Attack-based Care: Responsibilities

Written by Anna Williams | April 19, 2022

Throughout our Attack-Based Care series we have looked at several different approaches to treating different migraine attacks. We started off by looking at what the “Stoplight Theory” is (how to rate our pain) and the Migraine Toolbox we need to build to better manage this disease. Then we looked at different aspects that might guide us in deciding how to treat each migraine attack focusing on timing, pain level, symptoms and triggers. Today we are going to wrap up the series by looking at the tough topic of responsibility. This asks the difficult question about what treatments are actually FEASIBLE to take based on our responsibilities during any given attack.

Self Care

Part of managing migraine is the understanding that pushing through will often lead to the worsening and lengthening of an attack. Putting off taking an abortive treatment not only affects its ability to work, but also puts you in the situation where you may need an additional dose (if possible) or you may even have to resort to stronger “rescue” medication. We need to be realistic and understand that we cannot always just drop what we are doing to take care of an attack in the way that we want – we might be at work, driving, shopping, taking care of young children, etc. However, balancing the need for self care with those responsibilities that migraine often interrupts is essential to our overall health and well-being. Learning to stop and make the best choice for our health is vitally important, but so is being responsible in how we treat any given attack. Having access to treatments we can safely use in different situations is really important.


Medications come with warnings and the potential side effects for those medications vary greatly. Some medications may simply need to be taken with food, while others limit driving for several hours. Many result in sleepiness or dizziness, and may force you to lie down and sleep. Knowing your medications, the specific warnings for those medications, and what your options are depending on your situation in any given attack, is crucial. While one attack may enable you to take a specific medication, another while you are outside the home or taking care of others might preclude that treatment! So what do you do in those situations? Thinking through the different options ahead of time, and talking to your doctor ahead of time, can help you figure out the best approach for you. Questions to ask include: What side effects do I generally experience from the medications or other treatments I use for migraine? What are the limitations and warnings for each treatment option?


1. Work

Whether you work full time, part time or as a volunteer plays a large part in how you treat an attack. Living with migraine disease can be challenging because we do not know when an attack will hit. However, knowing your work schedule, what the process is to “call out sick” from work, or just to leave early because you are having an attack, is important. Equally important is knowing how you can get home safely! Other questions include: Are you able to get away out of public view to use a nose spray or an injection? Can you use a medical device discreetly? Does your work have a room you can lie down in for a short while until your treatment starts to work? If you need to take food or caffeine with your medication, is that possible?

2. Children

Whether you have young children, teenagers, adult children or a mix, it definitely changes how you treat an attack. Each age group has different needs, and planning your treatment options accordingly is important. There are some treatment options that require planning ahead. For example, are your children at an age when another adult needs to be present with them while you treat and recover from an attack. Do you need to have a back-up plan for picking your children up from school or activities? Knowing which medications you can use and care for children safely is very important. While self-care and early treatment is often key to aborting an attack quickly, that treatment also needs to be safe. This is where it is key to talk with your doctor about side effects you experience from medications, and to ask about medical devices for migraine which don’t have the same side effects. If you can catch an attack early enough, you may even be able to lie down on the couch with your children watching a video, and use an ice hat, migraine glasses, or other OTC tools.

Let us know! What different types of responsibilities do you have which might impact how you treat your migraine attacks? Do you have a “migraine toolbox” with various options, and have you talked with your doctor about your concerns and your specific situation?

1 Comment

  1. Dabhaidh on March 9, 2024 at 1:50 pm

    Usually my migraines are visual only. I noticed the symptoms, but thought it was the end of an attack.
    So, yesterday I get to my office a bit late (after contacting my boss to explain my tardiness), and sit down to [try to] work… but my mind feels like it’s stuffed with cotton. After about a half an hour, my boss looks at me from across the table and says, “you can call out for the rest of the day, you know.” But I wanted to meet a ‘hard deadline’ for a project on Monday, so I said I’d keep working. I lasted another hour. [When you feel like you can’t remember the technical steps to do your job, you realize staying is pointless.] So I left for the rest of the day. …Visited the grocers on the way home, experiencing vertigo, nearly fell over while walking, couldn’t find things while standing there, eventually made it home. Rest of Friday was a bit of a blur, but I remember some head pain.
    I fully intended to visit work today, but there’s still a very dull headache, and I’m overly tired. Looks like I’ll go in this evening or Sunday.

    A decade ago, I only experienced visual disturbances w/o pain. My SOP was to take an hour long nap and continue on with my work (I can’t do my job if I’ve gone blind for an hour; bad idea to drive for similar reasons).

    My migraines now’re a bit more variable. I don’t know what effects will manifest, so I can’t really plan. I try to assume that they’ll just be auras, and otherwise continue with my day… unless something worrying pops up. That “Alice in Wonderland” thing sounds kind of fun, but when a mirror you know to be shaving-standard now appears human-sized, and the building fixtures look shrunken, it’s a bit off-putting.

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