migrainepage
Would you like to react to this message? Create an account in a few clicks or log in to continue.

Work and migraines..

+4
tdu
Migrainegirl
ZomigMan
massageguy
8 posters

Page 1 of 2 1, 2  Next

Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  dcook60 Tue Jun 12, 2012 8:39 pm

how about a little positive note for a change? (i'm usually the prophet of doom.....)

i have relied on triptans for almost 20 years. the past several years i've had to take one or another almost daily. most all drugs give me side effects, in the form of more migraines and more pain in general, plus fatigue.

BUT i have had no side effects, zero, in all these years from imitrex, maxalt, and amerge. the other 4 triptans tried did not help.

certainly, i could not have a 30-hours/week job at age 72 if not for these miracle drugs. i feel great sympathy for those who find the triptans are useless. and i always add, as other people have, here on this forum, 'if one doesn't work try another and another'. unless, of course, they have intolerable side effects. dianne
dcook60
dcook60

Posts : 501
Join date : 2009-12-03
Location : spokane, WA

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  ZomigMan Fri Jun 15, 2012 5:02 pm

tdu wrote:ZomigMan, I am not attempting to debate you to be jerk, the 2 posts above are similar to stories I hear VERY frequently relating to Triptan side effects. I had this issue myself with Imitrex and won't touch it with a 10 foot pole because of it. It's nowhere near as bad with other Triptans, though I do get a minor version of the same side effects. I get the chest pain on ALL Triptans, along with pins and needles and sore joints. It's just a matter of how severe it is from med to med. Because of that, it's impossible to take them and work a physical job. I have always been told by my doctor that these side effects are not rare by any means and that a lot of people can't take Triptans because of them. I do not get those symptom from the migraine or any other meds I take for the migraines.

But.... the simple fact is getting rid of the migraine outweighs these side effects in some cases for me. Frova only gives me minor sides so I take it. But I can't function at work on it still. If I take it, it requires a sick day because of the side effects mentioned above. And a lot of other people are in the same vote. A lot of others are not. The only point I was ever making was that it's a realistic possibility that any person could fall into the first category, and they should be prepared for that possibility. I'm not sure why you take such exception to that point just being brought up?

My exception here as it were is that you and several others have claimed that Triptans are not effective for the majority of people, and/or that Triptans have such severe side effects for the majority of users that anyone taking them cannot work or otherwise function when taking them. That is contrary of my own experience using them and the many published results of studies on Triptans that indicate that Triptans are effective in a majority of people with migraines, and that the majority of them do not suffer extreme or severe side effects. In my view you are needlessly scaring people into thinking that Triptans are not effective, or that they will cause them to have such severe side effects as to their being ineffective to use.

I am not saying that Triptans are completely safe, or that everyone should use them, or that everyone will not have side effects. Side effects can and do occur with any drug and any substance. As posted here, obviously some people have severe reactions to Triptans and they simply cannot use them, or they have to run through the entire smorgasboard of them to find one that works. However, I would not hesitate to tell people that get migraines about them, and as the majority of people seem to get good or better results using them without severe side effects, I would recommend them to anyone that suffers from migraines and has not tried them. Triptans are effective in reducing migraine pain by countering the vaso-dialation that causes the pain in migraines. So in the process of reducing migraine pain, they raise your blood pressure. For that reason, if you are at risk for a heart attack or stroke or have high blood pressure, you should beware of using Triptans for migraines.

I have a post-it on my bathroom mirror that says, "Don't get hooked on the cure". I take Triptans only as needed and I take as little as possible to get rid of migraines. I have not found them to be addictive or to have severe side effects. They work for me in about 90% of my migraines. I have low blood pressure and I am in really good physical shape, so I am not at risk for a heart attack or a stroke. I also do not have any adverse effects using Triptans, and they are very effective in reducing or eliminating migraines that would otherwise have me in bed for a day or days at a time, and taking all kinds of pain killers. Triptans are VERY expensive. Zomig can run anywhere from $10-$40 per pill, and insurance may or may not reduce the cost. For that reason I would not expect anyone to eat them like candy, but my doctor tells me that some people take them daily to prevent migraines (against his recommendation). I have found it better to try to prevent migraines from happening by avoiding foods that have tyramine, and in the event I do get a migraine, I take Triptans at the fist sign of onset (usually a sharp headache on one side of my head behind either eye).

ZomigMan
ZomigMan

Posts : 83
Join date : 2012-05-24
Location : PNW

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  charmed quark Fri Jun 15, 2012 5:55 pm

Triptans are generally safe, the chest pain many experience is not cardiac but likely due to spasms in the esophagus as the tiptan takes effect, according to recent studies. But they are not that effective.

When I was first diagnosed with migraines, injectable triptans had recently become available and were considered extremely effective. In fact, some doctors felt that if your migraines didn't respond to triptans, they weren't really migraines.

So I was upset when I was told I couldn't use triptans as I REALLY wanted something that worked. But my neurologist said not to feel bad, that the earlier studies had dramatically overestimated how well they worked.

When done with proper randomized, double-blind methodologies, they found much lower response rates . Only about 1/3rd of people get a good response with any one triptan (using the maximum dose). See:http://www.ncbi.nlm.nih.gov/pubmed/11152011

And of those that do get an effective response, 30-40% have the migraine come back when it wears off.

I've seen a number of studies finding the same result. In fact this one lists the meta results of up to 10 studies and finds slightly lower response rates:
"Meta-analysis of Oral Triptan Therapy for Migraine: Number Needed to Treat", J Managed Care Pharm. 2003(9)
See table 2.http://www.amcp.org/data/jmcp/research-45-52.pdf

For example, Imitrex at 100 mg:
The combined study had 1,837 treated with Imitrex, Of these 559 (30.4%) had relief. 895 received placebo and 70 (7.8%) had relief. The number needed to treat is thus 4.7 patients. (95% confidence interval:4.0 – 5.9). The most effective triptan was Rizatriptan 10 mg, where nearly 41% of patients got relief compared to 8.5% on placebo.


These are numbers for being pain free after 2 hours. It is likely more people get a reduction of their migraine from the triptans but still have symptoms. Of course, these people rebound more as the triptan wears off.

It's also likely that if you keep trying different triptans until you find one that work, you'd get a higher response rate. But from what I've read, more than 50% of migraine sufferers don't get any significant relief from triptans. That's why researchers are hard at work looking for better abortants.

charmed quark

Posts : 273
Join date : 2009-12-23

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  charmed quark Fri Jun 15, 2012 6:44 pm

One last paper, a easier to read 2010 Consumer Report:
"Treating Migraine Headaches: The Triptans - Comparing Effectiveness, Safety, and Price including best buys"
http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/triptanFINAL.pdf

Good paper to check out.

The moist effective triptan here is (Table 2):
Axert 25 mg. 34% to 35% have relief at 1 hour, 57% to 75% have some relief at two hours, 18% to 52% have complete relief at 2 hours.

So even looking at "some relief", a lot of people are left out in the cold.

charmed quark

Posts : 273
Join date : 2009-12-23

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  tdu Fri Jun 15, 2012 7:02 pm

ZomigMan wrote:
tdu wrote:ZomigMan, I am not attempting to debate you to be jerk, the 2 posts above are similar to stories I hear VERY frequently relating to Triptan side effects. I had this issue myself with Imitrex and won't touch it with a 10 foot pole because of it. It's nowhere near as bad with other Triptans, though I do get a minor version of the same side effects. I get the chest pain on ALL Triptans, along with pins and needles and sore joints. It's just a matter of how severe it is from med to med. Because of that, it's impossible to take them and work a physical job. I have always been told by my doctor that these side effects are not rare by any means and that a lot of people can't take Triptans because of them. I do not get those symptom from the migraine or any other meds I take for the migraines.

But.... the simple fact is getting rid of the migraine outweighs these side effects in some cases for me. Frova only gives me minor sides so I take it. But I can't function at work on it still. If I take it, it requires a sick day because of the side effects mentioned above. And a lot of other people are in the same vote. A lot of others are not. The only point I was ever making was that it's a realistic possibility that any person could fall into the first category, and they should be prepared for that possibility. I'm not sure why you take such exception to that point just being brought up?

My exception here as it were is that you and several others have claimed that Triptans are not effective for the majority of people, and/or that Triptans have such severe side effects for the majority of users that anyone taking them cannot work or otherwise function when taking them. That is contrary of my own experience using them and the many published results of studies on Triptans that indicate that Triptans are effective in a majority of people with migraines, and that the majority of them do not suffer extreme or severe side effects. In my view you are needlessly scaring people into thinking that Triptans are not effective, or that they will cause them to have such severe side effects as to their being ineffective to use.

I am not saying that Triptans are completely safe, or that everyone should use them, or that everyone will not have side effects. Side effects can and do occur with any drug and any substance. As posted here, obviously some people have severe reactions to Triptans and they simply cannot use them, or they have to run through the entire smorgasboard of them to find one that works. However, I would not hesitate to tell people that get migraines about them, and as the majority of people seem to get good or better results using them without severe side effects, I would recommend them to anyone that suffers from migraines and has not tried them. Triptans are effective in reducing migraine pain by countering the vaso-dialation that causes the pain in migraines. So in the process of reducing migraine pain, they raise your blood pressure. For that reason, if you are at risk for a heart attack or stroke or have high blood pressure, you should beware of using Triptans for migraines.

I have a post-it on my bathroom mirror that says, "Don't get hooked on the cure". I take Triptans only as needed and I take as little as possible to get rid of migraines. I have not found them to be addictive or to have severe side effects. They work for me in about 90% of my migraines. I have low blood pressure and I am in really good physical shape, so I am not at risk for a heart attack or a stroke. I also do not have any adverse effects using Triptans, and they are very effective in reducing or eliminating migraines that would otherwise have me in bed for a day or days at a time, and taking all kinds of pain killers. Triptans are VERY expensive. Zomig can run anywhere from $10-$40 per pill, and insurance may or may not reduce the cost. For that reason I would not expect anyone to eat them like candy, but my doctor tells me that some people take them daily to prevent migraines (against his recommendation). I have found it better to try to prevent migraines from happening by avoiding foods that have tyramine, and in the event I do get a migraine, I take Triptans at the fist sign of onset (usually a sharp headache on one side of my head behind either eye).


Again, everything you are saying is fair based on your own experiences. I don't claim to be an expert, but I just think you are underestimating the instances of side effects though. And while I don't want to post any info on effectiveness because I don't know any (and again, they work for me), I think over estimating the effectiveness on a wide group. I will leave it up to other forum members with more knowledge on that matter though (like the poster above) to discuss that issue. I will only speak to side effects. I have had migraines since I was 7 and I am 36 now. I have seen numerous specialists in that time, and have been told by all of them that the side effects I experience are quite common. I have been told the same by my GP's and emergency room doctors. So you are posting advice for the OP based on your experiences, but the rest of us are simply posting a word of caution based on our own experiences. I don't think anyone said not to at least try them out. Just to prepare for either scenario or something in between.

tdu

Posts : 176
Join date : 2009-12-27

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  ZomigMan Mon Jun 18, 2012 2:46 pm

Well, at least someone is posting studies to debate the studies that I posted. So one would conclude after reading them that Triptans are effective in a smaller population than the original published results. However, it is hard to say what the actual effectiveness is by this contrast in results published. Somewhere between 30% and 80% effective, depending on where you look (the average of which is still 50%). Or Triptans are becoming less effective over time, or as they are used in a wider population. As for migraine diagnosis that is another huge issue in this process, as some people seem to have other types of headaches. My migraines were mis-diagnosed until I was in my mid 40s. I guess as Triptans are effective for getting rid of my headaches, my headaches are properly diagnosed as migraines? TOC here... I read that cluster headaches may also be treated with Triptans (though I think that migraines are being mis-diadnosed as cluster headaches). After being admitted to emergency room situations on several occasions, I have a rather low regard for emergency room doctors. I am also on the local ski patrol, and I see a lot of cases in the first aid room myself. My father was also a mal-practice lawyer, so I read a lot of medical cases from the age of 12. But putting all that aside...

I am still inclined to think that when people are happy with a med for migraines, they are less apt to post online in forums like these. It seems that forums like this one wind up with more people who are not responsive to available meds. That is my narrow view anyway. Also from my many discussions on migraines and Rx drugs used to treat them with my rather prominant neurologost/psychiatrist (double specialist) at Stanford Medical Center, Triptans are effective in his cases the majority of the time. If anything, he believes that his patients tend to over-medicate using them and rely on them more than trying to avoid migraine triggers. Some even take them as preventatives, before eating or being exposed to whatever triggers their migraines. He says that a lot of his patients cannot always get Zomig scripts filled when pharmacies run out, as has been my experience. So a heck of a lot of people are taking Triptans out there. My feedback and that from my neuro doctor anyway. Also it seems to me that most people on this forum use Triptans of some type or other, even the ones that say they are not effective, or if they have extreme reactions to taking them. tongue

So to put things into my personal perspective, Triptans are VERY effective for my migraines (as well as for others in my family). I had a migraine this morning and I took a Zomig an hour ago and it is fading away now... all but gone. No real side effects that I can tell. I get few rebound headaches after taking Zomig. As I have posted before, my migraines are generally triggered by amines like tyramine. Supposedly about 30% of migraines are triggered in this way. More are being triggered this way as the result of people being put on MAOIs, so the percentage of this type of migraine is actually growing. I have yet to find a study that separates out the triggers for migraines and the effectiveness of Triptans. I am also a male, and most people that get migraine are females. Maybe there is some significant aspect to that as well, I do not know. In doing research on my migraines, I have come to believe that my migraines are but one symptom of a rather complex process of digestion of food intake and the resulting amines in the bloodstream. Typically MAO-A in the gut would process amines like tyramine before they get to the blood vessels to cause vaso-constriction, and the resulting vaso-dialation and migraines. Tyramine causes a spike in blood pressure by constricinting blood vessels. People on MAOIs have to be carefull about eating tyramine or they may get a huge blood pressure spike that can cause a stroke or heat failure. They are also likely to get migraines from eating tyramine rich foods.

So perhaps we need to sort ourselves out here. There seems to be wide variation in types of migraine triggers, types of migraines experienced, and types of Rx drugs that are effective for them. Finding your type and triggers are critical. Avoiding the triggers after finding them is also critical (though not always possible). Having them diagnosed properly, and then figuring out what drugs may be effective for treating them is also critical. All of these would be effective methods for answering the OP here... I am not trying to beat a dead horse, the horse is alive and well, and people need some type of reasonable answer in their quest for treatment of this horrible 'disease'.
ZomigMan
ZomigMan

Posts : 83
Join date : 2012-05-24
Location : PNW

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  charmed quark Mon Jun 18, 2012 3:29 pm

I think you are right, there is a bit of a filter here, we are seeing the more extreme end of migraines.

I think most of the people here are here because their migraines are or were causing a significant impact on their lives.

But many still post after they find a good solution to their migraines. Sort of like veterans who get together to talk about the war, because nobody else could understand what it was like to be there.

I'm the latter. For about 10 years my migraines were destroying my life. Believe me, I avoided every possible trigger. I went on an elimination diet that took a good 6 months to really work through. In my case, elimination of triggers was some help but did not really resolve the problem.

Since I've been on good preventatives, my migraines are normally just a nuisance, only flaring up every now and then. I don't worry about triggers anymore, either.

But I still enjoy touching base here now and then, especially when I'm having a flare up.

charmed quark

Posts : 273
Join date : 2009-12-23

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  tdu Mon Jun 18, 2012 3:44 pm

charmed quark wrote:I think you are right, there is a bit of a filter here, we are seeing the more extreme end of migraines.

I think most of the people here are here because their migraines are or were causing a significant impact on their lives.

But many still post after they find a good solution to their migraines. Sort of like veterans who get together to talk about the war, because nobody else could understand what it was like to be there.

I'm the latter. For about 10 years my migraines were destroying my life. Believe me, I avoided every possible trigger. I went on an elimination diet that took a good 6 months to really work through. In my case, elimination of triggers was some help but did not really resolve the problem.

Since I've been on good preventatives, my migraines are normally just a nuisance, only flaring up every now and then. I don't worry about triggers anymore, either.

But I still enjoy touching base here now and then, especially when I'm having a flare up.

My story echos yours. In 30 years of dealing with migraines, and seeing specialists, doctor's naturopaths, and everything else under the sun I have addressed every trigger from every angle possible. I have done every elimination diet possible as well. I agree with Zomigman 100% about triggers, the hard part is a lot of us have multiple triggers, and it does not matter how much we adapt our lifestyle to counter them, we will still get migraines. And for a lot of us unfortunately working most types of jobs can be a trigger or there are triggers at the work place. Preventatives have been the only feasible option for me. Taking Triptans and narcotics multiple times a week while at work just does not mesh with a lot of people or a lot of jobs if they experience even mild side effects from the drugs. If you are one of the unlucky ones with severe side effects, it's completely out of the question.

I tried several preventative options in the past that just did not work for me and was turned off trying them. I had a serious rash of migraines though where my work was really affected so I decided to give it another shot. I ended up finding one that seems to work with few side effects (or has for the last while anyway). Not missing a day of work for 2 months, and not being dopey from meds at work has been such a load off my shoulders.

But, our own experiences and opinons aside, the original poster obviously has to try everything and see what works. The Triptans exist for a reason, so I wasn't suggesting he doesn't try them first. I was only suggesting he may also went to consider seeing a specialist as well as a backup plan in case he can't manage his work situation with the Triptans, or can't manage the side effects. If he's really worried about the work situation, he should have multiple options ready to pursue.

tdu

Posts : 176
Join date : 2009-12-27

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  ZomigMan Tue Jun 19, 2012 5:14 pm

A question to the last two that posted on this thread: what preventatives are you taking?

ZomigMan
ZomigMan

Posts : 83
Join date : 2012-05-24
Location : PNW

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  tdu Tue Jun 19, 2012 5:55 pm

ZomigMan wrote:A question to the last two that posted on this thread: what preventatives are you taking?


I am on Topamax. Currently on 50 mg, and having no limiting side effects. I get a bit of anxiety at times, and my memory can be a bit cloudy. Taking it at night, I am generally ok during the day. I don't know if I will stay on this dose, or if it will be increased. I guess it depends on if I keep having these results.

I'd have to take multiple doses of Triptans for really severe migraines over 2-3 day periods, and on top of the side effects listed I would get a horrible 'hangover' effect from them. So the mild side effects I am getting from the Topamax don't even compare to that. But, other people have nasty side effects from it. So it's the same deal, you only know by trying.

tdu

Posts : 176
Join date : 2009-12-27

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  Migrainegirl Tue Jun 19, 2012 6:00 pm

I've had to give up all the preventatives I've tried due to weird side effects.
I am taking vitamins and supplements which have helped me more.

On the positive side I have not had side effects from Triptans. Just 2 I tried were not effective. Frova works about half the time but I need to take Oxycodone with it.
Migrainegirl
Migrainegirl

Posts : 999
Join date : 2010-07-19

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  ZomigMan Tue Jun 19, 2012 10:17 pm

Oxy... just FYI, I was reading a study published in the journal Headache that found that migraine sufferers who use opiates and barbiturates, including butalbital, codeine, and oxycodone to treat their migraines are actually at higher risk for developing chronic migraine (having migraines 15 or more days per month).

I was given an Rx for butalbital for cluster headaches (mis-diagnosed) many years ago and they made me downright suicidal. I tossed them out in a hurry. I also found that I got migraines after being given morpheme and dilaudid when I was in the hospital with a colon attack 2 years ago. I was being fed intravenously with no food for 3 days, so it was not any food that I ate.
ZomigMan
ZomigMan

Posts : 83
Join date : 2012-05-24
Location : PNW

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  Migrainegirl Tue Jun 19, 2012 11:24 pm

Yes, a number of doctors are down on opiates these days. But honestly it is the ONLY thing that gives me any pain relief. I use a low dosage. And we have ruled out migraine rebound. I get them whether I have had any Oxy or not. The only thing cutting out the Oxy did for me was create a lot more days of being miserable and non- functioning. I honestly would be prematurely retired without it as I would be unable to work even at the level I currently am ( which is no where near 100%).

As with everything it seems, we all react different. I am very worried about this latest no-pain reliever trend. It will take a lot more even further ruined lives before they figure out that's not really helping people either. If they can't fix this nightmare, the least they can do is to provide some relief so we can have some semblance if a life!! (sorry, sore subject)


Last edited by Migrainegirl on Thu Jun 21, 2012 7:00 pm; edited 1 time in total
Migrainegirl
Migrainegirl

Posts : 999
Join date : 2010-07-19

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  tdu Thu Jun 21, 2012 4:33 pm

Migrainegirl wrote:Yes, a number of doctors are down on opiates these days. But honestly it is the ONLY thing that gives me any pain relief. I use a low dosage. And we have ruled out migraine rebound. I get them whether I have had any Oxy or not. The only thing cutting out the Oxy did for me was create a lot more days of being miserable and non- functioning. I honestly would be prematurely retired without it as I would be unable to work even at the level I currently am ( which is no where near 100%).

As with everything it seems, we all react different. I am very worried about this latest no-pain reliever trend. It will take a lot more even further ruined lives before they figure out that's not really helping people either. If they can't fix this nightmare, the least they can do is to provide some relief do we can have some semblance if a life!! (sorry, sore subject)

Oxy has also been very effective for me if taken at the right time. I have never had to increase the dose I have had to take of it, and I am very careful not to abuse it. It's the one failsafe drug I have that can 'get me through' a days work if I have to take something to plow through. I get minimal side effects, and 4-5 hours of relief probably 80% of the time. I don't even get close to that with Triptans unfortunately, and I get intolerable side effects with them as far as working. Luckily my Dr knows my history, knows how little of them I use, and is very understanding. But I get the third degree every time I pick up a prescription from the pharmacy because of the stigma these meds have now. But I am not exaggerating when I say Percocet is probably the reason I have been able to keep a job for the last 8 years. Every treatment is going to be different for every person.

tdu

Posts : 176
Join date : 2009-12-27

Back to top Go down

Work and migraines.. - Page 2 Empty Re: Work and migraines..

Post  Sponsored content


Sponsored content


Back to top Go down

Page 1 of 2 1, 2  Next

Back to top

- Similar topics

 
Permissions in this forum:
You cannot reply to topics in this forum