Migraines



Rather than the random bits of writing collected in other pages, I've tried to organize this information to be as informative as possible about migraines.  Hopefully those searching for help with theirs will happen across this page.  If you know anyone who suffers from migraines, please feel free to forward this link to them.
History
It's hard to neatly sum up my experience with migraines without going into the symptoms as well.  I'll discuss those in more detail later.

I was lucky in that my migraines didn't come on until later in life (they didn't start until around 1997, increased in frequency over the course of a year and a half later, then disappeared shortly after, right as I began grad school.  After that I only had them very infrequently.  The most I had was four in one semester, but it was rare if I had one normally, although I've already had three this year.


Patterns and triggers
Since I started working with statistics programs I ran some tests on the frequency of my headaches (I kept a record of them during that year and a half when they were the most intense).  They occurred more on the weekend than during the week, and, curiously, they increased in frequency right up till the end, then just stopped.

I kept a "migraine diary" in which kept track of the date, day of the week, and the time of occurrence.  The only pattern that was obvious was that I had a lot more on the weekend, and I have no explanation for that.  As I mentioned above, they stopped after I stopped teaching to go to grad school, but I was still living in the same place at the time.  Also, they didn't seem to be related to stress since I was more stressed out at the beginning of my teaching career than roughly six months into it when the migraines started.

I never figured out what the trigger was for mine in all that time.  For many people it's something they eat.  I presently have a hypothesis that Skittles trigger mine, although I'm not sure how seriously I want to test this out if it means actually triggering a migraine and having to deal with it in the absence of medication (I don't have anything other than Excedrin handy right now).  The reason I suspect Skittles is because I tended to be a candy junky during the time when I had the most frequent/intense migraines and I was eating them last week when I had two migraines in a row.  It's still a hypothesis at this point though.


Pathology of onset
The first thing I would experience was a distortion of my vision (sections just disappeared; it is difficult to describe anything more than that).  That would last from 20 minutes to an hour, usually about 40 minutes.  Within an hour of that I would begin to experience some pain.  Prior to finding a successful medication (more on that later), I could be in constant pain for the rest of the day.  The pain was aggravated by any activity that would increase blood pressure in my head (leaning over, picking up something heavy).  The constant pain was over (usually) after a day, but the blood pressure symptoms remained for another day.

Pain
The amount of pain I experienced with the migraines varied.  Actually, I've had worse "normal" headaches than most of the migraines I've had.  The more debilitating thing was the "auras" and the vasosensivity that lasted for another 24 hours after the full day of the original migraine.

The pain could also be on just one side of my head or all over the place at once.  The former is usually the case in other people, from what I understand.


Auras
The strangest symptom for most people is what most people call the "aura." I think this is misnamed because it sounds like maybe a haze that you can see through.  It isn't anything like that at all though, but it's almost impossible to describe appreciably unless you've experienced it yourself.

For me, the first thing that happens is that there is an isolated little "sparkly" area in my vision, usually off to the side.  It looks like the "snow" between tv stations where there's no definite form to it at all.  The area with this in it gradually grows ever larger and multiplies.  There are usually several small spots within a couple minutes.  By ten minutes from the start, the spots are large enough to start to touch one another and gradually fill in the majority of my visual field.  I've never been *completely* blinded by this, but it typically will cover more than 50% of the field before it begins to abate.

A secondary component of this is harder to convey.  These areas are not only "sparkly," they also tend to disappear.  It is as though that part of the visual field doesn't exist.  Imagine you draw a picture on a page, then you push in on the paper and have the middle fold inward while the sides of the picture are still there, only the sides are closer together now.  It's kind of like that, only it's something you would never experience normally.

Another more isolated visual phenomenon I've only experienced once (but I have heard anecdotally from other migraine sufferers) is that, rather than (or perhaps in addition to?) the auras, some people get a "blackness" or tunnel-vision before they get a migraine.  I had this happen once when I was teaching, and it was a lot like I was wearing a big cardboard box over my head with a very narrow slit to see out of.  I had to look all over the place to take in the larger view I could otherwise have captured at a glance.  Fortunately, that was a one-time experience.

Getting back to the auras, I had my first one about a year before I had an actual migraine.  It happened in a night class and I couldn't figure out what was going on. I ended up borrowing a pair of sunglasses from another student.  People probably thought I was just being silly but I was seriously scared.  I had forgotten about the whole thing until a year later when I was teaching one day and found that I couldn't read the board.  I tried to pretend nothing was wrong, but I couldn't tell what I had written.  The kids caught on that something was up because I was probably acting really weird.  I mean, 90% of what was going through my mind translated as "WTF?" I finally told them to just work on the material they needed to cover, and I headed for the nurse's area.  She realized it was a migraine and told me to lay down while they had someone else watch my class for a while.  Eventually it passed and I just had the headache, which, relatively speaking, was a relief.

As I said above, this was the most debilitating component of them for me because it meant that, however temporarily, I was blinded.  If I was driving (especially on a long trip), it was always annoying since that meant I had to get someone else to drive or I was just stranded wherever until the symptoms had passed... which could be as much as an hour later.  I'm not the type of person who likes to slow down either, so this was really frustrating.

Usually I had to just lie on the couch and try to find something on tv that I could listen to without having to watch it.  I certainly couldn't read a book or use the computer.  In fact, I also couldn't read even when I could see, technically speaking.  The words were there, but my brain was still "numb" to the meaning of the text.  Every word took a full second to comprehend.  I was literally sounding them out in my head since I could only pick up a small portion at a time.  I finally had to resort to the text-to-speech program to read a joke my dad sent me by email.

I'm not sure why migraines preferentially target the visual system or even what is happening in it, but it is one of the most salient elements of the experience of having one.  Actually, some people experience this symptom exclusively and never have any of the other components associated with a migraine, including the pain.  Some people call these "silent migraines."


Light and Sound Sensitivity
I also developed an aversion to light and sound occasionally.  Those symptoms were far less consistent than any of the others.  I only dealt with this a very few times, but it was very unpleasant.  I've never had a hangover, but it is apparently what people experience with them.  The worst time I had one of these, I literally went to bed at 7pm because I couldn't do anything else.  I was completely nonfunctional.  It was impossible to listen to anything because it was always too loud.  I couldn't read since the light was always too intense, no matter how dim I tried to make things (I had a dimmer on my bedside lamp since it was connected to an x10 controller).

I recall being driving almost insane by a bird chirping outside.  I had a tree right near my bedroom window in which a bird was chirping normally. It wasn't any louder than birds normally chirp, but it was incredibly powerful to me at that time.  I couldn't shut it out.  It was as loud as a baby screaming/crying right into my ear.


Nausea
Even less often than any of the above, I sometimes experienced nausea, but only on the most severe migraines.  This was fairly debilitating as well since it meant that I couldn't eat or move about.  Usually this mean lying on the couch and flipping through the channels, which is sort of prison sentence as far as I'm concerned.  I never actually threw up, but it was a pretty intense feeling that never seemed to go away for hours at a time.

Treatment
Regarding the medication: there are three approaches to dealing with a migraine.

1) Pain management - You have a migraine, you treat the pain. (e.g., Excedrin, etc.)

2) Abortive therapy - You have a migraine, but you stop it before it gets started. (e.g., Immitrex, etc.)

3) Prophylactic - You never have a migraine because you're keeping them from occurring. (e.g., Propanolol, etc.)

One thing the neurologist I was seeing when I first had my migraines was that I should try to keep them from happening as soon as possible.   He pointed out that brains tend to get into habits, so the best thing is to keep them from "practicing," so to speak.  As such, he advised that I go the prophylactic approach.  I took propanolol for a while and that prevented them from coming on.  However, I'm not a big fan of taking meds constantly, so I just took Imitrex, which meant I had to deal with the visual problems when they came on, and the drug would abort the headache before it could start.  Of course, if I didn't take the medication almost immediately, then it was too late.  I was usually paranoid enough to keep some on-hand in a number of places (my car, my ex's car, my shaving kit in case I was traveling, the medicine cabinet, my desk at school, and so on).


The final word
If you are having migraines, then it is worth it to be checked out and to find out, first of all, if they are being caused by something else.   Regardless, the cost of medication is certainly worth it to restore function to your life when the alternative is being out of commission (or at least functional only in a limited capacity) for as much as a couple days at a time.





Copyright Alexplorer.

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