September 21, 2006
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In this month's issue:
Children and migraine
Migraine and the workplace
Say what?! Generic drugs
Children and migraine
I don't know if it's on your mind, but it's on mine. If migraine is genetically based (and we believe it is), then will our children inherit the disease? Research at this point seems to demonstrate that if one parent has migraine, there's a 50% chance that the child we have it as well, even though the symptoms may not show up for years.But in some cases, the symptoms show up a lot earlier. More than half of adults with migraine report that they had their first attack before they were 15 years old. About a third of children with migraine have their first attack before the age of 5. And infants? Well, we're not sure exactly how infants understand and deal with pain, so it's difficult to know how early migraine may actually start.
How can I tell if my child has migraine? It can be tricky. I had migraine attacks earlier in life, but I had no idea what was going on. I wouldn't have used the word "headache" in most cases - I just knew generally that I was feeling sick. It may be the same for your child.
And children's symptoms may be different than typical adult symptoms. Children may have headache, and it may be one-sided, but it may also be on both sides. The more common things to look for in children are nausea, and a change in behaviour. Are they suddenly sad or angry? Do you find that it comes in patterns? Are they sick to their stomach, then tired? These may be indications that it's migraine. Also, about 25% may experience aura - usually a visual disturbance - early in the attack.
If you suspect your child may have migraine, watch closely for symptoms, and write down your observations. Then talk to your doctor, who can help confirm a diagnosis and suggest treatment.
Treating migraine in children
Of course, you should never ever just give your child your migraine medication. Some medications are used for both adults and children, but often either the doses are different or the medication has not been properly tested for child use. You may not need to use medication at all. There has been some success using biofeedback with children, for example. Children also pick up on relaxation techniques quite quickly.Treatment varies depending on what symptoms are predominant. For example, you may need to target nausea. Metoclopramide (Reglan) has been very helpful treating nausea and pain together. Or, some children have abdominal migraine, propranolol (Inderal) is a common treatment to try (in abdominal migraine there's pain in the abdomen and not the head). Propranolol is not used for children with asthma or diabetes. Ibuprofen may be used at certain dosages.
There are many other options. This article is just a quick introduction, but if you suspect your child may have migraine, you'll find some of these articles helpful:
Migraine and the workplace
Wendy Thomas, Chief Executive of The Migraine Trust in the UK, estimates that over 50% of those with migraine feel that their careers have been impacted by their migraine attacks. She also feels that things are getting worse in the workplace, not better. This is the case in many parts of the world.Migraine is often misunderstood by employers, or else there simply aren't adequate policies in place to deal with workers with migraine. Thomas says,"There are many simple steps that employers can take to help reduce the impact of migraines in the workplace - changes to lighting, VDU screens, flexible working, to name but a few."
Some policies may actually be causing a problem for migraineurs. Some places, for example, don't pay sick leave for the first two days away - a problem for those that are only sick for a day or two at a time.
If you're an employer, there is a lot you can do to keep your employees with migraine working efficiently. Some employers provide rest areas. Others have made sure that computers are properly placed, reducing glare and eyestrain problems. Others have allowed their employees more flexible working hours. If you're not a migraineur yourself, talk to your employess to get more suggestions. If you are a migraineur, you may have some suggestions for your workplace.
The Migraine Trust has Working with Migraine Pack that may help in your discussions with your employer, available for £5.
Do you have ideas about how to work with migraine? Or anything else you'd like to learn more about? Drop by the HeadWay MailRoom and enter your password - nomoache Maybe your ideas will show up in a future issue of HeadWay!
Say what?! Generic drugs
Little by little, drugs that have been used for migraine or headache are being offered in a generic form. For example, in the USA, Mylan Laboratories Inc. has just gotten approval to make a generic version of Topamax.Generic drugs are generally regulated by the government, so that they are exactly the same as the non-generic versions. They are usually quite a bit cheaper, because the company making them doesn't have to pay for the costs of developing the drug in the first place. There isn't a generic version of every drug, but it's worth asking about. For an explanation of how generic drugs work in one country, visit the American FDA's FAQ on generic drugs.