Wednesday Wonderings: blurred lines

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Migraines are the kind of disease people like to discount. It is just a headache, they think. It is just a once a year deal, they think. So when you are chronic and a lot different for you and certainly a migraine is a lot more than a headache, you are still discounted. You can be intractable and disabled but seen as not sick enough to actually be on disability. I’ve seen it. We often hover in that blurred line of disabled and not sick enough, by others, by insurance companies, by doctors… people that matter for our lives. People who don’t listen. People we have no control over. And they randomly choose one and that affects the fate of that migraineur’s Life.

And we walk the blurred line of functional and non-functional. One moment barely function and the very next non-functional. People wonder how we could do something one day and not the next. But the pain of a migraine varies within the migraine. Or can be half treated. And migraines vary themselves. One could be a 7, and you can be barely functional at that. One can be a 9 and you cannot function at all at that. We, though, have to live in the shifting of pain and functionality all the time.

Just as we have to live in the shift of tolerable vs intolerable pain all the time. We have limits to our pain tolerance. We cannot function when we exceed those limits. A 9 migraine is an intolerable pain.  To expect anything from a person in that level of pain is idiotic. Yet, people do. I have had people expect things from me at that level. Forced me to. And I didn’t get far.

But that blurred line between who we are with pain and who we are without it can really haunt us. With it we can be irritable, moody, frustrated, exhausted, confusion, have brainfog, memory issues, concentration problems…. we are fuzzy, zoned out, tired, moody versions of ourselves.  When do we get to see that person we are without the pain? Just a glimpse here and there? And that is the saddest thing of all. I barely know that person. Barely see that person. I am more the person in pain than I am ever without migraine pain.

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.

 

 

In the arena?

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I get a little tired sometimes about people with no pain or illness judging those of us with chronic pain and illness. Making assumptions about our lives. About our pain. About what we can or cannot handle.

Hell, I am just plain tired.

But if your not in the arena just at least understand you might not understand what you are talking about. Just might not. Maybe just listen a little. Give that a go instead.