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.