My father had a Siamese cat called Migraine. He gave it that name because it yowled a lot. My father had migraines, perhaps he felt the cat’s yowling expressed the intense pain of his migraines.
I get migraines too. Yowling is something I feel like doing when I get one – but I don’t have the energy to, as I’m lying in bed in the dark, unable to do anything at all, except lie prone and wait. A sip of water causes me to throw up, opening my eyes makes me wince, hearing the tiniest whisper creates agitation, and smelling anything at all jars every part of me. Even so, I’d love to be able to yowl out loud – expressing in voice the feeling my body is experiencing.
Migraines are fairly common. Stats suggest, ‘Around one in seven people get migraine. Over a billion people worldwide get migraine, and over 10 million in the UK. It is the third most common disease in the world (behind dental caries and tension-type headache). It’s estimated that 190,000 migraine attacks occur every day in the UK. Over three quarters of people who get migraine have at least one attack each month.’
It’s classed as ‘a primary headache disorder, beginning most often at puberty and most affects those aged between 35 and 45 years. It’s more common in women, usually by a factor of about 2:1, because of hormonal influences.
It is recurrent, often life-long, and characterized by recurring attacks caused by the activation of a mechanism deep in the brain that leads to release of pain-producing inflammatory substances around the nerves and blood vessels of the head.’
My attacks are typical and include, per WHO description, ‘a headache, which is of moderate or severe intensity, one-sided, pulsating in quality, aggravated by routine physical activity, with duration of hours to 2-3 days, nausea (the most characteristic associated feature).’
What I don’t get is why I get them, and what triggers them. I can go several months without getting one, and then have several at the rate of one every three weeks or so. Prior to 2013, I had maybe one a year – incapacitating me for 2 or 3 days at a time.
Then they started in earnest in 2013, when I was severely stressed by working full-time, travelling a lot and making sure my 95-year-old mother had all the care and attention she needed. I was getting them at the rate of at least one a month and sometimes more frequently.
My emails from back then to various family members document my search for a migraine cure or, if not cure, a management approach. The management approach I adopted was multi-pronged and scattergun My research led me to buy and take magnesium, coenzyme Q10, vitamin B2 (riboflavin) and vitamin B3 (niacin). I kept migraine log, I saw a dietician and adjusted my eating pattern to keep my blood sugar constant. I gave up alcohol. I meticulously drank the recommended amount of water. I experimented with meditation and mindfulness, and I finally visited my GP and the National Migraine Centre to get both a professional opinion on what was going on and some prescription medication, (one of the Triptans).
I also enrolled on a 3-month research programme investigating ‘caloric vestibular stimulation’ as a potential alleviator of migraine. That was bizarre, it involved lying twice daily on a wedge pillow with head phones with the ear-pieces fitted with a small thermal-electric probe that reached into the ear. (You can see a picture here). The head phones were attached to a machine controlling the temperature and randomly warmed and cool my external ear canal. It felt utterly weird and I don’t think had much impact on the frequency and intensity of migraines I was experiencing at the time. Though the results of the trial suggest that for some people it did.
The migraines continued at the same rate and I gradually dropped the various supplements. The cost of the supplements and my inability to know if any were having an effect contributing to this decision – they didn’t seem to be. I continued with the water intake, tried to keep to a regular eating pattern, and always had the medication to hand. The meditation practices dwindled – though I told myself that my continuing daily running is a form of meditation, as is daily journaling.
In early 2018 my mother died, and other aspects of my life changed. The full-blown migraine count dropped dramatically, reverting to one or two a year. Over the 4 years from 2018 to now, I started to allow myself the occasional glass of wine with no ill effects. I stopped meticulously tracking my water intake and was less systematic in following a 4-hour eating schedule.
All went well until the start of this year. I started to wake around 03:00, two or more nights a week, with a headache, causing me to creep downstairs to get a triptan tablet, fearful that a migraine would develop. (I’ve moved them to beside my bed now).
The headache/migraine log I keep shows gradually increasing numbers of waking in the night, and records the many days with an almost-migraine lasting till lunchtime or just beyond. And, now, in each of March, April and May I’ve had a ferocious migraine, lasting 48 hours. I ask myself, ‘What is going on? What shall I do to arrest this?’
As always, there are no obvious single triggers, there are multiple interdependent factors – the NHS says, ‘Many possible migraine triggers have been suggested, including hormonal, emotional, physical, dietary, environmental and medicinal factors.’ I’ve no idea what mine are, but this time I’m going to hypothesize two and work on these. The first hypothesis is that my eating pattern is a trigger. Although I always have breakfast, the rest of the day’s eating has become much more ad hoc. I’m going to return to being much more conscious of eating at 4-hourly intervals. Related to this, I’m going to monitor my blood glucose levels for a period to see if it stays within range or changes at points.
The second hypothesis is that my agitation in certain contexts is contributory. So, I’m experimenting with a meditation/mindfulness app – Smiling Mind – aiming to reduce these feelings of agitation that seem to have grown over the the past several months. Why they have I don’t know (yet).
What I’m learning from this migraine review is that a) I’m again willing to put time and effort into reducing their frequency in my life b) looking for a cause of them may not turn up anything c) overall, I’d rather live without them, but if they are part of my genetic inheritance then I can take conscious actions that may help manage and reduce their frequency and intensity.
What’s your experience of migraine management? Let me know.
Living, Learning, Getting Older 
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