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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!



Botox for Migraine Treatment – News?

March 10th, 2008

In today’s London Daily Mail, reporter Theresa Devereux raises the question:  Can botox injections poison your body?   According to Devereux, this question was studied by Dr. Walter Herzog of the University of Calgary, Alberta, who found that the toxins in botox may not stay localized in the muscles into which they are injected.  The abstract of the research by Dr. Herzog, M. Yaraskavitch & T. Leonard, published on January 9, 2008, can be found in the Journal of Biomechanics here. Dr. Herzog et al studied the effect of botox injections in cats and concluded that the injections caused measurable weakness in neighboring muscle groups.

Read the entire Daily Mail article here.

The US Food & Drug Adminstration (FDA) has been investigating reports of severe side effects from some medical uses of botox, and conducting their safety review, for some time.  It is not clear to me whether the results of Dr. Herzog’s study add anything new.

Given that botox is based on the toxin botulinum, which causes muscle paralysis, if it spreads beyond the injection site into other muscles, the consequences could be serious.  Devereux states:

The FDA is not advising doctors to stop prescribing the drug, but
they are conducting a safety review and say the reactions may be due to
overdosing.  However, they are warning patients that they should receive
immediate medical attention if they have worsening or unexpected
difficulty in swallowing or talking, trouble breathing or muscle
weakness following any injection of Botox.

The dangers appear to be acknowledged in the Botox labeling.  Migraine Blog reported on February 8, 2008, that:

The Warnings sections of the labeling for both botulinum toxin products
note that important systemic adverse effects, including severe
difficulty swallowing and difficulty breathing have occurred in
patients with neuromuscular disorders after local injection of typical
doses of botulinum toxin.  FDA now has evidence that similar,
potentially life-threatening systemic toxicity from the use of
botulinum toxin products can also result after local injection in
patients with other underlying conditions such as those with cerebral
palsy associated limb spasticity. Systemic toxicity has been reported
in children, several of whom required feeding tubes and/or ventilation
(breathing) support.

Migraineurs please read the research, and follow up with your doctor if you have any concerns.

– Megan Oltman

hypodermic image courtesy of happysnappr/Adrian Clark

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Posted in Medicine | Comments (2)

Migraineurs – You are in famous company!

March 9th, 2008

In the Chicago Sun-Times this morning, a list of presidential letters which will be auctioned by Sotheby’s next month includes:

• • Thomas Jefferson reporting on his debilitating monthlong migraine headache and George
Washington’s failing health.

Sometimes it just helps me to remember that people have suffered from this disease throughout history – and some of them achieved amazing things nonetheless – and with none of the treatment options we have – still it couldn’t have hurt to have lots of money, and slaves.  How much harder it must have been to be a working-class, or enslaved, migraineur.  (Hmm, maybe things aren’t so different now after all.)

– Megan Oltman

Jefferson Memorial photo courtesy of chadh

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It’s a Migraine, my friends

March 6th, 2008

Does Migraine negatively impact friendships?  You’d think so, wouldn’t you?  I’ve certainly changed more plans due to Migraine than anything else.  On the other hand, life, getting married, being an adult, being out of school, having a job, and having a family, can all impact friendships.  Add Migraine or other chronic illness to that list, and it’s the icing on the cake.

I must say all my friends seem to be quite understanding of my need to cancel plans, or the long gaps when I’m not in touch.  They are concerned and loving when I share with them about my struggles with Migraine.  I think,though, that I’ve already gotten them trained not to expect too much from me!  The best I can say about that is that none of them are all that great at being in touch either!  Which at least takes the edge off my guilt feelings.

My best time for friendships was the last two years of high school and the four years of college.  Law school wasn’t half bad either.  And my first few years of work, before getting married.  I was in a fun and stimulating environment, with a lot of people my age, sharing a common experience.  The first inkling of
change came when I fell in love, and my friend Kathe said, “We won’t be seeing much of you for a while.”  I vowed it would not be so, but sure enough – if you’re spending lots of wonderful delicious time with one person, you can’t spend as much of it with your friends. 24 hours in a day, right?  (Here’s me and Kathe in college.)

And then the pressures of a career close in.  And if you have kids – forget the next 10 years at least!  Then you leave the city where everyone was a subway ride away and you move to where you have to drive to get anywhere, where everyone’s more spread out, everyone has oodles of plans with their own
kids, and the people nearby aren’t always the ones you’d most want to hang out with.

But this was supposed to be about Migraine.  My migraines increased steadily at the same time these other life pressures increased.  Life threw some more things my way – the terminal illnesses and deaths of my in-laws, the long recovery from grief in my own household, my sinus problems, severe allergies, career changes for Danny and me both.  There have always been dear friends who I can call and cry to, or laugh with.  Sometimes I wonder how they could stand my repeated tales of woe.  As my migraines increased, time spent with friends decreased.

I just don’t see my friends, or talk to them, enough.  I miss them.  I’ve been missing them for over 20 years.  And I know Migraine has made it harder – much harder, for me to make new friends.  On one famous occasion Danny and I had an outdoor brunch at a trendy place with a couple we really liked – and I managed not to puke in the gutter until we were crossing the street back to their apartment.  We never socialized with them again!  Coincidence?

Year before last one of my best friends from High School, Laura, was ordained as an Episcopal deacon.  I flew out to Chicago for her ordination, meeting up with two more of our closest High School friends.  I endured long flight delays due to thunder storms, a noisy hotel, and lack of sleep.  Had a wonderful day
at the ceremony and party with Laura and her family, and David and Vick.  My migraine didn’t hit until I was out to dinner with David and Vick, head down on the table, unable to eat any of the expensive gourmet food I had just ordered.  They took me back to my hotel and took care of me.  They were angels.  But it was not how I had wanted to spend the time with them!  (The picture is from Laura’s ordination party – me & my High School buds, 29 years after graduation!)

Life is hard enough on our relationships.  We don’t need Migraine on top of it all, making it harder.  I just try to keep sharing, keep calling, keep trying to make plans.  And when I do talk to my friends, I feel so much better.

– Megan Oltman
Friends do make life worth living!

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Take at first sign of Migraine

March 5th, 2008

If you are among those lucky enough to be able to use drugs in the triptan class, Migraine abortives, you’ve seen this advice “Take at first sign of Migraine.”  Most of us find them quite effective when we follow this advice.  But like many things in real life, following the advice isn’t easy.

Triptans were the first, and are so far the only, class of drugs specifically designed to abort a Migraine attack.  When they were first introduced in the 1990’s, they revolutionized the treatment of Migraines.  Rather than simply treating pain, or reducing the inflamation of blood vessels, they work directly to end the neurological process which is Migraine.

As described by Dr. Gary L’Europa in his excellent article last June in the Providence (RI) Journal, Stop Limiting Migraine Medicine , the migraine process includes these phases:

Prodrome consists of fatigue, neck pain, hunger, thirst, and other physical symptoms that occur up to 24 hours before the headache.

“Aura occurs up to 60 minutes before the headache and produces a sensation of seeing sparkling lights or feeling numbness or tingling in the face and hand.

“Headache, lasting as long as 72 hours, consists of severe throbbing pain similar to that associated with meningitis. This pain is often associated with nausea, vomiting, light and sound sensitivity.

“Postdrome consists of fatigue, neck pain and lethargy that lasts 24 to 48 hours after the headache.”

So what’s the first sign of Migraine?  Most migraineurs report that triptans are not particularly effective in the prodrome phase; they wait to take them at the first sign of headache.  I can attest to the fact that my triptans are most effective if taken at the very first sign of head pain.  I haven’t tried them in prodrome, since fatigue, neck pain, hunger, thirst (and irritability) can have other causes.  Also because I am afraid to waste one of my precious triptans.  Which brings us to my main point.

Triptans tend to be very expensive.  Imitrex, which I take, retails at around $20 to $30 per pill.  It often takes two doses to end a Migraine attack.  Given the cost of triptans, many insurance companies began in 2007 to set lower limits on the number of doses per month they would cover.  My coverage went from 9 per month to 4.  This was based on some math they had done on what the “average” migraineur needed.  I guess I can take pride in being, once again, “above average!”  I have 4 – 5 migraine attacks per month.  Migraine researchers estimate that 46% of migraineurs have more than 3 attacks per month.  Do they limit the doses of insulin a diabetic can have to the amount an “average” diabetic would need?  (Maybe they do… someone fill me in… either way, it’s a scandal!)  Seems to me the reason our doctors prescribe for us, not our insurance companies, is because they treat the actual patient, not the average patient!

My insurance company politely suggests I look at having another triptan prescribed for me, as Imitrex is one of the most expensive.  I’d be happy to, but becasue of my multiple drug allergies, the neurologist I saw recently wasn’t willing to prescribe a different one at this point.

As Teri Robert pointed out in her article Doctor speaks out about insurance limiting triptan Migraine medications,

“Limiting triptans is beyond absurd. It’s counter productive, inane, and cruel. Many Migraineurs, when faced with a Migraine and no triptans, end up in the emergency room. Ever pay an emergency room bill? The cost of a reasonable month’s supply of triptans costs far less than a single ER visit. Duh! Maybe part of the problem is that many insurance plans have two parts — medical care and prescription coverage. The people managing the prescription coverage don’t care about ER payments because that’s a different budget.”

After many calls, 4 months, over $350 out of my pocket for medication (and several seemingly stress triggered Migraine attacks following calls to the insurance company,) they have now told me they will cover 9 pills per 23 days.  This comes out to almost 12 doses per month.  Which ought to be enough for my average month, but…

Can I take the Imitrex at the first sign of Migraine? Certainly not.  I have moments, or sometimes hours, of mild migraine pain up to 8 times per month.  That’s on top of my 4 – 5 “full blown” migraines.  This may be the sign of a transforming migraine pattern.  I have an appointment with a bona fide migraine specialist in early June – we’ll have to talk on this blog about the lack of qualified headache specialists another time.  For now, my attitude seems to be that the pain isn’t bad – many of you have it worse – so I save the Imitrex for when I feel a “real one” coming on.

Is this a good strategy?  Probably not.  My other alternative, I suppose is to pay out of pocket for additional Imitrex (at $26 per pill at my local pharmacy.)  I do get what samples my doctor can spare me when I see him.  But I have to say, when it comes to aborting Migraine, most of us are between a rock and a hard place.

– Megan Oltman

It’s a paradox wrapped in an enigma!

Signs of Spring photo courtesy of Just-Us-3

Hammer photo courtesy of Darren Hester

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Posted in Managing, Medicine, Rant | Comments (5)

How do you manage life with Migraine?

March 1st, 2008

Fine, thank you, how do you? Oh, sorry, wrong tape…

How do you manage life with migraines? With many interruptions. With difficulty. Intermittently. With ridiculous persistence and hope. Occasionally, with grace.

But, how? You want the nitty-gritty? It’s a lot like managing anything else. I’ve been coaching people for years in how to manage a small business, how to manage themselves to grow their business and have the life they want. You manage by having systems. By:

1) taking the great long overwhelming list of all the everything that goes into your enterprise and sorting it into categories,

2) listing out the individual tasks in each category,

3) creating the ongoing schedule of the tasks that need to be accomplished at regular intervals,

4) listing the one time, current tasks,

5) prioritizing those tasks and scheduling them,

6) listing any background preparation or materials needed before doing the tasks,

7) listing likely follow-up that will have to be done after the tasks, and

8) creating checklists.

No matter how difficult or overwhelming something seems, it can be managed if broken down into tasks, and if each of those tasks is further analyzed for preparation and follow-up tasks. This works for a business enterprise; it works just as well for enterprise YOU – the enterprise of your life.

But my head hurts! Yup. Mine too. That’s why when I take to my bed with migraine, my computer or at least a lined pad of paper goes with me. Unless I am too sick to have any light on, or think at all (and that certainly does happen), I lie down thinking, “what do I have to handle, make sure of, not forget, or reschedule?” And as soon as I’ve answered the question, I can give myself over to whatever I need to do to get better. It’s like calling in sick for your life. If I am going to help my (actual) headache get better, I have to be able to let go of as many as possible of the figurative “headaches” called running a life.

I need to have all the medications I need close to hand. I need to make sure people will be fed, whether or not I’m doing the cooking (maybe I’m just asking someone else to handle it). I need to cancel appointments, or have someone else do it for me. I need to remember to call the doctor, or whoever else I really should be calling. If I can’t stay in bed, if buying the groceries or getting the kids somewhere, or going to work simply cannot be avoided, I need a checklist for that too. That’s the absolute minimum checklist. What’s the absolute minimum list of tasks I cannot avoid doing?

When I’m having a migraine, my brain doesn’t work too well. If the pain is bad enough, there’s nothing to do but lie still and try to sleep. If it’s not that bad, I still live in an extended state of “Ummmm…”  If all I need to do is take meds, I still need a list of them or I will forget.

So I try to invent all my checklists ahead of time. Healthy day checklists – including what I need to do daily to stay healthy. Sick day checklists. Preparation lists and schedules, to refill prescriptions, to keep what I need on hand.

How do you take something as unpredictable and disruptive as a life with migraine disease and be systematic about it?  With many interruptions. With difficulty. Intermittently. With ridiculous persistence and hope. Occasionally, with grace.

– Megan Oltman

Today I’ve got a cold, or sinus infection, or migraine brewing, or some combination thereof.   Anybody’s guess.  Taking it slow, checking my lists.  Such is (my) life.

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Boy, that’s a Real Migraine!

February 28th, 2008

a. Europe’s $1.50 Headache Is Italy’s Migraine(Headline in Forbes.com today, article by Vidya Ram – the article is about the rising euro and its effect on Italian exporters.)

b.  SOUTHERN AFRICA: Integration and the migrant migraine (Headline from IRIN, posted by Reuters today – the article is about how the flow of Zimbabwean migrants to neighboring countries is hindering the goal of Southern African regional integration.)

c. Saturday – slept badly Friday night, migraine by afternoon, pain at level 3 on left, moderate nausea, picked up boys from movies, pain at level 8 on return, both sides now, extreme light sensitivity, took Imitrex 7 pm, lay down, room dark.  Can’t read or look at computer screen.  Vomiting on & off 3 hours, pain varied from 8 to 5,  went to sleep around 10.  Pain at a 3 on waking, tired, achy, depressed all day.

Okay, are you ready?  Which one is the real migraine?  You picked c, right?  Good job!  You get a gold star.  a and b are known as frustrations, hassles, problems or perhaps international crises.  They are not migraines.

Am I being too much of a stickler here?  Maybe.  Maybe not.  There’s a lot of real news about migraine in the news these days.  Partly thanks to the New York Times Migraine Blog, or maybe our chance for some recognition and understanding has finally come.  But most of us get annoyed by the trivialization of a very real and debilitating illness.

Interestingly, today the first 15 pages of results of a Google search on migraine are actually some kind of content about migraines. This was not so a few months ago, when I tried the same search and came up with many references like the two above, and one about a hockey team’s poor performance being a “migraine” for the team manager.

I am willing to ascribe most of this to ignorance, not evil intention.  I think it’s become a fashion to refer to a big hassle as a “migraine” instead of just a “headache.”  However, it does distract public attention from the fact that this is a disease.  A fact that most people still don’t know.

Is it okay to say “what a headache?”  If you’ve ever had a headache, you know what that means.  Most people have had a headache, and know that tension can lead to one.  So we call things that make us tense or upset “a headache.”  People also say “I just about had a stroke!” or “I just about had a heart attack!” I’ve been guilty of that myself.  After a stroke hit someone very near and dear to me, I didn’t feel like joking around about it any more.

This is in the category of being responsible for what comes out of our mouths.  We create our world through language.  We shape what is possible for ourselves and others.  You only have to listen to political double-speak to understand that.  Whoever gets to frame the issues tends to win the debate.

And so, maybe we can call a hassle a hassle and a crisis a crisis?  It seems like in our culture we always have to go one better, to make things more extreme.  If 10 years ago we called a hassle a headache, today we have to call it a migraine.  What will we call it 10 years from now?  A brain tumor?

– Megan Oltman
Somebody stop me before my head explodes!

cave waterfall courtesy of subflux; brain courtesy of Gaetan Lee

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Posted in Communicating, Current Affairs, Rant | Comments (7)

Snow and Hope

February 22nd, 2008

Our kids are out of school for a snow day today. It’s the first all year, and I don’t think we had even one last year. I wonder why a snow day makes me feel so hopeful?

Maybe it’s something visual – take a look at the view off my icy deck.

Snow is not as much fun as it was when I was a kid. I still have to worry about getting my work done to earn a living. I have to cope with clearing it off the walks and driveway. I have to cope with driving in it.  But I have always loved snow, and I still do, despite all the adult hassles it brings. Especially when it’s a novelty. I love waking up in the muted bluish light of a snowy morning, from the deep soft sleep the snow always brings. It must be the extra negative ions that make me sleep so well. But rational explanations aside, it just feels like snow magic.

One snowfall does not herald the end of global warming, but it makes the winter feel right, instead of off. If it’s going to be cold, it might as well snow. My overburdened migraine mind appreciates the peace and quiet, the way the day is simplified. (Shovel, cancel appointments, shovel, get warm, take kid to sledding hill, throw snowballs at dog.) I like the exercise of the shoveling. A good workout. I didn’t get enough sleep and may need a nap to ward off a migraine – lack of sleep is one of my surest triggers. But I know I’ll nap well on a snowy day!

I notice that the aches and pains index on weather.com seems to be low when it’s snowing.  Barometric pressure changes trigger migraines for many of us – so I wonder if the pressure is very steady while it’s snowing. I remember learning in Earth Science in high school that low pressure makes us hurt – because the pressure inside our bodies isn’t balanced by the pressure outside!  Are snowy days high pressure days?  Any meteorologists out there want to chime in?

Here is the big yellow doofus in the big white snow. Isn’t she cute?

Wherever you are, whatever your weather, I hope it’s treating you well.

– Megan

How can I do serious work on a snow day?

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Calming down the migraine brain

February 20th, 2008

Several people have asked me lately about relaxation techniques. If stress is our enemy, we need to relax, yes? But if we strive and worry about whether we’re relaxing, we tense up. Raise your hand if this applies to you. My hand is up. Luckily there are some very simple techniques you can use to begin to practice relaxation.

Relaxing is not the same as doing fun things – fun things may or may not be relaxing. When I had my first job out of college I used to go to the video parlor on my lunch hour and play PacMan (yes, I am that old). I would return to work with my wrists and hands asleep, so stressed out I could
barely cope. I learned eventually that video games are not relaxing for me!

Our nervous systems have two components – the sympathetic and the parasympathetic. The sympathetic
nervous system controls stress – this is where our flight or fight response comes from. The parasympathetic nervous system controls relaxation, which is often neglected in a busy twenty-first century life. We can build the tone of our parasympathetic nervous system in many ways, including through deep breathing, meditation, moderate exercise, yoga and movement, stretching, reading a good book, having an enjoyable conversation, playing with children or animals, being out in nature, loving touch or sexual contact. If we take some time to strengthen our relaxation “muscles” daily, we improve our ability to handle stress. According to Dr. Ian Livingstone, studies showed a 40% reduction in migraines in those practicing regular relaxation.

So here are a few ways to get started:

  1. Sit comfortably with your back supported, legs uncrossed, hands on your knees. Close your eyes. Breathe in deeply through your nose, for a slow count of three. As you inhale, allow your abdomen to inflate like a balloon. Then breathe out through your mouth for a count of five, gently pulling in your abdominal muscles as you exhale. Gently concentrate on your breathing. If you find yourself thinking of other things, don’t get upset with yourself. Gently remind yourself to focus on your breathing. Try doing this for five minutes at first. Each day you can increase the time.
  1. Lie on your back, legs uncrossed, arms resting comfortably at your sides. Bring your awareness to your feet. Notice how they feel, any discomfort. As you breathe in, imagine silver light being pulled with your breath into the soles of your feet. If there is any pain or discomfort in your feet, imagine that you are exhaling it out as you breathe. Next notice your ankles. Breathe in and pull the silver light up into your ankles. Breathe out any pain or discomfort. Continue to gently pull the silver light up through your body, being aware of each part of the body in turn and blowing pain or discomfort out with your breath. If pain still remains, don’t fight it or worry about it. Just keep breathing the light into your body and exhaling out the pain. Continue until your body is glowing from head to toe. You may want to do this in bed to help you fall asleep.
  1. Take a walk and practice keeping your awareness in your body as you walk – the way your muscles feel when they move, the way your feet hit the ground. Be aware of the rhythm of your breath and
    the rhythm of your walking. Look at any trees or plants, any living things or natural features you pass – fully observe them as you pass. If you find your mind getting busy, working or worrying at anything, gently return your attention to your body and to the trees, ground, plants, rocks or sky. If you are walking in the city be aware of the sky, the wind, any elements of the natural world.

Give these techniques a try and let me know what you think!

– Megan Oltman

Not trying to be stressless, but to stress less!

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The Migraine Life – Waking up into it

February 19th, 2008

My eyes are not open yet. The alarm is calling with its insistent “nature sounds.” Supposed to be a spring breeze; it sounds like a blistering gale. I crack an eyelid, reach and press the snooze. Do I still have a migraine? Not sure yet but I know I don’t want to wake up.

Danny rolls over. “Needa lilmor sleep,” I mumble. Opening my mouth and enunciating would be a mistake. I catch the elusive tails of my dream – something about books and a cat. Drift into vagueness. Ten minutes passes like no time. More roaring wind. I reach to turn it off, eyes still closed. Danny gets up. I roll onto my back, checking. Crick in the neck. Roll the head gently on the neck. Body is okay. Little point of pain lodged over the left temple. Tiny. Like a bad little seed. “You should have taken the Imitrex last night,” I chide myself. But I don’t know. There is no absolute answer.

Sun is pouring in around the edges of the blinds. The covers are warm. My husband is cheerful. He is wishing me good morning. I am stretching gently, still unsure. If I move will the seed grow? I have slept enough, but should I be getting up? Should my responsibilities be pulling me into the day? Should my fear of the next migraine pull me back to bed? Where do good sense and balance lie?  I don’t know the answer. But I know I want to get up, I want to get to my good work, I want to live my life. I stand and start my stretches. Pain seed
does not go away, but neither does it grow. Still dormant. I move into my day.

Will I have to reset the migraine ticker? What will I write in my migraine diary? Maybe the pain will leave entirely. It may stay; it may or may not grow. I will get down on the floor and stretch. I will take all my supplements and medications. I will try very hard to eat right. I will meditate before work. I will plan my day and stick as best I can to my plan. I will take a walk, pray and let go of fear and anxiety. Ten minutes at a time, or an hour, or a day. Let me appreciate each moment without pain.

– Megan Oltman

“How are you feeling?” “Okay.” “Just okay?” “Okay is not bad, I’ll take it.”


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“Breaking the Headache Cycle”

February 18th, 2008

Breaking the Headache Cycle by Ian Livingstone, M.D. and Donna Novak, R.N.

When my migraine pattern suddenly shifted from once month or less to three to four times per week, I went to see Dr. Livingstone. When I first saw him in August of 2004, it was six months after I had two episodes of anaphylactic shock, caused by ibuprofen. I was a little gun-shy of trying new medications. I did agree to try Imitrex – I needed to be able to abort my attacks. But instead of preventive medications, Dr. Livingstone suggested that I get into a regular relaxation routine – using deep breathing, meditation and
guided imagery to strengthen my nervous system’s relaxation response.

I first read the book at that time: Breaking the Headache Cycle: A Proven Program for Treating and Preventing Recurring Headaches.  I took on practicing meditation daily, and after about six months I found my migraines reduced to 2 or 3 per month. The methods outlined in the book were very effective for me, in combination with the migraine abortive, to reduce my migraines to a manageable level.

The authors say migraineurs’ nervous systems are “very reactive to any change, even good change. This
sensitivity is the hallmark of the migraine condition. Unless it is understood and recognized, the migraine disorder cannot be adequately treated.”

If our nervous systems are over-responsive, it makes sense that relaxation and meditation will calm down the responsiveness of the nervous system. Dr. Livingstone cites studies showing that preventive medications reduce migraine about 40% on average (the book was published in 2003 – there may be more up to date statistics on this); and other studies showing that a regular relaxation practice reduces migraines 40% on average. Is it a safe bet to say if doing both, we might reduce migraine 80%? That’s a number I could be very happy with!

Many times I pause and do deep breathing when I first feel pain in my head, or even just when I feel my tension mount.  This often down-shifts me from a budding migraine back to a state of no head pain.  I have come to be able to notice when I am getting too excited or too engaged – it’s not just negative 
stress that can trigger me! Not surprisingly, when I got out of the habit of practicing regular relaxation, my migraines increased again. As tricky as
it is to remember to take a variety of medications, in the right amounts, at
the right times, I think it is even more challenging to establish and keep a
routine of putting the busy concerns of life aside and take time out to look
inward, breathe deep, become aware of the body, calm oneself, and relax.

I came to these methods already convinced – I was not a stranger to yoga, meditation and relaxation. I had practiced yoga in many periods in my life, starting in my teens, and meditation and guided imagery from my early twenties. Later, as a life and business coach, I have used meditation and guided imagery with my clients to help them get clear about issues that were stopping them, and to visualize what they wanted in their lives. So I wasn’t surprised that this practice would aid with migraine disease as well. The challenge is
keeping it in my life as all the demands of life crowd in. The reward is getting to know my own system
really well, and gaining at least a little bit of control over it.

By the way, I think preventive medication is a great thing, and many migraineurs find a lot of success with it. I may be headed down that path myself, as my migraine pattern has changed and my treatment will need to change too. But I’ll always keep relaxation as part of my routine.  It makes me feel good!

– Megan Oltman

Nothing to gain from pain!

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