I've posted about this before but didn't get many opinions. I'm applying to a nursing program for this fall and have a good GPA in my prenursing classes. All seems well, except that twice a month (most months) I get migraines for one reason or another. I have taken drugs for them which work temporarily and then stop being effective. I do everything I can to avoid the triggers, but sometimes they just happen and I have no idea why.
I am so worried that these will stop me from being a nurse. When they happen, I am blind for about 15-20 minutes (mine have the aura) and then I am usually hit with so much nausea and light sensitivity and pain that I had to lay down. Usually they last for 4 hours and then are gone as if they were never there. I can just see me being at work and everyone needing me in several places at once and I get hit with one of these! I am in a panic to try to find some medicine that will control these, or I fear all my dreams of being a nurse are over!
Do any of you have migraines or do you work with someone who does? How do you work around these? I don't want to just have to give up everything because of something that happens a couple of times a month (I do actually have some months where I get away with having none).
Topamax is being used with some success too. I used to have 2-4 migraines a WEEK - now on Topamax and still at a low dose - 25 mg at hs - I get about 4 around the time of my cycle now and maybe 2 or 3 others during the month. I havnt been able to tolerate a dose increase though. I'm going to try upping it next week over spring break.
The triptans are sort of individual - and yes there are new ones. Certain people tend to respond to certain triptans better than other triptans so it is worth getting a few samples from your doc and trying them out.
Prophylactic treatment is worthwhile if the migraines are frequent or hormonal. There are several drugs they use for that. Again it's a hit or miss & trial and error thing to find the one that works for you.
Migraines are sheer misery - I wouldnt wish them on anyone!
Do any of you have migraines or do you work with someone who does? How do you work around these? I don't want to just have to give up everything because of something that happens a couple of times a month (I do actually have some months where I get away with having none).
Cara
I have had migraines since I was 14. They wax and wane in frequency, some are "triggered", some are idiopathic and some are peri-menstrual. I have a prescription for Relpax-which I haven't used in a couple of years, because I hate the way it makes me feel. I have found that making sure I get decent sleep, exercise at least 4 times a week (usually walking), and avoid triggers-chocolate, ETOH, sugar, and staying hydrated helps.
I also read an article in Natural Health Magazine that discussed that there are some docs/studies that link hypocalcemia to migraine, as well as low magnesium levels; it was a great article and made sense. Since then, I have doubled my calcium and upped my mag intake-it really seems to make a big difference for me, my frequency has dropped to one or two much less severe ones a month at most.
Here is a link for a product that I have not tried, but have heard some positive things about (from people as well as Natural Health magazine): http://www.gelstat.com
My migraines range from pro-dromal for days to severe (N/V, light/sound sensitivity etc)-I work in an ICU, so the consant "DING DING DING" of alarms is like torture. But I don't take anything more than ibuprofen when working-I don't like to feel "medicated"- all of the migraine meds I have been given make me feel spacey and tired; everyone reacts differntly-I don't tolerate them well. I can generally stay focused during a migraine; I have had them so long that sometimes it is just "normal" functioning to have one-the same way you keep going even though your back may be "killing" you-working three 12s helps decrease the chance of migraine and work coinciding. But I just tough it out-coffee, water, gingerale, saltines and motrin.
You can do it-don't let this stop you-the first step is to be aware if you have any triggers, or to get extra rest and hydration as you close in on your period. Good luck.
I have had migraines since I was in my teens. I am now 46. I also have the aura (flashing lights about 5 minutes prior to the onset of pain and then a blind spot once the pain hits). I understand all about the nausea and sensitivity to light and sound - every little thing seems like it is a sledge hammer on your head. Someone who has never had a migraine cannot understand, sometimes the attitude is "it's just a headache, take some Tylenol and get back to work". They cannot comprehend exactly how much these headaches affect your entire body. I try to avoid my identified triggers as well, but it is not always easy. I have tried many different medications (Imitrex and Zomig both made me violently ill, with continuous vomiting). The most recent med my doctor has tried is Maxalt. I must tell you that it is working well for me. Within 30 minutes after taking it I can function again (wiht just a slight headache left over) and it doesn't give me that dragged out feeling that these meds sometimes do. Don't give up...you can be a nurse (an an excellent one) even if you suffer from migraines.
Specializes in Education, Acute, Med/Surg, Tele, etc.
I too get them, and agree with trying most medication on the planet to help. I found with me making sure I was hydrated was a good thing...especially in that lovely stale dry air of hospitals. I also found I was drinking way to much coffee to stay alert..had to stop that quick.
Sometimes looking at the little things you do can help lower the risk of having one at work. Last time I had one at work was last year (WHEW!), and I saw the stars...ran and got 800 mg Ibuprofen with a huge glass of water right away (very time dependant..trying to be the nausea/vomiting! LOL)...and took a break in a darkened room. I still had to go home, but at least the other RN's knew I was trying to stay..and so did management! But alas...couldn't work this way, for safety reasons too! (not being able to read meds kinda puts things at risk huh?).
I also suffer from migranes. I feel it has almost ruined my life. I finally went to the dr. and got maxalt and it was a lifesaver. I take it when I first feel a headache coming on and they have saved me everytime. You might want to talk to your doctor or even go to a specialist. Just dont let the migraines stop you from pursing your dreams.
When they happen, I am blind for about 15-20 minutes (mine have the aura) and then I am usually hit with so much nausea and light sensitivity and pain that I had to lay down. Usually they last for 4 hours and then are gone as if they were never there.
Wow, that is the exact headache that I get 5-6 times a month. They are completely paralyzing. Unfortunately, I haven't been able to find a med that helps (except Reglan for the nausea). I've tried Imitrex, Zomig, Excedrine, Maxalt, and others.
Luckly, I tend to get them right when I wake up in the afternoon and I work nightshift, so they are usually gone before I go to work.
I used to get Migraines one or two times a week. Then a friend of mine told me that she read a book on Migraines and that drinking TEA was a big factor in Migraines. The ingredient in TEA called Tanin caused Migraines. I was a HUGE Iced tea/ Hot tea drinker. I gave it up; hard, but I did it!!! I have not had one migraine in 8 months! Not even with my triggers (bright light, no caffiene in the morning, msg, aspertaine(sp?)) Nothing.. I would advise ANYONE to give up tea and see how you feel.. The book also listed red wines, cheeses, some other common things..They are also starting to make "low tanin" teas.. I have done so well I am still scared to try any tea products , but if you drink TEA, shelf it and see how you feel, it changed my life!!!
I had terrible migraines, with aura, one half of my body, and face going numb, and terribley incapacitating pain behind my right eye. After my hysterectomy, they stopped. (not recommending one) BUT I get auras and numbness still. They started calling them migraine equvilants, no headache, but the blind spots, where if I were reading parts of the page would disappear. I had a MRA and was told I had an incomplete circle of Willis, and that these could be related to that also. The last med I was given was topamax. TOO many side effects . My best bet was to hit a dark, cool, quiet room, and pray for sleep.
I also get migraines and was actually using FEMLA to protect my job from all the missed work. A neurologist subscribed Zonnegran and it has been a miracle for me. I also take Imitrex nasal spray along with po Amerge if I do get a breakthrough migraine, but these only occur every couple of months now.
So, for me, my manager has been very understanding of my issue with migraines. But, also, know that your job is protected if you have your Doc fill out the proper forms.
Don't give up nursing because of migraines, I think that we as a group, probably understand migraines more than any other, because so many of us get the dang things.
There are new drugs developed all the time. First of all find a good Doctor and then take the time to find the right drugs and/or combinations of drugs that will help you. There will be a solution for you!!
...I'm applying to a nursing program for this fall...twice a month (most months) I get migraines...I am so worried that these will stop me from being a nurse...Do any of you have migraines or do you work with someone who does? How do you work around these?...
I got through nursing school myself with classic migraines (migraine with aura) that I get a few times a year. There were occasional accommodations that were made for me, such as making up some clinical hours and rescheduling of a couple exams. Don't let your migraines stop you. Just charge on, and do what you have to do to deal with them when you can't avoid them.
...Wow, that is the exact headache that I get 5-6 times a month. They are completely paralyzing. Unfortunately, I haven't been able to find a med that helps (except Reglan for the nausea). I've tried Imitrex, Zomig, Excedrine, Maxalt, and others...
I never had any luck with any of the tryptans, or the ergot-based migraine meds or pretty much anything until recent years. One big problem has been that I vomit during my migraines prior to any oral medication getting absorbed. Also, the injectable Imitrex didn't work for me.
I approached my neurologist with a study I had read about off-label use of Actiq for migraines, which is transmucosal fentanyl (actually approved only for breakthrough pain in people on continuous narcotics, which I am not). He let me try it, and it's made a tremendous difference for me. The narcotic gets absorbed through the oral mucosa, and acts within 10-20 minutes. I start the lozenge as soon as I get the aura, and I can actually function somewhat instead of rolling into a ball of misery. This medication is the only one that has made my migraines tolerable.
The rapid absorption is a double-edged sword. On one hand, it gives me ideal control to titrate against my pain, like having my own PCA. On the other hand, when I was newly taking it, it was easy to overshoot my ideal dose and vomit because of the medication, instead of vomiting from the migraine. Incidentally, I don't know if it's just me but my experience with this has left me wondering why anyone would abuse a narcotic. I don't get any sort of pleasurable feeling, just pain relief or nausea if I have too much.
Another one I have tried that avoids the oral route is the nasal spray butorphanol. It's also narcotic, but you don't have the control to titrate because it's a single dose. It didn't work well for me.
If you try the narcotic route, have some plan of action with regard to what's expected by your school or hospital administration if you have a migraine. You will probably be considered impaired and expected to bow out of patient care . I would like to hear from anyone who's had any experience discussing with admin or the BRN the use of prescribed narcotics and nursing.
Personally, after discussing my aura with a clinical instructor my first time with a migraine during the program, we agreed that I would start my Actiq lozenge while I closed out and handed off my nursing duties. I sat out the clinical, making up the hours another day. My last semester, a different instructor decided to let me keep working if I was up for it, and she kept a close eye on me to make sure I didn't seem impaired. She kindly double-checked everything I did (we had an unusually light clinical day, fortunately), and everything was fine.
gauge14iv, MSN, APRN, NP
1,622 Posts
Topamax is being used with some success too. I used to have 2-4 migraines a WEEK - now on Topamax and still at a low dose - 25 mg at hs - I get about 4 around the time of my cycle now and maybe 2 or 3 others during the month. I havnt been able to tolerate a dose increase though. I'm going to try upping it next week over spring break.
The triptans are sort of individual - and yes there are new ones. Certain people tend to respond to certain triptans better than other triptans so it is worth getting a few samples from your doc and trying them out.
Prophylactic treatment is worthwhile if the migraines are frequent or hormonal. There are several drugs they use for that. Again it's a hit or miss & trial and error thing to find the one that works for you.
Migraines are sheer misery - I wouldnt wish them on anyone!