Hey, doc, where is my magic pill?

help with pain

Migraines are unique in the sense that we do often think in the beginning they will be well managed and there is no reason to think otherwise. Likely, we have absolutely No Clue they can develop into chronic migraines. And ignorance is bliss.

And for a bit with episodic migraines they Are well managed. Your pain is controlled. Triptans work well and the migraines are not frequent so certainly, you do not have to worry about rebound headaches, which at the time you likely will also not have heard of.

But as they become more frequent you get in this limbo stage where you start preventatives and use your triptan the max the week. And you Still believe your doctor can help you with your pain. Because these are migraines not chronic pain, right? Surely, they can be managed much easier. No doctor says this is chronic pain and this is no longer easy to manage. And, hell, that would have been a realistic thing to say. Because it is. You can go back down to episodic and then it wouldn’t be chronic pain, unless it was high episodic which has the same impact. But let’s say you went right down to low episodic well then it wouldn’t be chronic pain anymore. But until it does… chronic pain. Until it does, it is complicated.  And because they don’t come out and say it for this limbo period we think this can’t be that bad. It can’t get worse. I’ll take the preventative and it will Substantially improve.

But it doesn’t because no preventative substantially improves anything. Best case 50%, which sounds awesome but is a rare result. And if you are daily, 50% still means chronic. So pretty complicated. You add in vitamins, lifestyle, exercise… and whatever else you need to add it, or try, or try again just to see if something works. Anything works. And at this point, it becomes pretty clear your doctor isn’t going to help much with pain management. And medication alone isn’t going to be the end all of treatment.

In the end, pain is always more complicated than we initially think.

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We all have migraines that exceed our capacity to cope. Mind-blowing pain. Roll up into a ball and just wait out of the pain.

Well, it so happens I have been having some high-intensity migraines this week. Not a pleasant ordeal. Just a little too many days in a row and it has made me emotionally fragile and just drained to the bone.

Yet, I had a doctors appointment and no ride to get there. The migraine at that point was sort of in the range of tolerable so I drove myself.

Mistake.

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Dumbified: a study

migraine

I have said, often, repeatedly, that I can’t think through a migraine. One assumes it is the pain level. Or is it the migraine itself?

Well, guess what they did a study on that. How thinking is impacted by a migraine. And we are right… we are dumified by a migraine. Or to put it better there is cognitive dysfunction with migraines, that is not permanent, but certainly feels that way when migraines are way more frequent than not.

The study was on migraine without aura. I would assume it is the same with aura, if not worse given aura symptoms.

Thirty-nine patients with episodic migraine (37 females, average 38 years old) were included and 24 completed the study. Participants performed worse during the attack in the majority of cognitive tests, compared to the headache-free status, and significantly so in word reading speed (p = 0.013), verbal learning (p = 0.01), short-term verbal recall with (p = 0.01) and without (p = 0.013) semantic cueing and delayed recall with (p = 0.003) and without (p = 0.05) semantic cues. Differences found were unrelated to age, gender, literacy, condition order, interval between evaluations, anxiety, pain intensity or duration of the attack. PubMed Cephalalgia.

In the end they conclude “Cognitive performance decreases during migraine attacks, especially in reading and processing speed, verbal memory and learning, supporting patients’ subjective complaints. These findings suggest the existence of a reversible brain dysfunction during attacks of migraine without aura, which can relate specifically to migraine or be a consequence of acute pain processing by the brain.

So either due to the migraine or the pain. Either way, that is a lot of dysfunction. For example, the one damn thing fibrofog doesn’t touch? Processing speed. And migraines do. That is impressive in a bad way. What is processing speed? “Processing Speed is one of the measures of cognitive efficiency or cognitive proficiency.  It involves the ability to automatically and fluently perform relatively easy or over-learned cognitive tasks, especially when high mental efficiency is required.  That is, for simple tasks requiring attention and focused concentration.  It relates to the ability to process information automatically and therefore speedily, without intentional thinking through.ETFO Like reading comprehension and doing simple math. Ever have a problem doing simple math in your head with a migraine? Processing speed issues. Ever read a sentence and not comprehend it? Or delayed comprehension? Processing speed. Fail to recognize an object? Or delayed comprehension?  Processing speed. Copy words and sentences incorrectly? Processing speed. Taking a longer time to respond to a question or respond to written instructions. All processing speed. That system getting glitchy can slow a person right down. I call it having to be really methodical in my steps. Makes my brain feel slower than molasses. Pudding brain, I call it. It can affect how we comprehend in conversations to how overwhelmed we become in by too much information at once. I know with a migraine thinking has to be very This Step and then This Step. So this study is intriguing because it shows the limitations we have cognitively with a migraine. And the frustrations that come with that.

Makes me think it is more than pain when they say it affects processing speed. But that is because I have read the research on FM where pretty much everything from short term, long term and working memory is affected from pain, except processing speed.

 

 

Abort Mission! Retreat!

when-you-are-out-and-about-just-doing-your-thing-and-then-is-that-sparkles-dancing-in-the-air_-ahhh-impending-doom-abort-mission-abort-mission-retreat

Yes, when impending migraine doom is about to strike you want to drop what you are doing and dive into the nearest cave to ride it out.

This seems to happen every time I leave the house. Assuming I don’t have a migraine when I do, which always gets worse when I leave the house. But assuming I don’t… migraine happens. I assume from all the triggers in that bright, smelly chaotic world my brain is overly sensitive to.

Often leading to finishing what I am doing and heading back home to treat the migraine. Before other symptoms like vomiting and digestive issues show up and make things a real challenge. Or the VERTIGO.

Because sometimes I get stuck where I am. Wherever that is. The migraine strikes. And it hits at a 9. With all assorted migraine hell. And I can’t drive. I am stuck, miserable until I can find a ride home. It is horrible.

And if it is work? And you can’t leave for whatever reason? Then I am in for hell. A hell of mistakes. Errors. Throwing up. Lack of clarity. Confusion. Dizzy spells. Trying to think straight. And low productivity, as a best case scenario.

10 Reasons Migraineurs Are Awesome

I think these guys get migraines. I think they feel my pain. Just saying. All that head butting..png

Migraines are not in and of themselves awesome to experience. They are a neurological condition and pain can be invited to that party, but not necessarily. It is a mind-blowing experience and not a positive one. So why would migraines make migraineurs so awesome, you wonder? We experience a very difficult experience, sometimes very often. I think that makes us very strong people, and very supportive people as well. We develop strong communities and make great friends in those communities. Here are some other things:

1. A super sense of smell — During a migraine attack, some of us have osmophobia, known as a very strong sensitivity to odors. We can smell your perfume a block away. We can smell those stinky socks you took off in the other room. It is so profound an ability, we might be able to smell what you had for dinner two days ago. The only thing that messes with this trick is that some people also get olfactory hallucinations; in other words, they can smell things that are not there. Like burning toast and sewer. Or rancid goat breath. Sometimes it is really hard to label phantom smells. And since we have a super smell machine, we might look all over for phantom smells. Nevertheless, superhuman smelling makes migraineurs awesome. Misplace your sandwich? We are on it! Think the milk is a little off? We will know it.

2. Superhuman pain tolerance — I’m not one to brag or anything but I can stand, communicate and even move while my head is imploding. This is a skill mastered with chronic migraines, which are classified as more than 15 migraines per month. Once you reach migraine warrior class, I mean chronic, you have to function in some capacity with them, in order to have a life. So we develop an astonishing pain tolerance. We are talking functioning on a seven or eight on the pain scale. Not so much when we hit 9, but I doubt many people can master that class of functionality. Not saying this skill is awesome in itself, but we need it… we really need it.

3. We can sense weather changes — Some of us may have a sense of an impending storm and other barometric shifts. It really rather smacks us right in the brain noodle. I sense… oh my god, that hurts like hell… yeah, a storm is coming. It’s useful if I’m there when you are having an outside gathering. I am your weather alert.

4. Some of us hallucinate without drugs — Yes, many of us get the “perks” of hallucinations without having to take drugs. We might have migraine auras and see flashing lights, translucent raindrops falling from the sky, cascading multi-colored sparks of color falling over our vision. We might see warping motion of objects that are not moving. We might have hallucinations involved with Alice in Wonderland syndrome (AIWS) that cause our body to morph larger or smaller to our perception or the world to get bigger or smaller. I have persistent migraine auras, so I have auras with or without the actual migraine. Most people find auras very unpleasant and disruptive; however, since I get them so often I tend to just enjoy the varied light show. They can be very visually disruptive given we generally need to see and AIWS in particular can be very severe. It is just an experience that we may not share with others. It is unique. It is indescribable. Sometimes entrancing and sometimes extremely disruptive. Sometimes visual and sometimes tactile.

5. We rock the sunglasses and hats — For those of us with an excessive loathing for light due to photophobia, we do not leave the house without sunglasses and/or a hat. And we rock it. Some of us actually wear FL-41 specially tinted glasses for inside that specifically help with photophobia indoors, and can be used outdoors in sunglass form. People often give us a double-take. Wearing sunglasses inside, are we just that cool? No, but coolness is a side effect I’m good with.

6. We live in moderation — You won’t find us getting carried away, because we have to watch our migraine triggers. Too much sleep. Not enough sleep. We likely will not, for example, go to a loud bar and get very intoxicated because a) a loud bar could be a trigger by itself and b) alcohol can be a horrible trigger. I personally learned this lesson in my early 20s when I was first diagnosed. And a migraine when you are intoxicated? Not recommended. So we learn moderation. Keep it mellow. At times that means work-wise as well.

7. We are always prepared — Yes, we are always prepared for impending doom. Since we must live our lives, when we do anything we are prepared for an attack anywhere we go. Migraine balms, medications, heavy-duty sunglasses, hat and maybe some icy cold patches. For example, we may want to get our rock on at a concert, but the loud noises are a massive factor, so we prepare and bring our migraine emergency kit and earplugs. Hope for the best, prepare for the worst.

8. We are spontaneous — Because a migraine may hit at any time, we do not do plans very well. We often cancel plans and feel exceptionally guilty about this. But, my friends, we do spontaneous very well. Because those low pain days or migraine-free days? We want to take advantage of them. We live for them. We want to experience our lives during them. Like now. Like, let’s get out there right now and do something — in moderation, that won’t trigger a migraine, of course.

9. We are great at diets and supplements — Many of us have tried so many restrictive diets to help with our migraines, and we are great with them. We know paleo, high protein, Mediterranean diet, anti-inflammatory diet and the ketogenic diet. We likely can recommend recipes. Have helpful recommendations. Tell you if we happened to lose weight, and let’s just say if we gain weight on every preventative med we are put on, we will probably consider that to be a plus. Since many of us have tried and are on numerous vitamins and supplements, we are a fountain of knowledge on them. We know what they are for, what they help with and even what the potential side effects are. We know all the good migraine ones.

10. We are empathetic — We understand pain. We understand pain that knocks you out all day. Or even for days. We understand pain that sends you to the ER. We understand pain that people don’t quite understand or can’t quite relate to. We understand it when pain becomes chronic, people understand it even less. So we empathize with suffering. We know how difficult it is to manage and cope with invisible disabilities and chronic pain of any sort

Migraines and mouth bacteria?

people, emotions, stress and health care concept - unhappy afric

The study that came out about food triggers and mouth bacteria was a pretty fascinating one… to clear it up for us Teri Robert has written Are Migraine Food Triggers and Mouth Bacteria Related? 

The fact is the gut is a fascinating topic and ripe for research. We develop our gut bacteria when we are young… and have it for the rest of our lives. Another fun fact, it is estimated about 90% of our serotonin is made in our digestive system. Chew on that! So it is a largely ignored area that affects a rather massive amount of things. So I actually found this study pretty fascinating, but preliminary and obviously we would have to see where they go with it in the future.

Just another day

godamnced-migraine

Today was a bad day. A day I could not take a triptan because it was a non-triptan day, as most are, so it was a endure the migraine day. But it was also a wake up with a full blown high pain level migraine day. And it didn’t abate. The nausea was amped up. I was quite frankly miserable.

Thing is, this is just another day.

Like so many other days.

It resembles yesterday, except I was emotionally distressed yesterday and pain can do that to you. Today the pain was higher, but emotionally I was pretty not present. Because cognitively I was not present. My spouse was getting frustrated with me because I kept not quite getting what he was talking about. That sort of not present. Too much pain and the cognitive faculties diminish substantially. Just sort of a brainless haze going on.

Just another day.

I barely ate because of the nausea which is the new norm for me. This nausea is persistent. I’ll give it that. And when people say ‘Oh you’ve lost weight!’ I sort of want to smack them. Not their fault for noticing. I have. Just not the way any person would like to. I would much rather an appetite again and to enjoy eating.

Just another day

I can’t sleep because the pain level is too high. There is nothing to do about that. I’ll get sleep sooner or later. Or none.