Migraines in-flight?
 

I can't think of anywhere else to put this thread.

Does anyone here suffer from migraines? Has anyone ever had to deal with one in-flight? What do you do?

This Thursday, I was returning from AMS to SFO on KLM. I was in business class, and enjoying the very good KLM service when, about half-way through the 11 hour+ flight, I developed a really bad migraine -- a classic, with all of the symptioms: aura, nausea, sensitivity to light, sound and smell and, of course, a splitting half-hemisphere headache. Fortunately, I had Imitrex with me, and shot up in the lav. I also took as many pain killers as I dared. The result of the self-medication was that, after an hour or two, the pain lessened enough to the point that I could sit down -- before that, I stood in a little corridor between the two J compartments with my head against the wall. The rest of the flight was merely miserable, though I did manage to nod off for half-an-hour or so.

Ugh. Not fun! And only the second time I've experienced this while in-flight.

So how do you migraine sufferers cope when this happens to you?

Glad you had some meds with you...! :(

I've had a couple of migraine sufferers as passengers. Such a terrible thing to experience during a flight, close confines, no real control over the environment.

With one woman, we made her as comfy as possible inside one of the lavatories. Fortunately it was non-stinky that day, but she couldn't lock the door without turning on the lights - so we FA's took turns watching it and redirecting passengers. The quiet(er) dark and air from the vent helped her a bit. With another passenger, I found some stray blankets and helped him make a sort of tent over his seat to block out the light as best we could. He had less fresh air though, but he needed to get out of the light more than anything.

I'd love to hear other ideas, though, on how you guys deal with this - I hate feeling so helpless when I have a passenger dealing with it.

My wife gets migraines, and Imitrex has been a big help. Have you read the instructions for Imitrex carefully? Our understanding is that if the first injection does not help enough that you can take a second injection an hour after the first. Then, no more for 24 hours.

There have been a number of cases for her where the first injection helped only a moderate amount and the second pretty much made things quite bearable. Check with your doctor about the possibility of the second injection, if the first one doesn't help as much as necessary.

Also, she has found that a drug originally designed for epilepsy called Topamax can be taken as a preventive, Again, check with your doctor, as taking Topamax on a regular basis has served to significantly lessen the frequency and severity of migraines for many people.

I don't think I could have handled the blankets, but the dark lav would have worked well. I'll keep that in mind, though I hope this doesn't happen to me again. May I ask which airline you work for? FAs as considerate as that would definitely influence my selection of carrier. :)

I've been taking Imitrex so long, I've forgotten the protocol, except that I can't take it more than once every 24 hours. I'll check with my MD and ask about a second shot in an hour. I tend to experience rather unpleasant side-effects from Imitrex -- it feels like every muscle in my neck and back are contracting, and lasts for about 10 minutes. It's a measure of how bad the migraine is that I'm willing to take an Imitrex shot at all.

I've been lucky in that my blood pressure medication is prophylactic for migraine, and simply growing older means I get them less and less. For some reason, though, this has been a bad year.

Most important thing - carry your meds, and take them as soon as you get symptoms. The earlier the better. If you can't remember how to use them, make sure you get a refresher course.

There are a lot of preventive migraine medications. Like everything else, which one is chosen is personalized. Don't take one over another just because it is recommended on a public internet board!

I'm fortunate in that the Imitrex tables work for me; they are easier to travel with. They normally work within about 20 minutes or so.

Me too. Also, at the first sign of any headache I take the Imitrex... since any headache I get can flip over into a migraine at any moment. And changes in barometric pressure are often the culprit.

The biggest problem I have is that I get so many migraines that the monthly 9 pak is not enough. For a long time my doctor ordered 18 for me per month, which was about enough. But then the lovely insurance company refused to pay for the 18.

So, the workaround was for my doctor to prescribe 9 of the 100 mg tablets, which I cut in half.

Isn't it crazy that we have to fight the almighty insurance company to get relief?
Rita

The only time I developed migraines was from a BA flight couple of years back when a 4-year old toddler sitting next to me screamed the lights out of my eardrums.

As for coping with migraines.....this may sound silly but Tylenol works well with me!! :)

As a fellow migraineur, I can sympathize. My worst was leaving IAD with migraine for a 24 hour extravaganza to ORD-NRT-HKG-SIN. My thoughts while getting on the plane were NOT good. Fortunately I had 2 days to recover before I started my presentations.

If not for the post-9/11 situation, I would suggest bringing on a machete and just cut your head off -- I am kidding of course, but as you can probably attest, by only a little. I have times where I've wanted to do that.

More practically --
When travelling, I would be sure to have several different ways to attack the migraine. Of course, discuss with your primary doc or neurologist.

1 If Imitrex has not helped you, then consider switching to another in the same class of medication. Some people have different responses to different ones, even though they are chemically very similar. If you get the migraines often enough, ask for a different one (Relpak, etc) and try before a long trip.

2. If you can take narcotics, I would ask for Tylenol #3 or Vicodin to keep in reserve (whatever works and you can tolerate).

3. I have also found that naproxen (Alleve) sometimes work -- it is not FDA approved for migraines, but it has been prescribed often for migraines. The usual dose is equivalent to 2.5 - 3 tablets of Alleve 2x/day. (If you are sensitive to these pain meds, take with some antacid like Maalox).

3. And also ask for as sleeping med -- sometimes just getting knocked out is the only way to let it resolve.

4. Finally, I have found that sometimes an icepak numbs up my face enough to keep the pain to a minimum until something kicks in. Carry a small icebag with you and the FA's will be happy to keep it filled with ice.

Good luck, "I share your pain"

--- Oh, and don't forget a good pair of eyeshades and earplugs.

A friend gave me a padded eyeshade (almost like a little pillow) that is filled with some aromatherapy beeds that are supposed to help with headaches. At first I said -- NO WAY -- since most odors and scents make the headache worse. But sometimes I do think it helps a bit.

Similarly, rosemary oil rubbed on the temples is reported to help. Same friend gave me a bottle from Bath & Body Works (I think). Once again, I am not really sure it makes a different. But when you are in the throes of a major migraine , you'll try anything.

And don't you hate how the littlest scent will make things worse. Note to all travellers: do NOT wear cologne.

I seem to get a lot of migraines when and after I fly. I've discussed this with a neurologist, and he agreed that the pressure changes due to flying can be a trigger for migraines.

I often rely on nasal spray administered medications when I fly. I don't want the hassle of carrying needles onboard with me, and many times I can't keep anything down with the nausea. The drawback is that I sometimes lose some of the liquid when I open the container to affix the nozzle to the bottle. The pressure change inside the bottle actually causes the medicine to jump out of the container when the top is removed. I literally feel like the same thing happens behind my eye.

I'm wondering if anyone else has noticed a correlation between migraines and flying.

I once had an awful migraine on a flight from GRU to EWR. This was one of my once-a-year, knock-down types that totally sidelined me. It hit around hour 3 of the 10-hour flight. Fortunately, I was in biz class and had room to stretch out; I also had a window seat so I could kind of turn toward the wall. I put on the sleeping mask that CO gives out in the amenities kit. I also travel with a pair of noise-cancelling headphones, which I put on without plugging into the IFE. I tried to lie very still and do some tan jun breathing; all of these things usually get me into a state of near-sleep that helps the migraine tremendously. This time it didn't work, however. I also travel with a prescription for Xanax (alprazolam). I took one of those, and after about an hour of lying there quietly suffering, I more or less fell asleep. I woke up in about 2 hours with the migraine mostly gone. After a Coke and an extra ice cream sundae (thanks, CO flight attendants - you're the best!), the migraine was a memory. Maybe some of those things will help you in the future.

Just have someone else smell-test the lav first! I have a feeling that dank musky thing would be the last thing someone with a migraine needs to catch a whiff of!

I think there are considerate people in every airline...but you're welcome to fly with me anytime (on CO). ;)

I also suffer from migraines. I find that sinus problems will trigger migraines just about as fast as cabin pressure - or maybe they're related.

I usually take Sudafed before and during any flight longer than 3 hours, and I've found that it seems to help tremendously in preventing the migraines.

And I don't do ice packs, I prefer the opposite - moist heat. A ziplock baggie with hot water across my face can relax me in a heartbeat.

Another trick is to put my head completely under a blanket, just as another passenger did. It has been suggested that reducing oxygen intake will force your constricted vessels to open up, thereby helping to relieve your headache. It seems to help with me.

Caffeine can also help, if you can tolerate it. Try drinking a cup of coffee. If you can't keep it down, sipping a Coke might be better.

I was diagnosed with migraines at the tender age of five, long before there were meds that were appropriate for me. So I learned all the little non-medicated tricks at an early age...