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This is my journal of living with Migraine and other chronic illness. Trying to live well, to live a purposeful life, with chronic illness, since I don't get the choice of living one without it!

Holidays don’t have to Hurt your Head

December 1st, 2008

How was your Thanksgiving? We just got back from a very relaxed five day trip to my sister’s house, where the extended family descends for an annual Thanksgiving extravaganza. There are a lot of reasons to love it. My sister and brother-in-law and nephews are warm and welcoming and they pull out all the stops to accommodate everyone. Danny and I bake pies and cook some side dishes and load them in the car with ourselves, our kids and our luggage, maybe some fruit and wine, and off we go. We don’t have to clean the house (not that it couldn’t use it). We get a mini-vacation from the worries of our daily life. Their house is set up so that even with a crowd, the upstairs rooms are pretty sound-proof, so if a Migraineur needs a quiet retreat, there is one.

I am very thankful at Thanksgiving time, for the loving and accepting, funny, intelligent and interesting family I have, the fun times and wonderful food we share. I have many blessings to count. I have never managed to travel to this particular fest, however, without at least a little pang of wishing it were different. I wish I could host an event like this at my house. I wish that I could host any event of more than a handful of people for more than a few hours, without getting a Migraine. I wish that my home was orderly, organized and clean to the point that preparing for overnight guests wasn’t such a huge task.

The internet and the newspapers right now are full of articles on how to have happy holidays on a shoe-string, or how to enjoy the holidays without the stress, and I don’t need to re-invent the wheel. Over at My Migraine Connection you can read Teri Robert’s interview with Marcia Cross on Holiday Parties with Migraines. Coming up on December 8, the December Headache & Migraine Blog Carnival will be posted at Somebody Heal Me on the topic of “Maximizing Your Enjoyment of the Holiday Season,” and there will be lots of good reading on the topic, I’m sure! (If you’d like to submit a post for the carnival, the deadline is the midnight Friday, December 5th, and you can submit your post at this link at Somebody Heal Me.)

What I’m here to say is – the holidays don’t have to hurt your head. Like me, you may find there are things you have to give up. I conceded Thanksgiving to my sister years ago, since she loves doing it so much, but for most of the past 6 years we have hosted a big holiday weekend at our house around New Year’s. We won’t be doing that this year. Having that many people in my house, and that much noise, for an extended period of time, is a whole series of Migraine triggers for me. I end up missing a chunk of the celebration, I’m not much of a hostess, my family feels bad for me, and I’m in pain that often lasts days after everyone leaves.

I was surprised to find myself in tears when I told everyone we would not be hosting this year. It’s not like it was unexpected! The truth is that it is hard to give up on something we want to do. What we can do is to look below the thing itself, and see what is important to us, and how else we can express that.

When you look at your holiday season, think about what is important to you, and how you can express that without hurting your head. One holiday party may be much better than five. You may not have to wear yourself out to cook huge meals – choose one or two things that are important to you or your loved ones. The quantity of toys will mean less to your kids than the time you take to stop and play with them.

I gave up trying to be Martha Stewart years ago, but as my Migraines became more frequent I have had to give up more. So where we used to make six kinds of Christmas cookies, maybe we will make two. Where we used to have 18 people for a holiday weekend with a big dinner, we will ask a smaller group to join us for just dinner on Christmas day. Where we used to climb on the roof and hang lights, we light a few windows. In our family we have always celebrated Hannukah and Christmas, since we have a mixed background, but several years ago we became clear that our kids didn’t need gifts every night of Hannukah and under the tree and in their stockings!  We buy less, and light the candles to remember our heritage and hope in the darkness, rather than as a reason for eight more gifts.

Festivity is great fun, but it can also be addicting. Advertising tells us to do more, buy more. Many people find that however much they spend and do, they still fall short of the “perfect” holiday they imagine in their mind’s eye. As Migraineurs, we need to go easy on ourselves. Whether or not you’re hurting financially this season, you don’t need the added stress of worrying about whether you have bought or done enough. A little can go a long way. What is most important to you about the holidays? Is it time with loved ones? An expression of peace and hope? Find ways to express what is important to you, that don’t hurt your head. Remember to get regular sleep, eat regularly, avoid your Migraine triggers, and enjoy the joys of the season!

Peace!

– Megan

Sliced turkey image coutesy of Roland Tanglao; advent candles image courtesy of Per Ola Wiberg; menorah image courtesy of Andrew Ratto.

Tags: Christmas, Hannukah, holidays, managing life with migraine, Migraine triggers, Migraines, Stress, Thanksgiving
Posted in Managing, Musings, Tips & Techniques, Weblogs | Comments (3)

Imitrex Now off Patent – Non-Brand Name Forms now Available

November 24th, 2008

Imitrex – the trade name of the drug sumatriptan by GlaxoSmithkline – is at long last out in generic form. Imitrex was the first of the triptan class of drugs to be released, and is therefore the first to be coming off patent. When Imitrex came out about 15 years ago it revolutionized treatment of acute Migraine attacks. Triptans work not as pain-killers but work directly to abort the neurological process involved in a Migraine attack. Although they are contra-indicated for some Migraineurs, particularly those with cardiac-related problems, they are tolerated by most, and make it possible to greatly limit the impact of a Migraine attack.

Kerrie at the Daily Headache reported last week that injectable sumatriptan is now available in a generic form, and the Wall Street Journal announced today that Dr. Reddys Laboratories has launched the generic version of sumatriptan tablets. This is great news for Migraineurs – Imitrex has been one of the more expensive triptans on the market, retailing for anywhere from $15 – $25 per pill. Many Migraineurs, myself included, have found ourselves in ongoing struggles with our insurance companies, which limit us to 4 (or 2, or 6) pills per month, forcing us to choose which Migraines to treat and which to suffer through. I am still fighting for reimbursement of over $200 for Imitrex that was prescribed, and which the insurance company said they would pay for and didn’t. But that’s just another health insurance headache story.

– Megan

Tags: generic drugs, GlaxoSmithkline, imitrex, Migraine attack, The Daily Headache, triptans, Wall Street Journal
Posted in Current Affairs, Medicine | Comments (3)

Radio Piece on Migraines, Neurological Illness, and More

November 20th, 2008

On Tuesday I had the great good fun to be interviewed by Coach Marla Martindale of A Winning Life with RSD, along with her co-host Chris Tatevosian, author of Life Interrupted – It’s Not All About Me. Marla’s weekly radio show Winning Life Through Pain is on every Tuesday and deals with living well with chronic illness, and other health related topics. We talked about managing life with Migraine, Migraine myths and tips for coping, communicating about our illness, and how to calm down our nervous systems, as well as discovering a lot of similarities in dealing with other neurological illnesses like RSD and MS. Oh and there were a few references to baked bees and general silliness. You can discover that for yourself, if you like. Give a listen.

(Oh, a warning, it’s a big file – 27.4 MB, so you if you’d rather not deal with loading it, go to Winning Life Through Pain to listen.)

– Megan

Tags: chronic illness, migraine, neurological illness, radio, Weblogs
Posted in Advocacy, Communicating, Tips & Techniques, Weblogs | Comments (0)

We Can’t Avoid Every Migraine

November 19th, 2008

This may seem obvious, but it’s something I need to remind myself of from time to time. We can’t avoid every Migraine. The job before us in managing life with Migraine disease is to avoid as many as we can, through avoiding triggers, getting rest, exercise, nourishment, drinking enough water, living a healthy life, through relaxing and calming our nervous systems, through getting the best medical treatment we can, appropriate use of medications, using other therapies to help us maintain ourselves, balancing our energy and our work-load, getting support, getting to know our own bodies and our own reactions… are you breathless yet? Yes, we do all of that, and it is a big job, and most of us can have a huge impact on the number and severity of Migraine attacks that we get. But we can’t avoid every Migraine.

I didn’t avoid the one that hit me last night. Sometimes you can see them coming, you can see the set up as it is happening, like in a movie where you start yelling at the heroine, “No, don’t open that door, don’t do it!” but she does it anyway. Here’s what happened to me: I missed a dose of my preventive medication; I had several days of anxiety over current financial uncertainties; I slept badly for two nights; I got my period; something upset me and I cried; I had a fun and exciting radio interview which I enjoyed very much; I began feeling some head pain and didn’t take an abortive right away because I needed to drive my kids to some appointments.

Chances are that even with the large stack of triggers I was dealing with, if I had taken my triptan and laid down at the first sign of pain, I probably would have minimized the Migraine, if not eliminated it altogether. In a perfect world, my husband wouldn’t have had an important commitment I didn’t want him to miss, and could have driven the kids. Hell, in a perfect world, we’d have safe available public transportation! No, wait a second, in a perfect world we’d have the public transportation and I wouldn’t have the Migraine!

Instead, I took Adam to his drum lesson, then we went to the library until it was time to get Rachel from her rehearsal, then we sat outside the High School for 45 minutes until she was let out from the rehearsal. I should have let her drive home but the effort of climbing out of the driver’s seat and into another was too much to face. By the time I got home I could only climb upstairs, vomit, give myself an Imitrex injection, and lie down. I couldn’t find my ice packs. The pain was so intense that even shifting position in bed made my head pound. All I could do was lie perfectly still with my bean-bag eye mask, do my relaxation breathing, and wait for the pain to ease. After a couple of hours it let up enough that I could sleep. It’s still with me today, though much less intense. I think if I keep very quiet it will leave today.

I am lucky that I don’t get a Migraine that bad very often. Not more than once every month or two. Most often I am able to treat the Migraines I get right away; most of them do not progress to that kind of excruciating pain. Life happens, though. We don’t live in a perfect world. We have a disease; we do the best we can. I have been going about a week between Migraines, which is great progress. I’m grateful. I hope you are doing well too.

– Megan

Tags: Adam Oltman Porcher, Adam Porcher, Migraine management, Migraine pain, Migraine triggers
Posted in Managing, Musings | Comments (3)

Keep Working? But How? Author Rosalind Joffe Gives us Some Clues

November 18th, 2008

 

Rosalind Joffe, co-author of Women Work and Autoimmune Disease: Keep Working Girlfriend stops in today on her virtual book tour. I asked Rosalind “how can we deal with the conflict between the need to slow down and care for ourselves, and the pace and intensity of the working world?”  Here’s Rosalind’s response, in our guest post for today:

Continuing to work – and managing to achieve some level of success – while living with chronic illness isn’t for everyone. Women Work and Autoimmune Disease: Keep Working, Girlfriend! explores the strategies and tactics that can help you. But the current work environment can pit us against our best desires to work and maintain a balanced life.

When my mother retired in 1992, she’d been working for 40 years. Testimonials at her retirement dinner reflected on her strong work ethic and her achievements. She’d reached an unusual level of success for a woman at that time in New York City public school administration. And she did it working between 40 to 50 hours/week, with a total of 3 months vacation yearly.

That’s just no longer possible. In the current labor market, the notion that there are no boundaries to the work day and working nights and weekends is the norm. Nor is this attitude limited to “white collar” or salaried jobs. Even hourly workers are expected to work more than their base time.

Cost cutting in a shrinking economy often means doing the same job that 1.5 or even 2 workers had done previously. In this 24/7 work world, too many organizations, big and small, assume that workers will be available whenever and wherever, regardless of the job or role in the organization.

So what does it mean for those of us whose personal resources are being taxed to the max due to a chronic illness?

First, take stock of your situation. Look carefully at who you are now and how you need to work so you can continue to work over the long haul. Throw the picture of “healthy you” in the trash – at least for now—and take a picture of you, right now, and tape it to your computer.

Now, think strategically. Give careful consideration to a career that offers relative stability. Although the current financial crisis shows us that nothing is for certain, some industries will always be more solid than others. You might want that sexy job but are you in a position to take the risk?

Additionally, when looking for a new job, focus on finding an organization that values its employees above all else. This can be the most critical element in your ability to keep working. My booklet, the Keep Working with Chronic Illness Workbook, complements the book. It has exercises and worksheets designed specifically with chronic illness issues in mind. Use this to seek work that meets your true needs and values.

Finally, no matter where you work or what you do, set limits. As long as you’re getting your job done to your satisfaction, you can decide where to set boundaries and draw the line.

At the end of the day, only you know if you can do the job. It often means modifying your own expectations. But when you take responsibility for managing your time and energy (even if you can’t make yourself healthy), you’ve put yourself in the driver’s seat. Remember, you could have a long work life ahead of you and now is the time to make it work for you.

Rosalind Joffe, co-author of Women, Work and Autoimmune Disease: Keep Working, Girlfriend! is president of cicoach.com, a resource for professionals who live with chronic illness. Check out her website CI Coach which is filled with resources about career challenges living with CI and her blog, Working with Chronic Illness.

Tags: autoimmune disease, career, chronic illness, working
Posted in Books, Managing | Comments (2)

Migraines on the Radio

November 17th, 2008

Coach Marla of A Winning Life with RSD asked me to be on her internet radio show tomorrow (Tuesday, November 14) at Winning Life Through Pain. Please come give a listen; we’ll be on at 2:00 Eastern, 1:00 Central, 12:00 Mountain, 11:00 Pacific, talking about living with Migraine and other chronic illnesses. You can click on the link above to get to Blog Talk Radio and listen to the radio show. Hope your heads are treating you well today.

– Megan Oltman

Microphone image courtesy of Matthew Keefe.

Tags: blog radio, chronic illness, migraine, reflex sympathetic dystrophy
Posted in Communicating, Tips & Techniques, Weblogs | Comments (0)

Relaxation for Migraineurs – A Cool Breeze Blowing Through your Brain

November 13th, 2008

BREESE – Breathe RElax Easy SmilE

(Yes, I know that’s not the right way to spell breeze.) I use the analogy of a breeze to learn to relax and disengage mental and emotional energy. In his book Breaking the Headache Cycle, neurologist Ian Livingstone, M.D. explains how our nervous systems need both a reasonable amount of stress, building the tone of the nervous system and keeping us growing, and a reasonable amount of relaxation, allowing the nervous system to rest and recover, and calm down.

Migraineurs are not necessarily more keyed up or more stressed than others (despite lingering myths about a “Migraine personality”), but our nervous systems are more sensitive to stimuli, and the higher our stress load, the lower our resistance to Migraine triggers. Dr. Livingstone cites research showing that Migraine frequency and severity can be reduced an average of 40% through regular practice of relaxation. A study at the University of Rajasthan, India, found that “Three months of intensive yoga practice—one hour, five days per week—curbs frequency and intensity of migraines by 70 percent,” according to Liz Somes in Psychology Today.

Imagine a soft gentle breeze blowing through our minds and bodies, carrying our stress away. We can generate the breeze through:

Breathe – We rarely breathe fully, but to breathe fully induces relaxation. In particular, we hold our inspiration and do not breathe out fully. One deep breathing practice is to breathe in deeply, to a count of three, and then breathe out completely, to a count of five.

 

Shortly after I started working with Dr. Livingstone I took on breathing like this for 10 – 15 minutes a day, and also any time I noticed myself getting anxious, tense or upset. Later that month I was driving to the airport for a business trip, cutting it rather close for my departure time, a situation which makes me very agitated. I noticed my stress level rising and the tension increasing in my hands, arms, shoulders, and neck. A few minutes later I had a tell-tale pinpoint of pain over my right temple. I began the 3 in – 5 out breathing practice and felt myself calming down. By the time I got to the airport half an hour later my head pain was gone.

 

RElax – Relaxation is a completely different state for our nervous systems than excitation. We need both states to be healthy. But many of us do not consciously and deliberately relax very often. Relaxation can occur in sleep, in meditation or visualization, in enjoyable conversation with a friend or loved one, in exercise or sexual activity, in reading or listening to music. Some of the activities we think of as relaxing – some computer or video games, for instance, actually excite us and raise our stress levels. I took on a daily practice of spending 15 minutes doing deep breathing, meditation and visualizations. Within a couple of months my migraine frequency was cut in half. When I stopped doing it regularly, within a couple of months the migraines had inched back up again.

Easy – give it up, let go, don’t worry! Stress and anxiety are real, physiological states. But they are also occurring in our minds, where we can notice them. I have taken on a practice of detachment with love, creative disengagement, stepping down. This becomes easier with a regular practice of meditation, where I can notice the things I need to let go of and picture myself dropping them.

SmilE – cultivate gratitude, humor and joy. This doesn’t mean you can’t gripe and vent when needed – but keep a commitment to do it in order to clear the bad stuff and regain your own optimism. Without gratitude, humor and joy, life is not worth living. When we smile it actually affects us physiologically, emotionally and mentally. Maybe you don’t want to smile – but try it anyway. You may say, “Megan, this just the power of positive thinking!” I won’t argue with you, but I will suggest that most of us spend most of our time submitting to the power of negative thinking! So try this for a change. Watch, read or listen to a gentle comedy. Look at something beautiful. Talk to someone you love. Play with a child. Find something to smile about.

If you practice generating the breeze, you can calm your system and reduce your Migraines. If you want to make it easier to practice, join us for the initial Free my Brain relaxation teleclasses. I will be leading a group in learning and practicing yoga breathing and full body relaxation, and guided visualization, in two 35 minute teleclasses, coming up on December 1st and 4th. Click here to read more or to register for the BREESE teleclasses.

– Megan Oltman

Grass in the breeze image courtesy of Andrew Storms.

Tags: breathing, Ian Livingstone, M.D., meditation, Migraine management, relaxation, yoga
Posted in Managing, Tips & Techniques | Comments (7)

Migraine Prevention – Early Success

November 12th, 2008

Shhh… I’m whispering so the Migraine monsters don’t hear me and punish me… Oh yeah, that’s kind
of like believing in ghosts. But I seem to be having some success with the topamax I’m on for Migraine prevention. I have a Migraine this evening, but I’ve been running six to eight days between Migraines, for the last three or four weeks. For a year and more before that I had been getting several Migraines a week. So the frequency is cut in half, which makes a big difference. These are early results – I’ve had good 3 or 4 week stretches before, so I can’t predict whether this will continue. But I am hopeful!

I’m still on the minimum topamax dosage. I would have increased it several weeks ago but for a switch in insurance carriers making it necessary to delay the glaucoma test Dr. Gerhardstein wants me to have before increasing the dosage. Now I am happy we have taken it so slowly. Clearly my body has had a chance to acclimate itself to the medication. I am not experiencing any of the side effects I had in the first couple of weeks, either.

The biggest surprise to me is that I have more energy generally. I am not exhausted in the afternoon and evening; I feel motivated and I am getting more done. The constant low level of head pain I lived with most of the time is just gone – it seems to me that pain may have been responsible for a lot of my fatigue in the last year. The last two weekends I have done yardwork and projects around the house that I have wanted to do for ages.

There is a downside, though. It’s very easy to start feeling like Wonder Woman in contrast with how I felt before. So once again I need to practice what I preach! Along with my clients, and you dear readers, I need to find that middle ground! For over five years now I have known that to have balance and well-being, to keep my energy up and my Migraines minimized, I need to pace myself. I need frequent breaks, and shifts in focus. I need time off in the middle of the day where I truly rest. I need to pay attention when I feel myself getting wired, when my blood pressure goes up, when I start moving and talking fast, when I feel the muscles in my forehead and scalp begin to contract. These are danger signs for me. Not least because I enjoy them – I like that edgy feeling of moving fast and powering through. But that energy is inevitably followed by a Migraine crash.

A few energy management tips:

1. Take a break or shift your focus every 45 – 90 minutes. If you are at a computer get up, stretch and do something else for a few minutes.
2. Take “green breaks” where you go outdoors, look outdoors through a window, look at a green plant, or at the very least look at a picture of a green plant. 2 – 5 minutes can make a huge difference.
3. Take deep breaths to slow yourself down if you feel your energy or stress level mounting.
4. Be sure to take a real break in the middle of the day – don’t work through lunch.

I failed at finding the middle ground today. I got a lot done, but there’s a price and I’m paying it. And so I learn my lesson again. I’m grateful to have more energy and less pain, and I’m committed to maintaining my energy by using it wisely! Let me know how you’re doing with your energy today!

– Megan

Tags: energy management, fatigue, Migraine preventive medication, relaxation, Topamax
Posted in Managing, Medicine | Comments (2)

November Blog Carnival: Art inspired by Migraine

November 11th, 2008

Go over to Pain in the Head for the November Headache and Migraine Disease Blog Carnival.  Generally speaking, a blog carnival is a
collection of links to a variety of a blogs on a central topic. The
Headache & Migraine Disease Blog Carnival has been created to
provide both headache patients and people who blog about headaches with
unique opportunities to share ideas on topics of particular interest
and importance to us.

This month there are a number of posts containing art, and others about the relationship between Migraines and art. Many of us find creating art, whether with words, images or other materials, helps to soothe our pain and release our feelings.  I want to give another plug here for Migraine Chick‘s new book of Migraine Haiku, which I mentioned a few weeks ago. Migraine Chick can make me laugh, and some of this haiku does that, with its biting cleverness. Some of the poems hurt too much to make me laugh, but they still provide the “aha!” of recognition and the satisfaction of meeting with another mind that really gets it. So check out the art in that book, and I hope also you go over to  Pain in the Head and read some of the artful posts you find there.

– Megan Oltman

Tags: blog carnival, Migraine art, Migraine Haiku, Weblogs
Posted in Books, Managing, Weblogs | Comments (0)

Your Host Seized by Election Fever

November 4th, 2008

I have to admit to a new illness – not a chronic one this time, but acute.  I have election fever.  I fear I
will be good for nothing until the election results are in tonight, and that will be late.  Tomorrow I will be exhausted and probably have a Migraine from lack of sleep.  I could hardly sleep last night, and my dreams were full of voting booths and speeches, polls and impassioned arguments.  Yesterday I had a teary conversation with my parents about how they raised me, about the values of inclusiveness and democracy, remembering the assassinations of Dr. Martin Luther King Jr. and Robert Kennedy in my childhood, my parents’ deep despair at those events and how they explained the world to me around them, and how this election feels like a fulfillment of what my parents have stood for their entire lives.  Who else out there is as worked up as I am right now?

I already anticipated that I would not sleep much tonight; I didn’t expect that I would have such trouble sleeping last night.  I didn’t expect that my irritable bowel syndrome would flare up, as it did overnight and is today.  It’s a good thing I live in a very small town because  a long line at the polls would not work for me today!  I plan to spend a few hours volunteering today, helping others get to the polls, providing rides if needed, as long as my body allows me.

As a coach, as a chronic illness coach I should probably be advising you, and myself, to relax, to get rest today, to go to sleep tonight and find out the election results in the morning.  I don’t think I would be capable of taking that advice.  We are human, and we must concede our humanity.  My Migraine Connection posted their poll of the week today – “Do You plan to vote regardless of a Migraine?“.  Of around 120 responses so far, 94% said yes, they plan to vote regardless of a Migraine.  That’s how important this election is to us.  The outcome here matters to all of us, wherever we stand politically and even wherever you live in the world.  I know many people who have devoted many hours to volunteering this election cycle; my illnesses make me unable to do as much.  I may feel very sick tomorrow, but I will know I have done what I can.

Be good to yourself today.  Vote if you can and you haven’t already.  Help someone else if you can.  Let me know how you’re doing!  I’ll be back posting again when my fever has passed!

– Megan Oltman

Tags: election, irritable bowel syndrome, migraine, volunteering, vote
Posted in Current Affairs | Comments (0)