Migraine prevention
August 25, 2016 10:10 PM Subscribe
The past two major events at my job have triggered serious (what-I-believe-to-be) migraines for me. These are events where I am required to work for long periods of time in extremely loud/stressful conditions. Both times I woke up the next morning with blinding pain, nausea, vertigo, etc. YANMD but 1. could some medical thing prevent this from happening (i.e., should I see my doctor and get a prescription of some kind) and/or 2. is there something else I can do to prevent it from happening?
I've worked there a year and a half and have done three of these events.
Spring Event, which I have done twice, is our really big event that is a 20-hour day for me preceded by several weeks of 12-15 hour days. It's a one-day event, BUT I can spend large amounts of time for it in the office away from the crowds (it's an outdoor street festival). The first year I did Spring Event (2015), everything was fine -- I was tired, but I didn't get sick.
Next up is Fall Event. This is two days - Day 1 starts in the afternoon and goes until late at night (after working all day in the office) and Day 2 is morning until late at night (12-15 hours). I have done this event one time (2015). Day 1 was totally fine, I felt ok, but it's super bright, VERY crowded, and EXTREMELY loud. I'm at the event positioned in the center of a big crowd with very loud music the entire time. I believe all the overstimulation and noise and everything is what triggered the problem. Last year for Day 1, I was able to take a break for about an hour (due to some changes this year, I think it's highly possible I won't be able to take a break on Day 1 this year). I felt ok when I got home, but I woke up the next morning with the symptoms I described above. The nausea was so bad I threw up and couldn't eat or drink water, even. It took several days to recover (I missed Day 2 which did not go over well but really couldn't be helped).
Then Spring Event 2016 happened. Now, the week leading up to it was worse than last year, and my day was a bit rougher, but anyway I woke up the next day with those same symptoms (including the vomiting).
Now Fall Event 2016 is coming up in about 6 weeks and I am living in complete fear and paranoia that I'm going to get sick again. I think I'm already making myself sick with worry about it! These two incidents are the only time I can remember anything like this happening to me -- I used to get migraines as a teenager, but this whole vomit element is new. To make matters worse, I absolutely hate Fall Event and am frankly embarrassed to be associated with it. The whole thing just makes me want to crawl in a hole forever.
Getting out of doing this isn't an option. Ultimately I think I need a new job that doesn't include these events, but I won't be able to make that happen in time to get out of doing Fall Event, so I really need a way to feel like I might be able to make it through without getting horribly ill. I'm very very worried about missing Day 2 again (I have no interest in working it, but I don't want to leave others high and dry like I did last year) and/or just being ill and going through the experience again.
Since skipping out isn't a choice, I'm trying to figure out how I can make this work. The only coping strategy I've come up with is to get these acoustic filter earplugs, which I've purchased but not tested. I also know I need an attitude adjustment because all my own negativity is sending me into a pit of anxiety about the whole thing (no idea how to achieve said adjustment, though). I hope there's more I can do to prevent going through this again!
Some particulars... I'm a woman in my mid-30s. I'm generally fairly healthy with what I think is a normal amount of human frailty/susceptibility to physical illness. I do have a tendency toward mental problems e.g., depression/anxiety. Also I'm highly sensitive. My stress level is currently high (surprisingly enough, these events aren't the only aspect of my job that doesn't work for me; also I'm in the middle of buying a house and moving between now and this godawful event).
TL/DR: Please see first paragraph. Thanks so much for any help or advice you can provide.
I've worked there a year and a half and have done three of these events.
Spring Event, which I have done twice, is our really big event that is a 20-hour day for me preceded by several weeks of 12-15 hour days. It's a one-day event, BUT I can spend large amounts of time for it in the office away from the crowds (it's an outdoor street festival). The first year I did Spring Event (2015), everything was fine -- I was tired, but I didn't get sick.
Next up is Fall Event. This is two days - Day 1 starts in the afternoon and goes until late at night (after working all day in the office) and Day 2 is morning until late at night (12-15 hours). I have done this event one time (2015). Day 1 was totally fine, I felt ok, but it's super bright, VERY crowded, and EXTREMELY loud. I'm at the event positioned in the center of a big crowd with very loud music the entire time. I believe all the overstimulation and noise and everything is what triggered the problem. Last year for Day 1, I was able to take a break for about an hour (due to some changes this year, I think it's highly possible I won't be able to take a break on Day 1 this year). I felt ok when I got home, but I woke up the next morning with the symptoms I described above. The nausea was so bad I threw up and couldn't eat or drink water, even. It took several days to recover (I missed Day 2 which did not go over well but really couldn't be helped).
Then Spring Event 2016 happened. Now, the week leading up to it was worse than last year, and my day was a bit rougher, but anyway I woke up the next day with those same symptoms (including the vomiting).
Now Fall Event 2016 is coming up in about 6 weeks and I am living in complete fear and paranoia that I'm going to get sick again. I think I'm already making myself sick with worry about it! These two incidents are the only time I can remember anything like this happening to me -- I used to get migraines as a teenager, but this whole vomit element is new. To make matters worse, I absolutely hate Fall Event and am frankly embarrassed to be associated with it. The whole thing just makes me want to crawl in a hole forever.
Getting out of doing this isn't an option. Ultimately I think I need a new job that doesn't include these events, but I won't be able to make that happen in time to get out of doing Fall Event, so I really need a way to feel like I might be able to make it through without getting horribly ill. I'm very very worried about missing Day 2 again (I have no interest in working it, but I don't want to leave others high and dry like I did last year) and/or just being ill and going through the experience again.
Since skipping out isn't a choice, I'm trying to figure out how I can make this work. The only coping strategy I've come up with is to get these acoustic filter earplugs, which I've purchased but not tested. I also know I need an attitude adjustment because all my own negativity is sending me into a pit of anxiety about the whole thing (no idea how to achieve said adjustment, though). I hope there's more I can do to prevent going through this again!
Some particulars... I'm a woman in my mid-30s. I'm generally fairly healthy with what I think is a normal amount of human frailty/susceptibility to physical illness. I do have a tendency toward mental problems e.g., depression/anxiety. Also I'm highly sensitive. My stress level is currently high (surprisingly enough, these events aren't the only aspect of my job that doesn't work for me; also I'm in the middle of buying a house and moving between now and this godawful event).
TL/DR: Please see first paragraph. Thanks so much for any help or advice you can provide.
You can definitely take triptans before you feel symptoms, to prevent a migraine. You'll need a prescription from your doctor for it. If swallowing a pill while you have nausea is an issue, you can also take it as an injection.
posted by tinymegalo at 10:18 PM on August 25, 2016 [3 favorites]
posted by tinymegalo at 10:18 PM on August 25, 2016 [3 favorites]
I take maxalt for migraines and it works great. Glare or bright sunshine can cause a headache, so sunglasses even inside helps me.
Something for nausea and pain if the headache doesn't respond to the maxalt or other migraine stopping med. I will take half a pain pill so I'm not stoned if I am driving or need to be with it, like at work.
I would suggest that you go to your PCP and get some help. There are many options these days. Good luck.
posted by cairnoflore at 10:22 PM on August 25, 2016 [1 favorite]
Something for nausea and pain if the headache doesn't respond to the maxalt or other migraine stopping med. I will take half a pain pill so I'm not stoned if I am driving or need to be with it, like at work.
I would suggest that you go to your PCP and get some help. There are many options these days. Good luck.
posted by cairnoflore at 10:22 PM on August 25, 2016 [1 favorite]
Earbuds and sunglasses with a brimmed hat plus lots of water+ electrolytes+ food is my suggestion. I find Excedrin migraine washed down with a coca-cola to be the best migraine stopper once it's already started and it's unlikely to have bad side effects. I never drink soda otherwise but I find that the sugar plus massive dose of caffeine is what I need.
It might not be then noise alone: is there any street food you only eat at these events? Do you not go to the bathroom for extended periods? Get dehydrated? Skip pooping because of gross porta potties? Drink more or less caffeine than normal? Migraines can be triggered by anything like that. And it might not be a migraine, it's kinds of odd for them to only start the next morning.
posted by fshgrl at 10:36 PM on August 25, 2016 [4 favorites]
It might not be then noise alone: is there any street food you only eat at these events? Do you not go to the bathroom for extended periods? Get dehydrated? Skip pooping because of gross porta potties? Drink more or less caffeine than normal? Migraines can be triggered by anything like that. And it might not be a migraine, it's kinds of odd for them to only start the next morning.
posted by fshgrl at 10:36 PM on August 25, 2016 [4 favorites]
Seconding a hat or visor with a brim - my migraines are massively triggered by overhead glare. That + stress and working long hours + lots of noise and people could all be contributing, but hopefully reducing the impact of those external stressors as much as you can for each would help.
posted by terretu at 11:32 PM on August 25, 2016
posted by terretu at 11:32 PM on August 25, 2016
I echo what brainmouse said. Hydration. I used to have a teacher who at the first sign of a migraine would immediately down a pint of water.
posted by oh pollo! at 11:34 PM on August 25, 2016 [1 favorite]
posted by oh pollo! at 11:34 PM on August 25, 2016 [1 favorite]
So migraines are a type of vascular headache. Taking aspirin could maybe help you prevent the migraine. (source: if I take an aspirin as soon as I get my aura, I can prevent the headache.)
posted by mchorn at 11:59 PM on August 25, 2016 [2 favorites]
posted by mchorn at 11:59 PM on August 25, 2016 [2 favorites]
Triptans are indeed amazing. See your doctor and use them if you can! I can't take them anymore because they interact with something else I take, so now my strategies include:
- 2 x Naproxen (yep, period pain meds) as soon as I start to feel a migraine coming on.
- Magnesium supplements - increased dose if I have symptoms
- Noise cancelling headphones in noisy environments
- Green light when at home (I have an LED light bulb that changes colours using my phone).
- Sunglasses in brightly lit environments (green if you can get them)
All of these have a degree of evidence behind them, although I'm on my phone so can't find the studies for you right now. If you can get triptans, do that. But test them before the event so you know ahead of time how they affect you.
posted by embrangled at 12:02 AM on August 26, 2016 [3 favorites]
- 2 x Naproxen (yep, period pain meds) as soon as I start to feel a migraine coming on.
- Magnesium supplements - increased dose if I have symptoms
- Noise cancelling headphones in noisy environments
- Green light when at home (I have an LED light bulb that changes colours using my phone).
- Sunglasses in brightly lit environments (green if you can get them)
All of these have a degree of evidence behind them, although I'm on my phone so can't find the studies for you right now. If you can get triptans, do that. But test them before the event so you know ahead of time how they affect you.
posted by embrangled at 12:02 AM on August 26, 2016 [3 favorites]
This is definitely something you should talk to your doctor about. There are lots of different things that they might prescribe depending on your specific medical history and details of the situation that you can share fully with them. Also you'll probably be taking some OTC meds and you'll want to make sure nothing's contraindicated. This is the sort of situation that a mindful doctor is going to be really glad you bring up to them ahead of time so they can help you take care of yourself instead of patching you up after you've pushed yourself to a breaking point.
Of course hydration is a big issue - if you've ever had a truly terrible hangover, compare that to your description in this question and note the similarities. If it helps, set a vibrating timer you keep on yourself (like wristwatches, which still exist!) to drink water throughout the event every half hour. Don't worry so much if it's not only water, by the way - drink whatever non-alcoholic liquid is appealing enough that you'll drink a lot of it. Set up ahead of time at home so drinking more water is as easy as possible when you're exhausted, like mixing up a big pitcher of iced mint tea or stocking up your favorite flavor of gatorade or sticking bottles of water in your bedroom and by your couch.
People who work concert venues and similar things always wear earplugs. They can make a huge difference, and you will be able to hear surprisingly well with them in. Similarly, sunglasses make working around glaring stage lights bearable. You can probably borrow some for the event if you don't have your own. Even the kind with a light tint instead of blackout shades can work wonders, and that way you can make good eye contact with the people who you're presumably in charge of or corralling.
Do you get a chair?? Put up as much of a stink as you need to in order to get a stool or some kind of perch in your position. The kind of strain standing for those hours without taking a break can do your body is no joke and can definitely lead to your symptoms, especially if you're not some kind of crossfit tai chi hot yoga enthusiast. Since you had to miss a day due to your illness during a previous event, if they give you flack for needing a seat bring up the fact that it's better for you to sit on a stool and be present than not be there at all.
Perhaps odd, but eat something filling and yummy before you go to sleep. Keeping your blood sugar up through the night can stave off that hollow sunken feeling in the morning and help with nausea if it's not too severe. Results May Vary, try ahead of time just in case.
Recently while traveling I had some pretty intense allergies from a local weed and woke up with migraine-level pain (none of my other typical migraine symptoms though) and a nearly immobile neck. My googling led me to this video, which is just veeeerrry gentle stretches for waking up with a stiff neck. Miraculously by the time I did the last stretch (after doing exactly as she says and holding each one for what seems like forever) I could move like normal and more than half of the pain was gone. Subsequently I did these stretches every night before bed and every morning upon waking up, and combined with an OTC allergy pill and the occasional ibuprofen all was well. They're very simple, and worth a try for you.
posted by Mizu at 12:05 AM on August 26, 2016 [2 favorites]
Of course hydration is a big issue - if you've ever had a truly terrible hangover, compare that to your description in this question and note the similarities. If it helps, set a vibrating timer you keep on yourself (like wristwatches, which still exist!) to drink water throughout the event every half hour. Don't worry so much if it's not only water, by the way - drink whatever non-alcoholic liquid is appealing enough that you'll drink a lot of it. Set up ahead of time at home so drinking more water is as easy as possible when you're exhausted, like mixing up a big pitcher of iced mint tea or stocking up your favorite flavor of gatorade or sticking bottles of water in your bedroom and by your couch.
People who work concert venues and similar things always wear earplugs. They can make a huge difference, and you will be able to hear surprisingly well with them in. Similarly, sunglasses make working around glaring stage lights bearable. You can probably borrow some for the event if you don't have your own. Even the kind with a light tint instead of blackout shades can work wonders, and that way you can make good eye contact with the people who you're presumably in charge of or corralling.
Do you get a chair?? Put up as much of a stink as you need to in order to get a stool or some kind of perch in your position. The kind of strain standing for those hours without taking a break can do your body is no joke and can definitely lead to your symptoms, especially if you're not some kind of crossfit tai chi hot yoga enthusiast. Since you had to miss a day due to your illness during a previous event, if they give you flack for needing a seat bring up the fact that it's better for you to sit on a stool and be present than not be there at all.
Perhaps odd, but eat something filling and yummy before you go to sleep. Keeping your blood sugar up through the night can stave off that hollow sunken feeling in the morning and help with nausea if it's not too severe. Results May Vary, try ahead of time just in case.
Recently while traveling I had some pretty intense allergies from a local weed and woke up with migraine-level pain (none of my other typical migraine symptoms though) and a nearly immobile neck. My googling led me to this video, which is just veeeerrry gentle stretches for waking up with a stiff neck. Miraculously by the time I did the last stretch (after doing exactly as she says and holding each one for what seems like forever) I could move like normal and more than half of the pain was gone. Subsequently I did these stretches every night before bed and every morning upon waking up, and combined with an OTC allergy pill and the occasional ibuprofen all was well. They're very simple, and worth a try for you.
posted by Mizu at 12:05 AM on August 26, 2016 [2 favorites]
Lots of "preventative" medicines are usually for people who get regular migraines. Many of them take time to begin working and can have lots of side effects. I think something like an Imitrex may be better - paired with Zofran (an anti nausea medication). Check with your doctor but you'll want something to possibly prevent it beforehand that works quickly that you don't have to take regularly - and something to take if/when you get one. Ativan helps me wit my dizziness. (Though I think my migraines/vertigo were because I guess I needed glasses.) Therefore I never had to take my Imitrex at this point but a combo of Zofran, Tylenol, Ativan, and sipping on apple sauce with an ice pack in a dark room helped with mine. I would suggest caffeine if you don't have problems with it otherwise (it makes my heart race.)
But yes, eat enough, stay hydrated, sunglasses, stay cool (cold water, those keep cool towels or ice packs), stay as seated as possible.
And while I understand not wanting to miss this event - I do wonder if there can be accommodations made for you. Your doctor can give you a note and if they're a large enough company they're required to make reasonable accommodations for medical situations. Reframe this as an accommodation for your health rather than "getting out of" doing something. Again, you know the work situation better than I do and I totally understand where you're coming from but I do want to mention that it's an option because it's triggering a health issue that you have.
Lastly - not a doctor - not a migraine expert - but I'm prone to them and got them often due to my health conditions and the fact that I've probably needed glasses for longer than I can even imagine.
posted by Crystalinne at 12:56 AM on August 26, 2016 [2 favorites]
But yes, eat enough, stay hydrated, sunglasses, stay cool (cold water, those keep cool towels or ice packs), stay as seated as possible.
And while I understand not wanting to miss this event - I do wonder if there can be accommodations made for you. Your doctor can give you a note and if they're a large enough company they're required to make reasonable accommodations for medical situations. Reframe this as an accommodation for your health rather than "getting out of" doing something. Again, you know the work situation better than I do and I totally understand where you're coming from but I do want to mention that it's an option because it's triggering a health issue that you have.
Lastly - not a doctor - not a migraine expert - but I'm prone to them and got them often due to my health conditions and the fact that I've probably needed glasses for longer than I can even imagine.
posted by Crystalinne at 12:56 AM on August 26, 2016 [2 favorites]
Yes yes yes. Go to a _headache center_. I just got about four different prescriptions -- one of them is essentially a kind of pain reliever based on electrolytes, one of them is a surprisingly inexpensive triptan -- any one of which is much much better than anything my general doctor thought about giving me.
Before this, I'd treated the nausea with a drug that made me very sleepy. Now, I have explicit instructions on when and how to take medicine to avoid this. There are a lot of people out there with migraines, and now finally some professionals are getting serious about figuring it out.
If you _don't_ go to a headache center, I can tell you that taking OTC electrolytes, taking breaks, drinking plenty of water and taking breaks, and wearing polarized sunglasses seems to have helped me significantly.
posted by amtho at 3:26 AM on August 26, 2016 [2 favorites]
Before this, I'd treated the nausea with a drug that made me very sleepy. Now, I have explicit instructions on when and how to take medicine to avoid this. There are a lot of people out there with migraines, and now finally some professionals are getting serious about figuring it out.
If you _don't_ go to a headache center, I can tell you that taking OTC electrolytes, taking breaks, drinking plenty of water and taking breaks, and wearing polarized sunglasses seems to have helped me significantly.
posted by amtho at 3:26 AM on August 26, 2016 [2 favorites]
All of this is excellent advice. For a slightly different twist, you might also want to think about whether there's any way to manage your stress levels. Stress can be a migraine trigger and this is clearly a hugely stressful thing for you. Maybe if you can find some ways to be extra gentle with yourself in the lead up or on the day that would help too. Can you give yourself permission to slack off on, or outsource, other stuff in your life in the lead up? Can you find a way to get yourself even small breaks the day of, to get some quiet, maybe do some deep breathing or meditation or whatever relaxes you?
posted by Stacey at 3:37 AM on August 26, 2016
posted by Stacey at 3:37 AM on August 26, 2016
I have been a regular migraine suffered for about 30 years. For about the last 8 years i have had sumotriptan to take as soon as I get symptoms. This can take the sting out but generally still means 2-3 hours of uselessness. This year I started to get more migraines, especially when away from home for work. the doctor recommended I try a more prophylactic approach. At the recommendation of my GP I tried beta blockers but the side effects were not great for me (a doctor friend swears by them and has cut back his attacks considerably with them). So I am trying my GP's second recommendation, Amitriptyline, which so far seems to be working out well. Basically talk to your GP and see what they can offer. The reason I made the change from treatment to prevention was that I was getting to a stage where I was getting so worried about getting a migraine while away on business that it was impacting my planning and adding to my stress levels.
posted by biffa at 4:33 AM on August 26, 2016
posted by biffa at 4:33 AM on August 26, 2016
Triptans have changed my life. The first few times I took them I felt groggy and weird for a while, and every once in a while I take them and feel a little weird even now, but in generally I pop one and it's fine.
I have learned to recognize very early onset migraine symptoms, too, so I can usually take them before nausea hits.
Here is some free advice if you do start with a migraine-interrupting medication: about a year after I had started on the triptans, I noticed that my use had increased and I was getting rebound headaches (less severe but still pretty bad). This is apparently pretty common and my doctor actually prescribed me some opiates to break the cycle.
However! What I started doing was paying close attention to my headache/rebound cycle and taking a big dose of ibuprophen to interrupt it. So I'd typically get a rebound headache in the early morning hours the day after using the triptans...but if I took ibuprophen premeptively late at night, it broke the cycle. Now I'm back to just a few migraines a month, which is normal for me. It is possible to manage rebound headaches without escalating, but there is not much in the medical literature.
Totally get meds. If you can find ones that work for you, it will transform your life. I have talked several people into getting migraine prescriptions and all agree. My life is so different now that I can travel and work events without worrying about headaches.
posted by Frowner at 5:27 AM on August 26, 2016 [2 favorites]
I have learned to recognize very early onset migraine symptoms, too, so I can usually take them before nausea hits.
Here is some free advice if you do start with a migraine-interrupting medication: about a year after I had started on the triptans, I noticed that my use had increased and I was getting rebound headaches (less severe but still pretty bad). This is apparently pretty common and my doctor actually prescribed me some opiates to break the cycle.
However! What I started doing was paying close attention to my headache/rebound cycle and taking a big dose of ibuprophen to interrupt it. So I'd typically get a rebound headache in the early morning hours the day after using the triptans...but if I took ibuprophen premeptively late at night, it broke the cycle. Now I'm back to just a few migraines a month, which is normal for me. It is possible to manage rebound headaches without escalating, but there is not much in the medical literature.
Totally get meds. If you can find ones that work for you, it will transform your life. I have talked several people into getting migraine prescriptions and all agree. My life is so different now that I can travel and work events without worrying about headaches.
posted by Frowner at 5:27 AM on August 26, 2016 [2 favorites]
Also, try preemptive medication during the day. If this were me, I would start taking a large dose of my OTC painkiller of choice (check with your doctor, but my doctor has always recommended 800mg of ibuprophen, double the normal dose, for this) in the late morning and continue every four hours through the event. If it fits with your dietary habits, I would also drink something sugary and caffeinated and eat something salty - I find that a can of Coke every so often helps a lot, and I don't drink soda regularly otherwise anymore. (I read about this tip from someone online and it really helps.)
It may be that you can totally preempt the migraine this way.
Another thing - if you get triptans or another treatment and you have strong reason to believe that you are likely to wake up with a headache already going strong, can you either take the triptan very, very late at night or set an alarm for 2am to take one? I am lucky that my onset symptoms usually wake me up in the small hours in time for meds, but I am familiar with that whole "waking up with a bad headache already in progress" situation.
posted by Frowner at 5:33 AM on August 26, 2016 [2 favorites]
It may be that you can totally preempt the migraine this way.
Another thing - if you get triptans or another treatment and you have strong reason to believe that you are likely to wake up with a headache already going strong, can you either take the triptan very, very late at night or set an alarm for 2am to take one? I am lucky that my onset symptoms usually wake me up in the small hours in time for meds, but I am familiar with that whole "waking up with a bad headache already in progress" situation.
posted by Frowner at 5:33 AM on August 26, 2016 [2 favorites]
Strongly recommending electrolytes in addition to lots of water. I get migraines, but I also get all those symptoms you describe if I do something strenuous and don't get enough hydration AND electrolytes. That scenario also triggers epileptic seizures for me, so it can be serious stuff even if 'dehydration' sounds like an insufficient explanation for such strong effects. Adding a simple packet of powdered electrolytes into my water, makes a universe of difference for me. Good luck!
posted by thegreatfleecircus at 5:38 AM on August 26, 2016 [2 favorites]
posted by thegreatfleecircus at 5:38 AM on August 26, 2016 [2 favorites]
I get super nauseated with my migraines. If I don't have one of my prescription pills with me, chewable non-drowsy dramamine helps pretty quick. Then I can stomach the 4 advil.
posted by Green Eyed Monster at 6:02 AM on August 26, 2016
posted by Green Eyed Monster at 6:02 AM on August 26, 2016
You know how people say "lawyer up"? Well, you need to doctor up!
You absolutely have a legitimate medical condition! Please work with your doctor on a treatment plan and documentation. I work with a student who has her migraines registered as a disability and carries a doctor's note, because she's met with lack of understanding from instructors in the past. She's decided to forstall that with documentation.
Great tools for you to have - a medical history up-to-date with your symptoms, a medication plan for treatment and prevention, and a source for doctor's letters should you need to miss a day or decide to ask for accommodations for this gruelling schedule from your employer.
Lots of great advice here on managing on the day of the event too.
posted by Squeak Attack at 7:05 AM on August 26, 2016 [2 favorites]
You absolutely have a legitimate medical condition! Please work with your doctor on a treatment plan and documentation. I work with a student who has her migraines registered as a disability and carries a doctor's note, because she's met with lack of understanding from instructors in the past. She's decided to forstall that with documentation.
Great tools for you to have - a medical history up-to-date with your symptoms, a medication plan for treatment and prevention, and a source for doctor's letters should you need to miss a day or decide to ask for accommodations for this gruelling schedule from your employer.
Lots of great advice here on managing on the day of the event too.
posted by Squeak Attack at 7:05 AM on August 26, 2016 [2 favorites]
honestly, since you're saying you only get them during events, i'm going to go along with many others and say: sunglasses, floppy hat with brim, water, water, water. if you don't get a chance to eat, put a couple luna bars in your pocket and have those throughout the day. use the ear plugs if you can, but those may not be practical if you need to interact with the public in your role. make sure your sunglasses are those GIANT ones, or the wrap around ones, so you get as much protection as possible.
posted by misanthropicsarah at 8:54 AM on August 26, 2016 [1 favorite]
posted by misanthropicsarah at 8:54 AM on August 26, 2016 [1 favorite]
I wouldn't even bother with those acoustic earplugs, their sound isolation isn't great compared to normal ones. Unless for some reason you specifically need a natural frequency response curve (like you're a musician, or listening to music) they're not really necessary. If you can hear someone shouting at you in a loud venue without earplugs in, you'll be able to hear them shouting at you with earplugs in. There will still be plenty of sound coming to your eardrums; it'll just be less punishing, and your brain will turn the perceived volume back up a bit. Things will sound a little funny (though your brain will quickly convince you that they sound almost normal; it's great at that stuff) but speech will still be comprehensible.
Seriously though, in terms of sound pressure there's like a 10 dB difference, roughly, between acoustic earplugs and regular ones. Because of the logarithmic nature of the decibel scale, means that acoustic earplugs with say 23 dB attenuiation will subject you to literally 1000% as much punishment as a set of regular earplugs with 33 dB attenuation.
posted by Anticipation Of A New Lover's Arrival, The at 11:02 AM on August 26, 2016 [1 favorite]
Seriously though, in terms of sound pressure there's like a 10 dB difference, roughly, between acoustic earplugs and regular ones. Because of the logarithmic nature of the decibel scale, means that acoustic earplugs with say 23 dB attenuiation will subject you to literally 1000% as much punishment as a set of regular earplugs with 33 dB attenuation.
posted by Anticipation Of A New Lover's Arrival, The at 11:02 AM on August 26, 2016 [1 favorite]
In addition to hydration and electrolytes, magnesium might help. Take extra starting well before the event. Try to keep your magnesium levels up during the stressful lead up time.
I also find that a little (good quality, natural) peanut butter or rice can help knock back the pain and nausea, though it is a little hit or miss.
posted by Michele in California at 11:24 AM on August 26, 2016
I also find that a little (good quality, natural) peanut butter or rice can help knock back the pain and nausea, though it is a little hit or miss.
posted by Michele in California at 11:24 AM on August 26, 2016
You've gotten good practical answers to your real question. So I'll just derail slightly: you see this as weakness or negativity on your part, but it isn't. You're describing extremely stressful schedules. Some people wouldn't get sick from them. Lots of people would. Even otherwise healthy people. That fact should have been obvious to everyone you work with, even before you started calling in sick. Whatever this organization is, there's something very wrong with it that nobody's figured out a way to relieve you for even an hour on the second day. So:
"Ultimately I think I need a new job that doesn't include these events"
Yep.
And it would also be reasonable to say "sorry, it's just not physically possible for me to do all this". I understand at this point that could cause problems for innocent bystanders. Those problems would be the fault of the crappy situation, not you.
posted by floppyroofing at 11:33 AM on August 26, 2016 [4 favorites]
"Ultimately I think I need a new job that doesn't include these events"
Yep.
And it would also be reasonable to say "sorry, it's just not physically possible for me to do all this". I understand at this point that could cause problems for innocent bystanders. Those problems would be the fault of the crappy situation, not you.
posted by floppyroofing at 11:33 AM on August 26, 2016 [4 favorites]
nthing all the suggestions to talk to a doctor, but just a fair warning that some migraine meds can affect people differently! i usually take imitrex when i have migraines, and it knocks me on my ass - it gets rid of the migraine, but replaces it with intense stomach pain and muscle cramps. that's the pill version, though, so maybe the injection or nasal spray would have fewer side effects (i don't take it all that often, thank god, since i'm on propranolol daily as a preventative).
a lot of this does sound like dehydration, though, so that's probably the most important thing for you to focus on! if you find that you start getting these headaches in other situations (and if you do, try to track what might have triggered them), i would run, not walk, to your doctor to talk about migraine medication and prevention
posted by burgerrr at 11:56 AM on August 26, 2016 [1 favorite]
a lot of this does sound like dehydration, though, so that's probably the most important thing for you to focus on! if you find that you start getting these headaches in other situations (and if you do, try to track what might have triggered them), i would run, not walk, to your doctor to talk about migraine medication and prevention
posted by burgerrr at 11:56 AM on August 26, 2016 [1 favorite]
Response by poster: Thanks so much, everyone. I will see my doctor (hopefully within the next few weeks) to discuss options, and I will definitely make sure I'm well hydrated. I do always drink lots of water throughout, but adding electrolytes is a really good idea. And as soon my move is over, my next focal point is finding a new job that accommodates reasonable, normal health needs (floppyroofing's comment is so interesting because I don't think I see my situation as weakness per se, but I've probably inadvertently absorbed some of this place's fucked-up organizational culture and it's working in my subconscious -- crap!).
One more quick thing I wanted to add, just in case anyone's interested: I think part of why I'm so upset about the whole situation is that I kind of set a goal last spring that I would be employed elsewhere by this year's Fall Event, but my house purchase/move made that impossible. I'm just having a little trouble adjusting to the fact that for now, I still work there and have to do this. Blech. But honestly, just writing all this out and getting so many good practical suggestions has already made me feel better about things. I really, really appreciate every answer!
posted by pupstocks at 5:41 PM on August 26, 2016 [1 favorite]
One more quick thing I wanted to add, just in case anyone's interested: I think part of why I'm so upset about the whole situation is that I kind of set a goal last spring that I would be employed elsewhere by this year's Fall Event, but my house purchase/move made that impossible. I'm just having a little trouble adjusting to the fact that for now, I still work there and have to do this. Blech. But honestly, just writing all this out and getting so many good practical suggestions has already made me feel better about things. I really, really appreciate every answer!
posted by pupstocks at 5:41 PM on August 26, 2016 [1 favorite]
Not sure if this might help, but my doc had me start taking multivitamins that have increased amounts of magnesium and riboflavin in them, as this seems to help a lot of folks have fewer headache days and less intense headaches. I take HeadacheFree and since May I've only had about 3-4 headache days (before I was having 3-4 per week.) Perhaps increase your magnesium and riboflavin for a few weeks before your event as a preventative.
posted by fairlynearlyready at 10:47 PM on August 26, 2016 [1 favorite]
posted by fairlynearlyready at 10:47 PM on August 26, 2016 [1 favorite]
Day 1 starts in the afternoon and goes until late at night (after working all day in the office) and Day 2 is morning until late at night (12-15 hours). I have done this event one time (2015). Day 1 was totally fine, I felt ok, but it's super bright, VERY crowded, and EXTREMELY loud. I'm at the event positioned in the center of a big crowd with very loud music the entire time.
This is pretty much my working life from May through September - I provide & operate sound systems and lighting and stages for events, including concerts & street festivals. IOW, someone like me is responsible for making it very bright and extremely loud (sorry.)
In a lot of ways your symptoms sound like you might have been suffering from some level of heat exhaustion (possibly why your Spring Event experience wasn't as bad - you were able to get into the air conditioning and out of the sun for a while.) So for preventive measures, nthing all of the above about water & sunglasses & sunscreen & hats & earplugs & some way of replenishing electrolytes and salt & sitting down. Every outdoor summer gig we do we provide coolers full of water & sports drinks and small packs of salty snacks and usually a 10x10 EZ-Up tent and chairs. And most of our people have their own sunglasses & earplugs & sunscreen, and we are all very aware of the need to stay hydrated and fed and not over-exert ourselves or get too stressed. This is basic self-care for working these kinds of events regardless of how healthy or prone to migraines you may be (so I'm definitely seconding floppyroofing's point about how this is not "weakness" on your part, this would be a tough day for anyone.)
Also, we try like hell to have enough staff at every show so that someone can take a break if they have to - go inside, or at least wander away from the noise and crowds, maybe just sit in the cab of a truck with the air conditioner running for 15 minutes. Your previous question suggests that you work for a tiny company, but between now and the Fall Event you might be able to convince your bosses that it would be good to get some volunteer help and/or temp hires and set up the days' schedule so that people aren't parked in the same position the whole time - like, you do a four hour shift in the middle of everything, then someone else takes over and you go work the ticket tent at the far end of the event where things are quieter.
posted by soundguy99 at 11:16 AM on August 27, 2016
This is pretty much my working life from May through September - I provide & operate sound systems and lighting and stages for events, including concerts & street festivals. IOW, someone like me is responsible for making it very bright and extremely loud (sorry.)
In a lot of ways your symptoms sound like you might have been suffering from some level of heat exhaustion (possibly why your Spring Event experience wasn't as bad - you were able to get into the air conditioning and out of the sun for a while.) So for preventive measures, nthing all of the above about water & sunglasses & sunscreen & hats & earplugs & some way of replenishing electrolytes and salt & sitting down. Every outdoor summer gig we do we provide coolers full of water & sports drinks and small packs of salty snacks and usually a 10x10 EZ-Up tent and chairs. And most of our people have their own sunglasses & earplugs & sunscreen, and we are all very aware of the need to stay hydrated and fed and not over-exert ourselves or get too stressed. This is basic self-care for working these kinds of events regardless of how healthy or prone to migraines you may be (so I'm definitely seconding floppyroofing's point about how this is not "weakness" on your part, this would be a tough day for anyone.)
Also, we try like hell to have enough staff at every show so that someone can take a break if they have to - go inside, or at least wander away from the noise and crowds, maybe just sit in the cab of a truck with the air conditioner running for 15 minutes. Your previous question suggests that you work for a tiny company, but between now and the Fall Event you might be able to convince your bosses that it would be good to get some volunteer help and/or temp hires and set up the days' schedule so that people aren't parked in the same position the whole time - like, you do a four hour shift in the middle of everything, then someone else takes over and you go work the ticket tent at the far end of the event where things are quieter.
posted by soundguy99 at 11:16 AM on August 27, 2016
Chronic migraine sufferer here. Nthing sunglasses. I am that weird woman wearing sunglasses in the gloom, as sunlight can trigger my migraines.
My migraine specialist recommended dispersible aspirin in a Coke as first line meds. The caffeine fast tracks the meds into your system. Some times, this short cuts the migraine entirely.
For nausea, ask your doctor for an anti-emetic. I'm in the UK, and have domperidone by prescription.
I also have a triptan med to take. Big thing here is that there are a fairly large amount of different triptans, so you can try others if the first one doesn't work too well for you.
Possibly most useful thing I've learned is to nuke the migraine with your arsenal as soon as you feel it coming on. So, try to be very aware about your aura or other signs of migraines starting and treat as soon as possible.
I've heard good things also about topimarate and amitriptyline (low dose) as migraine prevention meds. For the former, watch out for weight loss and interference with some forms of hormonal birth control (if applicable). I'm currently testing amitriptyline, and things look tentatively good.
posted by thetarium at 2:25 PM on August 27, 2016
My migraine specialist recommended dispersible aspirin in a Coke as first line meds. The caffeine fast tracks the meds into your system. Some times, this short cuts the migraine entirely.
For nausea, ask your doctor for an anti-emetic. I'm in the UK, and have domperidone by prescription.
I also have a triptan med to take. Big thing here is that there are a fairly large amount of different triptans, so you can try others if the first one doesn't work too well for you.
Possibly most useful thing I've learned is to nuke the migraine with your arsenal as soon as you feel it coming on. So, try to be very aware about your aura or other signs of migraines starting and treat as soon as possible.
I've heard good things also about topimarate and amitriptyline (low dose) as migraine prevention meds. For the former, watch out for weight loss and interference with some forms of hormonal birth control (if applicable). I'm currently testing amitriptyline, and things look tentatively good.
posted by thetarium at 2:25 PM on August 27, 2016
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