8/29/2014

What a Headache!

MargaretMargaret
Filed under: @ 9:13 am

The first migraine I can remember having would have been in my room in A dorm in late 1989 or early 1990. I don’t remember whether I didn’t have class that day or whether I was skipping class because I had a headache. I remember that I’d taken 800mg of ibuprofen that hadn’t helped and I had to climb out of my athletically arranged bed (yes, athletic, not aesthetic. The room was small, the bed was balanced on desk and dresser, and the ceiling was about a foot above my head) to POUND on my roommate’s door to tell him that the country music he was blasting was going to kill me. I also remember looking at the window and thinking that a quick trip down from 10 stories up couldn’t hurt worse than my head did already.

I must have had a migraine or two when I was in vet school, but I don’t remember any. It’s just that the non-medical parts of those four years are such a (merciful) blur that none really stand out. Except one, the migraine that I got after having eaten at a friend’s house. Dinner was good. Dessert was diet Jello made with diet 7-Up. I’m usually a fan of Jello, but within 10 minutes my lips were numb and five minutes later I had little hobnailed demons trying to pound railroad spikes through my right temple. THAT was when I learned that I’m sensitive to artificial sweeteners. To this day I am extremely careful about reading packages of sweetened products even though that damned global warming has made the print on the packages so small that it’s almost impossible to read (but that’s another story).

Then I graduated, we moved to Olympia, and I started working for Dr. Neanderthal Mouthbreather.
For those not familiar with migraines…. they’re exacerbated by stress. The whole three years – God, three and a half – that I worked in that place my adrenal glands were in such overdrive that I’m surprised I can get surprised anymore. And while it took me a good long time to recognize the pattern, in my defense I was so distracted on an every day basis that I’m surprised I managed to tie my shoes correctly. That was a real slum of a job!
In those three years I did start to suss out a pattern though.
Shrieking, blinding headache once a month? Hormones, check!
Shrieking, blinding headache after sharp or moldy cheeses? Mold spores, check!
Shrieking, blinding headache with red wine? Tannins, check!
With the interwebs and an increased ability to do basic research without leaving my home, as well as the ability to talk with a large number of colleagues across the country, I’ve discovered that I am a classic migraine sufferer. We are overwhelmingly female, pre- or peri-menopausal, and tannins, molds, artificial sweeteners, caffeine, dark chocolate, soy, and glutens are by far the most common triggers. Thanks be to Zarquon that neither dark chocolate nor glutens are on my list!
Damn it took a good long time to find a decent solution though.
There was one day at work that I’ll never forget. Dr. N-M was out of the office so I was on tap for the whole day. Except I couldn’t get rid of that beastly motherfucking headache! I took ibuprofen. No good. I took ketoprofen. No good. I took naproxen, I took aspirin. Then I started throwing up. So I was sitting in Dr. N-M’s dank, dusty office filled with crap to the ceiling (hello mold spores?), the lights off and my head resting on the cold metal of the filing cabinet and the receptionist coming back and telling me when I had clients coming in. It took me more than three hours to decide to give up. And I still caught hell for leaving early from Dr. and Mrs. N-M the next day. I wish them both much happiness! 👿
Over a period of months and a couple trips to the ER I finally managed to clue in on what was happening so I could talk to my GP. GP gave me a script for an oral version of the injectable NSAID I’d been getting. The injectable really helped with the headache so she figured the oral would be right up my alley. And the oral form did work, it’s just that when you’re taking Non-Steroidal Anti-Inflammatory Drugs you really need to do so with some food on your stomach. Because otherwise you might just puke. Oof!
Having to try and eat something when hobnailed demons are pounding red hot railroad spikes through your right temple is a challenge. Eat too fast or too much and you puke. Don’t eat enough and you puke. In both cases you lose the medication you’re trying to keep down that will drive out the demons so you can stop puking. It was a delicate balance and I went through a LOT of soda crackers and Coke.
Coke. Lordy! Blessed, blessed Coca-Cola! I don’t drink a lot of caffeine. And the reason I try to stay away from caffeine is that I’m NOT one of those folks whose migraine triggers include caffeine. In my case the caffeine helps change my blood pressure and helps either constrict or dilate (I can’t remember) the cerebral blood vessels that are in a snit when I do run across one of my triggers. I like to keep my body pure (snort!) so that the minimal amount of caffeine that is in Coke helps the best it can. Also Coke syrup is an mild anti-nausea agent and at least if you puke after you drink a Coke it tastes the same coming up as it does going down (I’m sure very few of you really needed to know that).

There are a number of different options for migraine medications though. And when I switched MDs after we moved up here and discussed the problem with my current MD she gave me a bunch of samples to see if any of them would work for me and yet keep me from having to try and eat while I was migraine-ing. Unfortunately none of them really worked until the miracle of rizatriptan came around. Rizatriptan is an ergotamine vasoconstrictor that is easily absorbed through the oral mucous membranes. It’s fast, for me it’s effective, and, weirdly, both the brand name and the generic contain two of my migraine triggers. Ergot is a type of fungus that usually grows on corn. And the tablets are sweetened with aspartame. Why it works for me I do not know. It plays hell with my blood pressure, makes me groggy and maladroit for 24 hours or so (back to loving Coke and its delicious delivery of caffeine), and tastes like the bottom of a peppermint toothpaste vat, but I can take one and if I have to I can be functional again in 10 minutes. (Note that it’s best if I don’t have to be functional in 10 minutes, but it’s possible if it’s absolutely necessary).

So why am I telling you all of this?
I had to leave work early, like 9 hours of my 10 hour shift early, yesterday because I had a migraine. You’d think that after 25 years I’d be canny enough to catch it before it gets bad, but there it is. I woke yesterday morning with a headache. That’s a fairly common occurrence, but usually once I’m up and moving the headaches go away. Yesterday it didn’t really go away. I went for a walk, I had a headache. I ate breakfast, I had a headache, I showered, I had a headache.
Now a rational person would think “Ah! Migraine! Take your damn medication, chug your Coke and get on with your life.”
But apparently I’m not rational. Or at least not when I have hobnailed demons and their 10 pound hammers in the offing.
I got dressed, I got in the car, I went to work.
At which point the fluorescent lights, the ambient noise and temperature, and the strong smells started to work their magic and within an hour I was seeing blue spots out of my right eye and I was so dizzy I could hardly stand.
So I had to leave my boss with my full schedule and her full schedule and come home to lie down in a dark room and put an ice bag on my head. When the demons get that frisky a migraine pill and a Coke just won’t suffice. I slept for the rest of the morning and a good portion of the afternoon. Which is why I got up at 0600 this morning and started working on my computer (sigh!).
I do not understand why I can be so bloody stupid about my stupid head sometimes. There is some theory that migraines are a form of partial seizure disorder. I wonder if I had the stereotypical tonic-clonic seizure activity if I’d still feel guilty about getting ill and having to leave work occasionally?
To be honest I’d prefer the tonic-clonic seizures!


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