Hey Nerds,
Let’s talk migraines. I want to keep this blog about things I know/experienced/have seen and I have my fair share of experience with migraines. Case in point, I’ve had two in the past week and a half. Putting it bluntly: migraines suck. Hard. So let’s talk what I know about migraines and some things I’m exploring regarding combating migraines.
MASSIVE DISCLAIMER: I’m not a doctor. I have no professional, or even informal, medical training. I did once take a CPR training to earn a safety badge and a course on continuous chest compressions and using an artificial external defibrillator (AED) from an employer. I also have quite a stockpile of Band-aids in my home because I once had to use up my FSA account before leaving an employer and so I bought a billion mega boxes of Band-aids. This by no means is meant to replace going to your primary care physician and talking about your options to treat you migraines. Believe me, I love my certified nurse practitioner who manages mine. This is just the mental vomit of one migraine sufferer to others.
Fun Fact: Did you know there are different types of migraines? According to the American Migraine Foundation, there are NINE types of migraines!
- Migraine with Aura (Complicated Migraine)
- Migraine without Aura (Common Migraine)
- Migraine without Head Pain
- Hemiplegic Migraine
- Retinal Migraine
- Chronic Migraine
- Ice Pick Headaches
- Cluster Headaches
- Cervicogenic Headaches
Me personally? I suffer most frequently from migraines without aura. Head pain that builds and builds until I am physically ill, which then usually marks my headache starting to subside. My grandmother suffered from migraines without head pain. She’d have the aura and visual disturbances, dizziness and nausea, but no pain. Both suck in their own right.
Let’s address what I’ve found is the hardest part of migraines. It’s not the pain. That sounds ridiculous, because they are literally debilitating. You have to hole away in a dark, quiet space and pray for relief (or sometimes sudden death). Sometimes even smells are too much to handle. It’s not all of that; it’s the convincing people around you that your headache is as serious as you say. For someone who may never have experienced a migraine, they don’t understand the pain and despair. They can’t understand why you wouldn’t want them around or to go see and do fun things together. You may even hear whispers of you are blowing it our of proportion for sympathy or to get out of an obligation. I’ll give you an example: the very first time my partner and I visited Hawaii a massive migraine hit me during the flight over. We had flown to Kona and I had to manage picking up the rental car, navigating to the hotel, and getting checked in before I could curl up in the bed without the lights on and pray it would go away. My partner wanted to go explore! See the things! Play in the ocean! I wanted to die. This was before I had discussed my migraines with my doctor and received prescription medicine. I powered through this bad boy all on my own. So while I curled up and wished for death, they headed out to see Kona. They came back with pre-made sandwiches (which smelled terrible and made me want to heave) and a bottle of beer with a cap that needed a bottle opener. After several failed attempts to locate a bottle opener to open the beer, as well as proffering up sandwiches that were declined, my dearest was getting frustrated. At this point I got out of bed, grabbed the beer and popped the cap off with the edge of the stone counter top in the bathroom, handed it back and then promptly turned and dry heaved into the toilet. And it was in that moment that my partner got it. I would much rather enjoy the beer with them and explore. Instead I was dry heaving in a hotel bathroom in majestic Hawaii. That trip was 11 years ago and my Nerd For Life is the most considerate, caring individual when I know a migraine is coming on. (They once suggested we leave a live sporting event mid-way through because they could tell I was getting worse–even when I was denying it and trying to stay.) We also learned to always travel with a bottle opener.
Let’s talk drugs. The very first medication I was prescribed for my migraines was Maxalt Melts (Maxalt-Mlt). So Maxalt is a form Rizatriptan and the melts were an oral tablet that dissolved in your mouth. They tasted terrible, but you started to feel relief in like 30 minutes. Rizatriptan narrows the blood vessels around the brain and reduces substances in the body that can trigger headache pain, nausea, sensitivity to light and sound, and other migraine symptoms (thank you drugs.com for that info). Honestly, I LOVED my Maxalt Melts. They worked quickly and I was back on my feet in no time. Unfortunately, I don’t take them today. Why you ask? My insurance company stopped covering it and I had to decide between paying like $300-400 per refill for the drug that worked quickly, or $9-12 for the drug that took 2-3 times longer to see relief. At the time I was making $40,000 a year and couldn’t justify the expense. So we shifted me over to Sumatriptan. It works similarly to Rizatriptan, though they are different, but I was put on a pill form. I still saw relief, but usually within an hour or two of taking my pill. These days, my current CNP has me trying both Rizatriptan and Sumatriptan as pills. We’re trying to see which works better for me, 10MG Rizatriptan or 100MG Sumatriptan.
Here’s something I learned from one of my doctors: during a migraine your stomach clenches up (or something like that), which is why it is SO important to take your medicine as soon as feel a migraine (or a headache you suspect might become one) coming on. Your pill has to get to the stomach to dissolve and disperse into your body. So take away numero uno is take your medicine ASAP. I used to wait too long thinking, “maybe this won’t turn into a migraine…” Now I err on the side of caution and take it. Maybe I wasted a pill or two here or there, but in the long run it’s worth it. This is also why the melts worked so well regardless of when I took them, because they started working immediately after melting. Also, if you need that second dose, TAKE THE SECOND DOSE. I was also trying to make my meds last longer and wasn’t taking the second dose.
Here’s something weird that started happening recently. My last two migraines I started seeing a multi-color, swirling aura in one eye. The first time it happened I naturally freaked the fork out because I had never had the swirling vision prior to a migraine. I had only once had the swirls, though not colorful, during a migraine. For a hot second, I thought I was dying. After maybe 15-20 minutes, the swirls went away and another 30 minutes later the migraine set in. The next week, I woke up to the exact same colorful swirl in the vision of my right eye and immediately took Sumatriptan. This early warning helped keep the migraine to a minimum and a nap helped nip it in the bud with minimal pain and light sensitivity.
Now my question is, why did I start getting these new symptoms with my migraines? Honestly, I don’t know. I’ll bring this up with my CNP the next time I go in, but I can tell you my hunch. Stress. We’re all living in a pretty stressful time and stress can trigger my migraines. So can too much sun, not wearing my sunglasses outside, tube lighting, not enough caffeine, too much caffeine, staring at a computer monitor too long, the weather, not enough sleep, and hormones. So what can you do to avoid migraines? Great question.
First off, I try to remain consistent. Routine helps me manage my headaches. Drinking enough water daily is a great start – hydration helps combat many things, migraines included. I also had a doctor tell me once that if I drink caffeine (coffee or a coke) in moderation at the same time daily, keep it up. Your body is used to it and the consistency can help with your migraines. In the same vein, try to keep your sleep and eating consistent. Go to bed and wake up around the same time each day and eat meals at similar times daily. Your body is an intricate machine and you have to take care of it! If at all possible, avoid stress or find outlets for stress that work for you. Be it meditation, exercise, long walks, or doing something with your hands, take care of your mental health so that your body doesn’t turn against you in the form of a migraine (or other unpleasant reactions).
I also have recently started down the path of being mindful of what I eat, because there is serious evidence that what you put in your body can help alleviate, or maybe even eliminate, migraines. Two resources for my current diet journey are:
- The Dizzy Cook (https://thedizzycook.com/)
This website is amazing. Written by Alicia Wolf, The Dizzy Cook, you get a look into her journey to living and managing her migraines, but also taking control via your diet. The Migraine Diet is detailed at length in super useful posts that include how to reintroduce foods to see if they are triggers, recipes for the holidays, and natural treatments for migraines. She has a cookbook, plus lots of really fun migraine-themed merchandise in her shop. - The Plant Paradox by Dr. Steven Gundry (https://drgundry.com/)
Dr. Steven R. Gundry is medical doctor with over 40 years of experience and the Director and Founder of the Heart & Lung Institute and the Center for Restorative Medicine in Palm Springs and Santa Barbara, CA. He wrote The Plant Paradox: The Hidden Dangers in “Healthy” Foods That Cause Disease and Weight Gain, a book that I am currently reading about how certain foods wreck havoc on our bodies through how our bodies identify and respond to them. That is a massive generalization of the content, but Dr. Gundry contends that by following his diet, of which you can find handy dandy cheat sheets here, you can eliminate your migraines (along with a VERY long list of other health conditions). His book is long and VERY heavy on the content, but it’s worth the read. He also has a condensed guide called The Plant Paradox Quick and Easy. You can find both, plus a cookbook and much more, on Amazon (here and here), plus Dr. Gundry has a blog and was a guest on the Armchair Expert podcast with Dax Shepard and Monica Padman.
All of this is to say, guys migraines suck, but you’re not alone. In the US alone there are an estimated 38 MILLION people who suffer from some form of migraine. What I implore you to do if you suffer from migraines is to do your research, talk with your doctor, and in the end do what’s best for YOU. And if you find yourself with an unsympathetic partner/friend/family member, pop open a beer for them on a counter and dry heave into a toilet. They’ll get the picture.
Cheers,
Head Nerd