Let’s talk about migraines considering its hellish presence afflicts so many of us. We instinctively want to understand what causes it, when to be concerned and how to find relief.
Disclaimer before you proceed: I’m not a medical doctor, nor should you rely on the information given as your only resource. It’s information from reputable medical researchers, but nothing will replace your own medical provider.
According the American Migraine Foundation, Dr. Matthew Robbins, states migraines are the “third most common and seventh most disabling medical disorder in the world”. Not hard to believe as you can hear the sonorousness moans ringing from wall to wall. As a suffering community, we whip out medication to assist our fellow sufferers from our emergency migraine prep kit and pray to God this wave doesn’t hit us next.
What is a migraine? Well there a several different kinds but I want to focus on with aura and without aura since they are most common.
Dr. Jennifer Robblee, from the Mayo clinic divides them both out, what caught my eye, while reading, is that an aura doesn’t necessarily indicate the migraine will happen that day. Something to give me pause, as I’ve had auras without a massive headache and then a day later it pops up.
These are the direct symptoms, or as she calls them premonitory phase:
Constipation or diarrhea
Mood changes (depression, irritability, etc.)
Muscle stiffness, especially in the neck
Increased frequency of urination
Sensitivity to light
Sensitivity to sound
After this phase, the migraine characteristic is:
Headache pain lasting 4-72 hours when untreated
Pain on one side of the head
Moderate to severe intensity
Worsening of headache with physical activity
Nausea and/or vomiting
Sensitivity to light and sound
I like to call the next phase the hangover but there is a fancier medical terminology called postdrome phase.
The symptoms of postdrome may include:
Lowered mood levels, especially depression
Poor feelings of well-being
Poor concentration and comprehension
People who do not suffer auras, skip right through the warning signs and right into the migraine phase but together experience the postdrome phase.
I was 21 when I was first diagnosed with my migraine. I didn’t know I had it at the time because I never had one before. The most I experienced as far as a headache went were the standard stress or tension headaches. I touch a bit on this in my previous blogs, but I will go over it again on how this mess happened and how it was discovered.
As I mentioned, I was 21 and driving home from work. Nothing remarkable happened that day, I was relaxed, listening to my music with the windows down and enjoying my drive. Suddenly I saw lines that were the color of gold and then white sparkles. My eyes began to dim to black. I panicked because I was driving and I figured, great, I’m going blind. Just I was I was trying to figure out how to pull myself to the side of the road, my vision came back. A wave of nausea overcame me, and I thought I was going to vomit all over the car. I raced home, desperate to lay in bed and feel a fan hit my face to cool me down. When I got home, I laid in my bed feeling sick as a dog and then suddenly the worst headache of my life came on. I felt paralyzed, fearing that any movement of my limbs would trigger the angry migraine in my head. At the time, I still had no clue what this was, but I was damn sure I was going to find out.
Naïve, I went to the eye doctor to let them know that I thought I was losing my vision. They took my eye pressure and it was extremely high. My eye doctor came in and said that she looked through my family history and noticed that my mom’s side has glaucoma. She asked if this happened early or later in life for them. I couldn’t quite remember but I said, I believe it happened earlier than normal.
She sent me off to Dr. Stiles, a great glaucoma specialist in the area, and one that my mom and uncle use. I felt weird sitting in the waiting room filled with elderly patients, as a young 21-year-old girl. Once I was called back, my doctor took my history, and was aware of my connection between my mother and uncle. I was placed through a series of tests that triggered another migraine. At the end of the visit, Dr. Stiles told me that he wanted me to see a neurologist, because I passed the glaucoma test, and I might be experiencing migraines, which can accompany high eye pressure readings.
So, I set my next appointment up with a neurologist at Saint Luke’s South. The appointment was longer than I’m used to but after a series of questions and examinations, the doctor told me that I am suffering from migraines. Migraines! I’ve never had them before. He told me that I have the type with aura, which will be my indicator that one is coming on. He prescribed me medication to take when I have my first symptom to decrease the severity of the headache. I grabbed a sheet of what to avoid from my doctor and my prescription. As I headed to the elevator, I glanced over them and one jumped out at me- MSG. During this time period, MSG was placed on most Chinese food I ordered, and I ordered a lot of it. There were several other items on the list, and it emerged from my gut that I had to make a lifestyle change to help combat this monstrosity. I sluggishly proceeded to walk over to the pharmacy wait for my prescription.
Over the years, the medication only helped me a bit, but the migraines became more powerful as I aged. They were debilitating, leaving me useless to the world. There wasn’t a lot out there as far a treatment that seemed promising. I empathize with those who don’t have a warning, because the migraine comes suddenly and they can’t take a pill, which takes a while to kick in, to ease their pain.
I did learn triggers that caused my migraines which included, weather, hormones, stress, red wine, alcohol in general, sunshine, and certain smells. I could no longer walk through the mall and handle the ladies trying to pester me with their perfume samples. I don’t think I’m alone with this, however. Most people get a headache after their nose has been assaulted by different perfumes and cologne.
So, what did I do once a migraine attacked? Well, I handled them different depending on my location.
At home: turn off all the lights, turn down the sound, get an ice pack for my head, and try to sleep.
Out with friends or shopping: retreat
At work: turn on a portable fan, use an umbrella to block the office light, wear my sunglasses, down a bunch of ibuprofen, and if I had access, grab an ice pack and tuck it underneath a stretchy headband.
At first, when one came during work, I would peace out. The frequency of which they were happening couldn’t allow me keep up on this trajectory. So, I had to learn how to work through the pain. I hid it well from others and sometimes I looked like a frazzled mess like someone having a mental breakdown and if they understood me, they knew that I was having a migraine.
I wasn’t alone though. I had a community of friends that had them and understood the pain. We would warn each other that the air pressure was going to change overnight and to prep ourselves that the awful migraine was going to gnaw at us. We also knew to rely on one another for medication when one came on. We understood our pain, and it didn’t feel like a dark lonely world.
Stroke and Migraine
So, after my stroke, I pondered, did stress accompanied by high blood pressure cause my SAH or was my years of migraines an indicator that it was about to rupture. I’m analytical and curious so I did my research.
I went to the AHA Journal in typed in stroke. Directly from the Journal:
“Several observational studies have indicated an association between migraine and vascular diseases and, in particular, between migraine and ischemic stroke, subclinical brain lesions, cardiac events, and vascular mortality.”
Ok, well that’s ischemic, but it doesn’t necessarily apply toward my stroke. I kept going down the article and the studies lacked sufficient information from their control studies to indicate a correlation between migraine and SAH. Perhaps, there isn’t much because SAH is rare and most people don’t survive.
The same information is mentioned from a NCBI journal
I did stubble across this while researching and left in dismay about SAH from NCBI:
“Several patient factors also increase the lifetime risk of rupture. These include: advancing age; positive smoking status; presence of hypertension; positive family history of intracranial aneurysms; and a patient’s personal history of other aneurysms or prior SAH. About 20–30% of patients with one cerebral aneurysm will have at least one other aneurysm. Once one aneurysm has ruptured in a patient, each of the patient’s other aneurysms should be treated due to their high risk of rupture.”
So, I was left wondering if my migraine factored into my stroke. My non-medical assessment is that my migraines, when brought on by stress, raise my blood pressure, causing the vessels in my brain to contract. The day of my stroke, I was stressed beyond belief accompanied by a migraine in the afternoon. Am I correct? Perhaps not, it might be a fluke that they all happened together. We will never know since there is not enough research to support this.
So I digress, and will get back to migraines.
Here are the 10 most common triggers for migraines, according to American Migraine Foundation. You can click on the link listed below for detailed information on each one.
Changes in or regular sleep schedule
Caffeine and Alcohol
Changes in the weather
So how do we migraine sufferers ward off or help decrease the severity of migraines? Well, the Mayo clinic has put together some information to assist. A lot of it seems basic and a good manual to live by in general regardless if you suffer from migraines. This is taken directly from the Mayo clinic and the link below will elaborate on each one.
Find a calm environment
Turn off lights
Try temperature therapy
Drink a caffeinated beverage
Establish regular sleep hours
Unwind at the end of the day
Don’t try to sleep
Check your medications
Don’t skip meals
Keep a food journal
Avoid food triggers that trigger migraines
Simplify your life
Manage your time wisely
Take a break
Adjust your attitude
Keep a migraine diary
Strive for balance
Essentially, this is a monster and it will show up in your life either as a kid, teenager or in your adult life. It’s not a one and done type of situation and there is no cure for it either. It’s something that you must learn to live with, and there are several resources out there that help you navigate in the right direction to decrease the occurrence or alleviate the symptoms. Several people can be out for days when it comes on, and some can be out for a night. It’s different for everyone.
Other Migraine Information
Wondering if you are suffering from migraines? Harvard Health published a simple way to know- POUND
P is for pulsating pain O for one-day duration of severe untreated attacks U for unilateral (one-sided) pain N for nausea and vomiting D for disabling intensity.
Last, when should we worry about our headaches. What should indicate that we need to seek medical attention?
Headaches Initiated by Exertion
Substantial Change in Headache Pattern
Constant Headache Always the Same Location of the Head (first red flag for me).
Worrisome Neurologic Symptoms
Headache that never goes away (second red flag for me).
Systemic symptoms (third red flag for me)
So, to conclude, if you have migraines, make sure you keep a diary and continue to seek medical care. Don’t see a doctor once and get your diagnosis and move on. That was my mistake. I didn’t follow-up with my doctor after I got my first round of medication. It didn’t work for me so I threw my hands in the air and said I will just live with it. This was a bad move because 1) I shouldn’t live this way and 2) perhaps I could’ve caught something in advance that was not favorable.
Overall facts on migraines can be found here: https://migraineresearchfoundation.org/about-migraine/migraine-facts/