Migraines ruining life/career and no one believes me. What now?
October 9, 2014 10:49 PM Subscribe
I am a mid-30's woman with a very successful career in finance, or at least used I to be successful. I suffer from very frequent migraines and I'm pretty sure I'm about to be fired for all the sick days I have taken this year and also my projects and meetings that have been affected.
From childhood to about age 30, I had 1-2 migraines a year. I would just stay home in bed and they would go away in a day. Since I turned 30, they have been coming more frequently so now I am getting them at least once per week.
They are also getting worse. It's not just the bad pain, which I might be able to work through. Light and sound make me throw up. Also my speech becomes unintelligible. I am not sure how to describe it, but I also feel verbally violent and hateful. I do not think I will harm anyone, but I am afraid for example of yelling at my coworkers or people on the train, who are nice and didn't do anything wrong. This is very out of character for me and it goes away when the migraine is over.
I have taken more than 30 sick days just this year, and also people are concerned because during some of my presentations and meetings, my speech has been very disorganized. I know from office gossip that has gotten back to me, that some people think I am taking illegal drugs, which I have never done in my life, or just lying and being lazy.
My doctor gave me Amerge and Imitrex. They mostly work but they usually take a few hours and I have to sit in a dark, quiet room during that time. Also if I wake up with a migraine at night, they do not work at all and I cannot go to work in the morning.
HR scheduled a meeting with my boss and me tomorrow morning, and I am terrified I will be fired. I do not have any close family or partner. I am seeing a good therapist who would be helpful, but I love my career and I don't know what I would do if I lose it.
What should I say during the HR meeting tomorrow? I am scared and worried I will start crying. I have some money saved, but again I am more scared about losing my career.
I know you are not my doctor, but is there any medical treatment for migraines this bad if the normal Imitrex and other drugs don't work? I eat healthy, get 7 or 8 hours a sleep each night, and exercise on the days I don't have migraines, so I don't think it's my lifestyle. But any advice would be welcome. Please help, I am very scared.
From childhood to about age 30, I had 1-2 migraines a year. I would just stay home in bed and they would go away in a day. Since I turned 30, they have been coming more frequently so now I am getting them at least once per week.
They are also getting worse. It's not just the bad pain, which I might be able to work through. Light and sound make me throw up. Also my speech becomes unintelligible. I am not sure how to describe it, but I also feel verbally violent and hateful. I do not think I will harm anyone, but I am afraid for example of yelling at my coworkers or people on the train, who are nice and didn't do anything wrong. This is very out of character for me and it goes away when the migraine is over.
I have taken more than 30 sick days just this year, and also people are concerned because during some of my presentations and meetings, my speech has been very disorganized. I know from office gossip that has gotten back to me, that some people think I am taking illegal drugs, which I have never done in my life, or just lying and being lazy.
My doctor gave me Amerge and Imitrex. They mostly work but they usually take a few hours and I have to sit in a dark, quiet room during that time. Also if I wake up with a migraine at night, they do not work at all and I cannot go to work in the morning.
HR scheduled a meeting with my boss and me tomorrow morning, and I am terrified I will be fired. I do not have any close family or partner. I am seeing a good therapist who would be helpful, but I love my career and I don't know what I would do if I lose it.
What should I say during the HR meeting tomorrow? I am scared and worried I will start crying. I have some money saved, but again I am more scared about losing my career.
I know you are not my doctor, but is there any medical treatment for migraines this bad if the normal Imitrex and other drugs don't work? I eat healthy, get 7 or 8 hours a sleep each night, and exercise on the days I don't have migraines, so I don't think it's my lifestyle. But any advice would be welcome. Please help, I am very scared.
I just wanted to post to say 'good luck' and also that I have had the same worries over an anxiety disorder that was stopping me working properly. Once I told my boss about it, things improved a lot. Is there any chance that the stress of not telling people about them is increasing their frequency? Hopefully your employer can help you make adjustments to your working life as they would for any long-term health condition/disability.
posted by Dorothea_in_Rome at 10:55 PM on October 9, 2014
posted by Dorothea_in_Rome at 10:55 PM on October 9, 2014
I'm really sorry you're going through this. I get migraines, though not nearly as often as you do, and they are just horrible. I especially hate when my speech is messed up. (On preview: yes, KathrynT, it totally happens) It's just scary on top of painful and nauseating and all of that.
First: not sure what country you're in, but depending on which one it is, this is a medical condition that may qualify you for disability and/or some sort of accommodation. Have you looked into that, and/or discussed it with your doctor? You probably won't have time before the HR meeting to go anywhere with it, but you should investigate it yourself and tell HR that you are doing so.
Second: have you been able to identify any triggers? It's not so much healthy lifestyle or not, and it can vary widely between people. For me, it's pretty much guaranteed when my sleep patterns change in any way -- but as a teenager they came like clockwork as a PMS symptom every month, and since I've been pregnant I've gotten them more frequently, too. For my brother, it's walking from a dark building into bright sunlight. For my mother, it's a variety of things, but the most reliable one is eating any single bit of fast food (even one french fry from McDonald's). It can be diet, sleep, the environment... a whole bunch of things. The "good" news about getting them so frequently (oh god, once a week, I just can't even) is that it it becomes easier to experiment. Can you journal exactly what you eat, how and when you sleep, how and when you exercise, what you were doing when the migraine came on, etc, and try to identify a pattern there? Under a doctor's guidance you may also be able to start experimenting with diet a bit more. Maybe you have some weird intolerance of some kind, and yes, these can totally develop even when you've shown no evidence of it before -- my best friend suddenly became dangerously (as in admitted to the ER) intolerant of salicyates around age 27.
Your doctor is probably the best route for treatments if you don't have any alternatives that work for you (my personal migraine treatment is a double dose of high-strength Excedrin and some very caffeinated drink; I've never tried prescription medication). I also have absolutely nothing but anecdotes to back this up, but a coworker of mine who is a firm believer in all things chiropractic (I am very much not) once gave me a shoulder and neck massage while I had a bad migraine at the office, and it went away within a few minutes. I was shocked. I haven't been in a position to repeat it since -- I'm not often around anyone willing to give me a backrub when these come on -- but it was pretty interesting, to say the least.
posted by olinerd at 11:03 PM on October 9, 2014 [7 favorites]
First: not sure what country you're in, but depending on which one it is, this is a medical condition that may qualify you for disability and/or some sort of accommodation. Have you looked into that, and/or discussed it with your doctor? You probably won't have time before the HR meeting to go anywhere with it, but you should investigate it yourself and tell HR that you are doing so.
Second: have you been able to identify any triggers? It's not so much healthy lifestyle or not, and it can vary widely between people. For me, it's pretty much guaranteed when my sleep patterns change in any way -- but as a teenager they came like clockwork as a PMS symptom every month, and since I've been pregnant I've gotten them more frequently, too. For my brother, it's walking from a dark building into bright sunlight. For my mother, it's a variety of things, but the most reliable one is eating any single bit of fast food (even one french fry from McDonald's). It can be diet, sleep, the environment... a whole bunch of things. The "good" news about getting them so frequently (oh god, once a week, I just can't even) is that it it becomes easier to experiment. Can you journal exactly what you eat, how and when you sleep, how and when you exercise, what you were doing when the migraine came on, etc, and try to identify a pattern there? Under a doctor's guidance you may also be able to start experimenting with diet a bit more. Maybe you have some weird intolerance of some kind, and yes, these can totally develop even when you've shown no evidence of it before -- my best friend suddenly became dangerously (as in admitted to the ER) intolerant of salicyates around age 27.
Your doctor is probably the best route for treatments if you don't have any alternatives that work for you (my personal migraine treatment is a double dose of high-strength Excedrin and some very caffeinated drink; I've never tried prescription medication). I also have absolutely nothing but anecdotes to back this up, but a coworker of mine who is a firm believer in all things chiropractic (I am very much not) once gave me a shoulder and neck massage while I had a bad migraine at the office, and it went away within a few minutes. I was shocked. I haven't been in a position to repeat it since -- I'm not often around anyone willing to give me a backrub when these come on -- but it was pretty interesting, to say the least.
posted by olinerd at 11:03 PM on October 9, 2014 [7 favorites]
Magic words: The Americans with Disabilities Act. If that doesn't stop HR in their tracks you either live in a federal appeals district when migraines are not covered or being fired means you can sue.
posted by Homer42 at 11:09 PM on October 9, 2014 [41 favorites]
posted by Homer42 at 11:09 PM on October 9, 2014 [41 favorites]
I don't have much to offer you, but here is a thought you can take with you to HR.
I am doing my best to cope with a serious chronic health issue.
If HR is coming to you because of the office gossip then you can put that to bed. It is nothing to be ashamed of or apologize for.
If the conversation is that your health issue is beginning to impact your job, then you should steer the conversation towards accommodations for your disability. On preview, as Homer42 says.
posted by PercussivePaul at 11:13 PM on October 9, 2014 [13 favorites]
I am doing my best to cope with a serious chronic health issue.
If HR is coming to you because of the office gossip then you can put that to bed. It is nothing to be ashamed of or apologize for.
If the conversation is that your health issue is beginning to impact your job, then you should steer the conversation towards accommodations for your disability. On preview, as Homer42 says.
posted by PercussivePaul at 11:13 PM on October 9, 2014 [13 favorites]
Call in sick tomorrow and call employment lawyers while you rest. Go see your doctor and get a note recommending stress leave, if that would be covered. Meet with the employment lawyer and find out how to get accommodation for your disability.
posted by Chaussette and the Pussy Cats at 11:25 PM on October 9, 2014 [2 favorites]
posted by Chaussette and the Pussy Cats at 11:25 PM on October 9, 2014 [2 favorites]
My dad suffers from frequent migraines. One or more a week. He had a drug that he could inject into his arm/ belly that would clear it up instantly. This is pretty serious medication and comes with health risks. I think it was called imigrian. This might work for you in the short run.
He was taking this and other medication multiple times a week for years until his GP finally referred him to a specialist. The specialist said it was causing rebound migraines and switched him to a different medication which has rapidly decreased his migraines. I don't know what he switched to unfortunately.
He also did some tests to try and find a trigger and one of his is glucose.
I would suggest going back to you doctor and getting a referral to a specialist who is knows the current research and making it clear that this is affecting your quality of life and your career and see if they can help.
posted by poxandplague at 11:46 PM on October 9, 2014 [2 favorites]
He was taking this and other medication multiple times a week for years until his GP finally referred him to a specialist. The specialist said it was causing rebound migraines and switched him to a different medication which has rapidly decreased his migraines. I don't know what he switched to unfortunately.
He also did some tests to try and find a trigger and one of his is glucose.
I would suggest going back to you doctor and getting a referral to a specialist who is knows the current research and making it clear that this is affecting your quality of life and your career and see if they can help.
posted by poxandplague at 11:46 PM on October 9, 2014 [2 favorites]
when you say doctor, do you mean primary care, or neurologist? You should definitely have a specialist and be trying regular medications to keep events to a minimum. What you experience sounds somewhat similar to some of the events I've experienced as part of a seizure disorder. It's complicated, and I also have had full seizures, but I was recommended Trileptal as a daily med because of the migraines I experienced with my partial seizures. I currently take both trileptal and zonegran daily & keep things under reasonable control. I'd look into working with the meds a bit further if you're having so many episodes.
Good luck.
posted by mdn at 11:48 PM on October 9, 2014 [9 favorites]
Good luck.
posted by mdn at 11:48 PM on October 9, 2014 [9 favorites]
I have a wheat/grain allergy, rather than celiac disease, but as a result I've read a good deal about celiac symptoms, and migraines as one of the multitude of possible celiac symptoms come up repeatedly. Here is just one example from the National Foundation for Celiac Awareness.
This might make some sense (note I am not a doctor, yours or anyone else's) if your symptoms are now getting worse at 30. Lots of disorders are all but asymptomatic in early childhood and then incubate for 20 or so years. Or at least so I read when I was diagnosed with an autoimmune disorder at just past 30.
Anyway, whether it's celiac or something else, I second the fine advice above to look for patterns, and document what you eat and what was happening in the period before an attack are critical.
I'd only add to that that finding a doctor that knows how to listen and has a talent for diagnostics is critical. Far too often, doctors treat the symptoms without ever addressing, or even investigating, causes and triggers. From what you say this is precisely what's happened to you, and apart from protecting yourself legally and professionally, you should protect your health by finding the most analytical gosh-darned doctor you can locate in your area.
Grit your teeth and then breathe out. You'll get through this.
posted by Violet Blue at 11:57 PM on October 9, 2014 [1 favorite]
This might make some sense (note I am not a doctor, yours or anyone else's) if your symptoms are now getting worse at 30. Lots of disorders are all but asymptomatic in early childhood and then incubate for 20 or so years. Or at least so I read when I was diagnosed with an autoimmune disorder at just past 30.
Anyway, whether it's celiac or something else, I second the fine advice above to look for patterns, and document what you eat and what was happening in the period before an attack are critical.
I'd only add to that that finding a doctor that knows how to listen and has a talent for diagnostics is critical. Far too often, doctors treat the symptoms without ever addressing, or even investigating, causes and triggers. From what you say this is precisely what's happened to you, and apart from protecting yourself legally and professionally, you should protect your health by finding the most analytical gosh-darned doctor you can locate in your area.
Grit your teeth and then breathe out. You'll get through this.
posted by Violet Blue at 11:57 PM on October 9, 2014 [1 favorite]
I have regular migraines after infrequent ones and that can totally happen - migraines are big mysteries still and come in a huge range of types and symptoms and causes. The book I found most useful for helping me understand them and pester my doctors to get on what is working to have a life not spent in the dark curled up is Living Well with Migraines by the woman who runs the about.com migraine site. Practical advice and a lot on how to explain migraines and treatment to people in your life, including doctors.
You need to see a specialist for this. A neurologist is good if they treat migraines, but you need someone who specialises in migraines, and not all neurologists automatically do.
You've got two ways to treat migraines - when they come and lowering them through prevention. Are you on a daily medication to lower the occurances? There are several varieties, and what a good migraine doctor will do is try the one most likely for 2-3 months minimum, then try another if that doesn't work. That should lower the total number of migraines you have.
Get an app or a notebook to record when the migraines occur. There are quite a few apps, but a notebook is fine. Record date, time it starts and ends, what meds you took (when), a 1-5 pain scale for the migraine and a note on what you ate. It's good to record any additional symptoms. I did this for about 4 months, and found that days when I had to rush to a morning appointment and missed breakfast caused migraines, and that I was very reliable for knowing a migraine was coming by light sensitivity, even without pain, and that shopping malls (I think it's the lighting and noise) are the worst places to go when I'm tired. I cut some foods to see what helped and hurt - just really helpful. It also made it easier for the doctor to see how frequent they were and decide what medications would help.
I'm really irritable in the run-up to a migraine because all my patience and self-control is going into coping with the pain, so I get angry faster over small things. My work situation is very different but for a staff who had chronic headaches, we were fine with her taking time off if she made up the time later. If your work can't do flexible hours, you need to talk to a doctor/lawyer about disability allowances.
Migraines have existed throughout history - the symptoms are recorded in ancient texts, and they're a very real and difficult disability. Unfortunately, they're not visible to other people, so it can be hard for them to understand. You can be in perfect health and still have migraines. They're not your fault.
posted by viggorlijah at 12:22 AM on October 10, 2014 [5 favorites]
You need to see a specialist for this. A neurologist is good if they treat migraines, but you need someone who specialises in migraines, and not all neurologists automatically do.
You've got two ways to treat migraines - when they come and lowering them through prevention. Are you on a daily medication to lower the occurances? There are several varieties, and what a good migraine doctor will do is try the one most likely for 2-3 months minimum, then try another if that doesn't work. That should lower the total number of migraines you have.
Get an app or a notebook to record when the migraines occur. There are quite a few apps, but a notebook is fine. Record date, time it starts and ends, what meds you took (when), a 1-5 pain scale for the migraine and a note on what you ate. It's good to record any additional symptoms. I did this for about 4 months, and found that days when I had to rush to a morning appointment and missed breakfast caused migraines, and that I was very reliable for knowing a migraine was coming by light sensitivity, even without pain, and that shopping malls (I think it's the lighting and noise) are the worst places to go when I'm tired. I cut some foods to see what helped and hurt - just really helpful. It also made it easier for the doctor to see how frequent they were and decide what medications would help.
I'm really irritable in the run-up to a migraine because all my patience and self-control is going into coping with the pain, so I get angry faster over small things. My work situation is very different but for a staff who had chronic headaches, we were fine with her taking time off if she made up the time later. If your work can't do flexible hours, you need to talk to a doctor/lawyer about disability allowances.
Migraines have existed throughout history - the symptoms are recorded in ancient texts, and they're a very real and difficult disability. Unfortunately, they're not visible to other people, so it can be hard for them to understand. You can be in perfect health and still have migraines. They're not your fault.
posted by viggorlijah at 12:22 AM on October 10, 2014 [5 favorites]
If you are in the U.S., have your doctor fill out intermittent FMLA paperwork. Thats what I currently do.
posted by KogeLiz at 12:52 AM on October 10, 2014 [6 favorites]
posted by KogeLiz at 12:52 AM on October 10, 2014 [6 favorites]
Seconding Homer42 and PercussivePaul regarding the meeting tomorrow. I'm not in the US, so unfortunately I can't give you more specific advice. I think migraine.com has a section about disability in the US though.
Until then, do a little research and make sure that you are very well informed about migraine. It is a very common neurological disorder, but many people have outdated ideas about it, especially since it is mostly an "invisible" illness. Also, migraine can take very different shapes and forms for different people (or indeed over someone's lifetime), which tends to further add to peoples' confusion about it. It helps if you can explain it well yourself. (I wish I had a penny for every time I have explained to someone that migraine is not just a headache, that my attacks are not triggered by stress etc. etc.)
I'm currently in a situation not entirely unlike yours, please feel free to memail me. :)
I wish you all the best!
posted by wavelette at 1:19 AM on October 10, 2014
Until then, do a little research and make sure that you are very well informed about migraine. It is a very common neurological disorder, but many people have outdated ideas about it, especially since it is mostly an "invisible" illness. Also, migraine can take very different shapes and forms for different people (or indeed over someone's lifetime), which tends to further add to peoples' confusion about it. It helps if you can explain it well yourself. (I wish I had a penny for every time I have explained to someone that migraine is not just a headache, that my attacks are not triggered by stress etc. etc.)
I'm currently in a situation not entirely unlike yours, please feel free to memail me. :)
I wish you all the best!
posted by wavelette at 1:19 AM on October 10, 2014
Nthing FMLA and a neurologist, if you've not been going to one already. They can prescribe daily medications that are intended to try to prevent migraines, and they can also evaluate whether these are truly migraines or if you have something a little different going on. Just short term, if you have any kind of birth control, have you changed it? Hormones can really mess with migraines. I had a Mirena IUD that I had to have removed after four months because it made my migraines so horrible and frequent.
posted by dilettante at 3:10 AM on October 10, 2014
posted by dilettante at 3:10 AM on October 10, 2014
My doctor gave me Amerge and Imitrex.
You need to see a specialist for better preventative treatment.
posted by DarlingBri at 3:31 AM on October 10, 2014 [6 favorites]
You need to see a specialist for better preventative treatment.
posted by DarlingBri at 3:31 AM on October 10, 2014 [6 favorites]
Your description of disorganised speech strikes a chord. Since my teenage years I have suffered from Hemiplegic Migraines, which often include some version of Aphasia. (I also noticed that aphasia is associated with the description of Basilar migraine.) If you haven't fully discussed these symptoms with a neurologist, that would be important. They are definitely recognised migraine symptoms.
(I'm afraid I don't have any good hints for treatment, as I generally only get a couple a year and I deal with them in much the manner you've described, by taking an anti-emetic [usually Stemetil] and a pain killer [Mersyndol] and waiting it out. The idea that they can go along this way for years and then accelerate to once a week fills me with a profound horror. You have my deepest sympathies.)
posted by Cheese Monster at 3:42 AM on October 10, 2014 [4 favorites]
(I'm afraid I don't have any good hints for treatment, as I generally only get a couple a year and I deal with them in much the manner you've described, by taking an anti-emetic [usually Stemetil] and a pain killer [Mersyndol] and waiting it out. The idea that they can go along this way for years and then accelerate to once a week fills me with a profound horror. You have my deepest sympathies.)
posted by Cheese Monster at 3:42 AM on October 10, 2014 [4 favorites]
I meant to add, when I was first diagnosed with migraine, the doctor noted that there was preventative medicaiton available for migraines, but it wasn't a good deal in my case because mine were so infrequent. There are some examples here. So if you haven't tried any of those, there are more things to try.
posted by Cheese Monster at 3:48 AM on October 10, 2014 [1 favorite]
posted by Cheese Monster at 3:48 AM on October 10, 2014 [1 favorite]
Have you tried acupuncture? The number of migraines I have has been drastically reduced by 4-5 treatments every handful of years. It could be fixing my chi or a placebo effect but it worked for me.
posted by JackBurden at 3:59 AM on October 10, 2014
posted by JackBurden at 3:59 AM on October 10, 2014
There are many other medicines for migraine besides Imitrex. I, too, was getting migraines that ruined at least 4 days per month. I started a low dose of Cymbalta in the spring and it has changed my life! I know other migraine sufferers who have had good luck with Elavil, Topamax, and some other drugs. My doc picked Cymbalta based on some of my specific circumstances. It may take trial and error, but it is worth exploring your options. A specialist can help.
I also made some changes to my diet that have been immensely helpful. If you shoot me a memail, I can get into more detail -- I'm dashing off to work at the moment but I would love to help you more. Honestly, conquering my migraines has been the best thing that ever happened to me.
posted by katie at 4:43 AM on October 10, 2014 [1 favorite]
I also made some changes to my diet that have been immensely helpful. If you shoot me a memail, I can get into more detail -- I'm dashing off to work at the moment but I would love to help you more. Honestly, conquering my migraines has been the best thing that ever happened to me.
posted by katie at 4:43 AM on October 10, 2014 [1 favorite]
You have definitely crossed the line from taking "medication as needed" to a prophylactic taken daily. I've been there. I now take a calcium channel blocker and my migraines have dropped from 6-8 a month to ~1-2 a month and are much more manageable. You need the best migraine specialist in your area. Start keeping a log of everything while you wait for the appointment - food, sleep, weather, alcohol, menstrual cycle, other activities. You are experiencing a debilitating medical issue and need to get it solved. There are lots of things you can try!
I don't know how employment laws work where you are, but others here can suggest how to say you have a medical disability and are working on getting it sorted out.
Best of luck. Migraines are horrendous and they can seriously impact your mental health, so take care of yourself as you work on getting a better treatment plan.
posted by barnone at 4:43 AM on October 10, 2014 [6 favorites]
I don't know how employment laws work where you are, but others here can suggest how to say you have a medical disability and are working on getting it sorted out.
Best of luck. Migraines are horrendous and they can seriously impact your mental health, so take care of yourself as you work on getting a better treatment plan.
posted by barnone at 4:43 AM on October 10, 2014 [6 favorites]
Nthing neurologist.
Look into Botox. It has done wonders for my migraines.
posted by brevator at 4:49 AM on October 10, 2014 [2 favorites]
Look into Botox. It has done wonders for my migraines.
posted by brevator at 4:49 AM on October 10, 2014 [2 favorites]
In the meeting, one positive thing you can do is present a plan of action for making yourself and your work better.
If you can find a specialist and get an appointment made before the meeting, that could be a significant step. Then you can say something like, "I realize that this is really affecting my work, and I've at last made an appointment with Dr. James XYZ of the migraine center in NearbyVille. I don't know what he will recommend, but there are a number of drugs and strategies I haven't yet tried, including A, B, C, and D. It might take a few weeks to find the one that works best for me, but I have confidence that we'll find something better.
I'm very sorry this has affected my work and you so much. I'm incredibly grateful for the patience you've shown so far, and when I'm well you can be assured I'll work twice as hard."
I'm not sure this will work here, but I hope it will. Even if it doesn't completely convince your boss, having a plan will probably help _you_ a lot.
Good luck... I know this is a difficult way to live.
posted by amtho at 4:52 AM on October 10, 2014 [8 favorites]
If you can find a specialist and get an appointment made before the meeting, that could be a significant step. Then you can say something like, "I realize that this is really affecting my work, and I've at last made an appointment with Dr. James XYZ of the migraine center in NearbyVille. I don't know what he will recommend, but there are a number of drugs and strategies I haven't yet tried, including A, B, C, and D. It might take a few weeks to find the one that works best for me, but I have confidence that we'll find something better.
I'm very sorry this has affected my work and you so much. I'm incredibly grateful for the patience you've shown so far, and when I'm well you can be assured I'll work twice as hard."
I'm not sure this will work here, but I hope it will. Even if it doesn't completely convince your boss, having a plan will probably help _you_ a lot.
Good luck... I know this is a difficult way to live.
posted by amtho at 4:52 AM on October 10, 2014 [8 favorites]
I'm very sorry you are experiencing this. I understand the pain of migraines although I don't think I've ever experienced anything as intense as yours.
Have you tried an elimination diet? I would recommend that. There are common foods and food groups- dairy, wheat, soy- that have been known to affect migraines. Mine have gotten less frequent and less intense since I have (mostly) cut out these groups.
You can try looking up "elimination diets", where you will cut out foods known to be possible triggers for intolerance symptoms, and then slowly introduce them back in to identify which foods they might be. I think it could make a big difference.
posted by bearette at 5:30 AM on October 10, 2014
Have you tried an elimination diet? I would recommend that. There are common foods and food groups- dairy, wheat, soy- that have been known to affect migraines. Mine have gotten less frequent and less intense since I have (mostly) cut out these groups.
You can try looking up "elimination diets", where you will cut out foods known to be possible triggers for intolerance symptoms, and then slowly introduce them back in to identify which foods they might be. I think it could make a big difference.
posted by bearette at 5:30 AM on October 10, 2014
I doubt you'll be fired at this meeting, usually there is a warning or a discussion prior to termination. But go in and listen to what they say.
Then explain, "I have a chronic illness and I am trying to get a handle on it. I have been seeing my doctor and my next step is a specialist. I love my job here and I don't want to risk it, does it makes sense for me to go out on disability until this is resolved?"
Ask if you can record the meeting. Stress will make you forget all sorts of details. Having a recording will be helpful.
nthing a Neurologist and botox. Tell your GP, "this is interfering with my daily life, my job is in jeopardy, it's time to get serious about finding the cause and having a solution."
posted by Ruthless Bunny at 5:31 AM on October 10, 2014 [6 favorites]
Then explain, "I have a chronic illness and I am trying to get a handle on it. I have been seeing my doctor and my next step is a specialist. I love my job here and I don't want to risk it, does it makes sense for me to go out on disability until this is resolved?"
Ask if you can record the meeting. Stress will make you forget all sorts of details. Having a recording will be helpful.
nthing a Neurologist and botox. Tell your GP, "this is interfering with my daily life, my job is in jeopardy, it's time to get serious about finding the cause and having a solution."
posted by Ruthless Bunny at 5:31 AM on October 10, 2014 [6 favorites]
I'm assuming you are in America.
In case you haven't had your meeting yet, tell them that you have been having serious health problems. Describe the symptoms that you discussed above, although I'd leave out being verbally violent and hateful. Tell them that you are working on seeing a specialist to alleviate these problems. The goals here are to (1) let them know you're sick and not lazy/on drugs, (2) let them know you understand there is a problem and are working on fixing it, and (3) make them think about their potential obligations under the ADA, which would include reasonable accommodations for you if your migraines could be considered a "disability." Even if the purpose of the meeting was supposed to be to fire you, they should think twice if there are ADA implications.
They may start talking to you about what those reasonable accommodations could be. It's okay if you need some time to think this through and request a followup meeting after you have had a few days to think. Think about what you could ask for that would enable you to do your job and manage your health. You could do some googling too, to see what other people have done. Your boss and HR may have some ideas.
If the meeting goes badly, or if they do not seem to be willing to work with you on this, consider seeing an employment lawyer.
posted by chickenmagazine at 5:34 AM on October 10, 2014 [2 favorites]
In case you haven't had your meeting yet, tell them that you have been having serious health problems. Describe the symptoms that you discussed above, although I'd leave out being verbally violent and hateful. Tell them that you are working on seeing a specialist to alleviate these problems. The goals here are to (1) let them know you're sick and not lazy/on drugs, (2) let them know you understand there is a problem and are working on fixing it, and (3) make them think about their potential obligations under the ADA, which would include reasonable accommodations for you if your migraines could be considered a "disability." Even if the purpose of the meeting was supposed to be to fire you, they should think twice if there are ADA implications.
They may start talking to you about what those reasonable accommodations could be. It's okay if you need some time to think this through and request a followup meeting after you have had a few days to think. Think about what you could ask for that would enable you to do your job and manage your health. You could do some googling too, to see what other people have done. Your boss and HR may have some ideas.
If the meeting goes badly, or if they do not seem to be willing to work with you on this, consider seeing an employment lawyer.
posted by chickenmagazine at 5:34 AM on October 10, 2014 [2 favorites]
if I wake up with a migraine at night
This makes me wonder if you're suffering from cluster headaches, which used to be classified as migraines but are not anymore. They tend to be cyclical, but if they're wanting to push through, they can be triggered or mitigated, so definitely keep a log of everything from food, alcohol, exercise, sleep, menstrual cycle, etc.
Also, definitely see a specialist.
As for the meeting with HR, can you have a doctor's note in hand that quickly? Have them explain that you suffer from crippling pain, and that they have no reason to believe you've abused medication. I know it's overwhelming to think of getting this done in a day, but having something that at least gives your employer pause is better than having nothing but your own word. It's okay to be pushy with the doctor's office (this is your career), so if they can't fax the letter, ask them to email a PDF. Failing that, take with you the prescribed medications (with your name, etc.); this demonstrates that you are trying to get help (of the right kind). Also make an appointment with a specialist whose name you can give; if you want to switch to someone else before the actual appointment, go for it; for now you just need to show that you're taking this seriously.
I am so very sorry. I get these too (including the throwing up), and it's brutal. Losing a day or two every couple of weeks (for me--more often for you) is not okay. So, so sorry.
posted by whoiam at 6:01 AM on October 10, 2014 [1 favorite]
This makes me wonder if you're suffering from cluster headaches, which used to be classified as migraines but are not anymore. They tend to be cyclical, but if they're wanting to push through, they can be triggered or mitigated, so definitely keep a log of everything from food, alcohol, exercise, sleep, menstrual cycle, etc.
Also, definitely see a specialist.
As for the meeting with HR, can you have a doctor's note in hand that quickly? Have them explain that you suffer from crippling pain, and that they have no reason to believe you've abused medication. I know it's overwhelming to think of getting this done in a day, but having something that at least gives your employer pause is better than having nothing but your own word. It's okay to be pushy with the doctor's office (this is your career), so if they can't fax the letter, ask them to email a PDF. Failing that, take with you the prescribed medications (with your name, etc.); this demonstrates that you are trying to get help (of the right kind). Also make an appointment with a specialist whose name you can give; if you want to switch to someone else before the actual appointment, go for it; for now you just need to show that you're taking this seriously.
I am so very sorry. I get these too (including the throwing up), and it's brutal. Losing a day or two every couple of weeks (for me--more often for you) is not okay. So, so sorry.
posted by whoiam at 6:01 AM on October 10, 2014 [1 favorite]
You need to see a migraine specialist - there are more options out there to both prevent and treat them. I'm another person who found that omitting gluten from my diet stopped my migraines completely after trying lots of other stuff. Good luck!
posted by leslies at 6:08 AM on October 10, 2014 [1 favorite]
posted by leslies at 6:08 AM on October 10, 2014 [1 favorite]
Nthing seeing a specialist. I have migraines as well, and I've had great success with Maxalt (rizatriptan). I take one as soon as I have an aura and it prevents the migraine or eases it if it's already started. Leaves me feeling sleepy and a little loopy, but I can function and it sure beats the pain - finding it was nothing short of life changing for me. I don't know if it's applicable in your case, but I'm throwing it out there just as an example that there are options, and you don't have to suffer. Good luck!
posted by sephira at 6:38 AM on October 10, 2014 [1 favorite]
posted by sephira at 6:38 AM on October 10, 2014 [1 favorite]
I am scared and worried I will start crying.
If you're worried about adequately communicating your health issue, maybe you should come prepared with a written statement? A cleaned up version of your question that states just the basic facts. Ideally you'd run this through a lawyer. But if that doesn't happen by tomorrow I'm wondering if having a written statement may be better than relying on whatever you say during an potentially upsetting and confusing conversation.
posted by mullacc at 7:16 AM on October 10, 2014 [4 favorites]
If you're worried about adequately communicating your health issue, maybe you should come prepared with a written statement? A cleaned up version of your question that states just the basic facts. Ideally you'd run this through a lawyer. But if that doesn't happen by tomorrow I'm wondering if having a written statement may be better than relying on whatever you say during an potentially upsetting and confusing conversation.
posted by mullacc at 7:16 AM on October 10, 2014 [4 favorites]
I want to let you know that all the symptoms you describe sound familiar to me, especially the aphasia and the extreme irritability. Those symptoms used to freak me out but understand they are part of my condition has helped me feel more normal. And I can now use my irritability to predict a migraine is on-coming and be prepared.
Your doctor has pretty much done the minimum for you and you will need t advocate very hard for yourself for better treatment. My migraines have been increasing since my late 30s, and I see my doctor pretty frequently to talk about new options, let her know I can't stand the side effects of a new med, and so on. In the past few years, we've reduced the number of really debilitating migraines and although I haven't eliminated them completely, I can continue to work through most of the ones I get now.
My two biggest triggers seem to be hormone fluctuation (migraine at every period) and barometric pressure. I'm on Amethia birth control pills to keep my hormones steady, and my doc and I are working on the weather-related ones.
I've talked with my supervisors about my condition - to let them know I might need to leave wok some days, or might have aphasia symptoms. My doctors has offered to work up FMLA paperwork for me, but I haven't needed it so far.
posted by Squeak Attack at 7:22 AM on October 10, 2014 [1 favorite]
Your doctor has pretty much done the minimum for you and you will need t advocate very hard for yourself for better treatment. My migraines have been increasing since my late 30s, and I see my doctor pretty frequently to talk about new options, let her know I can't stand the side effects of a new med, and so on. In the past few years, we've reduced the number of really debilitating migraines and although I haven't eliminated them completely, I can continue to work through most of the ones I get now.
My two biggest triggers seem to be hormone fluctuation (migraine at every period) and barometric pressure. I'm on Amethia birth control pills to keep my hormones steady, and my doc and I are working on the weather-related ones.
I've talked with my supervisors about my condition - to let them know I might need to leave wok some days, or might have aphasia symptoms. My doctors has offered to work up FMLA paperwork for me, but I haven't needed it so far.
posted by Squeak Attack at 7:22 AM on October 10, 2014 [1 favorite]
I've known many people who use FMLA time for migraines and if you've missed 30 days, seems like you should be one of them.
posted by WeekendJen at 7:44 AM on October 10, 2014 [1 favorite]
posted by WeekendJen at 7:44 AM on October 10, 2014 [1 favorite]
Yes, you do need to see a specialist, if possible a headache specialist. If your HR meeting discusses your absences, you could bring up that you are aware of the problem and are seeking more specialized treatment, as your existing chronic health issues which you had managed successfully before became more severe recently.
Agreeing with others that you need to investigate your migraine triggers. The ones I am aware of for myself are hops (which means avoiding hoppy beers for me), too much caffeine, and fluctuations in blood sugar level (I notice somebody else upthread gets migraines when they skip breakfast). Regarding the latter, I now try to eat low carb and not to skip any meals, as well as having snacks on hand so I don't go on too long between meals.
posted by needled at 7:54 AM on October 10, 2014 [1 favorite]
Agreeing with others that you need to investigate your migraine triggers. The ones I am aware of for myself are hops (which means avoiding hoppy beers for me), too much caffeine, and fluctuations in blood sugar level (I notice somebody else upthread gets migraines when they skip breakfast). Regarding the latter, I now try to eat low carb and not to skip any meals, as well as having snacks on hand so I don't go on too long between meals.
posted by needled at 7:54 AM on October 10, 2014 [1 favorite]
Came here to suggest prophylactic treatment (I am on Trokendi XR, the extended release version of Topamax), along with a migraine specialist. Magnesium and B vitamins tend to help me as well.
I have Imitrex, Treximet, and the injection form of Imitrex to help me manage my migraines. In addition, I limit dairy. I also identified my triggers. But this took a long time and a specialist, so again, please go into this meeting with a written plan. The law can support you.
posted by oflinkey at 7:58 AM on October 10, 2014
I have Imitrex, Treximet, and the injection form of Imitrex to help me manage my migraines. In addition, I limit dairy. I also identified my triggers. But this took a long time and a specialist, so again, please go into this meeting with a written plan. The law can support you.
posted by oflinkey at 7:58 AM on October 10, 2014
I get migraines often (1-2 a week), though not as bad as yours, since one or two doses of Excedrine Migraine usually clears mine up in a day and I've only vomited once from my migraine being so bad (normally I get a tingling/numbness in my hands and tunnel vision). I've recognized that my #1 trigger is stress. Like you, I also eat healthy (most of the time), get 7-8 hours of sleep a night and exercise. But man, when I'm at work, no matter what I do outside of it, I get hit with that stress and I get the migraines.
I imagine being stressed about losing your job over migraines might be leading to more migraines (it would for me). So that's just something to consider. I hope you find some relief!
posted by dearwassily at 8:19 AM on October 10, 2014
I imagine being stressed about losing your job over migraines might be leading to more migraines (it would for me). So that's just something to consider. I hope you find some relief!
posted by dearwassily at 8:19 AM on October 10, 2014
Try MigraineBuster (.com, and available in some pharmacies). It's identical to SinusBuster: basically, you're snorting capsaicin, and for the first few seconds you will deeply regret it. Then the nose pain goes away, and in my limited experience, so does the migraine.
Mostly. Enough to function. For a while. A few hours. But that's worth it.
posted by IAmBroom at 9:56 AM on October 10, 2014
Mostly. Enough to function. For a while. A few hours. But that's worth it.
posted by IAmBroom at 9:56 AM on October 10, 2014
I really feel for you, and I hope you can sort things out with work.
As far as getting rid of migraines, I'm here to suggest a preventive medication that has worked amazingly for me: Blood pressure meds.
After my doc and I had been through the rigmarole of trying all the migraine drugs on the market and sending me to a neurologist who prescribed me Depakote that made me crazy, he finally prescribed me generic atenolol. Somehow they help expand the blood vessels that normally contract during a migraine -- I guess it's connected to the lowering blood pressure thing? -- and it's an off-label side effect that isn't really talked about.
I take two atenolol pills twice a day and my twice-a-month migraines are a thing of the past. It is miraculous; I'd even say it has given me my life back. And, as a bonus, I have lower blood pressure!
If you are in the USA, the prescription is around $10 a month. I would be happy to pay ten times that.
posted by vickyverky at 10:19 AM on October 10, 2014 [1 favorite]
As far as getting rid of migraines, I'm here to suggest a preventive medication that has worked amazingly for me: Blood pressure meds.
After my doc and I had been through the rigmarole of trying all the migraine drugs on the market and sending me to a neurologist who prescribed me Depakote that made me crazy, he finally prescribed me generic atenolol. Somehow they help expand the blood vessels that normally contract during a migraine -- I guess it's connected to the lowering blood pressure thing? -- and it's an off-label side effect that isn't really talked about.
I take two atenolol pills twice a day and my twice-a-month migraines are a thing of the past. It is miraculous; I'd even say it has given me my life back. And, as a bonus, I have lower blood pressure!
If you are in the USA, the prescription is around $10 a month. I would be happy to pay ten times that.
posted by vickyverky at 10:19 AM on October 10, 2014 [1 favorite]
I'm sorry you're going through this tough time. Know you are not alone, that you have a group internet folks right here rooting for you.
I agree it would be a good idea to write it all out and let them know you are going to be seeing a neurologist and a migraine specialist to determine why the normal course of treatment isn't working. That this is a serious chronic medical condition and you are doing everything you can to resolve things.
Nthing the recommendation to look at your diet. I have problems with migraines and cluster headaches. My food triggers are sugar, alcohol and also a recent discovery: wheat! I've switched to brown rice pasta and gluten free bread, and cut down on sugar. My headaches have come down considerably. But sugar's been tough to break. For instance I had a lot of dried fruit last night and I'm getting a slight headache this morning.
Another datapoint: a good friend suffered from migraines and went macrobiotic and dropped caffeine. Headaches are gone.
I recommend you keep a food diary to see what triggers your migraines. If you can do it, drop the obvious (sugar, alcohol, wheat, chocolate, caffeine) and add them back one by one.
You may be experiencing a positive feedback loop, too. Sometimes it goes like this: migraines leading to work difficulties leading to stress/bad diet leading to more migraines. Your specialist will help you break the cycle and get back on track.
Good luck!
posted by lillian.elmtree at 11:30 AM on October 10, 2014
I agree it would be a good idea to write it all out and let them know you are going to be seeing a neurologist and a migraine specialist to determine why the normal course of treatment isn't working. That this is a serious chronic medical condition and you are doing everything you can to resolve things.
Nthing the recommendation to look at your diet. I have problems with migraines and cluster headaches. My food triggers are sugar, alcohol and also a recent discovery: wheat! I've switched to brown rice pasta and gluten free bread, and cut down on sugar. My headaches have come down considerably. But sugar's been tough to break. For instance I had a lot of dried fruit last night and I'm getting a slight headache this morning.
Another datapoint: a good friend suffered from migraines and went macrobiotic and dropped caffeine. Headaches are gone.
I recommend you keep a food diary to see what triggers your migraines. If you can do it, drop the obvious (sugar, alcohol, wheat, chocolate, caffeine) and add them back one by one.
You may be experiencing a positive feedback loop, too. Sometimes it goes like this: migraines leading to work difficulties leading to stress/bad diet leading to more migraines. Your specialist will help you break the cycle and get back on track.
Good luck!
posted by lillian.elmtree at 11:30 AM on October 10, 2014
He had a drug that he could inject into his arm/ belly that would clear it up instantly. This is pretty serious medication and comes with health risks. I think it was called imigrian. This might work for you in the short run.
This is just the liquid form of the meds the OP is already taking! But OP, you may find that the injections work better, if you can bring yourself to do it/don't have needle phobia. I use a combination of the nasal spray and the tablets, as I find the nasal spray is much faster acting, but I can't use it alone as it's not strong enough. It may give you nosebleeds in the winter time, but it's a small price to pay.
As for the work/HR issues, I know how hard it can be to discuss actual health issues in a professional manner when they're not VISIBLE disabilities. I have 2 sources of chronic illness/pain and neither of them are visible, and I've always felt like a huge fraudulent loser about taking time off to deal with them, but it is really 100% okay, and any decent HR manager will be aware of this.
You should definitely see a neurologist if you are not already seeing one. You may be able to find one who specializes in migraine care. There are various medications with off-market effects that work well for migraine prophylaxis; some are usually prescribed as antidepressants, and I've found they had too many other side effects for me, but there are also beta blockers which work very nicely, although you can't take them longterm if you have asthma. You can also take magnesium, which apparently helps prevent them from starting.
It can also be helpful to see an allergy specialist and find out if you have preventable environmental triggers, and maybe get some kind of ergonomics consultation to see if your chair/desk height/lighting is in any way suboptimal, as these can also be triggers. The most important thing for me was finding out about a spinal injury that I'd assumed was just aches and pains from desk job hell, but which turned out to be a tremendous migraine trigger.
posted by poffin boffin at 11:39 AM on October 10, 2014
This is just the liquid form of the meds the OP is already taking! But OP, you may find that the injections work better, if you can bring yourself to do it/don't have needle phobia. I use a combination of the nasal spray and the tablets, as I find the nasal spray is much faster acting, but I can't use it alone as it's not strong enough. It may give you nosebleeds in the winter time, but it's a small price to pay.
As for the work/HR issues, I know how hard it can be to discuss actual health issues in a professional manner when they're not VISIBLE disabilities. I have 2 sources of chronic illness/pain and neither of them are visible, and I've always felt like a huge fraudulent loser about taking time off to deal with them, but it is really 100% okay, and any decent HR manager will be aware of this.
You should definitely see a neurologist if you are not already seeing one. You may be able to find one who specializes in migraine care. There are various medications with off-market effects that work well for migraine prophylaxis; some are usually prescribed as antidepressants, and I've found they had too many other side effects for me, but there are also beta blockers which work very nicely, although you can't take them longterm if you have asthma. You can also take magnesium, which apparently helps prevent them from starting.
It can also be helpful to see an allergy specialist and find out if you have preventable environmental triggers, and maybe get some kind of ergonomics consultation to see if your chair/desk height/lighting is in any way suboptimal, as these can also be triggers. The most important thing for me was finding out about a spinal injury that I'd assumed was just aches and pains from desk job hell, but which turned out to be a tremendous migraine trigger.
posted by poffin boffin at 11:39 AM on October 10, 2014
OH GOD ALSO SO IMPORTANT I can't believe I almost forgot!
Check the brand name of the manufacturer of your Imitrex! If it is RANBAXY you should throw it away immediately and insist upon getting Dr Reddys (another generic) or Sandoz (full cost brand name) or literally any brand other than Ranbaxy, as they have been investigated numerous times for not meeting FDA standards and Ihave no idea how they haven't been banned forever. When my migraines mysteriously got horribly, scarily worse and I was convinced I was going to die of a brain tumor, I realized that the pharmacy had switched me to the generic ranbaxy brand, and about 5 minutes of googling made me realize that shitty underpowered/contaminated/maybe fake who knows medication was the culprit. It had got to the point where I would take 4 tablets and get absolutely no relief, and it was really fucking scary and I was pretty much resigned to my impending death.
posted by poffin boffin at 11:44 AM on October 10, 2014 [5 favorites]
Check the brand name of the manufacturer of your Imitrex! If it is RANBAXY you should throw it away immediately and insist upon getting Dr Reddys (another generic) or Sandoz (full cost brand name) or literally any brand other than Ranbaxy, as they have been investigated numerous times for not meeting FDA standards and Ihave no idea how they haven't been banned forever. When my migraines mysteriously got horribly, scarily worse and I was convinced I was going to die of a brain tumor, I realized that the pharmacy had switched me to the generic ranbaxy brand, and about 5 minutes of googling made me realize that shitty underpowered/contaminated/maybe fake who knows medication was the culprit. It had got to the point where I would take 4 tablets and get absolutely no relief, and it was really fucking scary and I was pretty much resigned to my impending death.
posted by poffin boffin at 11:44 AM on October 10, 2014 [5 favorites]
Seconding vickyverky. I also take a beta blocker (metoprolol), and my migraines were completely gone for six months after I started them, and now I still get them much more rarely than I used to. If I get one, it's usually gone within an hour after taking rizatriptan (brand name Maxalt).
If you have never seen a specialist about your migraines, I really recommend doing that and sorting out preventative measures as well as proper medication for attacks. Once you've got something that works, you will find it surprising how much better you'll feel and will be wondering why you waited so long to see a specialist.
Hope you feel better soon!
posted by amf at 1:14 PM on October 10, 2014
If you have never seen a specialist about your migraines, I really recommend doing that and sorting out preventative measures as well as proper medication for attacks. Once you've got something that works, you will find it surprising how much better you'll feel and will be wondering why you waited so long to see a specialist.
Hope you feel better soon!
posted by amf at 1:14 PM on October 10, 2014
Noise sensitivity is a known side-effect of magnesium deficiency. When I get noise sensitive, it is also accompanied by sensitivity to bright lights. Consuming magnesium-rich foods helps resolve it pretty promptly.
For me, this is associated with headaches that are often resolved by vomiting. I don't personally think of them as migraines, but I have been struck by some of the similarities between what I experience and what migraine-sufferers experience.
posted by Michele in California at 1:41 PM on October 10, 2014
For me, this is associated with headaches that are often resolved by vomiting. I don't personally think of them as migraines, but I have been struck by some of the similarities between what I experience and what migraine-sufferers experience.
posted by Michele in California at 1:41 PM on October 10, 2014
I second those who advise you to think about migraine triggers. Chocolate used to do it for me, but not any more. Now it's red wine and low blood sugar. You might try keeping a detailed diary of what you eat and other potential triggers to look for a pattern.
posted by mai at 11:06 AM on October 12, 2014 [1 favorite]
posted by mai at 11:06 AM on October 12, 2014 [1 favorite]
How did things go? Keep us posted...
posted by barnone at 7:27 AM on October 20, 2014 [1 favorite]
posted by barnone at 7:27 AM on October 20, 2014 [1 favorite]
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