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.

Uncle Leo's Eyebrows

I looked at my husband the other day with my irritated/angry face.  I squinted my eyes, furrowed my brow, tilted my head, and gave him some stink eye.  Something didn't feel right.  I ran into the bathroom, looked in the mirror, and was startled by my reflection.  I couldn't scrunch my face or furrow my brow.  Botox had frozen my forehead!  I returned to the living room, stuck my face in front of my husband's face,  and attempted to make my angry face again.  I said, "I'm seriously pissed right now, just look at my angry face."  He laughed.  I shrieked, "It isn't funny!  I can't make expressions!"  He laughed harder.  To which I reiterated, "IT'S NOT FUNNY!"  The laughter continued.  "Argh!  I can't look surprised, angry or quizzical right now if I wanted to.  All I can do is squint my eyes and wrinkle my nose.  Oh my God, how am I going to function in my melodramatic fashion if I can't move my eyebrows?"  I stormed out of the room before I had to listen to him laugh at my expense anymore.  I retreated the bedroom where I sulked and tried to remember why I was irked at my hubby in the first place.

Have you seen that episode of Seinfeld where Jerry's Uncle Leo's eyebrows get burned off and Elaine draws new ones on with a Sharpie?

Uncle Leo sporting Sharpie eyebrows.

I'm thinking maybe I should try that.  I could shave off my eyebrows and use an eyebrow pencil to draw on appropriate expressions.  I'd use a Sharpie, but that is too permanent since I change my expressions many times each day.  I wonder if dry-erase markers would work?

Botox may have made me expressionless, but I can report that in the two week period since I had the Botox treatment I have only had one bad migraine headache.  I'll take the frozen forehead in return for fewer migraines any day of the week.  Things are looking up.

Food Poisoning

I worked at a pizza place for four years while I attended college.  The state health department required food service employees to be certified to safely prepare food by taking their food handler safety course every few years.  The first time I attended the course the instructor played an audio recording of a woman recounting her experience with foodborne botulism illness.

After the health department investigated her case they discovered the culprit to be a foil-wrapped baked potato.  The woman and her husband had gone to at a restaurant where she ordered a baked potato with her meal.  It was later determined that the potato had been prepared the night before, but had not been served.  It had sat out waiting to be served for far too long after being cooked.  The restaurant staff didn't have the opportunity to serve the potato, so they placed it in the refrigerator at the end of the night.  The next evening they reheated it to serve.  I think the instructor told us that the botulism began to grow when the potato was left out at room temperature too long the night before.  Unfortunately, the temperature of the refrigerator wasn't cold enough to kill the botulism overnight.  Then, when the potato was reheated the next evening, it wasn't brought up to a high enough temperature to kill the botulism.

Do not confuse this potato with the culprit potato.

The woman described her hellish ordeal.  The botulism caused major swelling throughout her body and paralysis, including respiratory paralysis.  I don't remember the entire story, but I do recall this woman had to undergo a number of medical procedures without anesthetic because it could have completely shut down her failing body.  She talked about being cut open for these procedures and unable to scream out in pain even though she was trying.  She couldn't speak because her tongue was so swollen it was sticking out of her mouth.  She couldn't see because her eyes were swollen shut.  She could barely breath because of the respiratory paralysis.  Her tale was utterly horrifying.  For quite awhile her doctor didn't think she'd pull through, but she did.  Ever since I heard her story I have associated baked potatoes with botulism.

Fast forward to May 2011 when my pain doctor said we had exhausted all the migraine treatments he knew of, with the exception of onabotulinumtoxinA (Botox) injections.  (WTF?  Even the name, onabotulinumtoxinA, has the word toxin in it for crying out loud.  Who was the brainiac that thought shooting a toxin into your head was a brilliant idea?)  The doctor explained that the FDA has approved the use of Botox in chronic migraine sufferers to dull future migraine headache symptoms.  He proceeded with the preauthorization for treatment with my insurance company.  My insurance denied the request, as well as my appeal.  At the time I thought that maybe it was for the best.  Maybe fate was stepping in and didn't want me to have baked potato food poisoning injected into my head.  Before we could discuss any further treatment, my doctor left his clinic and I gave up the idea of having the procedure.  I tried to suck it up and figured I was out of treatment options since he said Botox was the last treatment he had in mind for me anyway.

In early 2012 I was once again at the end of my rope dealing with these effing migraine headaches.  My massage therapist mentioned that my facial muscles didn't seem to relax during a massage.  She suggested I research getting Botox injections in my forehead to relax those muscles.  I talked myself out of doing it many times because of the expense.  Then, a few months later, a friend of mine told me that she had cosmetic Botox injections in her forehead and a nice side effect was that her tension type headaches had disappeared.  After talking it over with my husband, I decided to give it a try.  We also decided it was time for me to look into going to a new pain clinic.  I made the appointment to get the cosmetic Botox injections in my forehead to help with my furrowed brow, then called my regular doctor to start the referral process to a new pain clinic.

In January 2013 I had cosmetic injections and noticed results within a few days.  I was not scrunching my forehead or furrowing my brow constantly.  Also, I was finally unable to unclench my jaw, which had been in a painful, permanently clenched state for years.  I still had migraines, but the tension release in my facial muscles was sweet relief.

About a month after the cosmetic Botox I visited my new pain doctor for the first time and he felt that migraine Botox treatment would be the next logical treatment option for me.  He went ahead and put a preauthorization request into my insurance company and lo and behold it was approved straight away.  I made an appointment to get the 25 injections in what he called a migraine pattern (spread around my temples, forehead, scalp, and neck).  Within two weeks of the treatment I should see results, and with any luck I won't have any migraines.

I went in for the treatment recently.  I attempted to distract myself from the boredom of sitting in a tiny exam room by reading the tattered, two-month old copy of People magazine and read about speculation that Princess Kate was pregnant.  (I have never been in a doctor's office with a current issue of a magazine...what's up with that?)  I got tired of reading old news so I sat in silence while my overactive imagination was hard at work.  I imagined scientists donned in white lab coats working diligently in a high tech laboratory.  They were piercing improperly prepared/handled, foil-wrapped baked potatoes with syringes and withdrawing botulism from them.  Next, they transferred the substance from the syringes into test tubes, then they put the test tubes into a centrifuge.  (I don't know why the centrifuge portion was necessary...it just seemed science-y.)  After that, the test tubes were labeled as Botox and shipped out for injection into migraine patients such as myself.

The doctor finally came in with a tray holding syringes he went over the possible side effects of the treatment.  Your eyelid could droop, you could have difficulty breathing, you could have flu-like symptoms, yada, yada, yada.  He then asked me if I still wanted to go through with the injections after hearing about the potential side effects.  I threw caution to the wind and told him I'd be remiss if I didn't give it a try, so let's get started.  The procedure was somewhat painful, but at least it didn't take too long.  Having needles shoved into your temple is never cool, unless they are for acupuncture or a really awesome face tattoo.

Awesome face tattoo?

I'll keep you posted on my progress.  I'm keeping my fingers crossed.
 

Nature's Superfood

I love the movie Zombieland.  Woody Harrelson plays a character named Tallahassee who has a fierce craving for Hostess Twinkies during a zombie apocalypse and there are no Twinkies to be found.  There is a scene in the movie where he comes across a broken down Hostess delivery truck and he's totally jazzed at the prospect that it could be filled with Twinkies.  When he opens the door he is greeted with an outpouring of Hostess Sno Balls.  He's pretty pissed, (totally understandable).  He yells, "Sno Balls?  Sno Balls?  Where's the f@*!ing Twinkies?"  His acquaintance, Columbus (played by Jesse Eisenberg), says, "I love Sno Balls."  To which Tallahassee replies, "I hate coconut.  Not the taste; consistency."  I can totally relate, but for me it is not coconut, it's bananas.  The consistency is disgusting and I cannot eat them without gagging.

My Mom has long touted the nutritional benefits of bananas.  They have potassium, vitamins C & B6, lots of fiber, they're a healthy way to satisfy your sweet tooth, and they are fat & cholesterol free.  There are probably other benefits she's told me about, but I just don't care.  The consistency trumps nutrition in this case.

As most migraineurs know all too well there are a number of foods that can trigger migraines, including aged cheese, chocolate, red wine, hot dogs, and bananas to name a few.  I could sit here and be bummed out that chocolate made the list, but instead I'm going to revel in the fact that bananas are on that list too!  Not only did they make the list, but when I tell my Mom she just might stop lecturing me about bananas being one of nature's superfoods.  Hallelujah!