Working Life: Esther Tomkins, nurse
I have two kids to get to school, Cara (14) and Ruairí (12), before heading to work at Beaumont where our migraine clinic acts as a resource for the whole country.
There are long waiting lists to attend so we see the most serious cases. The two main types of migraine are migraine with aura and without aura.
Migraine with aura refers to a range of neurological signs that occur prior to the headache and include blind spots, flashing lights and zig-zag patterns.
I operate a helpline at the clinic on behalf of both Beaumont and the Migraine Association of Ireland where I answer patients’ queries about migraine and chronic headache disorder.
I advise them on trigger management strategies.
Certain foods and drinks can act as triggers, as well as increases in stress and anxiety levels.
Other triggers include interrupted sleeping patterns or medication overuse.
I also give advice on medication to treat migraine and its side-effects.
I spend most of the morning on the helpline. A lot of our callers are women. Migraine is three times more common in women than men.
It is typically associated with hormonal changes and can be closely linked to menstrual cycle.
Typical onset time is puberty when hormones come into play. Migraine often runs in families.
Clinic days are hectic. The clinic is overseen by a consultant neurologist, supported by a multi-disciplinary team, of which I am a member. Patients are referred to us by their GP.
We discuss self-help approaches to managing migraine, including keeping a diary to record attacks and to help identify triggers.
With this information, we are better equipped to develop a treatment plan.
The focus in the clinic is on getting the diagnosis right. We have to know what kind of headache disorder we are dealing with in order to devise management strategies.
A diagnosis can be life-changing. Some patients benefit from preventative migraine medication which reduces frequency but does not cure the underlying cause.
The majority of our patients attend every three to six months and the majority are in their 40s. That is often the busiest point in their lives.
I head home to catch up with my kids. I’ve been doing this job for years, but it doesn’t feel like work.
It’s great to feel I’m helping people manage their pain.
