding from work, or co-workers. i am only in my late 20's, so most people think there is no way i can possibly be as sick as i am. well, i only wish they could live an hour in my painful shoes and maybe they would understand.

i am only allowed six sick days a year, and this year, i've already used double.

sorry i don't have any advice for you, i just wanted you to know you're not alone!

h

vamclouky3 · Feb 20, 2005

02/20/2005

:nurse: You know me not being an expert on nothing but you know there is only so much medicine can do for the body in order for it to "heal thy self nauturally". The body had developed a tolerance for the drugs taken and its not working anymore so you "need" something much stronger for the same effect i.e. smoking, caffiene, sex (just examples) but to read this exemplifies the need to self manage the symptoms.

Imitrex has side effects noted and truth be known Steroidal aside your going to have to decide some natural ways to conquer the migraine headaches. Have that coke once in awhile and your basically telling me also your STRESSED out with your life!!!! With toddlers who has the time to make school when you have to pick them up before six p.m. everday.

Your too young for this crap babygirl slow down before you end up in the mental unit and FMLA won't cover that. Sit down, regroup priorities again, find some suitable help with finances, toddlers, DOWN TIME, a study buddy for school if you don't drop out for being overtaxed; See your employer to redo your work days like everyother day SMWF schedule so you can manage your life better.

I dream of returning to school for my RN even though I am N.A. one day but in reality -- work full-time, kids under 13 in school, parents who are running out of patients with me, finances,etc..life sucks but you keep plugging away but remember your "a" human being first and foremost!

Make the re-adjustment before you collapse of strain the body knows when to stop doing nothing that is not working. Meditate, Aromatherapy,Homeopathic remedies w/Dr's assistance, look for a grant that helps single mothers out so your burden is lessened. Get Matthew Lesko's books on the web check through them and see what can be available for you in your state -- cannot hurt to look. Thanks.

__________________________________________________ 12:44 pm

I've used all the triptans as well, though maxalt mlt works the best. imitrex nasal spray worked but the taste just made me vomit even more. my PCP tried me on verapamil pm (sp?) before i started seeing my neuro. i had a spell last fall where i had a migraine for two weeks (yes two weeks!) and the maxalt had stopped working because i used it so much. i know what you mean about hating to go to er, i sure hate strolling in there and asking for what works (toradol, dilaudid, zofran). last time i was in er, they gave me phenergan, decadron, and something else i don't remember but i remember after i got it all in a 10 second iv push and my hand was on fire...about thirty minutes later i was in an awful stupor, and at that point, even death didn't seem like a nice alternative to my migraine anymore. it took 16 hours for that combo to wear off. i hate going to the er, because even tho they will call my neuro and pcp and they tell them what works and give orders (toradol, dilaudid, zofran!) they still give whatever they feel like. ugh.
i've never figured out any food triggers, either. what sets me off are bright lights, some sounds, severe stress, and my periods.
i also work rehab/subacute full time, go to school, and am a single mother to two toddlers. i know how it feels to have to juggle it all, and sometimes its hard not to have help, boy do i know. i feel for everyone here! hugs!
h

dustydog · Feb 20, 2005

To all you migraine sufferers, I can really empathize. I've onlly had them for about ten years but when I get them, my life gets put on hold. I had to quit nursing school after the first quarter because I could not get them under control. They were coming 2 - 3 times a week. The Zomig worked most of the time but I felt that everything I did was in a slow motion and thinking was very fuzzy. I think I was getting rebound headaches. PCP put me on 25 mg of atenolol every day which has now cut them down to once every 12 days. Will try to tweek this a little more. This coupled with severe arthritis in the cervical region has really made me wonder if I can go back to school and attempt to finish. I'n not a quitter and the though of just giving up gets me down. I do not have a family to worry about like some of you out there. I feel so bad for all you that are struggling through the pain and side effects of medication to hang in there and do your jobs. I pray you (all of us) will find relief....

mackrn · Feb 22, 2005

I need some advice here....
Four months ago, I went to bed with a bit of a headache and woke up with a migraine that I can't get to go away.

You might want to check and see if there is a hyperbaric unit in the area. We have a couple of nurses and doctors that have problems with migraines and have found that an HBO tx works great on them. Usualy able to return to work with in 30-45 minutes,

mackrn · Feb 25, 2005

Knew I shouldn't of responded to this thread as this week have treated two hospital employees for migraines (1 from OR and the other from Trauma Unit) after hours in the chamber. Since we cannot charge for the treatments as the insurance will not pay for I usually do not clock in, but both were back to work in 45 minutes without any discomfort. Just wish they would of called earlier in the day when still there as both stated had been hurting since after lunch.