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Posts Tagged ‘Migraine medication’

Migraines & Driving & Driving Migraineurs Crazy

September 30th, 2009

I may have mentioned that lately I have been writing articles for Health Central’s My Migraine Connection on legal topics related to Migraine, as well as answering some of the questions that readers ask on the site. A reader came on recently and reported that her driving privileges had come under supervision by her state’s Motor Vehicle Commission (MVC) because she had self-reported that she had frequent Migraines. The MVC was considering whether to suspend her license. She was asking what to do. This sounded like a nightmare to me; I was really distressed for her, so I did some research. In the first place I discovered, not too surprisingly, that her state’s MVC had broad powers to supervise, suspend, retest or otherwise question the driving of anyone they suspected might have any kind of medical condition that could make them an unsafe driver. Researching further, I learned that just about every state has given similar powers to its MVC.

My suggestion was that she get a statement from her doctor that she knows the signs of a Migraine and does not drive when she has one, and that she consult an attorney. She came back later and reported that her MVC had taken her medical documentation, made her retake the road test, but that they had not suspended or restricted her license.

I did some more research and wrote two articles based on it, one called Migraines and Driving Don’t Mix – reviewing cases which have found people driving under the influence of pain killers (legally prescribed for Migraines) to be DUI, and other cases which found people driving with a Migraine (not with medications) were not DUI. I did stress that Migraines themselves impair us – they slow our reflexes and reaction time, interfere with cognitive function, aura obscures our vision, the pain and nausea distract us. I even went so far as to say I wouldn’t be surprised to see a case somewhere in the future where someone had a Migraine, caused an accident, hurt someone, and was held liable or criminally responsible.

In the second article, called Migraines and Our Drivers License, I reviewed the Motor Vehicle laws which set up medical review of driving privileges, trying to make people aware that we could have our licenses reviewed or suspended if Migraines impact our driving and the MVC finds out about it!

It’s been an interesting few weeks for me on the inter-tubes – I did not make myself very popular with some Migraineurs over all this! One group of readers thought I was being condescending. On one site someone ranted about how if cell-phone talking, lane-changing speeding morons should be allowed to drive, why should Migraineurs be singled out? I was called “militant” and I’m not some people’s favorite person. Several people asked me to tell them how they are supposed to get to work, function, etc…

I think I learned a lesson about my writing style, and I’m going to do my best to be more chatty and down to earth when I’m delivering hard news. I think that’s what this was – a case of kill the messenger. I’m not the Migraines & driving police (or the anything police, for that matter). We’re all going to have to use our own judgment. I just thought it was important for people to know 1) that Migraines impair us, sometimes even when we don’t feel like they do; 2) that people have been convicted of DUI even taking legally prescribed medications; and 3) that right or wrong, our condition is being scrutinized by Motor Vehicle Commissions.

Last night I dropped my son at his music lesson and went to the supermarket. Near the end of my time in the market I was very hungry and jittery, and I started to get sensitive to light, an early warning sign for me of a Migraine coming. My son was across a divided highway from me, needing to be picked up, and I had a week’s worth of groceries in a cart. So I had choices to make. I could have called my husband, and he could have come and got our son, me and the groceries. I decided to eat something and see if raising my blood sugar would hold the Migraine off. So I went through the checkout line and sat in the car eating for a while. I felt less jittery and better right away, and I made the judgment call that the Migraine was not going to hit full force in the 15 minutes it would take to get home. I picked up my son, drove home, and all was well.

Was that the right thing to do? Was I putting convenience ahead of safety? Was I being a hypocrite in light of the articles I just wrote and the position I’ve been taking? We have to make judgment calls every day with this disease. If my head had been hurting, if I was getting dizzy or confused, I would not have driven. I have called for rides, or pulled over to the side of the road in those situations before. I always try to err on the side of caution. Several people have left comments since I wrote the articles, about family members who were badly hurt driving with a Migraine.

All I’m asking is that we take this seriously, that we plan ahead, have a back-up plan, and take ourselves off the roads before we endanger ourselves and others. And I know it’s not fair, that there are lots of morons on the road who shouldn’t be driving, and all of that. It’s a very uncomfortable subject – it challenges our independence. I know. Sorry. I’m not trying to drive you crazy. Please don’t kill the messenger!

– Megan

Rearview mirror image courtesy of Dean Shareski; Steering wheel image courtesy of Tomas Fano.

Tags: driving, DUI, migraine, Migraine medication
Posted in Communicating, Current Affairs, Managing, Travel | Comments (16)

Pills, Nasal Sprays, Injections, and Now a Patch?

February 27th, 2009

A clinical trial was begun this past fall, of sumatriptan delivered by transdermal patch.  Sumatriptan, the first to be developed of the triptan drugs, is a Migraine abortive, which acts directly on the trigeminal nerve to abort a Migraine attack in progress.  It was available only as the brand-name, Imitrex, until the past couple of months when the pills and the injectable form came off patent and were approved as generics.  Triptans can be taken by about three quarters of Migraineurs and are effective in aborting a Migraine, if taken early enough, roughly three-quarters of the time.

Regarding the patch, I think it’s a good idea. The injections work better than the pills for most people, me included. Bypassing the digestive system seems to limit side-effects, especially nausea, and personally I’d love to have the faster absorption like the injections without the major ouch of giving myself a shot! That said, I imagine the manufacturer is happy to have something they can patent and charge top dollar for, now that the pills and injections are out in generic. Call me cynical… but only partly!

I have to applaud every advance in Migraine treatment, small though it may be. And though you may call me a broken record, I am still your fired up advocate here and want to point out that we have had no new medications developed for Migraine, other than the triptans, in the past 15 years. So a little yay for another way to deliver triptans.

A way bigger yahoo! would be for more effective abortives, that could be taken by people with heart conditions, AND for effective preventives without hideous side effects that are actually developed for Migraine disease, not hand-me-downs from other diseases. Call me crazy? Well, a girl can dream!

– Megan

Patchwork quilt image courtesy of LePetitPoulailler.

Tags: imitrex, Migraine abortive medication, Migraine medication, Migraine preventive medication, sumatriptan, transdermal patch
Posted in Advocacy, Medicine | Comments (0)