It’s Enough to Give a Girl a Headache

September 22, 2011 - 1:20 pm 5 Comments

This is a more personal post than I normally put on this site, so I hope you’ll bear with me.  It’s about something that’s had a huge impact on my life, and it’s because of that that I’m making this an actual post instead of a multi-tweet rant; it’s something I’d like to be able to point people to when they have questions without repeating myself or getting frustrated, which is something I’m entirely guilty of, especially when in my current state.  It’s a bit long, and a bit wordy, and I hope you’ll understand.

I get migraines.

In fact, I have one right now.  Which is why it took me ten minutes to write a three-sentence long paragraph.

I think people in this day and age, generally, are aware of the pain migraines cause.  It wasn’t very long ago, however, that even the medical community thought migraines were a disorder exclusive to women brought on by hormones or hysteria or worse still, were nothing more than pleas for attention from lonely young mothers with children.  And the pain?  Either they were greatly exaggerating or making it up all together.  While it is true that women are more prone to migraines and hormones do indeed play a major role in migraines for some people, they are definitely a real condition which causes real, and sometimes boarder-line unbearable, pain.  And they certainly have nothing to do with attention.  In fact, I’d bet you dollars to donuts that if you try to give attention to a person suffering a migraine, they with either a) cry b) politely ask you to leave and lock the door behind you or c) shoot you.  That last one might seem a little extreme, sure, but you’ve gotta do what you’ve gotta do.  And you also have to have a sense of humor about these things or you might just end up pointing the gun in the other direction.

If you’ve never encountered pain that could be considered almost unbearable, let me ask you a question: do you know the definition of the word ‘writhe’?  Dictionary.com has this to say on the subject:

1. to twist the body about, or squirm, as in pain, violent effort, etc.
2. to shrink mentally, as in acute discomfort.

Both of those are pretty applicable to the activities you’ll be performing when you have a migraine.  You’ll also become very religious, whatever your former spiritual persuasion.

In fact, I’ve got a pretty strong theory that most exorcisms are actually archaic migraine treatments.  And about as likely to work as just about anything else, really.

You’ll put a frozen steak on your head even if you’re a vegetarian, you’ll drink more water than a marathon runner, and if you’re very very lucky and lie very very still, you won’t vomit it all up again.

You’ll also probably swallow a lot of pills.

Like many (probably most) Americans, I don’t have health insurance, and I don’t have the kind of money to be seen for what’s 99% certain to be a lifelong condition and then chuck out more cash for non-painkiller migraine pills that rarely work or painkiller migraine pills that will just make me stoned all the time (or worse, migraine pills that take away my migraine pain but cause a completely new kind of pain in the back of my neck so horrific I’m paralyzed for 24 hours thanks Imitrex!).  So I take Excedrin Migraine.  And that shit works.  Boy howdy does it work.  But unfortunately it’s chock full of caffeine and aspirin and acetaminophen in extremely high doses, all things which on their own can upset even the most steely of stomachs.

And guess what else upsets your stomach.

And if you have a persistent migraine, you have to take upkeep doses, so even if you’re pain-free, you’re jittery and more hyperactive than a twelve-year-old boy who’s just been given a bag of cocaine-laced confectioner’s sugar, and the threshold on your temper, on a scale of one to ten, is set to about negative six.

And if you want to sleep the pain away, and believe me, you will, you, non-insurance-having American, will take melatonin. Melatonin, according the Great and Powerful Wiki, is

a naturally occurring compound found in animals, plants and microbes.[2][3] In animals, circulating levels of the hormone melatonin vary in a daily cycle, thereby allowing the entrainment of the circadian rhythms of several biological functions.[4]Many biological effects of melatonin are produced through activation of melatonin receptors,[5] while others are due to its role as a pervasive and powerful antioxidant,[6] with a particular role in the protection of nuclear and mitochondrial DNA.[7]

In mammals, melatonin is secreted into the blood by the pineal gland in the brain. Known as the “hormone of darkness” it is secreted in darkness in both day-active (diurnal) and night-active (nocturnal) animals.

Melatonin will put you in a goddamned coma.  That is an exaggeration.  What is not an exaggeration is that if you had any plans that day and you do end up taking melatonin, you can forget about your plans.  In fact, you can forget about your day, because you’re going to sleep through it, and if you have to take an upkeep dose, you’re going to sleep through the night and maybe the following day as well, because

[o]ral caffeine may significantly increase the bioavailability of melatonin. The proposed mechanism is inhibition of CYP450 1A2 first-pass metabolism. After administration of melatonin 6 mg and caffeine 200 mg orally to 12 healthy subjects, the mean peak plasma concentration (Cmax) of melatonin increased by 137% and the area under the concentration-time curve (AUC) increased by 120%. The metabolic inhibition was greater in nonsmokers (n=6) than in smokers (n=6). The greatest effect was seen in subjects with the *1F/*1F genotype (n=7), whose melatonin Cmax increased by 202%. The half-life did not change significantly. The clinical significance of this interaction is unknown

according to drugs.com.

That’s right.  If you take this sleep-inducing hormone with a thing that would normally keep you awake, it will make you sleep up to twice as much.

And I won’t even get into the vivid dreams.

So by now, you’re in unspeakable pain, you’re bloated, nauseated, full of medication, and halfway in a coma.  So you should really probably eat something.  But you won’t want to.  I don’t care how much you love food, or what kind of cravings you have on a daily basis.  You will look in your fridge and find every item contained within a device for some sort of torture.  To say you won’t be hungry is a bit of an understatement.

Today I have had 750mg of acetaminophen, 750mg of aspirin, 195mg of caffeine (which, incidentally, is enough to be considered legally intoxicated on the stuff depending on your height and weight and oh did I mention I am five feet tall), and 3mg of melatonin.  I have have a spontaneous two hour nap and 40 ounces of water.

And I choked down half a slice of white bread.  And it was an end-piece.  And it was awful.

But honestly?  I think most people get that.  I really do.  Migraines, and the pain and discomfort associated with them as well as the drastic measures most people will go through to get rid of them, are a part of the culture at the point.

Here’s the part I don’t think a lot of people understand.  Right now, thanks to my Excedrin regimen, I am almost completely pain-free.  And I have a migraine.

Before I get into that, let me just clarify: there are tons of different types of migraines, over ten and sometimes up to twenty depending on your classification.  They all have a few basic, common symptoms: headache of a throbbing nature, persisting for four to 72 hours (yes, that’s three fucking days), nausea, and photophobia, all of which are generally exacerbated by routine activity (yes, migraines are made worse by the fact that you exist), but there are tons of different variant symptoms.  Everyone is probably aware of the ‘aura’ symptoms: seeing lights or spots, blurred vision, or ‘rings’ (hence, auras) around objects, especially those with vivid colors.  That has never once happened to me.  In fact, less than 30% of people with migraines experience auras (numbers thanks again to Wiki).  What I do get are prodrome symptoms, which are

altered mood, irritability, depression or euphoria, fatigue, yawning, excessive sleepiness, craving for certain food (e.g. chocolate), stiff muscles (especially in the neck), dizziness, hot ears, constipation or diarrhea, increased or decreased urination, and other visceral symptoms.[14] These symptoms usually precede the headache phase of the migraine attack by several hours or days.

And you know what the worst part is?  Believe me when I say it’s the euphoria.  Because you go from being amazing and talkative and happy and hungry and active and a great person to be around to absolute fucking despair.

And migraines are generally not considered a mood disorder.

Oh, and did I mention the sleeping?

Oh, and did you catch the part where these symptoms come on several days before hand?  Days.

And then there is postdrome, which, is, you guessed it:

effects of migraine … persist[ing] for some days after the main headache has ended. Many sufferers report a sore feeling in the area where the migraine was, and some report impaired thinking for a few days after the headache has passed. The patient may feel tired or “hungover” and have head pain, cognitive difficulties, gastrointestinal symptoms, mood changes, and weakness.[19] According to one summary, “Some people feel unusually refreshed or euphoric after an attack, whereas others note depression and malaise.”  (From Wiki.)

That actually makes it sound a lot better than it is.  Between pro and postdrome, I personally have experienced both binge eating and self-imposed starvation, delirium, hyperactivity, insomnia on a scale of days, flu-like symptoms, loss of hearing, loss of vision, loss of feeling in the left side of my face, and things as weird as an inability to use the same vocabulary that I would use if I had no migraine symptoms.  But I do also experience the euphoria, the restlessness that compels me to be productive, the change in my thought process that allows me to experience things differently.  In fact, during migraines where I am pain-free and not wasting your time with interminable blog posts, I make a point to read or write because I both understand and explain things differently than I do without a migraine because I’m forced by lack of blood flow to use a different part of my brain.

My dad thinks this is really cool.  And you know what, it would be a lie to say it’s not.  The pain, of course, is stupefying.  But if nothing else, it can be pretty damned interesting.

And it’s completely fair to say that migraines, and/or their symptoms, can make you a completely different person.

Now, let me make myself really really fucking clear:

I am not writing this post because I want pity.  In fact, the last thing I want is pity.

What I do want is a better understanding of something that affects the lives of millions of people, including myself and a pretty good percentage of the people I know.  Migraines are not just headaches.  Migraines are a lot more than that, and they can be tough to deal with.  But just like the migraine sufferer who wants to be left alone in a dark room, I’m not doing this for attention, except the attention that comes with understanding.  Migraines are strange beasts, and though they’ve come to the forefront of the social consciousness, at least in western culture, there’s still a lot about them that people don’t understand.  For those of us who put up with the less-common, or perhaps just less-discussed, symptoms, it can be frustrating.

This post, to be sure, is a culmination of that frustration, but it’s also born out of the questions that people have asked me.  People want to know more, and sometimes a personal experience detailing both the good and bad of a condition, even when the condition is, yes, I’ll admit, mostly very bad, can bring a little light to where once there was shadow or doubt or disbelief.

So don’t comment with sympathy (though empathy from fellow sufferers will not be turned away, because I’ve had a good long bitch, and if you want to put your personal experience in the comments to share, I welcome any additional details or information you find relevant to this post).  What I want is the most normal life I can possibly have with such a truly weird condition, and that’s not really that hard to do, most days.  What I want is for someone to read this post and have more knowledge of a common but yet poorly understood condition, for them to be brave enough to ask questions, and to seek help, if they themselves share this condition.  Having migraines is not something to be ashamed of.  It’s something to take care of, and to take care of yourself because of.  It took me a long time, and a lot of forced decisions – I dropped out of college because my migraines were so bad in my junior year that I couldn’t leave my apartment in the morning – to grasp that.  If this post does that for even one person, then writing this, as personal and potentially pity-party inducing as it is, was worth it.

5 Responses to “It’s Enough to Give a Girl a Headache”

  1. Zenvar Says:

    More than anything, I am actually scared after reading this. I too suffer through migraines, but I guess I’ve been lucky, I only get the intense pain and the photophobia. Having said that, the only medication that has worked for me was MASSIVE doses of vicodin, massive to the point to where I was worried about overdosing. I too wish there was something that could help people that suffer from migraines. Hell, I have medical insurance all my doc’s ever said is to take excedrin which has never done anything for me. Also, thank you for this amazing article, you describe the entire situation better than I can ever imagine doing myself.

  2. Kim Says:

    Once upon a time, after I had been suffering from migraines since I was five (and I still hope there is a special place in hell for every teacher or friend of my mom who told me “oh, honey, children don’t get headaches – you’re just saying that in imitation of your mom.”) one year when I was about 26 or so, I landed a decent job and it had health insurance. And one day when my boss was afraid that I was going to ruin the typewriter by sobbing and snotting into it, he talked me into going to a specialist. I knew it wouldn’t help, but I did it anyway because getting everyone to shut up once and for all about “going to a doctor for it” would at least take one stressor out of my life!

    Well, it didn’t “help” per se, I mean, I wasn’t “cured” – you can’t cure migraines any more than you can cure diabetes. And it was frustrating for a long time because the man made me a freakin’ walking, talking pharmacy of different types of drug regimens. The upshot of most of those was that I was in pain AND spaced out all the time. One drug did work: ergotamine. I was ecstatic about that! But turns out you can’t take it for more than three months running or it’ll end up paralyzing you. So oh well.

    We also tried biofeedback, and I got to where I could raise the external temperature of my hands to 110 degrees at will (I still can!) And when I did that it really did drain the excess vasodilation from my brain, and the pain would go away. But the problem is that the minute you stop concentrating on your hands (or feet, as the case may be,) the pain comes right back. And you can’t do this while you’re driving, or working, or pretty much anything. I do find still it handy in the winter though when my hands or feet are cold!

    The thing I took home, though, that has been of actual lasting value, was an education. Now I know exactly what that pain is and some of the things I can avoid doing. For instance, now I can tell when I’m tensing up the back of my neck or my shoulders, thereby blocking blood flow to my head, and I can will myself to stop it. (If I don’t, the blood-vessels in my head will attempt to compensate by over-dilating and that will equal pain.) I can avoid ever letting myself get hungry, or tired, and I can listen to my body and hear what it’s really saying it needs so that I can eat what my body needs, when it needs it, and not what people say I’m supposed to be eating or what’s “correct” for any given time of day. OK, I get a lot of weird looks when I eat sauerkraut for breakfast, but I’d rather have that than migraines.

    I learned that there is NO virtue whatsoever in saying “Oh, it’s not so bad right now, I’ll wait until it gets really bad before I take any pain killers,” because when it gets worse, your stomach is going to refuse to digest those painkillers and you may as well just flush them down the toilet. So I make no apologies about nomming painkillers the instant I feel the slightest beginning of the slightest echo of a migraine coming on (and I can spot one miles off, now!) In the long run, I actually end up taking far less druggery this way.

    Most of all I learned that it is not just “all in my head.” I also learned that it is NOT “a sinus headache” which almost all women who get migraines think they are actually having. The pain does often center in the areas we think of as our “sinuses” but excess snot is not what is causing them. They are caused by blood vessels in the head hyper-dilating in response to stress or sudden relaxation or pretty much any damn thing! The kicker though is that antihistamines and decongestants do help a bit, because they act as vaso-constrictors. (This is also why Excedrin works so well – caffeine is also a vaso-constrictor. And why do those headaches come back when you don’t take your maintenance dose of Excedrin? It’s because you’re having withdrawals from the caffeine! Sometimes I wonder if the makers of Excedrin know this and actually get women hooked on caffeine on purpose in order to sell their product.)

    In the end, with all the fancy-dancy prescription drugs and medical technologies out there, what I learned was that one or two over-the-counter painkillers will do the job for me if I take them correctly in a timely manner. That and a little bit of lifestyle change, helped me get the condition under control. I still get migraines, but it has been a long time since I got one that made me want to blow a hole in the side of my head just to let the pressure out.

  3. Aliza aka ZPAwoman Says:

    Not enough people understand migraines at all. If I had a dollar for every person that said, “It is just a headache” I would be a millionaire.

    I have insurance, however like you mentioned, the prescription drugs space me out to much and can’t function. Excedrin works most of the time but there are some days nothing helps but a pitch black cave and no movement or it will be puke city.

    I think the worst ones I get are the ones behind my eye, you know the ones, where you feel like your eyeball is throbbing and going to explode or just pop right out of your head. Fun times. Thanks for the blog. I will be sharing with others so they can understand too :)

  4. Adria Says:

    Thank you so much for this entry. There’s only so many medical articles I can link to for the ignorant to read before they start ignoring them. I have suffered from migraines since I was around 8 and it took them YEARS to diagnose them as such. I was in so much pain as a kid, yet the nurse never wanted to let me call my mom (a mistake on their part as she ripped them a new hole when she found out they were trying to prevent me from calling her). Once I was diagnosed, I was put on Imitrex, which DIDN’T work but I suspect gave me heart problems instead. Like you, I find the Excedrin Migraine works but the downside is the caffiene. I am sensitive to caffiene and taking Excedrin Migraine guarentees that the migraine won’t be as bad but I will be awake for at least 48 hours straight.

    That said, even with the Excedrin Migraine, I am still photosensitive, queasy and in a lot of pain for awhile. Yet people still try and treat me like I have a “normal” headache to which I always reply “Let me beat the crap out of your head with a shovel and then you can carry on with your day in the same condition as me.”

  5. Kristin Says:

    You know, I think I’ve had only one minuscule headache in my entire life, so the concept of migraines are kind of elusive to me and the most “answer” I ever get from anyone (and I have a feeling those are the people who just call everything a migraine out of exaggeration ><;) is "it's a really bad headache". So thanks for sharing something that's, well, real and puts things into context.

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