Thursday, 14 November 2013

Living With Migraines

Good Day Everyone,

Today I’m going to share my experience of living with migraines. 

A quick disclaimer to say that I am not a medical professional and that you should not make any changes to your migraine treatment without discussing it with your doctor first. Whilst I will be talking about the treatments that I have tried, I am not recommending that you try them too. This is simply my personal experience of living with migraines.

I was first diagnosed with migraines when I was 13 and hence have been a sufferer for most of my life. A migraine is a very severe and excruciating headache that is often associated with or follows on from other symptoms such as nausea, vomiting, increased sensitivity to light, sound, movement and impaired vision to name a few. Migraines can last from a few hours to 2-3 days. The exact cause of migraines is not known but genetic, hormonal and external factors are thought to play a role. Migraines can run in families, my mum also suffers from them, and women are more likely to suffer from migraines than men.

I typically suffer from two kinds of migraines and these are just my own categories, not medical classifications. The first type is a migraine at the base of my skull and the other type is behind my eye (typically left eye for some reason). I can almost always tell when I’m about to get a migraine either because I’ll have been exposed to a known trigger or even without a trigger, I will develop certain symptoms that warn me its coming such as;
  • Developing neck stiffness
  • My head will start to feel too heavy for my neck to hold up 
  • I get a lot of tension built up in my neck and shoulders
  • I start to yawn a lot 
  •  I get very nauseous (but I’ve never actually vomited)  
  • I get very sensitive to light especially bright white light that you get in offices or on computer screens

If I'm developing a migraine behind my eye then I often get a flickering light in my vision... it's hard to describe but basically it puts a strain on my eye. Once I’m suffering from a full blown migraine attack I get the most excruciating, pulsating pain in my head where it becomes very difficult for me to move because any form of movement makes it feel like my brain is sloshing around in my skull, being battered, and that causes the pulsating sensation to worsen. Often it feels like a pressure is building up inside my skull making it feel like my head is going to explode. I feel like I want someone to drill a hole into my skull just to release this pressure (apparently that’s exactly what they used to do in the olden days... no joke!).

When I’m in the midst of a severe migraine I have minimal awareness of what’s going on around me as the pain is so debilitating and completely takes over my world. Where possible, I will seek out a quite dark room (preferably my bedroom) where I can lay still until it passes or I eventually fall asleep. I have found through experience that heat can have a soothing effect on my migraine and so I will use a hot water bottle to heat up my pillow which I put on my neck or the side of my face with the eye migraine. Sometimes I will actually place the hot water bottle wrapped in a towel on my neck / face. I also find that certain smells like fresh coffee, tiger balm and anything menthol or minty-ish helps to ease the nausea. When I have a migraine behind my eye, it makes my eye very sore and the affected eye doesn't open as fully as normal. Just by looking at my eyes, some work colleagues could tell that I was suffering from a migraine. 
Things I use to help with my migraines
The migraine can last from a few hours to a couple of days and afterwards, once the pain has passed, and I’m back in the land of the living I usually feel incredibly exhausted, like I've just ran a marathon. I’m also usually starving following an attack for some reason and recovering from a migraine is one of the rare times where I actually crave sugar.

When I was 13 my GP (family doctor) asked me to keep a food diary so that we could identify any dietary triggers as well as a diary of when I developed a migraine, what I was doing at that time, where I was etc to see if we could identify any external triggers. This was one of the best things I ever did as after a few months of this somewhat tedious task, we were able to identify my triggers and these have remained true my entire adult life.

There are several types of food and drink, which if I consume, can quite quickly cause a migraine. These include;
  • Cordial juices such as Ribena and Robinsons 
  • Fizzy citrus drinks such as Sprite, Fanta or 7-UP
  • Cheese  - too much will trigger a migraine so whilst I do occasionally eat cheese I know there is a limit and I've gotten quite good at sensing when I’m getting close to that limit

There are also certain smells that, for me, can trigger a migraine such as;
  • The smell of alcohol especially red wine (my worst nightmare is being stuck on a long haul flight next to someone drinking red wine!)
  • Petrol and diesel
  • Paint 
  • Strong smelling perfumes especially the sweet vanilla variety

In addition, if I don’t get enough sleep, go too long without eating or get very tired then I know I’m at risk of getting a migraine, especially, if I’m in an artificially (brightly) lit environment such as offices and shopping malls or working at a computer screen. So when you add all of the above combined with a crazy career where I worked long hours and travelled overseas, it’s easy to see why my career was plagued by my migraines.

As a teenager, my GP prescribed me pink Migraleve tablets which I would take when I could sense a migraine coming on or as soon as one had started. After a few years my migraines eased dramatically for some unknown reason and I rarely suffered in my late teens, but then in my early twenties, they came back with a vengeance!!!

In my twenties there would be times when I would have 4-8 migraine attacks per month. I went through phases of my life where I literally felt constantly drugged up (I can assure you I wasn't but that’s how I felt). As a result of my migraines I've missed nights out, had to cancel dinner plans and even spent entire weekends bed bound. They really did rule my life at times! As the migraines were so severe and frequent my GP put me on a preventative medication called amitriptyline. I would take this on a daily basis to prevent a migraine from happening in the first place. However, as I avoid taking medication as much as possible I didn't feel comfortable taking amitriptyline every single day for a condition that did not affect me every single day. Amitriptyline is also an anti-depressant and has quite a few side effects so I was concerned about the effects of taking this long term. I soon found that I wasn't taking it daily and thus it wasn't able to work as a preventative treatment.

The treatment that did work for me was a drug called Zomig (zolmitriptan) which I take when I sense a migraine coming on so it’s not a preventative medication like the amitriptyline but a reactive treatment. I have taken Zomig for several years now and most of the time, if I take it when I first sense a migraine coming it usually does work to stop it from turning into a full blown attack. When I initially started taking Zomig, I would often try to manage without the medication or take a ‘let’s wait and see what happens’ approach. What often happened was that it developed into a full blown migraine, I would take my medication, which wouldn't work as I’d left it too late and missed that window of opportunity of preventing the migraine and would then spend the next day or two in agony cursing myself and taking very strong prescription painkillers! I was prescribed Co-Codamol which is a combination of paracetamol and codeine that I would take when the Zomig didn't work. I soon learnt that it was better to take the Zomig at the early signs of an attack rather than trying to ride it out without drugs and then ending up on prescription painkillers that made it very difficult for me to function due to how woozy they made me feel.

Given how frequently I suffered from migraines, I actually didn't take many sick days from work at all. I learnt to take my Zomig with me everywhere I went and even when I did have a migraine, taking time off work wasn't an option due to deadlines so I would grab a coffee (to smell) and just muddle through until I could get home. I also started carrying Vicks VapoRub, a menthol balm, around with me to smell as it eased the nausea. There were times when I would have a long drive home from work meetings and if I was having a migraine attack, that was the one time where I did stop, especially if I was driving at night where the glare from oncoming traffic headlights would make my migraine worse and affect my vision. In such circumstances, I would pull up into a service station, grab a coffee, text my hubby to let him know where I am and curl up with a blanket on the back seats of my car, waiting for the medication to kick in. Sometimes I would actually fall asleep and wake up a couple of hours later feeling a bit groggy but better able to function. As a result, the drive home would be much longer but as my mum always says, its better to arrive late than never and I would never risk putting myself or others in danger by driving when I know I’m not well enough to.

Nowadays I am more or less migraine free – yippee :o) Since giving up work at the end of 2011 (due to the progression of my arthritis), I have only had two migraines and they were both triggered by a combination of fatigue, hunger and stress. Whilst I was incredibly gutted to have to give up on a career that I’d worked so hard to develop, I also realise that I’m in a very fortunate position where I can now take it easy and concentrate on keeping myself as healthy and feeling as well as possible. Looking back, I genuinely believe that my lifestyle and career played a big role in causing my migraines. My eyes have always disliked bright artificial white light and every office I've worked in has had such lighting plus I've always struggled with the glare from office computer screens, combine that with working long hours, travelling long distances, eating irregular meals, being stressed and not getting enough rest and sleep probably took a toll. Now that’s a lot of factors there and at the time I kind of knew my lifestyle and work life balance was probably the cause of most of my migraines but giving up work wasn't an option. 

Unless you or someone that you’re very close to suffers from migraines, it’s difficult for most people to understand and appreciate just how debilitating they can be. If you suffer or think you suffer from migraines then it’s very important to get the correct diagnosis and medication for you. A doctor may also conduct tests to rule out other causes of head pain. I've had brain scans twice in my 20s to rule out anything more sinister. During one particular attack I became incredibly sensitive to movement, light, sound and even touch. I actually thought that I was suffering from something else as the pain on this particular occasion was off the scale. I seriously felt like I was going to die from the pain! I ended up being admitted into hospital and put on a morphine drip whilst I had various tests and scans. The doctors concluded that it was indeed a migraine but of a different nature than what I’d had in the past. Luckily a migraine of that severity and magnitude has only ever happened twice and its not something I would wish on my worst enemy.

There are lots of different types of medications available to treat and/or prevent migraines so if something doesn't work for you then there are other options. As well as medication, there are other things you can do to reduce your chances of getting a migraine and steps to manage the migraine itself. Based on my experience I have found the following most helpful;
  • Keeping a diary to identify potential triggers - food, drinks, smells which I can then avoid
  •  Eating regularly and keeping hydrated
  • Not delaying taking medication when sensing a migraine is imminent
  • Ensuring I get enough rest and sleep
  • Make time to relax my mind, as well as my body
  • Heat compresses like a hot water bottle help ease the pain for me, but for some people, a cold compress works better
  • Laying down during an attack in a quiet and dark room (avoiding movement, sound and light)
  • The smell of coffee or menthol eases my nausea
About eight years ago I also started going for regular head and neck massages which I've found to be really helpful in relieving the tension in my neck and shoulders which in turn has helped to reduce the frequency of my migraines.

There are also various support groups and websites that can offer support to migraine sufferers. It’s always interesting talking to other sufferers to find out what things help them cope with their attacks and comparing notes. But it’s also important to remember that we are all different and so what works for one person may not work for another. Ultimately, it’s about trial and error to find out what works for you.

I hope you have found this post interesting and that it’s given you a bit of an insight as to what it’s like to live with migraines (if you’re not a sufferer yourself). If you are a sufferer then I hope that there may be some tips here that you might find helpful. If you have any tips or strategies of how you cope with migraines then do let me know. I’m always interested in other people’s experiences.

Below are some websites where you can get further information and/or support on migraines;

Love Sheen xxx

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