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Old 01-02-2012, 07:06 AM   #1
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Employment and Migraines

I wonder if anyone has had to take early retirement, or applied for disability due to migraine headaches. I'm afraid that going into my 6th year working with migraines, I don't know if I can coninue working 40 hours.

My migraines are once again returning, so I will consult my neurologist about a plan, possibly increasing my Topamax dosage again. I am currently taking 200 mg each night at bedtime, but am waking up more frequently with a migraine, and it is lasting for days as it did at onset 6 years ago.

I am permitted to take the name brand, and have never tried the generic, but I understand that the name brand for me is about $600 per month for the insurance company.

Does anyone take the generic of Topamax? Does it work well?

 
Old 01-04-2012, 01:47 PM   #2
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Re: Employment and Migraines

I considered taking disability time when I was struggling with head issues. I get migraines, but over the past year I developed some neck problems (still figuring them out) that were causing other kinds of head pains. I was seeing a physical therapist who told me I shouldn't ever work overtime and that I need my rest, but of course work can be pretty demanding at times. They also said I should lay down for about 30 minutes a couple of times per day. I talked to my employer about all of this and they arranged for a soft bench in a room where I could lay down. I used this as needed and didn't need to take any disability time. I did always have the fear of having too many instances of sick days, since my workplace has a rule about instances of sick times rather than the total number of days. I'm always right on the borderline, but I imagine I would just need to talk to HR if that were an issue.

I noticed that topamax was very expensive at full price. I saw it was over $800 per month full price last I checked. Unfortunately I wasn't able to try either the name brand or generic since I was worried it would affect my birth control pill. My BC pill is actually my main way of preventing migraines. My menstrual migraines were my most severe and always resulted in sick days, so I now control my cycle where I only go through those times 4x per year. What a difference with less migraines! I've been working on "untraditional" ways of preventing these migraines or keeping the severity down. Although they aren't tension headaches, my doctor suggested trying muscle relaxers and xanax (also to help my neck as well). The muscle relaxers didn't work at all for me but the xanax actually has helped some.

I wish you the best of luck with finding something that works better to keep your migraine frequency less. It is awful having to deal with them so often. When you mentioned early retirement, I'm not sure how early it would be for you, but that's definitely a big decision. I felt emotional even about the disability time because I felt like the migraines would be taking over even more of my life, since they had already taken over other areas. I hope you are able to not have to deal with either, but perhaps if so, you can start with some disability time first to see if that is enough, then go from there. Also, other than a higher copay, is there any other penalty for you to continue with name brand topamax? I've heard mixed things about generics, but plenty of good things out there.

 
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Old 01-04-2012, 02:04 PM   #3
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Re: Employment and Migraines

I do have neck issues, also, but my neruologist says the neck and migraines are not related. I have muscle relaxers for my lower back that I need sometimes after working on my floors at home.

I am able to get the name brand Topamax, no problem, but I think my husband's company (he is the owner) has had to change insurance due to the increase in premiums, and I thought I could help by taking the generic, although I would rather continue with the name brand.

I take Lexapro already, and have been taking it for as long as I have been taking the Topamax. I don't lose time from work for the headaches, even though the headaches seem to last as long as they originally did prior to the Topamax. For me, it seems as though the Topamax works for a while when the dosage is increased, then the headaches "break thru" once again.

I'll ask my neurologist about xanax when I see him for a regular appointment in February. By the way, my migraines started right about the time that I had my last period. I'll be leaving my job in 2013, at which time I'll be only 57 years old.

Thank you for sharing your information. I also hope you are able to have more migraine-free days.

 
Old 01-04-2012, 07:25 PM   #4
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Re: Employment and Migraines

Hi CaringWmn,

I have taken name brand Topamax and am currently taking the generic version. I cannot tell the difference and have not experienced any more migraines since the switch. I immediately started getting the generic version once it became available since it saves me significantly/month. I also take Corgard which is a beta blocker and my migraines decreased from 3-5/month to 1 to 2 every several months with this combination. I do notice that I have fewer migraines when I take the Topamax/beta blocker combination than if I just take Topamax solely.

If you've been at your job at least 12 months consecutively (and a certain number of hours, so I think that you must be full-time or the consecutive time will need to be longer) then you could file for FMLA. Of course you would need to get a medical professional to sign off on it, HR involved, etc but the FMLA documentation would then protect you at work for any migraine related absences. I don't currently have a 'regular' neurologist at the moment, but it is something that I plan looking into since I've had issues with migraine absences in the past. Although they've gotten a lot better because of the preventative medications that I take, I think it would ease my mind a lot to have that FMLA protection. Just something that you could look up.

Hope you feel better soon!

 
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Old 01-05-2012, 07:20 AM   #5
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Re: Employment and Migraines

Yes, I am with my boss for going on 31 years now. He is aware of the problem with my migraines. I am trying to work with my neurologist to keep them in check. I will also mention to him about your experience with Corgard and find out what his response is to the combination.

I'm relieved to know you have no issues with taking the generic brand of Topamax. I would like to try it, with the beginning of this new insurance company in an effort to keep the premiums at a minimum. I can then report back to this forum my own experience with the generic Topamax.

I don't recall that I've had more than a few days off due to my migraines, but I have worked with them. The type I have are that they are constant. The Topamax keeps them away somehow. I don't have sensitivity to light or nausea, which is what people usually relate to migraines. I have pain from my left temple, along the left side of my head to the back of my head, all the time when the Topamax doesn't work.

Just a month ago, my neurologist wrote a prescription for compounded Midrin to take when I have a "breakthru" migraine that tends to last a while.

In February, I will ask if he can increase my Topamax dose so I can have the relief from the constant migraine once again.

I appreciate any information, advice or personal experience from the forum, since I will be having a scheduled appointment in February.

 
Old 01-08-2012, 08:14 AM   #6
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Re: Employment and Migraines

Hi there,

That's good that you've been with the same employer for so long and your boss is understanding of your migraines.

As far as the Corgard, it does not need to be that medication specifically, but you could just ask your neuro about a beta blocker in general. I had a neuro in the past who firmly believed that Topamax was more effective when taken in unison with a beta blocker (I believe that there are a few commonly used as a migraine preventative). In my case, this just happened to be true.

I think that you should be just fine with the generic Topamax. Just try to stay positive about it and not worry about the generic being any different. Sometimes I feel like migraineurs can stress so much about something, I often wonder if we cause migraines because of the anxiety over the actual supposed 'trigger'. I have found that I have done this several times, gotten worked up over things (which sometimes you can't control).

I have to say that I LOVE Midrin! I have never had much luck with any of the triptan abortives and a neuro prescribed Midrin because of this several years ago. It aborts probably 90% of my migraines...I was heartbroken when it was taken off the market. But I am currently trying to get a prescription for the compounded Midrin version since I am so happy with it! I hope that it gives you the same results.

One last bit of info that I have received from a neuro that is helpful for me, I take the Topamax split up in two different doses each day. I take 100mg daily so I take 50 in the morning and 50 at night. The neuro explained that this would be more effective because the half-life of Topamax is not a full day so if you take it twice a day, you will get a more even dosage during the day and night.

 
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Old 01-09-2012, 06:48 AM   #7
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Re: Employment and Migraines

Oh, maiyen, you have provided GREAT information and advice! This is going to be so helpful to me! I will try the Topamax generic, speak to my neuro about a beta blocker and also split up my 2 - 100 mg Topamax tablets during the day instead of taking both before I go to bed!

I am willing to bet that I will notice a difference! Thank you!

Edited to add: I am happy to hear how much you like the Midrin. I have been skeptical about taking it, but now am anxious to try it.

Last edited by CaringWmn; 01-09-2012 at 06:49 AM.

 
Old 01-09-2012, 05:22 PM   #8
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Re: Employment and Migraines

You might want to ask your neuro before splitting up the Topamax dosage just to make he/she agrees. I don't want to advise anything against your neuro's orders

Hope that some of this works out for you!

 
Old 01-10-2012, 07:52 AM   #9
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Re: Employment and Migraines

Thank you, maiyen. I will follow your advice. I don't recall that my neuro gave the advice to take both tablets at bedtime. When I ask for refills, the secretary asks me how I take them so she can call in the prescription to the pharmacy.

I actually began taking them at bedtime in case they made me sleepy during the daytime.

I had started with one neuro, then changed when I had a very long wait in the waiting room. I get in right away with the neuro I am going to now. With the first neuro, I had the option of when to take the Topamax.

However, I will consult about the times of day when I take the Topamax.

I almost began taking them separately last night, but I might do that tomorrow. I want to find out if I feel sleepy during the day, and just give it a try to see if I feel differently. Then I can ask my neuro if he agrees with what I am doing. I have an appt. in February.

Even today, I have a dull headache lurking.

 
Old 01-10-2012, 01:01 PM   #10
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Re: Employment and Migraines

I've taken Midrin for my migraines, but it hasn't worked too well. Same with Xanax and Topamax.

I'm on Lamictal right now, and it's been the only medication that's worked long-term. I tried 6 others when I was younger, and man did that suck.

Good luck! It sounds like you'll be finding your solution for migraines! And congrats on keeping up with your job for so long, that's so great to hear.

 
Old 01-12-2012, 07:05 AM   #11
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Re: Employment and Migraines

Thank you, Sachimi. I will jot down Lamictal on my appt. reminder so I can mention it to my neuro next month. I want to go in with information to discuss. I have appointments every 6 months, so it's a long time in between when I forget to ask about something.

It's interesting to learn about all the migraine medications that work for different people. I'm a bit disappointed that my neuro has not mentioned anything else, so it's really great to be able to reach out thru this forum.

 
Old 01-12-2012, 07:37 AM   #12
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Re: Employment and Migraines

I'm grateful that my mother is a nurse, and my doctor is someone she worked with and is friends with. I have a second opinion from a medical professional right there. She can tell me if anything is serious or not, and sometimes suggest medications.

 
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Old 01-15-2012, 06:09 PM   #13
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Re: Employment and Migraines

Sachmini - Thanks for sharing with us about the Lamictal! It's always good to hear about things I haven't heard about so I have more ideas of what to try. I haven't found a single thing that works well alone and always have to do a "cocktail" of different things for any relief. When I had mentioned the Xanax, I definitely can't depend on that alone, but it offers a little bit of relief when combined with other pain meds, caffeine, etc. Do you feel that the Lamictal makes a significant difference on its own?

Since I've been pretty successful in getting down the number of migraines I get (due to regulating my hormones), I'm also on the hunt for a good abortive! I wonder if any of the preventive medications could possibly help the hormonal migraines as well? They seem almost in a category of their own with treatment for me.

 
Old 01-15-2012, 08:49 PM   #14
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Re: Employment and Migraines

Lamictal ( and "self-medicating" with caffeine ) has taken my migraines down from an everyday occurance to maybe one every 4-6 months. I drink a single can of Coke or Dr Pepper every day, my doctor recommended it but did not require it of course. I don't take anything else, though I'm going to see about raising my dose ( my new birth control seems to be interfering, I'm having more headaches and symptoms I'd get before a migraine ).

Lamictal ( lamotrigine ) is used off-label for migraines. It's an anti-seizure ( epilepsy ) and bipolar treatment medication, so it's not a surprise for your doctor not to mention it. I've used several that are for the treatment of migraines on-label, but they didn't seem to help. I don't have any history or family history of seizures that I know of, but this did help. I used to take Xanax occasionally for anxiety ( a nasty ex who very subtly caused me a lot of stress! ) and when I got a migraine from the stress, it helped. I also took Prozac for a while ( with a previous medication for migraines ) but that combination didn't work for me. My doctor told me that it can help in conjunction with some medications, you just have to find the right one for you.

 
Old 01-16-2012, 07:10 AM   #15
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Re: Employment and Migraines

Sachimi, this is really helpful information, and I thank you for offering it to me and others who are seeking more advice for migraines.

The Topamax was originally prescribed for anti-seizure medication. My father has been epileptic for much of his life, however he does not take topamax. My mother began getting migraines in her eye when I was a child. She suffered for a long time with hers, which would put her in bed crying for hours.

I have been taking Lexapro since about 2005 for my mood swings, prior to beginning the Topamax. The Lexapro worked instantly for me, thankfully.

My husband's company changed insurance companies this year, so I will find out if the name brand Topamax will be allowed for me. This might be the time when I will have to find out if the generic of Topamax works as well as the name brand.

 
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