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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!

When is it Time to Use Migraine Preventive Medication?

September 6th, 2008

When is it time to use Migraine preventive medications?  It has been a difficult decision for me, as it may be for many of you.  There are clear medical guidelines, and recent research that backs them up.  And yet it is not an easy step to take.

3 or more Migraine attacks per month

Headache specialists will generally prescribe Migraine preventives if you have 3 or more Migraine attacks per month.  My HA doctor told me his guideline is one per week, on average (which sounds very much like 3 or more per month).  If you think about it, a Migraine every week, or nearly every week, is a threshold level for having a serious disabling impact on your life.   Every week you will lose hours or a day or more to pain, photophobia, nausea, whatever package of symptoms you tend to have.  You will miss work, family time, social time.  You will waste hours in a darkened room.

Silent Brain Damage

There’s more to it than the impact on our daily lives.  Recent research shows that Migraine attacks at a frequency of 3 or more per month, over an extended period of time, leads to brain damage.  The evidence is now very strong that Migraine is a progressive brain disease; it worsens over time.  The more frequent, and longer time since onset of Migraine attacks, the greater risk of damage.  The damage shows up as lesions in the white matter of the brain.  The researchers called it “silent brain damage” because there are no known effects of this damage – yet.

Teri Robert, author of Living Well with Migraine Disease and Headaches, discussed the implications of this research in her recent article on My Migraine Connection,  “Yes, Migraines can Cause Brain Damage.”  Teri gives us an excellent explanation of the research, concluding that:

Migraineurs who experience frequent Migraine attacks and / or have a long history of Migraines are at increased risk of “silent brain damage,” brain damage that (so far) does not seem to cause any symptoms. This again shows that reducing the frequency of Migraine attacks (aka Migraine headaches) is critical.

So why wouldn’t you go on preventives?

I have averaged 7 Migraine attacks per month for the last 9 months.  I have been considering preventive medication for the last 8 months.  My hesitation comes from:

• a reluctance to take strong medications that will affect my central nervous system.
• a history of being sensitive to medications and their side effects.
• a desire to take a natural approach to caring for my health.
• the fact that I had a 50% reduction in Migraines a few years ago from regular relaxation practice.
• the fact that there are no medications that were developed specifically for Migraine prevention, which seems to often lead to the need to try many different medications to find the one (or combination) that works for a particular person.
• the sense that it’s easier to deal with the devil I know (Migraine attacks) than the devil I know not of (medications and their side effects).

I suspect that many of you who are reluctant to try preventives have some of the same reasons.  Please do leave a comment to share your thinking.

I will be starting preventive medication in less than two weeks when I next see my headache specialist.  I believe in a holistic approach to dealing with Migraines,
including (among other things)  relaxation, meditation, rest, exercise, physical therapy, massage, diet,
trigger-avoidance, and appropriate use of
medications.   At this point, preventive medication is appropriate!  I need to stop losing 6 – 9 days a month to Migraines.

I have my hesitations about the “better living by chemistry” theory.  I think there are inherent conflicts involved in our pharmaceutical production being governed by a profit motive.  However,
that does not mean that drugs don’t save lives and prevent or mitigate disability.  We need drugs
available, and we need much better choices in drugs than we have now.  Holistic approaches
can reduce Migraine frequency, they can help, but cannot change our inherent neurological make-up.  I use supplements and diet to care for my overall health, but if I got appendicitis you bet I would go willingly to that surgeon.  Knowing that I am at risk of brain damage, you bet I will take the drugs that reduce that risk.

– Megan Oltman

Embarking on the pharmaceutical unknown.  Wish me luck!

Pill image courtesy of [O*] ‘BharaT; brain image courtesy of Gaetan Lee.

Tags: brain damage, migraine frequency, Migraine preventive medication
Posted in Managing, Medicine | Comments (4)

What Do Migraineurs and Movie Stars Have in Common?

September 5th, 2008

Good looks?  Great personalities?  Multi-million dollar incomes?  Well….  Actually I was talking about
shades.  Great big stunner shades.  Jackie O glasses.  Bright light being one of the biggest Migraine triggers, a good pair of dark sunglasses is a must for a Migraineur.  Many of us really can’t be outside without them.  Some of us even wear them inside.  I don’t find that necessary most of the time, but during an active Migraine attack I’ve been known to wear them indoors.

What should you look for in a good pair of sunglasses?  Do:

• Try them on!  They need to block light coming into your eyes from every direction, especially above.
• It’s also important to try them on to be sure they stay on without putting pressure on your head.  You don’t need to avoid the glare trigger and then get a Migraine from having your temples squeezed!
• The lenses need to be dark enough.  You won’t know that unless you step out into the bright sun with them on.
• Get them polarized.  This cuts glare way down.
• If you can, get an anti-reflective coating on them.  This also cuts down on the reflection and glare coming into your eyes.

I also have a Don’t for you:

• Don’t get Transitions-type lenses!  (Or at least, don’t think of them as a substitute for real sunglasses.)  These are the lenses that darken in sunlight.

Why not?  A year ago I got transitions lenses on my regular glasses.  Here they are, barely darkened in the
bright light on the deck (notice the squinting!):
They never get as dark as most of us will need.  They won’t darken at all unless there is UV light shining directly on them, which means that if your car has UV blocking glass (as most do these days), they will never darken in the car, no matter how bright the sun and glare you have coming into your eyes.  The optician was very annoyed that the opthomologist had recommended them!

I bought a good pair of prescription sunglasses this year, since I can’t manage contact lenses (another set of Migraine triggers involved for me).  They were about 5 times more expensive than any sunglasses I’ve ever bought, but they should last 5 years.   As long as I don’t lose them!  And look how glamorous they make me.

– Megan Oltman
I hear Hollywood calling!

Tags: glare, Migraine trigger, sunglasses, sunshine
Posted in Tips & Techniques | Comments (3)

Migraine, Chronic Illness and the Not So Happy Homemaker, or All in a Labor Day’s Work

September 1st, 2008

I do not claim to have ever been a great homemaker. I enjoy well organized space. I enjoy design, and
line, and tweaking the environment around me for comfort, beauty, and efficiency. So perhaps I am a perpetually frustrated homemaker, because these joys are rarely ever mine. I live in a state of clutter, disorganization, confusion and catch-up. Uh-oh, now I’ve told the truth. Will you ever listen to what I have to say again?

Wherever you start on the spectrum from neat-freak to pig-pen, Migraine and chronic illness will hamper your ability to get it all done. I remember a time before my Migraines and sinus infections became frequent, before chronic fatigue reared its ugly head, and, let’s face it, before I had children, when my home was tidy on a weekly basis, at least. When Danny and I first moved in together I wanted to get up on Saturday morning and get the housework over with, and then enjoy the rest of the weekend. He wanted to lounge around on Saturday morning and get to it later. Which generally meant we’d be cleaning at 5 pm, when we had plans to go out later, and we would do less than I wanted, and I would worry about it and not get to relax at all. But this is a blog about Migraine, right, not about relationships?  I thought that issue was difficult at the time. What I deal with now is of a different order of magnitude.

I have a generous, hard-working and willing husband who tries to maintain order in our home, with or without my help. He is also a fabulous cook and does most of the cooking. I have a nearly adult daughter who is a willing helper when she has the time, and a son who has come a long way with being helpful. I am also the one of the four of us who is not diagnosed with ADHD. This means I am the only one who can really multi-task. It means I’m the only one who notices a lot of the clutter. It means that I am the Captain of this house. So if the Captain is in sick bay, the ship may end up on the rocks.

I have had, this past 12 months, the worst year for Migraine and the year with the most sick days, since I began my Migraine and wellness diary 5 years ago. That means the house is in an advanced state of mess. It had never been tidy, but it’s worse than usual. Deborah at Weathering Migraine Storms posts about her craft projects and I feel jealous – I love crafting too, but it seems pointless to decorate when everything is a mess. The energy I’d like to spend on creativity, or on organizing, is so often taken up with the basics, dishes, kitchen counters, laundry.

But I have to stop and count my blessings. Unlike some Migraineurs, I can still work for a living. So if my energy and time is limited, and I spend it helping to keep a roof over my family’s head, I can’t fault myself for the state of things under that roof.

My advice to you, and me: cut yourself some slack. Do the best you can and take the time to enjoy life.  Keep blocking out your time in the calendar to make the most of the time you have, working from your priorities.  See More Time Management for Migraineurs: Managing the Time we Have for some more ideas on how to do that.  As for me, today I’m post-drome and having some vertigo. I am doing my best to make my way through a back-log of dishes (the dishwasher is broken) and fold the laundry, with plenty of resting time in between. Happy Labor Day!

– Megan Oltman

Dirty dishes image courtesy of Easternblot – eva.

Tags: ADHD, chronic fatigue, chronic illness, clutter, crafts, housework, migraine, sinus infection
Posted in Managing, Musings, Tips & Techniques | Comments (2)

Blogging for Invisible Illness Awareness Week

August 31st, 2008

Coming soon – I will be doing a post on Migraine disease as an invisible illness for Invisible Illness Awareness Week, Sept 8-14, 2008.  Please visit the Invisible Illness Awareness Week Blog for lots of great posts on what it means to have an invisible illness – one that effects your life and abilities, that others cannot see.  I’ll be posting on the topic on September 8, along with lots of other bloggers on that day.  If you’d like to join in, visit the blog link above.

What can we do about our invisible illness?  Nancy Bonk had the great idea of wearing a big bandaid across our foreheads – to make our disease visible.  I’m thinking maybe a baseball cap with a bandaid embroidered right across the front – “Migraine Disease and Headache Disorders – Invisible No More.”   What do you think?  Would you wear one?

– Megan

Tags: chronic illness, headache disorders, invisible illness, Migraine disease
Posted in Advocacy, Weblogs | Comments (5)

this time it doesn’t even rhyme

August 30th, 2008

Who’s that trying to remove my brain?

Crack my skull and scoop it out like an egg?
Maybe they’re trying to get me to leave –
If they whack me on the temple a few more times
I might leave town, you never know.

Who’s that trying to remove my brain?
last week they tried grapefruit spoons –
serrated edges scraped my skull – is it sectioned inside like a fruit?

This week blunt instruments are in vogue
I wish they’d learn some anger management.

I wish they’d stop trying to remove my brain.
What did I ever do to them?
Maybe they don’t like silly poetry
Made up by a migraine-addled red-head.
They’re over-reacting, I swear.

There must be someone trying to remove my brain

I know they’re trying to remove my brain.
It hurts like they’re trying to remove my brain –
crack my skull with a nutcracker and pick out the meat
couldn’t just be my own neurons going nuts…
Could it?

– Megan

Coming to you from Migraine Central

Soft-boiled egg image courtesy of Sharon Mollerus; grapefruit image courtesy of x-eyedblonde; walnut image courtesy of Masayoshi Sekimura.

Tags: brain, migraine, pain, poetry
Posted in Silliness | Comments (2)

August Blog Carnival on Dealing with Those who Don’t “Get It”

August 18th, 2008

August Headache Blog Carnival.  Slow and steady wins the race?  I’m a week behind here, but it’s not too late for you to go read lots of good blog posts on the topic of “Dealing With People Who Don’t ‘Get’
It.”  It’s posted over at Diana Lee’s Somebody Heal Me.  Many thanks to Diana for another great collection of blog posts.  I’m particularly partial to James Cottrill’s “How to Introduce a Migraine.”  Try out “The World Health Organization says I have one of the world’s top 20 disabilities.  Guess which one!”  

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 and migraine
disease patients and people who blog about headache disorders with unique
opportunities to share ideas on topics of particular interest and importance to
us. Visit the link to this month’s carnival for a collection of
informative entries on basic strategies for coping with migraines and
headaches.

Entries for the September 2008 Headache & Migraine Disease Blog Carnival on the theme of “Tips on Improving Doctor & Patient Relationships“ are due by the end of the day on Friday, September 5th.particularly useful, educational or inspirational for headache and migraine sufferers are also welcome. Posts may be submitted through the form on the carnival website.

Posts that relate to the September carnival’s theme will receive preference. Entries on topics that are

Tags: Migraine disease, Weblogs
Posted in Communicating, Weblogs | Comments (0)

Top 100 Women’s Health Blogs

August 16th, 2008

Between travel and illness, I’m just catching up (story of my life), but I wanted to mention this really
interesting list of the Top 100 Women’s Health Blogs, posted last week by Alisa Miller over at Nursing School Search.  These 100 blogs will keep me reading for awhile; the list is broken out in categories of Nutrition & Special Diets, Exercise, Infertility, Pregnancy, Childbirth & Breastfeeding, Weightloss, Health Challenges, Fit & Healthy over Forty, Physical Well-being, and Mental Well-being.  Free my Brain was honored with a mention in the Health Challenges section.  Thanks Alisa!

– Megan

Image of lots to read courtesy of austinevan.

Tags: nursing school, Weblogs, women's health
Posted in Weblogs | Comments (5)

Can Crying be Bad for You?

August 15th, 2008

I believe firmly that it is good to express our emotions, rather than suppress them.  Sometimes we
just need to cry.  Crying on a friend’s shoulder.  Weeping at a funeral.  I’ve had several such completely appropriate crying occasions this summer.  Both times I got Migraines.  Today I have a sinus infection.   It’s a crying shame!

I am speculating here, and make no claims to scientific accuracy in this post.  I’m wondering about the physiology of crying.  It’s more than just salty water running down your face.  I don’t know if anyone really cries like they do in the movies, or in literature, delicate trails of tears, without anything swelling, nothing disgusting.  I’ve certainly never been able to achieve that.  For me, crying involves swollen nasal passages, a red blotchy puffy face, a fountaining nose.  Altogether much yuck.  Crying is a well-known Migraine trigger.  I suspect the good old trigeminal nerve must be involved – it runs right through and controls all the regions involved in a sob-fest.  And then it must get irritated, and set those neurons on their merry way, doing their haywire Migraine thing.

I don’t know if I can explain the sinus infection this way, but I’ll try.  I’m not suggesting spontaneous generation – there must have been an infectious agent.  Who knows what rhinoviruses lurked at the airport, on the plane, in the rental cars, in the colleges and even friends’ homes we visited.   But I suspect that my crying must have swollen passages and shut down my tiny sinus ducts, trapping some opportunistic organisms, backing things up and leading to infection.

Yesterday I attended a very sad memorial service.  A friend lost his wife – a bright, funny, lovely woman of 37.  Witnessing his pain, and the pain of her parents and siblings, all of her friends, his friends…  Well there was much weeping.  Completely appropriate weeping.  I felt knocked out for the rest of the day, and by evening I had a Migraine, my throat was sore and my sinuses were doing their nasty thing.  Today I think the weeping is still going on – just inside my head rather than on my face.

Like so many things that can trigger us, crying can’t be avoided.  It’s part of life.  Probably I would have gotten this infection anyway.   So I will remember LM from my bed today, drink lots of tea, take my vitamin C and zinc and magnesium, and hope this clears up soon.

– Megan

Crying clown face image courtesy of Prakhar Amba.

Tags: crying, migraine, sinus infection
Posted in Medicine, Musings | Comments (2)

Where did Megan go?

August 13th, 2008

A big gap in posts here, but not due to Migraines and illness, for once.  I took my daughter on a trip to look at four colleges in the mid-West.  Perfect weather almost all week, some very promising colleges, and we had a fun time – many hours of cracking each other up

in the car, and some lovely visits with old friends.  We were in the Windy City,

and the Twin Cities, and many miles of America’s Dairyland in between!

I had only one Migraine on the trip – the day we flew in.  The triggers were two nights of insufficient sleep, stacked with the change in altitude on the flight.  I had two marathon days of driving, which certainly exhausted me, but didn’t trigger any Migraines, I’m happy to say.  Clearly fatigue and stamina are issues for me, but I was glad not to be coping with frequent Migraines as well.  Stress may not be a direct trigger (I have my doubts) but a trip away from the daily stresses of my life is always welcome!

– Megan

Walker Sculpture Garden image courtesy of Eli Duke; Wisconsin Farm image courtesy of Randen Pederson.

Tags: fatigue, migraine, Migraine triggers
Posted in Travel | Comments (3)

Silly Headache Rhymes – Frigraine Edition

August 1st, 2008

Along on Friday afternoon, I started seeing red.

A Migraine came to visit and it smacked me in the head.
It whacked me on the temple; it threw me for a loop.
I almost tossed my cookies as I staggered on the stoop.
I should have slept this morning; I should have slept last night.
I should have been born perfect, and then I could live right!

– Megan Oltman

Frigraine is what I call those sneaky Friday afternoon/evening Migraines – they always come when I’m pushing to get work completed for the week.  Not getting enough sleep Thursday night doesn’t help either.

Migraine hamster image courtesy of Anita Martinz.

Tags: migraine, poetry
Posted in Silliness | Comments (2)