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Update from Migraine-land

May 5th, 2008

My computer is well again, thank goodness.  And I have just been through a bad migraine patch – 6 of the last 11 days.  For those with Chronic Daily Headache or Chronic Migraine (Migraine 15 days out of the month), that may not sound too bad.  A few of my migraineur friends have lived with the same migraine for 6 weeks or 5 months.  On the other hand, for others who have 1 or 2 migraines a month, or less, that may sound awful.  I used to have 2 a year.  The good old days!

(By the way – do I have Chronic Migraine myself, or is mine still considered episodic?  I have not hit the 15 days a month marker yet, but I seem to be close some months.  We’ll see what Dr. Young has to say at the Jefferson Headache Center when I go in June.)

But life goes on.  I learn more all the time about managing this disease.  I always try to share what I am learning.   I have been thinking a lot about managing Migraine triggers.   Part of my recent bad streak is probably due to having been in a course that activated many triggers for me.  Lack of sleep, florescent lights, lots of noise, having to concentrate way beyond my fatigue point.  It took me about 4
days to recover from 2 days in that course.  It was a price I paid willingly for a useful piece of professional knowledge.  I can’t always avoid triggers.  But I will try not to do weekend courses like that without spending a few days in bed afterwards.

My friend, neurological-chiropractor Dr. Heidi Kaufman introduced me to the concept of neural fatigue.  I
haven’t found a good reference on this yet, but basically the idea is that neurons get tired out and stop functioning as well.  I experience this when I am exposed to a lot of noises at the same time – I lose my ability to sort one sound from another and all I hear is undifferentiated noise.  Parts of the course were like that, as some participants insisted in talking across the instructors.  I believe this is an instance of what Dr. Hayrunnisa Bolay described in her research findings of

a mechanism that leads to problems with discrimination of tones and
lateralization of sound, particularly in a noisy environment, in
patients with migraine.

“Cochlear Dysfunction Apparent in Migraineurs,” April 12, 2008, RM Global Health. (Thanks to Rain Gem for pointing me to this fascinating study.)

Another instance of just how weird this disease is:  for some time now when I am fatigued, I have trouble with spatial perception.  This occurs most often in a car, where I have trouble perceiving how close or far away other objects are.  It feels like everything is moving too fast for my brain to catch up, to quote one of my buddies in a recent discussion on the MMC Forum.  I find myself afraid I am going to fast, or that I am about to hit something when there is actually plenty of room.  In case you’re worrying, I pull over right away if this happens when I’m driving.  It happens most often when my husband is driving, and I flinch and gasp at what appear to me to be near misses, when actually he is leaving sufficient distance, slowing down and stopping quite appropriately.  I am wondering if this is an instance of Alice in Wonderland Syndrome, an unusual sort of migraine aura which affects spatial perception.  I enjoyed this article in the NY Times blog a few months ago, and here’s a new one from Teri Robert: Alice in Wonderland Syndrome – The Basics.  Since Lewis Carroll was a migraineur himself, he may have been describing his own experience when he wrote of Alice’s strange growth and shrinking.   Adventures in Migraine-land.

I may appear to be rambling.  I may, in fact, be rambling.   I’m leading an exploration of migraine triggers right now at WEGO Health.  It’s part of a series of lessons on Migraine Management Coaching.  Please come and visit if you’d like to look more deeply into what may trigger your migraines, and how to manage your triggers!

– Megan

Now the dogwoods are blooming – life is great!

Tags: Alice in Wonderland Syndrome, chronic fatigue syndrome, chronic migraine, cochlear dysfunction, disease management, migraine, migraine aura, neural fatigue
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