Thursday, July 14, 2011

Why Migraines Suck

I had such great plans today. I was up at 5:00 this morning, was going to cycle to work, get a jump on the day, be productive, and then cycle home, have dinner, take L to soccer, and then perhaps attend a tweet-up.

It was going to be such a good day.

But then, out of nowhere, a migraine came along and changed all that.

I know, I look like shit. This is what migraines do to me.

It could have been worse: the migraine could have struck halfway into my ride. That would have been the worst. I would have had to call Lori and wait, wherever I was, to be rescued. Suffering in public is never good.

It's after lunchtime, and I'm only now coming out of the fog that is my migraine. By some standards, this wasn't a bad one. On a scale of 1 to 10, where 1 leaves me with vision trouble but no pain and 10 is all-out war on my brain—sight, sound, and touch is unbearable; breathing is heavy, body is in spasms, and I'm spewing from both ends (sorry, awful picture)— this one was about a 7. My head was pounding, sight and sound was painful, and I finally passed out after an hour or so. It'll probably be another couple of hours before I start to feel like myself again.

This isn't the first time I've written about my migraines, but for those of you who only started reading my posts in The Brown Knowser, let me give you the post I wrote for my other blog.

For those of you who suffer from migraines, I feel your pain. For those who have never experienced one, count yourselves lucky.

Notes From A Migraine Sufferer

When I suffered my first migraine, as a teen in my senior year of high school, I didn't even know what a migraine was. I thought I was just having a severe headache. I stayed home from school that morning, suffering in my bedroom. When I threw up, I thought I might have caught a flu bug. I stayed in bed for most of the day. By dinnertime, I felt better: more or less like my old self; maybe a little tired, with a slightly foggy head.

Back then, migraines were few and far between. I'd get one every few months or so. I could probably count on one hand the number I'd get in a year. And when I was in college, they seemed to go away. I don't remember ever having a migraine while I was in journalism school, nor in the years that followed.

It wasn't until the early 90s that I suffered my first migraine in more than seven years. Lori and I were living together and I scared her so much that she was tempted to call 9–1–1. I think it was when I started slamming my head against the wall that she started to panic. When I blacked out from the pain, she sat with me to make sure I was still breathing.
I have a handful of symptoms that accompany a migraine. I don't always experience all of them every time, but I will experience at least a couple at once. My symptoms include:

  • uncontrollable yawning
  • heavy breathing
  • chills and sweating
  • extreme sensitivity to light, sound, and touch
  • convulsions
  • blurred vision, tunnel vision, or loss of vision
  • extreme pain in my eyes, in various regions of my head, and in my neck
  • aching teeth (often caused by clenching my jaw)
  • vomiting
  • diarrhea
  • blackouts

One of the worst episodes of a migraine came a couple of years ago. I had spent an evening out with a couple of friends, Perry and Andy, at The Manx. We had enjoyed a couple of pints and warm conversation. In the course of the evening, I had consumed two, maybe three pints of beer. It is often thought that alcohol could be one of my triggers for a migraine, but if it is, it's not a guaranteed trigger. I've had migraines after consuming alcohol—large and small quantities; I've experienced migraines when I haven't had a drop to drink.

When Andy, Perry, and I parted company, I headed up Elgin Street to catch my bus home. About halfway up Elgin, a migraine hit me with no warning, or at least no warning that I recognized. I was tired and yawned a bit, but not with the fierceness of a migraine yawn. Before I knew it, my vision was blurred, my head was pounding, and my breathing was heavy. I had to sit down. The sounds from the street were crippling, the lights of traffic blinding.

I vomited in the street. Passers by looked at me and told themselves that I was just another drunk reveller on a Saturday night. With disdain, they passed me by.

Somehow, I made it to a bench, where I lay down, sweating and trembling with chills. And eventually, I blacked out.

Much to the shame and credit to Ottawa residents, I was left alone. Apparently, no one checked to see if I was okay (or if they did, I didn't respond and they didn't call for help). Also, no one robbed me while I slept. My fanny pack, containing my wallet, phone, and other valuables, was left untouched.

I awoke just before 3 AM, as a few drops of rain began to fall. In a haze, I arose from the bench and made my way to my bus stop. Mercifully, the buses to my part of town were still running. When I finally crossed my front door, I staggered to my living room and collapsed on the floor, where I slept until Lori found me after sunrise.

By far, that was the worst migraine I have ever experienced. It left me vulnerable, not only to my pain, but to the elements and the unpredictability of strangers. I was defenceless throughout that ordeal.

When I described my experience to my doctor, he put me on propanolol, a beta-blocker, and gave me some pills to carry on me, to take when another such migraine struck. He warned that these pills (I have since disposed of them and forget their name) were extremely powerful, and that there was a 1 in 10,000 chance that they could trigger a stroke. But they would help diffuse the migraine. I only used them once, and thankfully I was at home: these pills effectively knocked me out so that I wouldn't feel the effects of the migraine. I was no better off than when I blacked out on that Elgin Street bench.

The beta-blockers worked to some extent. I still suffered migraines, but I wouldn't feel the pain. The only symptom I seemed to experience was with my vision. I would be able to see, but parts of my vision were blacked out, like I was wearing blinders. I wouldn't be able to see to my peripheral or wouldn't be able to see below me, like the lower half of my sight, when looking straight ahead, was blocked. And what I could see was diffused in light waves. It was almost a psychedelic experience.

Taking the propanolol daily, though, left me with a lack of energy. I was tired all the time. Also, I was warned by my doctor that these beta-blockers also came with the risk of a stroke, and so I eventually weaned myself from them.

Since then, my migraines have returned on a regular basis. On average, I get a migraine once a week. If I feel the onset early enough, I can take a couple of migraine-strength Advils. If I notice the migraine too late, there's nothing I can do but ride it out. The majority of migraines hit me early in the morning. On Tuesdays and Fridays, when I wake early anyway, I typically get to them in time. I've noticed that on Thursdays, for some reason, I'm a bit of a slug getting out of bed, and if a migraine calls on me on those mornings, I typically get to them too late.

Yesterday, I experienced one of my worst migraines in months, if not since that evening on Elgin Street. And I experienced a new symptom that had me quite concerned, one that made me think that this was the "big" one. As I bent over the toilet, vomiting (too much info?), blood ran out of my nose. It dripped into the toilet, and as I wiped at my nose with my hand, I gazed at the red and thought: is this a brain haemorrhage? I was scared, but with the pain flooding my senses, I did nothing about it. I didn't call for help. I simply wiped the blood away, flushed the toilet, and cleaned my face. The blood stopped as quickly as it started. It reminded me of one time, snorkelling in Thailand, when I pulled off my mask and the suction pulled a fountain of blood from my nose but didn't persist. It freaked out those who saw it happen, but by the time I reacted it was over.

Yesterday, after I cleaned myself up, I staggered back into bed. I was shaking, from the chills and from the shock at seeing blood, but I passed out before I could do more.

Life as a migraine sufferer is not fun. There's little that doctors understand and less that they can do about it. And unless you're willing to go on risky drugs to prevent them, there's not much the sufferer can do except try to get to it in time or to try and ride it out as best as possible.

And not panic.


  1. Been there too Ross. It's worth it to continue trying the meds. I have become well educated on the options, after avoiding medication for years out of fear of the side effects.

    I was suffering for about 15yrs - and it became a couple of times a week, with over-the-toilet, someone-please-kill-me migraines two or three times a year, I would follow each one up with more research.

    It has paid off. Armed with 5 years of charts of my own headaches, and strong opinions from the (real) medical research I worked with my doctor to solve it, and have now had 7months now without any migraines.

    Tips: Triptans - the one your doctor gave you with a risk of stroke was probably the cheap first generation triptan - likely Imitrex. I didn't even want to try that, and only explored 2nd generation Triptans which are better behaved. Work with your doc or a neurologist to try them out of the next few months. My best result was Maxalt. Relpax works, but I felt scary with it.

    Try other beta-blockers. My near total cure has resulted from Nadolol. Just one a day, and I've been able to reclaim my life.

    It's really hell living with them - as you know. Keep a diary, I can give you a form I gradually developed over sev years if you want. Fight back - it's worth the effort.

  2. Thanks, Ross. Great comment with lots of good advice. I'll start tracking my migraines better than I have.


  3. Oh, this post brings back terrible memories of a migraine I had two weeks ago. Although, I didn't really know it was a migraine. I couldn't see straight, was nauseous, could not even lay down ... I thought I had heat stroke from mowing the lawn. But I also wondered if it was perhaps a migraine. Reading this post confirmed it for me - yes, I had a migraine. I've only had them about 5 times as an adult, and I can't even imagine the amount of pain that comes with weekly suffering like you experience. I'd definitely investigate some of the tips Ross noted. Your quality of life is at stake with a weekly bout.