There is someone I know who gets debilitating migraines, and it seems like she gets them quite often. It seems she rarely calls in sick from them, but tries to power through and work. This week, she has had to call in sick because it’s been that bad. In talking to her about it, she says that she’s dealt with these debilitating migraines for about 30 years. She went on to say that there were times when she either had to lay her head down while in the office, or even go lay down on a couch that was in the office for several hours. Now I have to assume she was on the clock all these times.
It’s horrible that she gets these and that they have to interfere with work, but how fair is it to remain on the clock but be laying down. I know for a fact she doesn’t like to “waste” her Personal Time Off (PTO) on being sick or leaving early, etc. In fact she’s accrued a large amount of PTO over the years and has been able to take some nice week-long vacations.
She says she refuses to go on prescription medication for this problem because she doesn’t want to be doped up or suffer from the side effects of the meds. But I guess my question is, if they are that crippling that she cannot work, or has to eat up PTO, shouldn’t she should do something? I fear that as she ages, they may get worse and she won’t be able to work at all and may have to give up her job. She’s about 34 and a single mom. I guess maybe she could go on disability?
If she’s 34, the frequency has probably leveled off. Once a week or so is pretty normal. I’d suggest a daily med (I take Topamax). It does have some side effects, but nearly everyone will tell you a little big of brain fogginess* is worth it to go from 6 debilitating migraines a month to 3 nagging headaches a month.
The other option that works really well is something like Imitrex or Maxalt or Zomig. For most people those will knock out even the worst migraines in about an hour or so. They’re not narcotics, they don’t mess with your head.
*The brain fogginess I get from taking something like Topamax isn’t anything like, say, Vicodin, it’s a bit hard to explain, but if you google around for side effects of it you’ll be able to read all about it. You’ll see a lot of references to ‘not being able to remember a word’. For me, it manifests itself in dropping words while typing. It’s strange. But it’s worth it to not have all the migraines.
As for her PTO, as long as she’s getting her work done and not making your life harder, I’d stay out of it.
It may not be the best choice, but after 30 years you have time to get used to these problems and to know what to do about it. It’s one of those “the beast you know vs the unknown” problems. Most people tend to go with the beasts they know. Depending on if she has allergies to certain medications she may be stuck choosing between migraines and opiates for instance, which is not a nice choice at all.
Since you stated her age, she may be holding out for menopause. Migraines can be hormone induced or aggravated, and menopause clears it up for more than half of women sufferers.
It’s pretty much her business what she does about it. If she gets her work done I personally wouldn’t have an issue with a break to recover, but maybe her boss thinks differently (and doesn’t know). If you want to rat her out if you think boss doesn’t know, I guess that’s your prerogative as well, but I wouldn’t think highly of it.
I didn’t know that, but I do remember when I started getting debilitating ones back in first grade that the doctor said when I went though puberty that they would get better or worse. I suppose if what you said is true, menopause might do the same thing.
Also, as far as recovering from them. Without meds, if I have one that’s debilitating, the ONLY way to get rid of them is a three hour nap (and possibly puking). If it comes on fast enough, sometimes driving isn’t even an option.
Well yes, I know what is involved with “recovering”. I also will get them so bad I cannot drive or walk straight, but they usually occur at the end of the day so at worst I go home half an hour early while I can still drive. I take a naproxen sodium and sleep for at minimum 45 minutes. Two hours is best for the biggest recovery, but I will feel woozy for the rest of the day either way. On a few occasions, I have contemplated going to an urgent care clinic since I was continuously vomiting for hours. And this isn’t even that bad for migraines! I’ve known people who cannot move, look at light, or hear sounds for 3 days without excruciating pain.
It is up to the boss as to whether he/she’s okay with the long breaks to recover, that’s all.
She’s being (IMO) stupidly stubborn if she refuses to seek treatment of some form. At the very least, something to stop the migraine would be helpful, and not all medications have side effects or a sedating effect. They don’t generally give you opioids for migraines.
I say this because I’ve dealt with migraines for over a decade, tried numerous medications (without any noticeable side effects), and have finally been migraine-free for the past couple years due to a Mirena implant. And these past couple years have been fucking awesome compared to before then.
(That actually makes me wonder if she has actual migraines versus really bad headaches, because there is miles of difference between the two.)
I wonder if she’s really having migraines or just headaches. I know my migraines are absolutely debilitating, with the resulting nausea being the worst part. I suffered immensely for a couple years before I found a neurologist who could provide me with the proper prophylactic treatment regime. Topamax, Pamelor (tricyclic antidepressant) and Corgard (beta-blocker) fill out my drug cocktail; I take them twice a day, every day. There are definitely side effects that suck, but your body adapts to them after a while and the trade-off is DEFINITELY worth it. The only thing I hate more than the medicines I must take indefinitely are the migraines.
Yeah, probably not. In my case, my neurologist and gynecologist worked together on looking into triggers, and hormones weren’t obvious at the start but as the frequency got worse, to one a week plus one every day of the week of my period, it was at least worth a shot at knocking out the ones that were obviously hormonal. Turns out that was the culprit.
Ambivalid, my migraines weren’t always debilitating - and thank goodness I never ended up in the ER - but having dealt with other headaches and things before, migraines really do feel different than regular headaches, and once you experience the real thing you realize how regular headaches just are not the same thing. I could dose the ever-living crap out of myself with high neurologist-approved doses of Aleve (naproxen, 4-6 tablets) for more “typical” migraines and be miserable but mostly functional at work, as long as I caught them early. But then every now and then I’d get the ones I missed and they would practically send me into the nearest dark hole to try to find some peace.
Migraines, as I know them, are not something that one could “power through”. The pain is intense enough that I would be vomiting in short order if I couldn’t find a cool dark quite place to convalesce.
I don’t get them anymore because I learned what triggered them and how to recognize them in a timely manner. I have about 15 minutes to do something or I’m down for hours.
I’ll just walk through mine in case the symptoms match. Mine start with a sinus headache. many things can trigger it but the important thing is to understand that these headaches immediately trigger a back neck headache. If that goes unchecked then I get the migraine. The cure for me is to cure the sinus headache and that involves: sudafed, ibuprofen and caffeine. Hot tea works the best. I then use a hot steam vaporizer with a towel over my head. I also take an ice cube and run it over my neck, face and temples.
I can stop a migraine in it’s tracks if I take the OTC medicines within 15 minutes of onset.
All migraines are different but I listed my experience in case it matches up.
Yeah, getting to them early seems to be the trick. Getting an “aura” (ocular migraine) ahead of time was a blessing for me, because it meant that if I took 4 Aleve right when the aura was a small spot, I’d probably just be left feeling tired that day and part of the next. Sadly, that was usually the only warning sign I could figure out, and I didn’t always get them.
Considering it’s now thought that up to 90% of “sinus” headaches are actually migraines, a lot of them have to be something you can power through. I got several of them last month, and while the pain was at times enough to make me want to cry, I wasn’t sick to my stomach (I do take daily antiacids, though) or light sensitive.
I find migraines to come in different degrees of severity. Some I can power through and try to maintain a semblance of a normal life, or at least get through work. Other times, not a chance, I crawl home and hide.
But if I get a full blown debilitating migraine, I use sick time and don’t cheat my employer. It is not fair to them or myself. I get out of the office and take care of myself first. Of course, I found a doctor who has worked with me in developing a course of care that has almost eliminated the worst of my migraines and usually makes what I do get manageable. It is not 100% but so much better.
It sounds like the OP’s coworker really does need to see a doctor. Whether or not she has migraines or just severe headaches, treatments are available that are far better than the headaches. I question anybody who would voluntarily live with that if they have an option.
Is it “fair” - it depends on the job and the boss. Most of my jobs I’ve been salaried - I need to work until the job gets done - so if I have a migraine, I’m skipping lunch and working late to finish it off. My last job had sick time, but if you showed up you got paid for the day, so if I got a migraine at work once I was there, I was paid anyway. The job before that I was salaried without a sick time allocation - if you were sick you stayed home.
Its a migraine, I’m not contagious, and if there is a place to lie down and I might feel better in an hour or two or three and be able to finish out the day, thats a better deal for my employer and coworkers than me driving home (which is really hard with a migraine), taking a nap, waking up at 2pm and not working.
If I’m hourly, which I haven’t been for years, then it probably isn’t fair to stay on the clock while you nap.
To get good migraine treatment, you have to find the right doctor, first. Some doctors have an attitude to migraines that has solidified and will not ever change. You will not get up to date treatment from them. Others are openly dismissive, their manner and comments like “true migraines are actually very rare”, “it’s usually impossible to really tell the difference between a migraine and a regular headache” give the impression that you’re either malingering or a wuss or both. If your coworker has experienced more than one of these doctors, she’s not going to trust that going in one more time is going to change anything.
Back in the day, I found one pretty good doctor, but the newer meds weren’t available and I ended up getting the most relief from “chronic low doses of caffiene.” Anyway, if your coworker has any historical reason for dismissing medical help, the only way I would try to change her mind would be to introduce her to someone who knew a doctor in town who had worked with them and fixed their migraines. Personal testimony and a personal referral, with assuranced that the doctor is supportive, would have more chance of working that any amount of general information, no matter how true.
I’ve used Imitrex and Relpax. You take them as needed, not daily (they will rebound on your ass if you take them too often). Relpax causes me a minor amount of drowsiness on occasion. I just hate that I can only get 6 pills at a time. That lasts me 3-5 weeks.
To me, a migraine isn’t something you “power through.” You may still be able to stand, but you’re largely non-functional.
This person you know is being stubborn to a fault. Slap them upside the head and explain to them that triptans (as I’ve noted above) abort migraines before they get out of control, and don’t give you “medicine head.” Continue slapping them until they relent, and go see their doctor.
One month and 10 days later, she is still unable to come into the office due to her migraines. She came in last week for one hour. She just showed up today, will be off in 1/2 hour. She even said that she thought she felt better, but then driving here, she began to feel bad again. How can someone live like this on a daily basis??? I just don’t get it!! But then again, is this what people with fibromyalgia and the like have to deal with?
I got hormonal based migraines and non-hormonal based migraines. I took frovatriptan for the hormonal ones, and midrin for the nonhormonal ones [there was a difference in auras - smells for hormonals and lights for non hormonals] the hysterectomy took care of the hormonal ones and I am left with about 1 migraine every couple of months that midrin works for. I was getting 10-15 hormonal based migraines a month, and I had a bad reaction with topomax [yes, fuguing and aphasia is not a good thing with a daily med] and imitrex made me get hives on my left side [if I am going to have a minor reaction with hives, it always seems to start on my left hand. go figure.] I could pop a frova when the first tickle of an aura hit and it worked like a charm. Thanks to the arthritis, I already take ibuprofin daily to get me out of bed and excederin never worked for any migraine I ever had.
[It peeves me for people to suggest that a regular dose of a minor analgesic will knock out my migraines when I had 30 years experience and working with my PCP and neuro demonstrating what will and what won’t work on me.Chirping merrily that just taking an excederin with a cup of tea will fix me right up makes me all stabby]
See that’s my point, you worked hard to find what medication worked for you. I don’t think she’s doing that. She says that allergies trigger them. I then asked if she takes allergy medicine and she did say yes. Apparently, it’s not working too well. I’m thinking if the allergies are that bad, maybe moving to a different environment is called for?
In my case, my neurologist and gynecologist worked together on looking into triggers, and hormones weren’t obvious at the start but as the frequency got worse, to one a week plus one every day of the week of my period, it was at least worth a shot at knocking out the ones that were obviously hormonal. Turns out that was the culprit.