Getting lots of migraines at work, what can I do?

[Watermelonices]

Really struggling at the moment, work in healthcare in a busy role.

Am suddenly for the last few weeks getting quite debilitating headaches/migraines which seem to be triggered by heat, the sun, screens and noise, which I can’t avoid at work. Oh and stress which is huge.

They are massively affecting my functioning and I’ve had to go home a few times.

Patience is wearing thin with management , I’ve had loads of tests but it points to stress/migraines. I have exhausted sickness absence and am getting worried about finances.

Does anyone have any advice? The only thing that has changed is work has become more target driven and demanding and I am struggling a bit, because I feel so bad.

thanks

It should say on the box. I find 10 mg amitriptyline at night more effective than propanolol.

What dose have you been given? Are there any instructions printed on the prescription label on the box?

I take 20mg twice a day, which isn't a particularly high dose but it dropped my blood pressure too low to increase any further, ideally my GP said she'd have prescribed double that if I'd tolerated it.

Some people are prescribed a sustained release form which I think is a higher dose once a day

Yes - the pink 40 mg ones are slow release.

It's a bit trial and error, everyone is different. 40mg of amitriptyline daily did absolutely nothing except make me tired and fat!

I think it says 1-2 tablets when needed

That's really odd, I've only heard of them being prescribed "as needed" when used for anxiety. What dose are they?

Yes - the hunger at 40 mg is insatiable! I started on preventatives 37 years ago and used to take pink Migraleve until I discovered triptans. I stopped drinking coffee 8 years ago.

Much sympathy. I have very sensitive eyes too, and I'm finding the newer types of electric light extremely migrainous , also bright sunlight, and the newer computer screens.
What saves me in the car is dark ski glasses with flaps to reduce light coming in from the sides and over the top of the lenses: I paid far more than I normally would for Moncler Steradian SG 99 Black/Grey,. There may be something similar that's cheaper. I didn't find ordinary prescription sunglasses or the 'official' blue light blockers any use. I don't drive BTW so if you try that you obvs need to make sure you're safe to drive.
In the office you may need to get a sick note and support from your GP, because you should not be working in a bright space especially on a screen. You need blinds or reflective film on the windows and a shady corner for the computer. I've actually put black film over my own office windows which face South!! but something less dramatic might be enough for you and tolerable for your colleagues. If you explain, possibly with your GP's help that this will enable you to reduce your sick leave, they should treat your requests a reasonable adjustment. It would not be expensive.
I hope you can plug on with this and get taken seriously because it is a genuine and debilitating health problem and once you get into a cycle of frequent migraines it is much harder to come out of it.

OMG yes, I was so glad to get off it! I don't know how I'd cope without triptans, and a private prescription for vydura, as I have too many migraines a month to take a triptan every time.

Waiting on a neuro appointment as preventatives aren't working well so far and I'm getting 8-10 attacks a month.

So you need to go back to your dr and ask to be referred to neurology for proper treatment for your migraines.

in the mean time ask for something like sumatriptan to try to abort them at the first hint (you have to take it within an hour of onset) and ask about a preventive, there are lots and lots and propanalol is nowhere on the list of first line preventives for migraine, you are being fobbed off

if you can afford it, self refer to a neurologist who specialises in migraines (you can google what they like to treat). And for about 300 pounds you will get a treatment plan and prescriptions to see if you can get ahead of it

if you want to try and muddle through, try Solpadeine, max dose and lying in a quiet dark room until it has completely gone (take the day off work). Then and only then try going back to work.

i am guessing that you are never actually shifting the migraine and so you think it keeps coming back but actually it the same one that is just waxing and waning a bit

if you can shift it properly, you might be able to go back to work and tolerate more of the noise heat and light than you can when you are in a semi migraine state

This is my go to brilliant drug

10 mg, they were prescribed for anxiety, but I had not really used them, but then another dr said they could be used for migraines so I tried them

A good dietitian may help. Amines are a huge trigger which includes but is not limited to seafood and meat (unless it’s very fresh), cheese, banana, chocolate, citrus and more.

www.fedup.com.au/factsheets/factsheets-by-symptom/headaches-and-migraines

Try drinking more water (not easy in healthcare I know). One of the side effects of pain killers can be headaches so try not taking them or trying different ones.

On the screens, it depends what screens you are using but have a look at the 'display screen equipment' part of the health and safety at work act. You should be getting regular breaks from the screen and regular eye tests paid for by your employer.

You need actual migraine medication and you probably need to go on a daily preventative med if it is this disruptive. Exactly what you take depends on so many factors.

both my teenage dd and I have migraines. We take the same rescue medication and both have a daily prevention plan, but they are very different because our migraines are different.

Same here.

Try Sumatriptan.

Avoid dairy like the plague.

The only time I have ever experienced migraines in my life was early pregnancy. Have you ruled that out?

Take evening primrose oil daily. This changed my life. I used to get a week of migraines each month. Started taking EPO for better hormonal balance and now barely get migraines. After having them my whole life 😭

Is there a link between stress, migraines and fluctuating bp (very high at times but normal at times when resting)?

And if so, which tends to come first and which is the knock on effect?

Yes high bp can cause a headache, but its not technically a migraine if caused by high bp, its called a hypertensive crisis and needs immediate medical care. How high is your bp spiking to?

Not as high as that but higher than normal- 140-150/90-95 ish but then goes to normal if I sit quietly somewhere

Can I ask your age? Just wondering if you are peri menopausal/menopausal/ post menopausal? Migraines can be a sign of hormone imbalance. I have a friend who did have migraines peri menopausal which where debilitating and I have since read this a common symptom of hormones fluctuating.
My friend was gobsmacked, when taking HRT the migraines stopped after a couple of weeks with HRT regimen.

so that's unlikely to be high enough to be causing a hypertensive headache.

You really need to get to see a doctor about your headaches that is going to take you seriously and treat you appropriately.

There are lots of great medications out there that really do work very well. You just need to get a doctor to evaluate you and prescribe something sensible (which is NOT propranolol - that is for high bp and heart rhythm issues - and at a push anxiety)