Medical Un-Professionals

I’m in awe of how fast 2014 slipped away.  I feel like that Days of Our Lives opening sequence with the hourglass and the narrator saying, “Like sands through the hourglass, so are the days of our lives.”  That was the show to watch back in my high school and college days.  I had to record it on VHS and watch it later, which makes me feel old because that has now been replaced by DVR.  I no longer watch Days.  I had to quit that show when Marlena was possessed because the storyline was too ridiculous.  (I guess I didn’t think it was too ridiculous for Kayla to be buried alive by Vivian with a supply of oxygen in her casket and some sort of communication system so she could taunt Kayla, but Marlena being possessed was.  Please don’t question my teenage logic.)

2014 was an event-filled year.  We spent time at a family reunion at TeBri Vineyards in Monroe, Oregon.  Time spent with family is always a treat, but made even more special because several relatives from Norway made the trek over.  I spent many hours during the spring and summer working with shelter dogs, which was good medicine for my soul.  Working with a homeless dog to earn their trust can be challenging at times, but spending time with them to make them more adoptable makes my heart happy.  Breaking a dog of a bad habit such as car chasing, or patiently working with a scared dog to get them to come out of their shell, is quite rewarding.

 
The biggest bit of excitement came late last summer when my husband and I moved from our small town filled with family and friends to a bustling city.  The hubs was offered a career opportunity that he couldn’t pass up and I was fortunate to be granted a transfer with the government agency for which I was already working.  The biggest change for me work-wise was instead of working glorious part-time hours, I am back to a full-time schedule.

We bid adieu to our cute little home on an acreage nestled next to a river that we could enjoy from the privacy of our back deck and moved into an apartment.  We said goodbye to all the deer, turkeys, coyotes, and other critters along the creek and said hello to traffic lights, thin apartment walls, and noisy neighbors.  We moved from our panoramic view of Mount Adams and Mount Hood, to the view of a sandy hill that is technically a mountain, but looks more like an overgrown anthill.

Mountain views back home.

"Mountain view" at our new place.

 
It is a treat to have civilization (AKA restaurants, movie theaters, grocery, concerts, hockey and department stores) nearby, but I often find myself homesick for that quiet little house on the river.  Now, instead of having a doggie door that my pooches could use to come and go as they please, we have to take potty break walks up and down a flight of stairs several times a day.  That is fine, except for the days that my 13 year old lab is sore from playing too much Frisbee at the dog park earlier in the day and she cannot navigate the stairs to our second story abode.  Her 60 pound frame isn’t too heavy to hoist up on my bed at night, but it is a different story lugging her up a flight of stairs.

Pee o'Clock is between the hours of 1:30 - 4:30 a.m.

Settling in to city life has been an adjustment, as I knew it would be.  The chaos of moving, saying goodbyes to all of my extended family, co-workers (most of whom feel more like family member than co-worker), and friends (including my beloved shelter pups), leaving my support system and my comfort zone, packing, unpacking, changing our address, meeting new co-workers, learning some new job duties, doubling my work hours, and adding a short commute, culminated into stress, and triggered many a migraine headache.  Sometimes life feels like a constant struggle to live a normal existence.  During the bad days, my frustration reigns supreme and I feel like a salmon swimming against the current.  I wish I didn’t have to battle just get through the mundane tasks of life on such a regular basis.  I try to celebrate my good health days, but there is a cloud of apprehension following me.  Even on my good days, a migraine will usually start creeping into my head at some point.  I am terrified of the days the migraine gets out of hand and I end up having to call in sick or leave work early.  Thankfully, I am still receiving Botox migraine treatment.  Even though I’m experiencing regular migraines, I suspect they would rate higher on the pain scale if I didn’t have Botox on board.

Medical Unprofessional

December was lousy.  I had 30 out of 31 days with migraine pain.  I was able to get Christmas dinner on the table, but by the time dinner was ready, I was too sick to sit down and enjoy the meal with the family.  Bah humbug!  When the pain is out of control and I am in a lousy mood, I try to remind myself what I am thankful for.  I am particularly grateful for the support of my family and friends who help me deal with chronic migraine.  My parents are always more than willing to help in any way they can.  My husband will pick up the slack on housework when I’m down for the count.  He will also bring me medications, water, or whatever I need at the drop of a hat when I’m under the weather.  Then there are my crazy dogs who keep me feeling a little less isolated.  When it seems life is passing me by while I’m stuck in bed in the middle of the day with a sleep mask on to hide my light sensitive eyes from the evil rays of sunlight, I am comforted by their company.  The rhythmic sound of their deep breathing next to me, and the weight of one of their heads, heavy with sleep, on my feet makes me feel a little less isolated.  These are some of what I call my “medical un-professionals” who are just as important, but in a different way, than my medical professionals.

I don’t have much more to share right now, except to tell you that I have started a new migraine treatment recently approved by the FDA.  I plan to post all about it soon, after I’ve had a chance to see what kind of results I get.  Fingers crossed that I’ll have some good news to share.

You'll Never Know If You Don't Try

I have tried a boatload (by boatload I'm talking about a barge sized vessel, not a tug boat sized vessel) of both over-the-counter and prescription medications to treat my migraines  I've also tried treating the migraines without medication.  Over the years I have read about and heard many different suggestions that might alleviate my migraine headaches.  Today I'm going to focus on some of the more natural remedies I've tried.

Aromatherapy is something that people commonly recommend, particularly lavender and peppermint essential oils.  I jumped right on that...I love peppermint.  My Mom and I invested heavily in peppermint products.  Peppermint candles, peppermint candies, peppermint hot chocolate, peppermint mochas, and peppermint essential oil. I even discovered that Paul Mitchell makes a Tea Tree Lavender and Mint moisturizing shampoo and conditioner that smell heavenly.  While the aromatherapy was soothing, it did not do much to reduce my migraines.  I think the best luck I had with an aromatherapy product is Origins Peace of Mind, which is a minty lotion that I gently massage into my temples and the base of my neck when I'm not feeling well and it will help some.  When all else fails sometimes I may mix up some hot cocoa with a shot (or two) of peppermint schnapps, a peppermint swizzle stick, and some mini-marshmallows.  It might not do a damn thing for my migraine, but a nightcap will usually relax me a bit and maybe, just maybe, the peppermint in the schnapps will provide some migraine relief.  I used to keep York peppermint patties around occasionally nibble on them during a migraine, until one unfortunate day when I got a whopper migraine with nausea and I puked up a peppermint patty.  Now I can't see a York peppermint patty without that memory haunting me and my tummy turning queasy. 

Then there are pillows.  I have spent a small fortune on pillows over the years.  I thought a proper pillow that provides good neck support might help out my migraine situation since the majority of my migraines are accompanied with neck pain and muscle spasms.  I have spent over $100 a pop on many a pillow that provided negligible migraine relief.  My bed is cluttered with mass quantities of pillows now.  And let me just note that memory foam pillows are outlawed for pillow fight use at our house.  Somebody might suffer a concussion if smacked upside the head with one of those suckers.

Here's a fun suggestion for potential migraine relief that I have heard about.  Pinch your left nostril closed so you are only breathing out of the right side.  I tried it.  When no one was looking.  It didn't provide any migraine relief for me.  I had heard it years ago, but it apparently made a resurgence in the news recently because it was suggested to me twice in the past few months.

And there's caffeine, which I view as a double-edged sword.  It can alleviate migraine pain, but if you drink it too often it can trigger migraines.  I have to proceed with caution in this department.  If I'm at work and a migraine begins I can sometimes grab a soda or mocha and the jolt of caffeine will quash the migraine.  I find it best to order a small caffeinated beverage because if I drink too much caffeine the migraine will come back with ferocity when the caffeine wears off in my body.

It was once suggested to me that my migraines could be connected to my sinuses and maybe I should try using a neti pot.  I didn't know what a neti pot was so I Googled it.  Oh my God!  Gross.  I talked myself into trying it because what it if rid me of my migraine headaches?  I would never know until I tried.  I had a heck of a time mustering the courage to actually go through with using it and it took me several days after buying the neti pot to actually try it.  When I finally attempted the neti pot, it was an epic failure.  I thought I was going to drown and my husband laughed as I choked on the water instead of irrigating my sinuses.  I likened it to being waterboarded, to which my husband pointed out was a gross exaggeration, especially since I had never experienced waterboarding (thank goodness!).  I didn't care if he thought I was being a drama queen.  It was a traumatic experience and I decided the neti pot likely originated as a form of corporal punishment.  For a moment I imagined myself in Gitmo instead of standing in front of my bathroom sink.  It took a couple of months to gather the courage to attempt the neti pot again.  Lo and behold I got it figured out, but it didn't seem to do anything for me.  I tried it daily for several weeks to see if it would eventually give me any sort of relief.  I kept up with it until "the incident."

"The incident" started out innocently enough.  I had a cold and my nose was all stuffy.  I decided to use some nasal spray to open my sinuses before using the neti pot .  Several minutes after using the nasal spray, when I felt like I could breathe easily, I broke out the neti pot.  The neti pot flushed any remaining nasal spray far into my sinuses.  It was accompanied by a horrible burning sensation and I teared up and yelped in pain.  Just thinking about the "the incident" makes my eyes water.  That intense burning sensation wouldn't subside for the longest time.  (I liken it to having a deep paper cut.  Not the kind of paper cut you get from a normal piece of paper, more the kind you get from a file folder.  Then take that paper cut and place it into a glass of freshly squeezed grapefruit juice for about 30 minutes.  I think that is probably a fair comparison.)  The neti pot has been stashed in the deepest, darkest corner of the bathroom cabinet since "the incident" and will likely never been seen again.

Let me reiterate that these are just my opinions and experiences with different treatments that I've tried over the years.  These aren't all of the things I've tried, just some I thought I'd share.  I'll write more about some positive pain management treatments and techniques in a future blog post.

Dear Diary

When I was a wee lass, my big sister received a diary for Christmas.  She was five years older than I and she didn't particularly enjoy having a little sister constantly pestering her.  I was intrigued by this strange book of blank pages secured from prying eyes by lock and key.  I also got the word diary confused with the word diarrhea.  Whenever I asked her what she wrote in her diarrhea, she just got mad at me.  Her anger made me even more curious.  I believe I attempted to open it when she wasn't around, but was never successful.  I'll never know what secrets were secured in her diary.

I got a diary of my own when I was older.  I tried to use it, but never got into it because it seemed like a homework assignment.  That's how I feel about the migraine diary.  It's a homework assignment.  Not only is it homework, but it's on a subject (migraines) that I hate.  Am I the only one out there who despises that stupid migraine diary? I have been so bad about keeping it updated in the past.  I only do it when a doctor is adamant that I keep it updated.  I've been disciplined and have kept my migraine diary for seven straight months this year.  (Granted, I have only done it because I was properly motivated...my doctor needed it to include it in the paperwork for treatment pre-authorization to my insurance company.)

Several months ago I promised my doctor that I would be vigilant and keep detailed records.  I created a beautiful migraine diary form in Microsoft Excel.  I presented several months worth of diary forms to him recently and he perused them for a few minutes before saying, "You're borderline obsessive compulsive, am I right?"  If by "obsessive compulsive" he was referring to how I record my pain level as experienced at four intervals each day, along with a section to mark the migraine symptoms experienced, and another section to mark down any medication taken; then taking said information and printing out a one page report for each month that is centered both vertically and horizontally on the page, then I guess the answer is yes.  I could also take the data and make a beautiful graph of my pain levels if he'd like, but I didn't bring that to his attention because I didn't want to come off even more OCD than he already thought I was.  And for the record, I prefer to think of myself as detail-oriented, not obsessive compulsive.

My form is a work of art.  Besides, what was he expecting to see?  A diary like I had in junior high school where I dotted each i with a heart?  Maybe something like this:

Dear Diary,

Today I had a hellacious migraine.  One of my co-workers turned on the fluorescent lights at work.  Don't they understand how bad the lights hurt my eyes when I have an effing migraine?  I put on my sunglasses to shield my eyes from the evil light, and now I'm certain that my co-workers think I put my shades on because I was nursing a hangover from the night before.  Great.  To make matters worse, my migraine intensified by noon and I had to leave work early.

Crankily Yours,

Katie

Isn't it easier to mark down that my migraine was a pain level 5 in the morning and a pain level 7 at noon, then mark a box that my migraine was accompanied by light-sensitivity and another box that indicates an inability to work?

I know my doctor liked my form and I think it's funny that he thought I was obsessive compulsive.  Little does he know that I have worked a number of years in jobs where presentation of presented material has become my forte.

When the doctor asked if I was borderline obsessive compulsive I laughed and said, "Maybe."  My hubby happened to be at this appointment with me.  He laughed at the same time and said, matter-of-factly, "Yes."  I gave him serious stink eye over his response.

Mountaineering

When I was in about five years old, my kindergarten teacher asked me what I wanted to do when I grew up.  My response to her query was, "I'm gonna be a mountain climber."  I have no idea why I said I wanted to be a climber.  Maybe it sounded adventurous.  Or, maybe I was having some sort of ESP as a child and I saw the word "mountaineer" in my future, when really it was "migraineur."  :-)  What I do know is that climbing a mountain is the last thing I'd want to attempt as a migraine sufferer.  My teacher, who is a very nice lady, responded with something along the lines of, "No, you can't be a mountain climber.  You need to pick a different profession."  I remember standing there in a daze.  My hopes had been dashed.  I accepted that I couldn't be a mountain climber as a fact because my teacher said so, and started thinking about a different line of work.  Apparently I was an agreeable child.

As an adult I've often laughed about that memory.  I thought teachers weren't supposed to quash the dreams of innocent children.  As it turns out, my teacher was right.  Maybe I should send her a thank you note for setting me straight when I was young, because mountain climber would never have worked out for me.  That kind of physical activity paired with migraines would have made me a lousy climber.  I picture climbing to Mt. Everest base camp, then having to be carried back down by a Sherpa when I am rendered useless with a migraine. 

I had a killer migraine last week.  It stuck around for two very long days.  I had a ton of things to do around the house.   I could barely load the dishes in the dishwasher before having to lay down for 30 minutes before tackling the next simple chore on my list, which would be followed by more down time.  Progress on my task list was moving slower than molasses in January and my frustration was increasing exponentially with each passing hour.  As I lay on the couch my mind wandered back to my kindergarten memory of my teacher killing my dream of being a mountain climber.  Right now running the Swiffer across my kitchen floor sounds about as daunting as climbing Mt. Kilimanjaro.

The Guilt Trip

zip line fun

Who doesn't love a good vacation?  I know I do.  With each vacation I take there is a dark cloud looming...inevitably I will get a migraine at some point during the trip.  I've come to learn that air travel is a migraine trigger for me and that whenever I fly somewhere I am more likely than not to have a migraine when we land at our destination.  The same is true for when we return home.  I prepare as best as I can and carry medication close at hand.  Then there are other times I get one, for example when we went zip lining over Fremont Street in Las Vegas last fall.   At the end of the zip line there was a big spring that catches your zip line to stop you.  When my zip line hit the spring there was a little whiplash action and my neck instantly began to ache, and a migraine manifested shortly thereafter.  (Note to self:  Save the zip line for the last day of vacation rather than the first.  Lesson learned.)

A number of years ago, I'm thinking 2004, my ex-husband and I went on a vacation to Switzerland.  It was a once in a lifetime, dream vacation.  We started our trek in Portland, Oregon with a plane change at Chicago O'Hare.  By the time we had made it to Chicago, I was dealing with the onset of a migraine and feeling frazzled.  After the hours long flight to Zurich, Switzerland I had a full blown, monster migraine.  I just needed to lay down, but our journey wasn't over.  We had to retrieve our luggage, load into a double-decker tour bus, and and embark on an approximately two-hour journey to Interlaken, Switzerland. 

Interlaken

We sat on the top deck of the bus in the first row of seats with windows completely surrounding us.  We were treated to gorgeous views and sunshine as the bus meandered through the Swiss countryside.  I tried to enjoy the scenery, but I just wanted to crawl up into a tiny ball.  The bright sun was killing my eyes through my sunglasses.  The voices of excited travelers filled up the small space and the noise was deafening to my overly sensitive ears.  To top it off, we were traveling with a large group of my ex's co-workers and their spouses, many of whom I had been looking forward to catching up with.  I was trying my best to hold it together and be friendly, but my version of friendly during a migraine probably comes across as aloof.  I hate for people to see me when I'm having a migraine because I don't feel like myself.  It's embarrassing.

Interlaken

I remember letting out a sigh of relief when we got to Interlaken.  Interlaken is a quaint and clean town nestled in the in between two lakes with phenomenal views of Jungfrau (the third largest Alp in the Bernese Alps, the summit is 13,642 ft).  The architecture in Interlaken is old and beautiful.

Hooters in Interlaken

Oddly enough there was a Hooter's restaurant there that totally didn't fit in with the historic feel of the quaint town.  If you were to play one of those games where you search a picture to find the thing that doesn't belong, that Hooter's would probably be the thing in a picture of Interlaken.  (Of course we stopped in to get some wings while we were there.)

Migraine Hangover?

When we made it to the hotel not all of the rooms were ready for check-in.  Some people in our group were fortunate to get rooms, but ours was not ready.  I remember sitting down in the lobby of that beautiful hotel and tears started streaming down my face.  I wasn't sobbing, I was just so tired and in such pain that my eyes were tearing up and that's when my ex lost it and yelled at the hotel staff to get us a room straight away.  The poor staff, they hustled to get a room ready.  As soon as we entered the room I flopped onto the most comfortable bed I have ever slept in and had an injection of Imitrex.  Sweet relief, but I still had to sleep off the migraine hangover the rest of the day.



I'm still a tiny bit bitter that I had a migraine during that trip.  It was a fabulous adventure tainted by yet another migraine.  I remember feeling guilty because not only did it affect my trip, but it also affected my ex-husband's trip.  Instead of exploring Interlaken that first day we were holed up in our room waiting for me to feel better.  I also wish that my friends didn't have to see me so sick and watch my ex yell at the hotel staff.  Embarrassing.

The $500 U.A.

I'm fired up.  Not only does visiting a pain specialist cost an arm and a leg, they also feel it necessary to test my urine for drugs.  Do they assume the worst and figure that if someone is coming to see them that there is a chance they are not in pain, but making it up to seek narcotics?  I suppose that scenario does play out on occasion.

The pain clinic I now go to has a drug testing policy.  There is a mandatory urinalysis (UA) on your first visit, and they can randomly select you for UAs at future visits.  So I go along with their policy and submit a specimen to them on my first visit.  It's not a big deal to me at the time.  It turns into a big deal when I get a statement from my insurance showing that the urinalysis cost $500.00.  No, that was not a typo.  Apparently a pee test there costs $500.00!  Are you kidding me?  Holy cow.  I've had to take pre-employment drug tests in the past and I know those only cost approximately $50.00.

I called the clinic and inquired if they had made a typo, maybe keyed in an extra zero in their figure when they billed my insurance.  They informed me that they had not.  They said that they ran ten different tests on my sample and each test costs $50.00.  Wow. 

Here's my beef with the situation...I'm not seeking any heavy duty painkillers or narcotics of any sort.  I'm simply seeking therapeutic Botox treatment.  Even the doctor agreed that there isn't anything else left to try at this point.  I also made it clear to him that I'm not agreeable to any sort of narcotic pain medication because I just don't want to go down that road.

No wonder insurance is so expensive.  $500 pee tests are just one tiny example of exorbitant costs.

Botox: Take 2

I went in for my second Botox treatment the other day.  I felt like whomever has that voodoo doll of me was relentlessly stabbing pins all over its head.

I must say that the injections hurt less this time, but the after effects were worse.  I awoke at 2:00 a.m. the next morning and couldn't sleep much after that because of throbbing pain at the 20+ injection sites.  Ice packs helped some with the pain and less than 24 hours later I was feeling much better.

I have a ton of little red spots on my forehead from the injections and some of them are accompanied by tiny bruises.  It could certainly be worse.  Last time I had one big goose egg and bruise on the center of my forehead for several weeks.  Eventually the bruise turned a lovely yellow color so at least it was less noticeable than the deep blue/purple color it began with.  To me it felt like I had a unicorn horn sticking out of my head, but I doubt it was that noticeable to everyone else.

I felt I looked like this with my goose egg/bruise.

My doctor is pretty cool.  He and his nurse let my husband take pictures of the treatment to use on this blog.  (Thanks doc!)  The procedure doesn't take long at all.  Here's a couple of before shots:

Syringes of Botox and whatnot

Me being over dramatic about the injections.

Here are some pictures of the procedure:

We've got a bleeder!

My doctor was asking questions and making me laugh during the procedure.  Not cool.  I was trying to go to my happy place where I can be completely still, a technique I've learned from living with chronic pain, giving myself injections of medication, and getting several tattoos.  (Sorry about the tattoos Mom, I know you're not a fan and are probably rolling your eyes as you read this.)

I think the temple is the most painful injection.
The doctor was making me laugh in this pic, but I was trying to be still.

Am I the only one who is kind of freaked out about pregnancy ultrasound pictures some people post on social media?  I wish people would just make the announcement that they are expecting without the visual aid of an ultrasound photo.  Seriously, it feels like a flashback to biology class or that scene in Spaceballs where the alien pops out of the guy's stomach.

Scene from Spaceballs

Well, the doctor suggested taking pictures of the ultrasound when they put the Botox injections in my neck, so here it is.  I guess it shows the needle going into my neck muscles, but it just looks like a bunch of wavy lines to me.  At least there's no freaky alien looking thing in my ultrasound picture.  You're welcome.

They only used the ultrasound on the neck injections because they have to insert the needle deeper and need to make sure they get it in the right spot.  I've heard that if they get it in the wrong spot there is an outside chance that it can mess with muscles associated with respiration.  YIKES!  What would happen in that situation?  Would I have to live in an iron lung until the Botox wore off?  That's a few months!  I snap back to reality and decide to push the thought into a dark corner in the back of my mind.  The thought will probably creep up again and my subconscious will produce an associated nightmare in the next couple of months.

I'm in and out of the clinic in about 30 minutes.  I walk out looking like my forehead was attacked by a small swarm of angry bees.  The procedure is non-invasive and I could drive myself home, but not this day since I've got my chauffeur/husband with me.  (I drove the hour to the clinic so he will drive the hour home.)  The worst side effect I have after these treatments is muscle weakness in my neck that starts about two days after the procedure.  I experienced it last time and it lasted approximately two to three weeks.  It is painful muscle strain sort of feeling and I feel like a bobble-head.  I am most comfortable sitting in a high back chair where I can let my neck rest against the back of the chair and I don't have to hold it up.  When nobody is around I sometimes put on a cervical collar to allow my neck muscles to relax.  The muscle weakness also makes doing yoga a bit more challenging, but I can get through it with some slight modifications.

The Botox is helping.  I still get migraines, but my pain level is less intense.  I will go back for another treatment in three months.

Voodoo Doll

If this blog had feelings I suspect it would feel neglected right about now.  My husband hijacked the Mac so he could work on an important project with a looming deadline.  I've had a difficult time sneaking it away from him over the past few weeks.  Ever since my PC took a dump a couple of years ago we've shared his laptop.  Sharing a computer has been a fantastic exercise in marital compromise.

Sometimes I wonder if somebody out there has a voodoo doll of me and is stabbing pins into it to give me migraine headaches.  If there is I think the voodoo doll would look something like this:

There's a screw jutting out of its head to represent the migraine headache.  The eyebrows are wonky, like someone who has had Botox injections as a migraine treatment and their brow line is a little skewed as a result.  One eye is bigger than the other.  I'm sure I'm not the only migraineur who experiences incredible pain behind one or both eyes that makes me concerned that my eyeball(s) might pop out of my skull.  Then there's the slight smile on the face.  I'm a big smiler, but my smile is hampered when I'm having a migraine.  Sometimes it turns into a frown, but I try to smile through the pain to cheer me up a bit.  Do I sound like Pollyanna now?

For those of you who may not be familiar with Polyanna, she is the unnaturally cheerful character in a series of books by Eleanor H. Porter as well as a movie version made by Walt Disney in 1960.  She is an orphan who is dealt a lot of crappiness in her life.  She doesn't let the crappy stuff bring her down, instead she plays something called the "Glad Game" where she finds something to be positive about in every bad situation.  She spreads her happiness and cheer throughout her town and lifts up the spirits of the many curmudgeon residents.  The story is so sugary sweet that it makes me want to vomit.  Pollyanna is just so damn cheerful that I wonder if she's doped up on Xanax.  I think that the lesson in the movie of having a positive mental attitude and optimism is a good one to share.   But, I also think it is important to face and accept the crappy circumstances we can't change in life so we can put them past us and move forward.  So I guess I'm a little bit like Pollyanna, but not as oblivious to reality or freakishly cheerful.

Hayley Mills as Pollyanna

I can't change the fact that I have migraines, but I am not angry about it.  I'm certainly not excited about the migraines and it does bring me down from time to time.  When I'm feeling bummed out I seek out things for which to be thankful.  For example, I am thankful for the fantastic migraine medications created in recent years, I am thankful for each day I don't have a migraine, I am thankful for an understanding boss when I have to call in sick to work, I am thankful for my parents who are supportive of seeking out new/different treatment options, I am thankful for my husband who is willing to take care of me when I can't take care of myself, and the list goes on and on.  I'd continue, but won't for fear of sounding too Pollyanna-ish.

In addition to being thankful, I have found a fabulous tool for dealing with chronic pain is laughter.  Having a laughter-filled conversation with friends and/or family, or watching an episode of Saturday Night Live is medicine for my soul.  Laughter elevates my mood and helps keep me smiling.

If there is someone out there with a voodoo doll of me who is giving me migraine headaches, give it up already.  You'll never make me stop smiling for long.  I can handle these migraines.  I got this. 

The Twilight Zone

I'm often left alone with my thoughts.  Migraines render me useless and I have to lay down because sitting and standing is far too painful.  When I'm stuck laying around I spend time thinking about work, family, friends, things I wish I could be doing, dream vacations, fabulous shoes, and what I would do if I won a huge lottery.   After hours, or sometimes days, of laying around waiting for a migraine to disappear I run out of normal things to think about.  It's as if my mind goes into some sort of Twilight Zone (cue Rod Serling and the Twilight Zone music) and I start thinking about ridiculous, unimportant things.

For example, my washing machine has three settings...Regular, Super Clean, and Ultra Clean.  Both Super and Ultra sound awesome, but I can't help thinking about what criteria the manufacturer used that ranked Ultra higher up on the cleaning scale than Super?  Why didn't they just use titles like Clean, Cleaner, and Cleanest?

Then I wonder if I were on The Price is Right and made it to the big wheel how would I spin it?  Would I be one of those people that reaches up as high as I can, grabs two of the wheel's spindles (one with each hand), then jumps up and throws my entire body weight into the spin?  No, I couldn't do that.  I hate it when other people do that.  The wheel goes around way too many times and the audience gets bored waiting for it to stop spinning.  Then, what if the wheel stops at 75 cents?  Would I spin again if I were the first contestant?  I probably would, even against my better judgement.  If I ever made it to the big wheel I'd just hope to be the third contestant because that's the power position.  You know what number you have to beat and it takes the guesswork out of your decision for stopping where you're at or going for more spins.  I don't have any desire to go on that game show so why am I making a plan for how I would play the game anyway?

What is Grimace?

A moment later my mind is barreling along another tangent.  I wonder what the hell is that weird McDonald's character named Grimace?  I know the the Hamburgler and Mayor McCheese are guys with hamburgers for heads.  Ronald is, of course, a clown.  There's Birdie, who is an easily recognizable bird.  But what is Grimace?  Is he a part of the chemical compound of food preservatives used in the food that the mere mention of makes one grimace in disgust?  Perhaps if you took the food preservative and studied it under a high-powered microscope you would discover that the structures of the preservative look like purple, inverted candy corn-shaped, blobs?  Who was the marketing genius behind the creation of Grimace and what was their thought process?
 
It would be rewarding if I spent my downtime thinking about solving the problems of the world and having philosophical epiphanies.  Alas, I find it is difficult to think straight when my head is pounding.  At least half of my attention is diverted to how badly my head hurts and how I hope the migraine will cease sooner rather than later.  I guess thinking about stupid stuff helps distract me to some extent and keeps me from focusing on feeling that my life is passing me by while I wait for a reprieve from the migraine.

Emotional Baggage

Migraines come with their own set of emotional baggage.  When I have a migraine it is closely followed by feelings of guilt that I let someone down by having to call in sick to work or cancel plans. There are feelings of worry that I am going to miss a deadline because I had to call in sick to work, or that friends will view me as unreliable for canceling plans with them.  Then there are feelings of anger that my body betrayed me yet again and forced me to call in sick or cancel plans.  There is also frustration that the migraines keep screwing up my life.  The cherry on top is the sadness that I'm missing out on something fun that I had planned.  It's a formula that looks something like this:

Migraine + Guilt + Worry + Anger + Frustration + Sadness = Migraine Hell

I remember one evening in particular about four years ago when I was living alone in Portland, Oregon.  I had leased a super cute apartment with floor to ceiling windows on one entire wall that extended through the living room and into my bedroom.  I moved in during the winter, not giving much thought to the fact that these windows got the evening sun.  By the time summer rolled around, the afternoon sun heated my apartment every night.  There was a tiny air conditioner in the apartment, but it couldn't keep up with the intense sun...it just moved the hot air around so I felt like I was living in a convection oven.  The apartment was often 80 to 90 degrees Fahrenheit and it was absolutely miserable in there.  If I have to suffer through those kind of temperatures I think I should be on a sandy beach, working on my tan, being served daiquiris by a cabana boy.

I had been stuck inside my inferno apartment for several days straight because I was sick with a migraine.  I'd missed a couple of days of work and was feeling guilty about that.  We had an important, upcoming event and there was a lot of preparation I needed to handle.  Let's just say that not all bosses are understanding about missing work for chronic migraines, so I was worried that the boss would be angry with me.  I was also not looking forward to how much work was piling up for me to deal with when I returned.

Several of my friends had invited me out to First Thursday in the Pearl District in downtown Portland.  First Thursday is basically a walk through various galleries in the area to look at different art exhibitions.  After that we'd planned to go out for dinner and cocktails.

When Thursday morning rolled around the migraine was unrelenting for the fourth straight day.  I called in sick to work.  Then I called the chiropractor and she worked me into her mid-morning schedule for a chiropractic adjustment and an acupuncture treatment.  I was hoping the treatments would alleviate the pain.  The chiropractor was quite worried about my pain level and before I left she gave me her cell number and instructed me to call anytime if the pain intensified.

Around 5:00 p.m. the pain was only getting worse.  I had to call my friends and cancel on our First Thursday plans.  I was feeling pretty depressed about missing our outing so I laid in bed and cried for a little while.  I cried because I was bummed out; because my friends might think I'm a flake for cancelling on them; because I had a Vegas vacation with the boyfriend (now husband) in nine days and I didn't know if I would be better by then; because I hurt; because none of the migraine medication I had on hand seemed to help; because I didn't know if the pain would ever subside; because it was so blasted hot in my apartment; because I hadn't slept well in days; because I was worried about work; because the chiropractic adjustment and acupuncture hadn't helped; and because I was feeling so sick I didn't think I could take care of myself.

I called my parents later that evening.   They were, of course, worried and offered to come and help me out.  I talked them out of that.  I didn't want them to drive four hours to sit in my apartment/oven while I laid in bed feeling like crap.  My Mom talked me into at least calling the chiropractor.  I had held off on doing that because I felt I was imposing on her calling after hours even though she told me I could.  She was really cool about it though and she directed me to go to the emergency room.  She told me to get ready and she'd call me back.  When she called me back she had located the hospital nearest to me and had called ahead to let them know I would be in soon.

The task of getting semi-presentable for the public was daunting.  I'm the kind of girl who never leaves the house without a hefty application of eye make-up.  I decided to wear sunglasses to mask my lack of eye make-up, and to help with the sensitivity to light that I was experiencing.  I changed out of my pajamas and put on some Adidas track pants and pulled on a sweatshirt.  It was too hot for a sweatshirt, but I figured that I didn't have to wear a bra if I wore a sweatshirt and putting on one less garment seemed ideal.  My long hair was a crazy mess.  I'd washed it when I returned home from the chiropractor, but couldn't brush it because I didn't feel well.  To make matters worse, I had laid on it while it was still wet and it had dried with a wicked case of bedhead.  Thank goodness I had a cute baseball hat to cover that.

After what felt like an eternity to get ready I then had to tackle three flights of stairs and a drive to the hospital.  That feat sounded about as easy as completing a triathlon on a good day, which is saying a lot because I don't even know how to swim.  The pain was at its absolute worst when I was standing or sitting, so getting from my apartment to the hospital was difficult.  I cried from the pain the entire way.  I had to take a few minutes to gather myself in the parking lot of the hospital before I went inside.

After I checked in with the registration clerk in the emergency room I slouched into a chair in the waiting room.  There was a young woman sitting there who was throwing up into a barf bag.  Although I felt bad for her, it did make me feel a little better about myself...I might not look too great, but at least I wasn't puking in public.  Her puking was pretty gross so I attempted to distract myself by text messaging the boyfriend about my $h*tty week.  He felt bad for me and offered to come over and take care of me, but I talked him out of it.  I don't particularly like people to see me in that kind of pain.  Besides, he lived two hours away and would have to take time off of work.  It was nice that he offered though.

When I eventually saw the doctor he ordered X-rays on my neck because I was having terrible neck muscle spasms.  He eventually sent me home with a prescription for muscle relaxers for my neck and pain medication for the migraine.  Thank goodness that the Walgreens pharmacy near my apartment was open 24 hours a day so I could get the prescriptions filled.  I returned home around midnight and with medication on board I was finally able to fall asleep and escape the pain.  The next day I felt quite a bit better.  The medication broke the migraine cycle.  The migraine wasn't completely gone, but it certainly wasn't as bad as it had been.  I managed to go to work that afternoon.  I slowly recovered over the next few days.   Thankfully, I was well enough to have fun on vacation, my friends did invite me out again, and my boss was understanding about me missing those few days of work.

That is just one of the many instances when a migraine derailed my life over the past 20 years.  It's hard to see the light at the end of the tunnel when you are in the middle of a migraine, but the headache always passes at some point.  I would like to think that chronic pain has made me much more appreciative of the little things.  Just waking up without migraine pain is a reason for me to celebrate and for that I will be thankful.  I guess I can add thankfulness to my migraine emotional baggage.

Gross.

Vomiting is never a good experience, but vomiting while having a migraine is quite possibly the worst feeling I've ever experienced.  Not only do I have a splitting headache, but puking somehow makes it feel exponentially worse.  I never know when I will get a "puking migraine" as I call them.  I can function with most of my migraine headaches because I've learned coping mechanisms over the years, but if it turns into a puking migraine I'm done.

Lucky for me, I don't get nausea with migraines often.  But when I do, I can't stop vomiting until the migraine ceases.  If I swallow migraine medication with water, it comes back up.  I get so dehydrated and crave a tall glass of water, but even the tiniest sip of water comes back to haunt me.  Oh, the humanity!

Sometimes, when I'm having a migraine and feeling sorry for myself, I will seek out comfort food to try and cheer myself up.  Years ago I ate one of my all-time favorite candies, a peppermint patty, during a wicked migraine attack.  I ended up getting nauseous shortly thereafter and the peppermint patty came back up.  Peppermint patties will forever be associated with vomit now and I doubt they will ever sound appetizing again.  Maybe that's a good thing...I don't need the sugar.

I could go on, but honestly that is more than enough on the topic of puking migraines.

Yogi

I was a competitive long-distance runner in high school.  It was difficult to run with constant migraine pain, but I grit my teeth and powered through.  I didn't race during college, but I continued to run three miles, five times a week.  I suspected the running intensified my migraines, but I couldn't bring myself to give it up.  Running was therapy for my mental well-being.  I loved listening to the fast-paced rhythm of my footsteps on the ground, my dear border collie running at my side, the quietness of being alone with my thoughts, the smell of fresh air, the satisfaction of doing something healthy for my body, and the runner's high after a run was complete.

At some point I finally accepted the fact that running was exacerbating my migraine headaches and it was time to try a different workout.  For that I'm a smidgen bitter, but I try not to dwell on it too much.  It's just one of many lifestyle adjustments I've had to make as a migranieur.  Over the years I tried other workouts like the elliptical, treadmill, and weight machines at the gym, as well as many workout videos in my home.  It was apparent that these high energy aerobic workouts weren't doing me any favors in the migraine department either.  I finally decided I'd give yoga a try.

Switching to yoga was a tough crossover for me not physically, but mentally.  I'd always been into high intensity workouts and I never thought I'd get a good workout from yoga because it seemed too low key.  It also didn't seem like it was my kind of workout.  I am a country girl and I thought yoga was for new age, vegan, yuppies who live in trendy metropolitan cities.  For the kind of folks who go out for happy hour at an oxygen bar to do wheat grass shots.  Well, my stereotype was completely off base and I've since learned that many types of people enjoy yoga, myself included.  I've been doing yoga several times each week for about two years now.  Yoga wasn't as easy as I thought it would be.  I was pleasantly surprised that it gets my heart rate up and I work up a sweat.  The best part is that that mastering a challenging yoga pose can be quite rewarding. 

Yoga Mat Thief #2

I don't know how zen I am while doing yoga.  It can be difficult at times with two goofy Labrador Retrievers sniffing around.  The moment I toss my yoga mat down they get excited.  They seem to think that if I'm on the floor I must be there to play with them.  More than once I've gotten into a complex pose requiring a lot of concentration and balance when my 90-pound chocolate lab decides to smash into me and we both go ass over teakettle.

Yoga Mat Thief #1

The lure of a vigorous dance workout recently got the better of me and I popped in a Zumba DVD.  I bust a move to a 50-minute advanced workout, totally keeping up.  I hadn't done a workout like that in over a year.  I worked up a sweat, but I never once was short of breath.  Afterwards, I surmised that yoga provides spectacular cardiovascular results since I wasn't huffing and puffing my way through the Zumba workout.  Unfortuantely, I paid the price over the next few days.  A terrible migraine started the next day and didn't go away for three days.  It was so bad that I missed two days of work.  I think it was a not-so-gentle reminder from my body that I should stick to yoga.

I guess you could say I've come around and accepted the fact that I'm a yogi.  To celebrate I got some no-slip, toeless yoga socks.  Shit just got real!

Tongue Tied

When I'm having a migraine I regularly find myself stammering, stuttering, and even mispronouncing words.  I also start speaking and completely lose my trail of thought mid-sentence.  It is just another lovely migraine side effect.  One that leaves me feeling like an idiot.

I had to read off of a document at a work meeting recently while I was having a migraine.  I was focused on reading everything word for word and when I finished I thought I had pulled it off flawlessly.  The guy sitting next to me started laughing and let me know I'd read something in the document wrong.  I'm not even sure what I said, but I was quite embarrassed.  It could be worse though.  Just check out the news story about a television reporter who had a migraine that caused her slurred speech on air by clicking on the link below.  (You will be routed to YouTube.)

Reporter Serene Branson: Not a Stroke, Just a Migraine

Winner Winner Chicken Dinner

The first headache I remember experiencing happened when I was about 6 years old.  I told my Mom that my head hurt and she explained to me that I had a headache.  She told me to go rest and that it should go away.  I went into the living room and stretched out on the gold velour sofa that was quite stylish back in the day.  I had headaches off and on as a I grew up.  Sometimes I would take an aspirin and lay on the sofa until I felt better.  It was tough having a headache and laying on the sofa back then...there was no remote so if I wanted to change the channel I had to drag myself off the couch and turn the dial to one of the other five channels we had.  (When my Mom wasn't around I'd watch old Three's Company reruns.  If she'd catch my sister and I watching those we'd get in trouble because they were rubbish.  If my sister or I were quick enough, one of us could jump up, run to the TV, and change the station before Mom caught us.)

When I was 15 years old I had a terrible headache that lasted a couple of days.  I was standing outside the music room at our high school with a couple of my BFFs and I was having a difficult time thinking beyond how bad my head ached.  That headache never went away and I now know it was the start of my chronic migraines.  When I say that migraine never went away, I mean I had it every minute of every day for months on end.  When it did finally go away, it would only be gone a day or two before it returned.

I would take over-the-counter pain relievers, but they never helped.  My parents knew I had headaches and together we just chalked it up to stress of academics and competitive sports.  We did not suspect I was having migraine headaches because both of my parents, my sister, and both of my grandmothers had migraine headaches on occasion.  Their migraines were accompanied by visual aura and mine were not, which is why we ruled them out.  (We now know that migraines are often not accompanied by aura.)  Beyond telling my parents that I had headaches I didn't convey to them how bad the pain was.  Since I thought I was having a headache I didn't want to be a whiner or some sort of hypochondriac and complain.  Besides, I didn't think there was anything that could be done for a headache besides taking an over-the-counter painkiller.  I just sucked it up and started living my life while simultaneously coping with a tremendous amount of pain.

If the Internet was then what it is now I'm certain I would have Googled my symptoms and found out that I was suffering from migraine headaches.  (Either that or I would have self-diagnosed myself with a brain tumor.)  But at that time the Internet wasn't a tool that we had readily available like we do now.

Fast forward through the remainder of high school and four years of college.  I was still dealing with the same chronic pain and struggling to get by.  It was a very dark time for me.  I'd scramble to get through with my daily activities of homework, work, and workouts so I could get home, crawl into my dark bedroom, and lay with my pain in silence.

During a particularly bad migraine episode I gave in to a friend's urging and he took me to the emergency room.  The doctor at the ER said if the pain went away after an injection of Imitrex that it was a surefire indication the headache was a migraine.  I was skeptical that an injection could make any headache vanish just like that.  To my astonishment, the injection worked.  Within 20 minutes I felt the sweet relief I'd been longing for over the past seven years.  My doctor sent me home and referred me to my regular physician.

I didn't go to the doctor often.  Just when I jabbed myself with a rusty piece of metal and needed a tetanus shot or a few times to get allergy medication.  I hadn't talked to the doctor about the headaches because I thought they were normal.  My regular doctor had recently left the area and was replaced by Dr. A-Hole*.  Dr. A-Hole was terribly rude and accused me of coming in just to seek narcotic pain medication.  He said that because I had not complained of the migraines to the previous doctor, (as there weren't any chart notes in my file regarding migraine pain), that I was making it up.  He then prescribed me narcotic pain relievers (WTF?  If he thought I was making it up, why did he prescribe me narcotics?)  That's not what I wanted and I never even filled the damn prescription.  He also gave me a prescription for Imitrex pills.  I did fill that prescription, but found no relief with the pills.  I went back to see Dr. A-Hole and he had me try the Imitrex nasal spray, which turned out to be ineffective.  Finally, he prescribed me the Imitrex injections.  They seemed to work, without fail, every time.  The only downside was that they were expensive.  I had to ration them out so I wouldn't break my budget.  Imitrex only stops a migraine after it starts, it does not prevent them from starting in the first place, so I still had daily migraines and would only use the Imitrex on the worst of the worst migraines.

After about a year I went back to Dr. A-Hole and requested an MRI of my neck.  Since my migraines were usually accompanied by intense neck pain I wanted to make sure that everything was alright in there.  He balked at the idea and we got into an argument about it.  He finally said he'd order an MRI, but that it was a waste of time and money.  It was like he agreed to do it out of spite so he could show me that he was right and nothing was wrong.  Fortunately, he was right, the MRI didn't show anything bad going on in my neck.  I didn't care that he was right.  I felt better knowing that my neck had been closely examined so I could at least rule it out as the cause of my pain.  I decided that working with Dr. A-Hole was not working out...I needed a doctor who was more of an advocate than an enemy.

I found a super nice doctor who was concerned about my migraine situation.  He referred me to a neurologist at my first appointment.  When I visited the neurologist he went through a lengthy panel of questions and looked over my MRI.  He diagnosed me with migraine headaches.  He said that, based on the family history of migraines, the cause was likely genetic and that I had hit the migraine jackpot in my family.  Lucky me, why couldn't I have hit a Powerball jackpot?  Why couldn't that luck follow me to Las Vegas sometime?

My kind of Jackpot!

My story doesn't end here, I'll fill you in more another day.

*Name has been changed to protect the identity of an imbecile.

Cowboy, baby!

The first time a doctor referred to me as a migraineur (a person who experiences migraines), I pictured how to spell the word phonetically in my mind and came up with my-gran-ear.  I used word association to help me remember the proper pronunciation.  Migraineur ends similarly to the way the word pioneer ends.  That's the moment my mind jumped the track.  The word pioneer made me think of old west cowboys, and the word cowboy made me think of the Kid Rock song, Cowboy.  (Side note: I think Kid Rock is skeevy, but I do like some of his music.)  The song Cowboy is pretty trashy, but it has a great sound.  He sings about moving out to California, drinking, drugging, pimping, and whatnot.  Not a family friendly song (sorry Mom).  I don't know all the lyrics, I just sing along to the "cowboy, baby" chorus part.  Whenever I think of the word migraineur now, I have an instantaneous response to think about that song, (I wanna be a cowboy, baby!), and it is stuck in my head the rest of the day.  It kind of makes me feel like a bad ass for awhile.

Cowboy?

I wish being a migraineur made me feel like a bad ass, like the Cowboy song.  In reality it just really sucks ass.  Since I am blogging about migraines I feel that I must address what a migraine is and give you an idea of what a chronic migraineur deals with. To me this is about as much fun as reading the fine print on a sweepstakes entry.  As a general rule, I avoid talking about migraine specifics because it's depressing and I'm tired of discussing it, especially with doctors. Because of this aversion I am not going to go into tremendous amount of detail.

Migraine headaches are a neurological disease, not just a headache.  They are more common in women than men, and they can be triggered by a number of factors (stress, hormones, bright lights, flashing lights, diet, air pressure changes, strong scents, and muscle tension just to name a few).

A migraine occurs in phases, the first of which is called the prodrome phase that is associated with symptoms like hyperactivity, neck stiffness, food cravings, dizziness, ringing in the ears, excessive yawning, and irritability.  Some people will also experience an aura.  Aura symptoms include visual abnormalities like seeing wavy lines, experiencing vision loss, speech difficulties, and a tingling sensation in the extremities.

How I feel prodrome phase.

Following the prodrome is the migraine attack that can last a few hours to a few days.  It is a terrible, intense, throbbing pain generally experienced on one side of the head.  It can be accompanied by lightheadedness, nausea, vomiting, and sensitivity to light, scents, and sounds.  Migraines can be so severe that all you can do is lie down in a quiet, dark place and wait for a reprieve from the pain.

How I feel during a migraine attack.

Finally, there is the postdrome phase when the migraine attack has ended, but the migraineur is left feeling physically exhausted.  I also call this the hangover phase because after effects of a migraine attack feel eerily similar to the way I feel the morning after I consumed too many cocktails.

How I feel postdrome (aka hangover) phase.

One other term you'll often hear me use is chronic migraine, which is my diagnosis.  Chronic migraine sufferers experience migraines 15 days or more each month.   

I have read different theories about what goes on in a person's body when they experience a migraine.  The theory I've come across most often, as I understand it, is that migraineurs have excitable neurons bouncing around in their brains.  When a migraine trigger is encountered the neurons fire and eventually cause dilation/swelling of the blood vessels in the coverings of the brain.  The impulses transmitted by the nerves of the dilated blood vessels are sent to the brain and experienced as pain.  I'm not a doctor and I don't know what is going on inside my head when I have a migraine, but what I do know is that it is incredibly unpleasant.

So there you go, a brief introduction to migraines.  If you would like to learn more just do a web search and you'll be inundated with web sites dedicated to migraine.