Physician with Migraines?

Started by Titus Pullo
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Titus Pullo

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10+ Year Member
This might come off a bit neurotic, but what are the implications of having migraines as a physician, specially the aura component? Those that have them no doubt know what I'm referring to, but for those that don't, it's vision similar to the after-effects of looking at a bright light, only lasting for 30-45 minutes.

Does this condition rule out certain specialties?
 
I don't think it should rule out anything.

I've got migraines without aura, and I'll be doing ortho. I just have to be super careful to avoid triggers and always have medicine with me.

This just decreases the number somewhat and makes it so I can stop it quickly.
 
I have migraines without aura as well and survived residency, fellowship and now practice by doing just as above: avoiding triggers and making sure I take medication as soon as possible when symptoms appear. I still get them but not as often as I used to.

If you don't know what the triggers are, you might consider keeping a diary to figure that out.
 
I know a guy in residency with true classic migraine. He knows how to manage them so they're pretty rare.

I think the key to surviving residency with any medical condition is to work hard and be accomdating when you are feeling well so people will acommodate you when you need it. Depending on your work ethic your colleagues may think either.

"Oh man, did you hear Titus got a migraine? I'll cover his stuff until he feels better. Poor dude"

OR

"Jeeze, Titus got another migraine? More like he's hungover. I wish I got to call in every time I get a headache"
 
Good to know ... I only get 4-5 per year, and 90% of the time they are aura without headache, so it's more of an annoyance than anything else, but I was wondering if there would be issues with procedures or if it were to get worse in the future. Given the infrequent nature and the fact that I can still read/work/etc., I've never looked into prophylaxis, but I was more curious as to whether anyone else has the same issue.
 
I had not had one in years (took prophylaxis for a year, then stopped and luckily didn't get any of my "special" migraines) until last week. I am on night float and I was signing out to the day teams when I got a field loss and scintillation. I let them know why I was a little distracted all of a sudden, and everyone was supportive. One of my seniors had to scrub out of a case this week due to the nausea associated with his migraine. It was a parathyroid, so there was no difficulty in finding someone to take over at short notice. I guess it would only be a problem if you are going to be in a position where there is no one else than can help if you can't get the job done, and it is a time sensitive thing.
 
a resident with very frequent migraines should look into suppressive therapy with beta blockers, topamax, calcium channel blockers, etc.

of course, i choose not to follow my own advice and just make sure I always ALWAYS ALWAYS have imitrex with me. When I'm in the hospital, I have a much lower threshold for taking imitrex. If it's that time of month (menstrual migraines), i will frequently drink more caffeine than normal and eat a little more than usual/more frequently which can sometimes prevent them since hunger is definitely a trigger.

know your triggers, have a low threshold for meds, and work through it if at al possible.
 
Samoa said:
Are you asking whether the field loss and scintillation of the aura are an issue? Or are you more worried about the potential loss of concentration and judgment from the pain of the migraine itself?
Click to expand...

I have the same issue with field loss caused by the aura for ~45min. Not bad enough that I wouldn't feel comfortable driving, but reading takes a bit more concentration. Would this prevent specializing in something like surgery or emergency medicine?
 
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