Migraines

Unlucky for me, I’m among the multitude of people who suffer from migraines and among those whose migraines are frequent and severe. So, I thought I’d post something about what it is like for those who are lucky enough never to have felt a migraine. Right now, I’m sitting in the postdromal stage of one that flared up suddenly last night while I was out with my girlfriends. Thankfully, after many years of suffering I am better at recognizing the early signs and I treated it as soon as I got home. So, I’ve collected all my personal information about migraines here so you never say to someone with migraines that they just have a “headache” and perhaps to illuminate some of the signs and symptoms to those who are suffering but have not yet recognized the earliest warning signs.

Triggers

One of the best ways to deal with migraines is to prevent them. This is mostly improbable, since some migraines have nothing to do with anything we have control over, like hormones. More women than men suffer from migraines and many women report having migraines closely associated with the major monthly shifts in hormones: ovulation and pre-menstrual, when estrogen makes its biggest shifts. Also, there have been studies that indicate that those with higher IQs tend to suffer from migraines more than those with lower IQs (oh, the price of genius!). Also, migraines beget more migraines, and I’m guessing there are correlations between anxiety, depression, and migraines since migraines definitely can create feelings of isolation and prolonged pain is a contributor to depression. However, here are some triggers for migraines that people may be able to help control:

• Food: this could be chocolate (like for my ex-brother in law) or MSG (like for a friend of mine) or it could be a food oil (this is mine). Really, as far as I understand it, it could be any number of food items. I have found that a particular oil restaurants use for frying causes an almost immediate migraine. I don’t know which specific oil it is but that’s what caused my migraine last night. Since I don’t know which oil it is, I can only eliminate fried foods at offending restaurants because sadly, I LOVE fried foods. It’s a sickness, I know, and I refuse to get a fryer for the house but my willpower is weak enough to eat it out at restaurants. Thankfully, hot chicken is not fried in whatever this offending oil is. So, once a migraine sufferer figures out if there are any food triggers, it is easier to avoid those.
• Stress: this is another one that’s almost impossible to avoid. Regular exercise and meditation help. A life based in compassion is helpful too, since it helps you from getting that extreme tightness in the base of your neck and shoulder-ear syndrome (when you get so tense that you find your shoulders tighten up towards your ears… or am I the only one who has this issue?). Finding ways to relax is just generally helpful but may help prevent stress related migraines.
• Sinus issues: I can usually tell the difference between my sinus headaches and any symptoms associated with a migraine but I have known sufferers who underwent sinus surgery and found a drastic decrease in their migraines. Keeping allergies and sinus symptoms under control is good for overall health though.
• Others: I’m not a headache specialist, so I don’t know everything that causes migraines. Obviously, this isn’t all external, as there are differences in the brains of those who have them and those who don’t. Despite what a doctor I chose to leave the care of said, migraines are not curable. The doctor or scientist who finds a cure for them will likely win a Nobel.

Once you figure out your triggers, it is good to learn to recognize the earliest signs and symptoms of a migraine. The sooner you treat a migraine, the more likely you are to mitigate the worst of it. I’ve found that treating a migraine early can shorten the duration, as well as prevent the worst of the symptoms. Understanding that migraines come in 4 stages has been helpful for me.

Prodromal

• This stage is before the searing pain begins. I have found it to be characterized by excessive yawning, extreme irritability and uncontrollable emotions, and mental haziness. You may experience other symptoms.

Aura

• Aura can consist of a number of sensations and not every migraine comes with an aura. The most commonly known are light and noise sensitivity but I have also experienced touch sensitivity, typically beginning with sensitivity in my scalp, and aphasia. Aphasia and speech difficulties appear to be among the least publicly recognized symptoms but for me it manifests as an ability to remember words. I will speak a sentence and be unable to come up with the most common of words to complete the sentence, as if there is a stopper between my brain and my mouth. This particular symptom is exceptionally frustrating and if I experience it, I know I need to get medication in me immediately because all hell is about to break loose in my head. Aura can also manifest as visual disturbances, such as colors, spots, or lines on the edges of your vision.

Attack

• So, imagine a headache- oh, your poor head aches a little bit. It’s uncomfortable. You’ll take an aspirin and then all is better. Ok, now imagine someone taking an iron heated in the fires of hell and applying to your brain- that’s a migraine. You’ll take an over the counter migraine medication (a combination of ibuprofen, tylenol, and caffeine) with no relief, then you’ll take a triptan (Imitrex, Maxalt, Zomig) and for 30-45 minutes, your pain will actually intensify to the point you either want to or do vomit. It could just be such severe nausea that you wish you could vomit. The pain is different for different people. For me it typically affects both sides of my head, for others, just one side. The symptoms of your aura and prodromal stage may intensify at this point and continue on with the pain. This could last a few hours, this could last a few days. Yes, I said DAYS. Now imagine all of this, every week, for 3-4 days at a time each time. I lived through that. It isn’t pretty.

Postdromal

• Hooray! You lived! You thought at some point that this was it and your brain was just going to explode or you just hoped for the sweet relief of death to stop the pain. Yes, it’s that bad. I’ll get to treatments in a moment but sufferers of migraines may get to the point where they will do anything to stop the pain because it is so excruciating. However, now that the worst of the pain has subsided, you have what I call the migraine hangover. The postdromal stage can be marked with continuing but lessened pain, exhaustion, and continued mental haziness. My migraines tend to be marked throughout with an ability to focus so that, even if people are speaking directly to me, I can’t exactly process what they are saying. Forget focusing on working on a computer. You may just need to stay in bed for another day in the dark and quiet to recover from the previous day of staying in the dark and quiet.

Treatment

• For some reason, doctors do not recommend clawing your brain out and throwing it away to deal with migraines, no matter how much you may want to after going through the above over and over again. So, I’ve found some things that work- some are medications, some are holistic/ natural treatments.
• Triptans: triptans changed my life more than a decade ago. What sufferers of migraines will learn though is that a specific triptan will not last forever. Imitrex used to work, but no longer. Zomig doesn’t work at all and actually makes the pain worse. Maxalt is my godsend! For others, perhaps they love Zomig, etc. It’s a matter of changing landscapes for migraines so that the triptan may need to be changed and/or the dosage increased by leaps and bounds to have any effect.
• Topamax: This is a daily preventative. I didn’t care for this stuff. It works for others. Read the side effects closely.
• Elavil: This is a daily preventative and is actually an anti-depressant but not an SSRI. I found that this helped mitigate both intensity and frequency of migraines with minimal side effects, though it can increase prolactin in women and it didn’t exactly prevent all migraines.
• Gabapentin: I don’t have much to say about this one. Also a daily preventative, it is an anti-convulsant that has shown efficacy in helping prevent migraines.
• Muscle relaxers: Some sufferers of migraines use muscle relaxers to deal with some of the tension associated with the attack.
• Pain killers: I mean, opioid based pain killers here. I’ve heard of a number of people prescribed these for their migraines. While I will admit, they are helpful, I would also caution against chronic use due to the likelihood of addiction. It would be compounding a problem to also become addicted to drugs while trying to treat a serious medical condition.
• There are probably other medications you can speak to your doctor about. I’m not an expert, I just know what I’ve tried.
• Lavender and peppermint oil blended in a carrier oil applied to forehead, temples, and neck. Lavender relaxes and peppermint helps change blood flow. I’ve found that these are helpful as a treatment during just to help with the intensity of the pain but in no way act as a preventative, nor will they decrease the length of the migraine. Mostly, this is a palliative measure.
• Warm/ cold compresses: Another palliative measure, I’ve found that warm compresses applied to the back of the neck help with some of the pain. Some people recommend a cold compress to the back of the neck while feet are placed in a warm bath to redirect blood flow. I have not found this to be helpful.
• Over the counter migraine medication: Usually taken in conjunction with prescription medications, this can help if taken early enough to help with symptoms.
• Feverfew: This one is controversial in the medical community but I’ve found it to work. I had a feverfew plant and would chew a couple leaves at the start of a migraine and found that it greatly reduced the severity of the attack. However, I killed my plant so now I take feverfew supplements daily.
• Magnesium: I’ve left the BEST FOR LAST! Magnesium has been my GODSEND as far as migraines are concerned. I personally take Cardiovascular Research Magnesium Taurate. I don’t have gastrointestinal issues with it, like with other forms. I take it daily and if a migraine begins to hit, I take additional at that time. I refuse to even try life without it at this point. I’ve lived without it, in the weekly migraine haze, and I’ve lived with it, being able to function more often than not. That’s my choice. However, magnesium is the first thing I suggest to anyone who is having a migraine.
• There may be other things out there to try. Some people out there suggest a combination of fruit and vegetable juices as a treatment. I haven’t found that to work.

So, that’s what I have to offer. I’m not a doctor and you should definitely consult a physician if you are suffering from migraines. These are just my experiences but they are pretty vast experiences- from 2001 until the present, I’ve been combating this particular monster. Migraines aren’t “headaches”. Not in the sense of a sinus headache or a hangover, anyway. They aren’t something someone can just shrug off. If you have a friend who is upfront about having migraines and they constantly have to reschedule plans, it’s likely they aren’t flaky, they just can’t leave the sweetness of quiet and dark at the moment. Migraines can lead to such isolation, depression, feelings of hopelessness, and anxiety. There is a very real fear of being anywhere without migraine treatments on hand when you are a chronic sufferer because you may not know all your triggers or your triggers may be uncontrollable things inside you. If a friend visits with you while they are suffering, feel blessed and recognize that you are important to them, because they’d rather be curled in bed but are pushing through some serious agony to be with you.

I hate to leave anything on a negative note but the fact is, at this point, there’s little optimism where migraines are concerned, unless you’ve found which handful of pills (medications and supplements) and which diet will lessen the frequency. There’s so much conflicting information out there and so far, there is no cure. However, by finding what works for you, you can still live a very full life and if you’re lucky enough to have a job that will accommodate your multitude of sick days, consider yourself blessed.