Migraine in the workplace – Facebook Live

0:00 my name is dr Elizabeth Leroux and i’m a
0:02 neurologist and a headache specialist in
0:04 montreal
0:05 and i do my life and passion is to work
0:08 with people who live with headache
0:09 disorders and especially migraine
0:12 so i was fortunate enough recently to be
0:15 invited to give a talk to something
0:18 called benefits canada
0:20 benefits canada is an association that
0:22 regroups insurance companies and
0:24 employers to educate them and to provide
0:27 them information
0:29 about different workplace relevant
0:31 topics
0:32 and so um i did a one webinar in english
0:35 and one in french more than
0:38 750 people registered so that means
0:40 there were a lot of employers and
0:43 insurers on the line
0:45 and so what they wanted to know is what
0:47 is migraine
0:48 is it a real problem what is the impact
0:51 of migraine in the workplace and why
0:54 should we pay for drugs such as botox
0:56 and cgrp antibodies you know is it worth
0:59 it does it earn us anything um and it
1:02 the the webinars were extremely
1:04 successful uh in that the most attendees
1:07 actually 97 of them said that
1:10 they learned about migraine and they
1:12 were more likely to consider migraine in
1:14 their future choices so this is the type
1:17 of initiative that
1:18 pays off uh
1:20 from from migraine canada so you can we
1:22 can influence the system you know the
1:24 famous system uh that has impact on you
1:27 at the end of the day
1:28 so you know generally speaking the uh
1:32 the benefit consultants will actually
1:33 decide which drug drug plan to buy and
1:36 that this is a drug plan that you as an
1:38 employee will have all right so i hope
1:39 that’s
1:40 clear enough so i will just proceed with
1:42 questions and deliver the answers
1:45 um
1:46 so i already explained why the audience
1:48 of employers and insurers are important
1:51 obviously you know the insurance
1:54 companies provide they pay for the drugs
1:57 and then
1:58 the
1:59 the drug plans the employers of course
2:01 if they know about migraine well they
2:04 will be more likely to understand you
2:06 and to provide you workplace
2:08 accommodations that can help you to work
2:11 better even if you have migraine and of
2:14 course the employers are the clients of
2:16 the insurance companies they buy the
2:18 drug plan so we want them to know what
2:20 migraine is and to understand migraine
2:23 so one thing i covered during the
2:25 webinar was presenteeism
2:27 presentation is a you know it’s a bit of
2:30 a technical term but i’m sure if you
2:32 live with migraine and headaches you
2:33 know what that is
2:35 it is that when you have a headache or a
2:37 migraine attack and you cannot just take
2:39 off you have to go to work you go but
2:42 then you’re slowed you have nausea you
2:44 you you are sensitive to light you’re
2:46 irritable you have brain fog so
2:48 obviously your brain is not able to
2:50 deliver your best at work and so you’re
2:52 there for but you’re not fully
2:54 productive so that’s what presenteeism
2:56 is
2:57 and this is something that is studied a
2:58 lot in the workplace
3:00 uh and so we could wonder if migraine
3:02 has a significant impact and the impact
3:05 of migraine on presenteeism is massive
3:08 it is massive um there’s actually
3:10 research showing that migraine is
3:13 probably
3:14 explaining up to 16 percent of all if
3:17 you take all diseases diseases together
3:20 migraine is a very significant cause of
3:22 presenteeism and there’s
3:25 if you live with migraine and you’ve
3:26 ever worked with a migraine you you
3:28 understand this so we want employers to
3:31 be aware of this and to do something
3:33 about it because as if you if you want
3:36 to work your best you have to be well
3:37 treated for migraine
3:40 um another thing that we we questioned
3:42 was why do insurance companies have
3:44 criteria to cover things like emma vague
3:47 mgality hov and botox and soon bft or
3:51 g-pants right
3:53 well obviously an insurance company has
3:55 to make decisions they have to decide
3:56 what to pay for and they will ask you to
4:00 try things that are cheaper that may
4:02 work such as oral preventives the
4:04 pyramid propranolol and the triptyline
4:07 before they decide to cover things that
4:10 are more expensive
4:12 um so that that makes sense from a
4:14 business perspective uh from a medical
4:16 perspective sometimes we wish we could
4:18 just try you know the cgrp antibodies or
4:20 botox right away because they are more
4:23 tolerated than a lot of oral preventives
4:26 this being said as a clinician i do see
4:28 people who fare very well with oral
4:30 preventives
4:31 so we so far the idea is that you try
4:35 some oral preventives and then you have
4:37 access for coverage at least to second
4:40 line options
4:41 now some drug plans do not cover for
4:44 these options and that’s where we really
4:46 need to push to tell them that migraine
4:48 is a real problem it has an impact on
4:50 the workplace and they should be covered
4:54 one example came up as a combination of
4:56 botox and cgrp antibody taking both
4:59 together why is that not covered or
5:01 declined by many insurance companies and
5:04 the obvious answer to that is that while
5:06 it’s more expensive
5:07 and they can the argument that the
5:09 insurance companies use is that there
5:11 have been no studies right showing that
5:14 there is a benefit or that it is safe
5:16 the agreement of experts about the
5:18 combination of botox and cgrp antibodies
5:21 is that is very safe because botox does
5:24 not interact with
5:25 mostly any medication and cgrp
5:28 antibodies do not interact with oral
5:31 medications or botox or for for most
5:34 part other antibodies
5:36 so it is something that we you can
5:37 advocate for and um and we at migraine
5:40 canada we have some tools to help you do
5:42 that
5:43 um another thing that that we discussed
5:46 with the employers is that how does
5:48 migraine compare to epilepsy because
5:50 everybody i mean people who have
5:51 epilepsy are not questioned that much
5:54 you know about do they have a real
5:56 problem
5:57 and let’s go back in history just to say
5:59 that epilepsy in the past was a demonic
6:02 possession
6:03 why because there was no proof of what
6:05 it was
6:06 and then when the eegs the
6:08 electroencephalograms appeared well then
6:10 it was proven that epilepsy was a real
6:13 nerd like brain disorder
6:15 and so nobody doubted it anymore and
6:17 then tons of research happened and it
6:19 was treated and so now epilepsy has a
6:22 very different flavor than a demonic
6:24 possession it is a true neurological
6:26 disease
6:27 the same is happening for migraine but
6:29 we do not yet have a proof like a blood
6:32 test or an mri or a ct scan that we can
6:35 use in clinic to prove that you have
6:38 migraine we have such tools in the
6:40 research
6:41 world but not in the clinical world
6:44 so i think that’s one of the reasons why
6:46 migraine is still stigmatized but it’s
6:49 improving
6:50 now let’s get to the meat of it okay so
6:52 what migraine canada is doing to um
6:55 improve how you can be live with
6:58 migraine in the workplace you know what
7:00 what did we tell employers to do
7:03 and if you have ideas we’d love to hear
7:05 from you okay so here are some ideas
7:08 so we would love to have a program uh to
7:10 propose to employers
7:12 so they can
7:14 just educate their hr people human
7:16 resources people and employees at large
7:19 about migraine so people understand what
7:22 migraine is so such a program
7:25 could be really good
7:47 router says that i my connection is not
7:50 too good all right so what we want to do
7:52 about the workplace is awareness so
7:54 education
7:56 then we want to uh for the employer to
7:58 have resources for people living with
8:01 migraine
8:02 um
8:03 and then we want them to
8:06 i have to see the people stop texting me
8:08 because it’s it’s a bit um it’s a bit uh
8:10 it’s a bit uh
8:12 disorienting okay
8:14 we want people to encourage medical
8:16 management to say it’s okay to see a
8:18 doctor for migraine and it’s okay to
8:20 have allied health care like
8:22 physiotherapy or psychology or
8:24 occupational therapy or osteopathy or
8:27 other things
8:28 to help you
8:29 we want to break the stigma so if you
8:31 live with migraine people should not
8:33 look at you as you’re weak or you don’t
8:35 know how to manage your life or your you
8:37 know you should just like stop eating
8:39 chocolate
8:41 so and that’s true education
8:43 and then we can tell employers to
8:45 provide you with useful things um such
8:48 as flexible schedules a no sense policy
8:52 light adaptation right to avoid
8:54 different lightings that can trigger
8:55 migraines
8:56 and have an optimal desk so you have a
8:59 good posture to have water breaks um
9:02 to be able and especially if you have a
9:04 bad migraine and you need to skip work
9:07 not ask you to go to the emergency
9:09 department to get a doctor’s note
9:11 because that’s a very
9:13 bad use of of medical resources
9:15 especially now during covid
9:17 um so it there’s there has to be a trust
9:20 and collaboration with the employer
9:22 so there’s a lot that can be done
9:25 then what can you do to kind of make
9:27 this relationship with your employer and
9:29 co-workers better
9:32 well you can become you know you can
9:34 take things in your own hands
9:36 by becoming a bit of your own expert
9:38 right so to use a headache diary to be
9:41 aware of your triggers to be aware of
9:43 your frequency
9:45 uh to be open uh in in a reasonable way
9:48 with your co-workers often the
9:50 co-workers will kind of know if you are
9:52 at work with a migraine because it
9:54 sometimes you know it shows it just
9:56 shows in your face and how you behave
9:58 um and and inform colleagues and maybe
10:01 tell them to go migraine canada so they
10:03 can learn about migraine right
10:06 and then of course if you need medical
10:08 care
10:09 seek it right and we all know it’s
10:11 difficult to find a doctor and it’s even
10:13 more hard to find a headache specialist
10:16 but
10:17 do what you can right to seek to find
10:19 the treatments that work for you
10:22 and then finally be kind to yourself
10:25 i always tell this to my patients
10:27 migraine is a disease of the brain and
10:30 sometimes it will impact your capacity
10:32 to work i have patients who are on
10:34 disability i have patients who are able
10:36 to work three or four days per week
10:38 i have patients who had to kind of
10:40 reorient their careers because of
10:42 migraine and this is true for any
10:44 serious medical condition
10:46 so don’t plug yourself to death saying
10:49 that you’re weak or that you’re you’re
10:50 just a bad person or you could you
10:52 should do more um because the challenge
10:55 with migraine is to kind of know your
10:57 limits do the best you can but then
11:00 sometimes you just can’t do
11:02 all you want to do and you have to
11:04 accept at least part of it for a while
11:07 so be kind to yourself
11:10 now we’ll we’ll move on with three
11:12 takeaways that i wanted the audience to
11:16 uh including like the benefit people the
11:18 insurance people and the employers to
11:20 get from the talks i gave
11:23 the first one was cover the medications
11:26 okay choose a drug plan that allows
11:29 people to have access to second line
11:31 issues like uh options like botox and
11:34 grp antibodies and there are more to
11:36 come the gpans are coming now and by the
11:39 way you can have a look at our excellent
11:40 webinar i’m promoting myself here a bit
11:43 um on gpans that is on youtube
11:46 then we want uh of course insurance
11:48 companies to adopt reasonable criteria
11:51 right it those options should not be the
11:55 last resort it’s fine to try known
11:58 options first but please don’t ask every
12:00 like patients to try everything before
12:03 they can access second line options and
12:06 then if a patient finds something that
12:08 works right um cover it cover it for a
12:12 long time because migraine is partly
12:14 genetic it’s not going to go away you
12:16 cannot just cure it like an infection or
12:19 cancer that you can kind of treat
12:21 forever so there’s no fixed cure for
12:24 migraine so if you if you are a success
12:27 if you take some i shouldn’t say that if
12:29 you do get a relief
12:31 with a cgrp antibody or botox or
12:34 whatever else treatment right
12:36 um then it should be covered for as long
12:38 as you need it so those are the messages
12:41 we wanted them to get
12:42 and then you know are you aware um are
12:45 we aware of the impact our presentation
12:47 had
12:48 yes because we got very good feedback
12:51 documents all of this is of course
12:53 statistics
12:54 so as i mentioned 97 of attendees found
12:58 that the presentation helped them to
13:00 better understand new treatments
13:03 migraine the causes of migraine symptoms
13:06 of migraine and that is very likely to
13:08 make a difference
13:10 in these for these employers
13:38 canadian agencies for drugs uh even pcpa
13:41 the pan pharmaceutical alliance that
13:43 discusses the cost of medications for
13:46 the public payers we are engaging with
13:48 healthcare ministries in all provinces
13:51 we send letters to all the provinces and
13:53 it’s very important because there are
13:55 smaller provinces we’re not forgetting
13:57 you
13:59 and we will also be partnering with gpac
14:02 which is a the global patient alliance
14:04 coalition
14:05 advocacy coalition to implement programs
14:08 in the workplace so that’s coming up for
14:10 2022
14:12 so thank you so much for listening um
14:14 your support is so important to us and
14:17 this support can come in many ways uh
14:19 and mostly by promoting and diffusing
14:22 migraine canada talking about it telling
14:24 other people with migraine about it um
14:26 and then if you want to volunteer and
14:28 soon will be a charity so you’ll be able
14:30 to donate to support our efforts
14:33 uh so we want to help you and i think
14:34 that at present time the employers and
14:36 the insurance companies and the health
14:38 care ministries and public payers are
14:41 all
14:42 in our network so we are doing work and
14:44 we hope that this work makes it to you
14:46 so you can have access to treatments if
14:48 you do need them
14:50 so
14:51 uh i i’m not too sure if i can look at
14:54 the chat i think there are a dozen
14:56 people here nine people so if you have
14:59 any
15:00 questions there’s a comment here thank
15:03 you for sharing so if you have any
15:05 questions on this topic for the next
15:06 minute or two i’m happy to take them um
15:10 and yeah it was a pleasure to uh
15:11 interact with you and soon we will learn
15:14 to use facebook better
15:17 so i’m looking at the chat so if you
15:19 want to chat and send a comment or
15:21 question
15:22 that’s your moment that’s your time
15:39 all right i see no question
15:44 that’s good so i’ll take it as a i was
15:46 very clear
15:48 so stay tuned for more uh webinars and
15:50 more information from us uh i wish you
15:53 all the best to find relief and to get
15:55 access to the options that help you
15:56 living with migraine or any headache
15:58 condition and on that i wish you a very
16:01 good friday oh is there a way to receive
16:03 the newest updates yes um if you
16:06 actually go on our website and you sign
16:09 our petition uh you will be put on our
16:11 mailing list uh so if you go just right
16:14 on our website to look for a petition
16:16 um
16:17 and then uh you can actually get updates
16:20 for the record we do not have yet
16:22 newsletters
16:23 um because we’re just like we have so
16:26 much to do but we we are planning to do
16:28 newsletters so you can have updates on a
16:30 regular basis
16:34 so chantal asks uh are there suggestions
16:37 for dealing with migraines while
16:39 pregnant and tryptons are not an option
16:41 um
16:42 so that’s that’s a very interesting
16:44 question
16:45 uh i will recommend our youtube webinar
16:47 with dr rose jamarco about hormonal
16:50 issues and migraine
16:52 pregnancy is a very sensitive topic so
16:54 of course i will not like give medical
16:57 advice
16:58 but there are options that you can
17:00 discuss with your physicians uh
17:02 regarding this but i think it’s better
17:03 if i do not advise uh you uh uh
17:07 in this uh this fashion on pregnancy but
17:09 yes there are options and there’s
17:10 actually things you can discuss
17:12 um
17:14 all right and carol says thank you so
17:16 i’ll say thank you for that and on that
17:19 i think
17:20 i will close and wish you a great
17:23 afternoon and weekend bye everyone