To not want DH to return to work

[bouncybunny12]

DH has had migraine with aura since Friday (lost partial vision and then migraine started with vomiting) which usually only lasts a day or 2 if he ever gets them which is occasionally. He has been to see GP and was given Migraleve but has not made a dent in the pain so has been told to come back tomorrow to try a triptan. He says that his work will think he is trying it if he stays off any longer but I think he should not go in as his working environment is fluorescent lighting, stood all day, hands-on type of work and it will definitely make things worse and cause him to have to leave again, making it two absences instead of one continuous absence. He is a very integral member of his team and I severely doubt they would give him trouble for being this unwell but he is paranoid that they will. AIBU?

God my symptomatic migraines with aura last up to 12 days. Then for a good 10 days afterwards everything seems too bright, too loud and overstimulating, probably because it's a massive attack on the senses. I work in the NHS in a similar environment to your husband and can't bear it post migraine. He should get himself signed off otherwise he could end up triggering another one.

Day 1 of sumatriptan and no joy, just feeling tingly and having a dead arm. Headache itself keeps dipping in and out with neck pain too. Will see how it is in the morning.

Anyone got any other suggestions?

Getting checked by somebody else to make sure it isn't a stroke/clot/aneurysm or sinus infection/neck injury that's been written off as just another one of his migraines.

Has he never been offered a preventative? I was getting 3-4 migraines a month that wiped me out for days, gp prescribed propranolol which has been a life saver

For next time, I was told by a specialist and agree from experience that the best thing for migraine is to take a large dose of aspirin right at the start. Migraleve is crap and gives me rebound.

Is he still throwing up? If I'm vomiting I use an Imigran nasal spray which is incredibly helpful (triptan). Has he tried the cool gel sheets on his neck or forehead? They've been a bit of a revelation for me but an ice pack might bring some relief. I also use an acupressure pillow when I have neck pain.

FYI my normal meds are Sumatriptan plus Naproxen and that combination usually stops it, especially if I take it early enough.

Poor guy, it sounds like a doozy.

This is the first time he’s seen a doctor about it since his first “bad” migraine in 2018 when he had uncontrollable vomiting and got taken to hospital from school (we are 23)

Any other migraines from then up to now have been more low level and short.

Did he take the OTC triptan OP, or prescribed. The former is a lower dose. Also, I believe that they are designed to be taken at the onset of an attack, so may be less effective at this point. They were the only thing that worked for me, though they did make me feel spaced out.

My migraines with aura are generally pain free, but I feel nauseous and spaced out and very sleepy, once the aura subsides. Occasionally I lose my speech and my coordination goes. I've tried 4x different triptans, and none make any difference. I can't take beta blockers so I now just take aspirin at the onset and go to bed for 12 hours.

I have at least 3 days afterwards where I cannot usually work due to the hangover (postdrome) from them. Exhausted, woolly headed etc. I work from home sat at a laptop, and I cannot stand the glare from the screens (despite having blue light shields on them, and the brightness and contrast turned way down).

Also get hormonal migraines which nothing touches, pain wise. They are agonising but I can generally function up to a point, and go to bed when they get too much. Really struggle with screen usage though. Is better now working from home as no fluorescent lights to deal with - I can't stand them when I don't have a migraine, never mind with!

I'd second advice to make sure this isn't something other than a "bad migraine". It sounds hideous and I hope your DH feels better, soon.

He was prescribed 50mg which I believe is also the OTC dose. GP seems reluctant to prescribe anything stronger..

I suggest you go to urgent care or A snd E. He needs the migraine cocktail and the GP has no idea what they are doing. Triptans only work if taken within a couple of hours of the start of a migraine and they have a two dose option if dose one doesnt work within the first hour or so.

if he is developing neck pain, i would also want other potential causes of head pain ruled out. Has DH hit his head or been in a whiplash situation recently?

I thought I had migraine and only visited A & E when I lost sight in one eye. It was actually a mini stroke.

I would take him to A & E.

Triptans are amazing for me, but would struggle to get them to work in DHs situation because it's got a good hold. Has he at least stayed in a dark room (all the time, even when it eases)?

Did the GP give him anti sickness pills?

If the GP agrees I would give him lots of water and a triptans + anti sickness pills + paracetamol. Stay in dark room laying down. Lots of tea

2 hrs later another Triptan and repeat. Ideally a double dose, but only if GP agrees. He will feel woozy, but it's the only way to make a dent when it's taken hold (for me anyway!)

Next time take the Triptan and anti sickness pills at the very start, sit in dark room for 30 mins and hopefully that's the end of it.

Such a shame it hasn’t worked for him. I’m pretty sure he can take another in 24 hours, but do check. It’s worth trying again at the onset of the next one, if it happens. I found that the OTC dose was actually about right for me if I caught it in time. Higher doses are strong stufff. Good luck to him. It’s a miserable condition.

No head injuries or whiplash situations. We have a walk in centre near us so might go there but I would have to convince him to sit in a fluorescent waiting room with crying kids and loud inconsiderate people for hours, which is very difficult but I will try.

It'll be worth it to be sure it isn't a case similar to my best mate, who spent so long trying to convince a&e that the never ending head pain wasn't 'just a migraine' that they missed the effective intervention period for a stroke.

Op how is he doing, I agree with others that the GP doesn't know how to treat migraine. Triptains only work effectively near the start of a migraine and they should have prescribed this first. Migroleave is only paracetamol and codine with an antisickness drug added and really isn't suitable for migraine (I've no idea why they are still able to sell it as such).

If the triptan hasn't worked then normally I just have to ride it out. Painkillers like Aspirin or Ibuprofen are best, I do take Naproxin (stronger then Ibuprofen) if I can a migraine I can't break. If this isn't normal for him then it is definitely worth getting him check out throughly rather then just assuming it is migraine.

If he's the sort of person prone to throwing up with a migraine then sumatriptain injections or one of the nasal sprays are best to ask for, like Zomig. Anything that goes in by the stomach is much less likely to work.

i have chronic migraine and it took years for me to get my meds right. He shouldn’t go to work as his aura could make it dangerous for him to commute - get a sick note off the GP for a week for next week as even if the Triptan works he could have a rebound headache and often you can feel a migraine hangover for days when they have gone on for so long. The heat will be making it worse too. Get him to have some electrolytes x

I keep hearing about migraine cocktails but in my 18 years of migraines this has never been an option at a&e where I live! Thankfully under neurology now and under control.