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Migraine

August 10, 2011

Other titles I considered for this post include:

Honey, Hand Me an Icepick

Why I Love Opiates

or

“It Will Prepare You For Childbirth”

Here’s what seems most bizarre during a migraine attack: no one can see that anything’s wrong. People actually smile at me, as though my eyeball were not about to pop out and liquid brain were not about to slide down my face. People try to talk to me in voices that sound huge and impossibly loud. I have to explain the situation to them even though the effort it takes to talk and open my eyes is exhausting. And when it’s finally dark and quiet, the phone always rings. The whole thing starts to feel like a mean joke.

My first migraine headache hit me at age 20, during the summer after my sophomore year at Barnard. I had a headache on the subway coming back to my dorm after my internship and thought it was the heat, so I took a nap when I got to my room. I woke up to the worst pain I had ever experienced. I thought I was dying. I thought that my brain was slowly pushing its way out of my right eye socket. I wanted to dig out that eye with my fingernails just to speed up the process.

It sounded lame even to me when I explained to the head of composition in the English department that headaches–not projectile vomit or high fevers or anything measurable– had prompted me to cancel, sometimes twice a month, the classes I was teaching. But I really was working and studying through so much of the pain.

Joan Didion describes this early stage of chronic migraine perfectly– “… I had no brain tumor, no eyestrain, no high blood pressure, nothing wrong with me at all: I simply had migraine headaches, and migraine headaches were, as everyone who did not have them knew, imaginary. I fought migraine then, ignored the warnings it sent, went to school and later to work in spite of it, sat through lectures in Middle English and presentations to advertisers with involuntary tears running down the right side of my face, threw up in washrooms, stumbled home by instinct, emptied ice trays onto my bed and tried to freeze the pain in my right temple, wished, only for a neurosurgeon who would do a lobotomy on house call, and cursed my imagination.” (“In Bed,” The White Album, 1979)

Of course, I didn’t go see a doctor, either. I just stumbled to 24 hour drugstores for Excedrin and Starbucks Double Shot iced liquid sugar/caffeine and then stumbled home, filled my pillow case with ice packs and fantasized about a massive hypodermic needle. I wanted to use this needle to go in through my temple and extract the unbearable pressure behind my eye. Excedrin rarely helped after awile. When I was in Europe or Australia, I could get an over-the-counter drug, essentially Tylenol 3 (acetaminophin and codeine), that worked every time. So I asked vacationing friends to buy the biggest boxes available and bring them back for me across the oceans. Not European chocolate or Australian wine. No, I wanted pain killers.

Once I finally had health insurance and the courage to see a neurologist, I got prescription medications, including a daily preventative called TopaMax. (By the way, you know things are bad when you are disappointed that your MRI has come back clean, your blood pressure is fine, your neurological exam goes well and your test for epilepsy has ended without inducing a seizure.) I think that because migraines are so elusive and invisible, it’s tempting to put all of one’s faith in the first person who promises help. So, I took TopaMax eagerly, despite the fact that relatively common side effects include “loss of some neurological function” and “memory loss.” It’s also a good thing I read the fine print, too, because I managed to catch this uncommon side effect: my birth control was maybe going to be less effective. So I threw it out. No way was I taking that risk. And Praise The Lord, the drugs worked! Or so I thought.

This June, our new doctor in New Haven suggested that I try a few things to get rid of even those twice monthly headaches I was still experiencing. By regulating my hormones, he suggested, we might relieve them altogether. Why not go back on birth control? I wasn’t taking the TopaMax anymore. Also, I should cut out wine, chocolate, cheese and nuts. Oh, and I should take a drug called a Beta Blocker as a preventative; it would “open up” the blood vessels in my brain.

Soon, I was in bed again two or three times a week. I had a migraine in July that lasted for over three days. The only thing that helped during that attack was a combination of acetaminophen and oxycodone. And it only helped for six hours. In desperation, I went online, clutching an ice pack to my right eye and cursing the light from the laptop screen. I went looking for something, anything that I hadn’t already heard of that could be causing this pain. I was incensed when I found this: “Certain medications can aggravate migraines, especially oral contraceptives” (mayoclinic.com). I threw out the birth control (again) and seethed with anger.

The TopaMax hadn’t taken care of the headaches. Going off the artificial hormones in my birth control had done that. Here I was, back on the same birth control and getting headaches with the same frequency. And not a single medical professional had ever even mentioned the possibility that they were connected–not my gyn, not my primary care physician, not even my neurologist. Doctors make mistakes. Fine. But I am talking about a common side effect of one of the most common prescription drugs! And I found out about it on the internet.

That was six weeks ago. Each week since then, migraines have become less frequent. Last week, I had one, and a relatively low dose of Imitrex killed it. No narcotics necessary. This week, so far, nothing. (Knock on wood.)

I still want to live headache-free. But this time, I asking for help in a new place. Today, I had my first appointment with Brooke, at New Haven Rolfing. She’s working with the connective tissues in my body to help loosen the muscles in my upper back, strengthen those in my lower back and retrain my nervous system. (It feels like a massage but with the precision of acupuncture.) My shoulders and neck always tense up and hurt like hell before, during and after a migraine, so I’m going to start with that and see if the connection goes both ways. Lose the muscle pain, lose the head pain? I think it’s worth a try. Because I want fewer prescriptions, not more. I want a solution I can use while pregnant or breast feeding.

My neck and shoulders feel like someone hit them with a baseball bat, but Brooke warned me that I might feel bruised after our session. (Rolfing does not actually give anyone bruises, by the way.) And anyway, pain like this is easy. I know where it came from and that it’s going away.

I don’t know if this is true, but someone once suggested a silver lining to all this: migraine attacks may prepare me for childbirth. It makes a certain kind of sense; at least contractions end and after the pain, you get a prize. So far, all I know is that I should take care of this body in every way I can. The price for ignoring its signals is way too high. I have never particularly felt at ease in this body; now, I think I may just grow to love it.

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4 Comments leave one →
  1. Jef Mehr permalink
    August 11, 2011 9:09 am

    I also get migraines, not as frequently as it sounds like you do, but having had one on monday I can emphasize with the pain…I told my wife they same thing when she got home that you wrote in your blog…that I wanted to take a drill to my right temple to elleviate the pain. For me, most of the time midrin will take care of it if I catch it early enough, but if I am in a full-blown migraine like on monday…I took 4 vicodin, 2 midrin, and 6 ibuprofen over 8 hours and it barely made a dent.

    • August 11, 2011 9:17 am

      It is supposed to run in families. I don’t know that two sisters and one cousin makes a case for heredity, but I haven’t exactly done any extensive poling. 4 vicodin didn’t touch it?! What are these monstrous things? No one knows! (That essay from the ’70s is crazy because we really haven’t learned much since then.)

  2. Jef permalink
    August 11, 2011 11:49 am

    I know Denielle (my sister) gets them also, but my Mom and Dad do not and I don’t think any of my other siblings do. Mine didn’t start until I turned 35, never got them before that. It is hard to describe to someone that doesn’t get them…my wife tries to emphasize with my “Headache” but I can only tell her that it is not the same as a headache for me…headaches I can work through…migraines are completely debilitating and all I can do is sit in the dark and hope it goes away (or sometimes I go in the tub with the shower running on my head for an hour or two with all the lights off in the bathroom…that sometimes helps). Luckily I only get a really bad one like monday’s about 1x or 2x a year.

    • August 11, 2011 1:34 pm

      The shower helps me and a lot of people I’ve talked to! This is one reason I’m hopeful that relaxing body tension in general might help me–the steam and pressure relaxes muscles and that’s a big part of why it helps.

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