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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!

Vitamin Therapy for Migraine Prevention

February 15th, 2008

This is not News in the capital N sense but news in my life.  I had my first neurologist consult in 4 years today, since Dr. Livingstone moved to Arizona.  I am, like many of us, a complicated case.  In my case the complications include my anaphylactic allergies to (apparently) most NSAIDs (non-steroidal anti-inflammatories, a.k.a. most OTC pain meds and quite a few prescription ones).  My new doctor wants to go very slowly in adding medications because of these allergies, and the fact that I tend to get a lot of medication side-effects.  So for the moment he added another form of Imitrex as an abortive (now I will be able to give myself injections, oh lovely) and prescribed vitamin therapy for prevention.

In a startling piece of non-news, I am sensitive to medications.  He shrugged – “sure you’re sensitive – you get migraines.”  This vicious circle is familiar to most migraineurs.  Sensitive nervous system – gets migraines.  Sensitive nervous system – gets side effects.  Sensitive immune system (I guess) – develops medication allergies.  So for the next three months, I am to try 400 mg per day of magnesium and 200 mg per day of B2 (riboflavin).

I am certainly in favor of using nutritional means to deal with illness.  That fits with my holistic philosophies on life!  So I am crossing my fingers.  I know a number of people who have had success with magnesium, though many of them take preventive medications as well.  I have to admit I’m not 100% happy, though.  My recent increase in migraine frequency is taking its toll on my life.  I guess I’m ready to be a bit more aggressive about my treatment.  So we shall see… my new doctor search may not be over.

Read more about magnesium for migraines in The Magnesium Solution for Migraine Headaches.  Let me know what you think!

– Megan

So many pills, so little time!

newspaper image courtesy of Matt Callow

Tags: magnesium, migraine prevention, vitamin therapy
Posted in Books, Managing, Medicine | Comments (0)

It’s Not Me, it’s the Migraine Talking

February 10th, 2008

I have been back on track with practicing my relaxation routine this past week and I was going to write you a nice inspiring post about that. I was on a 13 day migraine free run and feeling pretty good about it. Yesterday the beast sank its claws in again and hasn’t let go yet. I feel like all the inspiration has been sucked right out of me. But that’s just the migraine talking.

I resent the arrival of a migraine on the weekend, stealing my weekend time away. On the other had there’s less anxiety with a weekend migraine as I am not missing work – not missing things crucial to my livelihood. Just missing my down time, my marriage time, my family time, my fun time, my get the house in order time. Well, I guess I’m not missing down time, actually, because I am down!

Lying around. Watching tv, reading when I can stand the light, hanging out on line, drinking lots of cups of tea my sweetie brings, enjoying the comfort of my bed, receiving periodic visits from the family, with hugs and snippets of conversation. It’s not really all that bad, for down time.  That was me talking.

Then I can’t stand the inactivity any more. I decide to sit up and be okay, and I start folding laundry or some such ridiculously strenuous task. The pounding returns and the nausea starts back up. Danny comes in to watch a movie with me and we try to talk about plans for next weekend, and it strikes me what I am missing, how uncertain my life is. And I start to cry. Knowing that crying can make the migraine worse, I try to stop myself.  I remember how accepting I have been in the past month, and I start beating myself up for not being accepting right now. That’s the migraine talking!

Serotonin levels drop during migraine attack. I imagine the migraine slurping up my serotonin. So of course I’m going to feel unhappy. Aside from the pain itself, which is not happiness inducing, it’s hard to feel happy without serotonin. So I use what I can to comfort myself – hugs and tea and toast with honey, dark chocolate (when the stomach can stand it) and gentle movies, puzzles and pillows and good books. If I can concentrate at all, I come and write to you here, and that helps me remember who I am, that I am not the migraine, that it is what it is, that this too shall pass.

– Megan Oltman
Moderate migraine, day 2, hoping for relief soon

Oh, yes that’s Arizona again – Spider Woman Rock in Canyon de Chelly.  I didn’t have a migraine for that part.  Down below is New Mexico – the sunset over Albuquerque from Sandia Peak.

Tags: depression, relaxation practice, serotonin, weekend migraine
Posted in Communicating, Managing, Musings | Comments (2)

This is snot about migraine…

February 9th, 2008

Okay, I just had to share this.  I’m up past my bed time, getting punchy.  In the continuing quest for relief from my recurrent sinus infections we are considering whether surgery to remove nasal polyps might be helpful.  Apparently there is a frequent correlation between seasonal allergies or asthma (I’ve got the allergies, not the asthma), aspirin allergy (which I have) and nasal polyps.  My doctor wants me to research this connection, known as Samter’s Triad.

So I’m on pubmed.gov reading these medical studies all written in medical jargon and all very serious… So here’s one about “Medical and surgical considerations in patients with Samter’s triad” and they’re going on about doing “functional endoscopic sinus surgery (FESS)” and then the patients were CT scanned and they measured the FESS results by a test called (I kid you not) the “Sino-Nasal Outcome Test (SNOT-20).”

So if I go through with this – you can ask me “hey, how’d your SNOT test come out?”  “We were hoping for a better outcome – but all we got was the same old SNOT…”

Who said doctors have no sense of humor?

– Megan

Gotta laugh, otherwise we’d cry.

Tags: endoscopic sinus surgery, nasal polyps, Samter's Triad, sinus infection
Posted in Medicine, Silliness | Comments (0)

Migraine Management – My Other (other, other, other) Full Time Job

February 6th, 2008

A week or two ago I posted about living healthy – a few comments there got me thinking (again) about just how challenging this is.  Getting it all right really does feel like a full-time job.  It’s time-consuming-picky-detail-oriented, and doesn’t fit with the way most “normal” people live their lives.  (By the way, I’m still interested in finding one of those “normal” people – if you spot one, let me know!)

This morning I am off to the doctor for a general health consult.  I have a lot of questions for him and wanted to go in when I wasn’t feeling awful, for once, and would be more able to pay attention.  I’m feeling okay today – not great but okay.  Okay is good, I can live with it.   So I have been preparing for the appointment: printing out the last 9 months of my “wellness calendar.”  Here’s what January looked like:  I color in days when I feel great as pink (when “I’m in the pink”) – I only had one of those.  Days when I am sick but functioning are orange; when I am functioning about half-way are red; totally out for the count are brown.  I had a very red and orange January, luckily no brown days.

So then I printed out the narrative part for the last month, that shows how much I slept, what changes I made to my diet, details of my migraines and sinus infections.  I printed my checklists for caring for myself when I have a sinus infection or migraine, so the doctor can review them.   I wrote out my questions.  Here’s what my desk looks like right now.  The yellow book in the pile is Breaking the Headache Cycle by Ian Livingstone, M.D.  I don’t think messy desks are identified in there as a migraine trigger, but it still seems ironic!

I got up at 6:10 to get the kids’ breakfast and get the younger one off on the bus (the older gets herself off on the bus – let’s be clear about that).  I dealt with dishes and then went back to sleep for 45 minutes since I’d had only 6 1/2 hours of sleep which is a pretty reliable migraine trigger for me.  But when I got up again there was only time to prepare for the doctor and write to you here.  So I have not done my meditation/relaxation practice for the day or gotten my exercise, both of which are important to keep myself healthy and resistant to migraine triggers.  I’m going to have to fit them in this afternoon, when I will also be worrying about getting all my work done for the day.  Stress alert!

I so want to be perfect at my treatment plan and know perfectly (!) well I’ve never been perfect at much of anything.  It reminds me of one of those annoying parabolas (or was it a hyperbola?) from Trigonometry – approaching zero but never reaching it.  The ridiculous emotional see-saw of trying to do it all but without stressing about it.  Time for the Serenity Prayer again.  Time for the rainbow picture again – the perfect rainbow over the field outside my window – reminding me of the return of hope.  What would we do without it?

– Megan Oltman
Hurrying up without Being in a Hurry!

Tags: healthy living, Ian Livingstone MD, Migraine management, migraine treatment plan, relaxation, wellness calendar
Posted in Managing, Tips & Techniques | Comments (2)

Migraine Early Warning System

January 31st, 2008

One of the first things you learn when you started dealing with your migraines is to identify and avoid triggers. I learned this shortly after a murderous 5 day migraine I had in Arizona – I was at higher altitudes than I was used to, and there were forest fires all week, exposing me to lots of smoke. I was drinking way more coffee than usual to keep up with a busy vacation schedule with lots of driving. Voila – smoke + altitude + excess caffeine = nasty head-banging five day migraine. For those of you living in Arizona – I don’t hold it against you or your state! It’s a beautiful corner of the world and I wish I had been able to visit with less pain. I saw Sedona in a migraine-fog – I understand it actually looks something like this:

Anyway this experience started me on an important inquiry – what are my triggers, and how can I avoid them?

There are common migraine triggers and then the ones that seem relatively unique to each of us. For one it’s eating dairy, drinking wine, for another flashing lights, particular smells, loud music, smoke, being startled, being in a crowd of loudly talking people, the bright packaging at the supermarket, the tv. It’s important to know what your migraine triggers are. If your brain is a loaded gun, ready to fire off with a migraine, and you know what pulls the trigger, that helps, right? You can avoid the triggering event or substance and reduce the likelihood that you’ll get a migraine.

Some lifestyle changes may be necessary to avoid triggers.  Get into a regular sleep routine.  Stop eating dairy. Stay away from places with flashing lights. Avoid smokers.  (Just for instance.  For a complete list of common triggers, visit mymigraineconnection here.) If you live with a smoker, you may need to an agreement that he or she won’t smoke in the house. If you smoke yourself, you may need to make a major change! If your kid’s hard rock music does it, you may need to have some rules around when and how loud it can be on. But some triggers are unavoidable, and we can’t avoid all of them all the time.

So I started asking myself – those may be the triggers, but what loaded the gun in the first place? By the way, it’s most unfair of me to be comparing our unique, sensitive and brilliant brains to  guns. I hate guns. But we can’t deny the violence of the migraine. And even if you are a gun owner, I think we’d all agree that you’ve got to keep the thing unloaded around the house to avoid tragic accidents. So what loaded my migraine gun, and how can I keep it unloaded?

Migraine is a response to triggering stimuli. Current thinking is that stress itself is not a trigger but may predispose us to be more vulnerable to our triggers. You can read more about that here. For me, over-stimulation itself is enough of a stress to tip me over into migraine, even if I’m not aware of any other triggers. On some stereo speakers you can turn the volume way up, others you will blow out by turning them up high. Our brains have the blow-out factor set way lower than the other 88 – 90% of the population. So, I say when we are stressed for a long period of time without relief, when we are highly stimulated without relief or let-down, we are loaded for migraine. We may have an ability to go into hyper-drive, to perform effectively, rapidly and intensely. But the more we do that, the more often and the longer duration, the more likely we are to load ourselves for a migraine explosion.

It takes more attention, more thought, more observation and introspection to determine your early warning signs than to determine your triggers. The good news is that if you do get attuned to them, you have a much higher likelihood of avoiding the migraine altogether. When I took on a daily relaxation practice, doing deep breathing and meditation to calm my system down every day, I reduced my migraines. When I got out of practice, the migraines started increasing again.

So what’s your early warning system?  For me it’s a tightness in the shoulders and neck that moves up into my head. Also a sense of agitation – moving and thinking really fast.  What are the signs for you that come before the triggers, the ones you have the best chance of diffusing? Please leave me a comment to let me know what you think.

(This is supposed to be a picture of your nervous system when it’s all calm and serene, but Thor looks like he’s ready to play.  Imagine him curled in a furry purring ball.)

– Megan

Hoping you catch your signals before the guns go off

stereo speakers courtesy of  Valerie Everett

Tags: altitude, caffeine, migraine prevention, Migraine triggers, relaxation, smoke
Posted in Managing, Tips & Techniques | Comments (3)

Happy Birthday!

January 30th, 2008

If my topic today isn’t (mostly) about migraines, I won’t be the first migraineur-blogger to write off topic.  I wrote last week about acknowledging and appreciating the people in our lives who support us.  So I’m doing some more of that today:

Today is my sweetheart’s birthday – Happy Birthday Danny!  Here are some roses for you!

You pick me up when I’m down, you keep me honest and focused and give me back my perspective when I lose it.  You care for me when I’m not well, you make me laugh, you make me think.  You excite me, you calm me down.  You awe me with your brilliance, you nurture me with great food, great touch and admiration.  I’ve known you my whole life, you’ve always been a part of me, even when I didn’t know it yet.  And even though for 5 days every year I call you the old geezer, I think it was very gracious of you to come into the world 5 days before me and break a path for me.  But then you always were a gentleman.

Love always,

Megan

Tags: birthday, love
Posted in Communicating | Comments (0)

Do I have migraines, or do they have me?

January 26th, 2008

(or – I wish there was another word for sorry!)

I work with people with chronic conditions, and we talk about this – do I have the disease, or does the disease have me?  I also work with small business owners and I ask them – “do you have the business, or does the business have you?” Maybe having a business is a form of chronic disease. If so I’ve got another one to add to my list! But I digress…

My buddies on the mymigraineconnection forum were having a discussion today about apologizing for the effects of our migraines. I think we’re in agreement that there are a couple of meanings of the word “sorry.” One is to apologize, but another is to say “I feel for you” or “I am sad that you feel that way.” When someone experiences the death of a loved one we say “I am sorry for your loss,” but we don’t mean that we are feeling personally responsible for the death. I think English needs another word for sorry!

The famous quote from Erich Segal’s Love Story is “Love means never having to say you’re sorry.” I’ve always had a hard time with that line, but I don’t think Segal meant that we can do whatever we like to those we love without acknowledgement. I think he meant that forgiveness is part of loving someone. And even if we can expect forgiveness from those we love, love still needs to be nurtured and watered and fed, like any living thing, or it can wither. I think part of how we nurture and feed those we love is to acknowledge the pain they feel for our pain, the huge help they are for us, the disappointment, inconvenience and extra work our disease causes. So if I say “I’m sorry” when my husband brings me up a meal on a tray, or when I have to ask my son not to play drums right now, or I can’t take my daughter out shopping, what I really mean is “this disease stinks. I wish I didn’t have it and I wish I didn’t have to ask you these things.”

In Emotional Intelligence author Daniel Goleman talks about the ability to stand back from our emotions and observe them. This ability is what gives us some perspective, some emotional intelligence – when we can “count to 10” instead of reacting right away, we have some power over what we feel. So to tie this in with feeling sorry, maybe when we say “I’m sorry,” when someone brings us a glass of water, we’re separating ourselves from the migraine disease – we’re saying “I am not my disease. I have migraines but they don’t have me. I wish I didn’t have them – but there is a me here, completely separate from the disease, who regrets the trouble and sorrow the disease brings.”

My heart goes out to those in constant pain, in part because of this – the more pain, the more constant, the harder it is to keep that healthy perspective. When I can remember that I am not the migraine, the migraine doesn’t have me, that’s when I can take back my life.

– Megan Oltman

With enormous love and gratitude for Danny, Rachel, Adam, Mom & Dad, my siblings and in-laws and the many other family members and friends who bring me glasses of water, literal and figurative.

Lunch tray courtesy of Wordridden/Jessica
Glass of water courtesy of Venkane/Nevena

Tags: acknowledgement, apology, appreciation, Communicating
Posted in Communicating, Managing, Tips & Techniques | Comments (3)

I Got Them Old Migraine Blues Again, Mama!

January 25th, 2008

Yesterday the beast sank its claws into my brain,

Oh yes yesterday the beast sank its claws into my brain,

It may be awhile ‘fore I can shake ‘im loose again.

I got them old migraine blues again, mama!

I keep trying and trying to live a healthy life,

Yeah I just keep on trying to live a healthy life,

And I’ve got to keep on fighting, against the pain and strife,

Got them old Migraine blues again!

I’m trying to earn a living, just trying to make some bread,

Yes I got to earn a living, my kids do need that bread,

But it’s hard to keep on working with that beast perched on my head.

Is there light down the tunnel, this ain’t no funhouse ride!

Want that light down the tunnel, cause this ain’t no funhouse ride –

The light sure wants to blind me, but I’m tryin’ to let that slide.

Today I’m just post-droming and the beast has slunk away

Yes I think now I’m post-droming and the beast has slunk away

I’m trying to take it easy so he don’t come back today

Got them old migraine blues again, Mama!

If anybody wants to set this to music, let me know!  Post-drome, if you’re not familiar, is the part of the migraine after the headache is past.  For me it’s weak and shaky and my head’s a little tender.  Lately I can’t always tell if it’s post-drome or just a let-up in the pain.   But it’s a better way to start the day than in the midst of the head pain.

– Megan
Post-droming and hoping, to keep the beast away

claws image courtesy of delta407

Tags: blues, migraine, post-drome
Posted in Music, Silliness | Comments (2)

Living Healthy to end the Brain Drain

January 22nd, 2008

Here’s the view down the lane from me this morning – I took a chilly walk with Kimi. Snow is coming in a little while. I did all the things I should this morning, stretched, meditated, ate a light healthy breakfast, took my supplements and meds, stayed calm. Planned my day, did some work, took a walk.  A morning of living healthy.  (Go ahead, give me a gold star!)  I’ll do that a few times and then I’ll think I don’t have to any more. Anyone else out there like me?

I’ve been thinking about what it takes to live healthy. Like everyone, I’ve been secretly hoping for the magic pill. Where do we get that fantasy from? Is it from fairy tales, a constant wish for the magic wand that banishes all ills, or the knight on the white horse to take us away, or is it pharmaceutical commercials (potential side-effects include loss of common sense, temporary irresponsibility…)?

But wouldn’t it be nice? Just give me the magic pill (once, mind you, I’m not interested in something I have to do every day, or refill prescriptions for, or pay co-pays ad nauseum…) and then I can live like everybody else.

Oh, like everybody else, huh? What does my fantasy mean by that? Hmm well I imagine everybody else can stay up as late as they want, as often as they want. They can eat sugar without getting hooked on it. They can drink coffee without revving their systems up so much they get migraines. They can live without exercise. They can drink alcohol. They can be around cigarette smoke. They stay calm cool and collected. They certainly never ever have to meditate, or breathe deep, or stretch. They don’t have to go to the chiropractor every two weeks, they never need a nap, they have abundant energy all day, their houses are tidy and clean… How much of the human race have I eliminated by now? I guess there may be one or two paragons like this somewhere, but I know I haven’t met many! Funny thing is, to live healthy with my conditions, mostly I have to do what common wisdom and the medical profession tells us we all need to be doing. The main difference seems to be: for those of us with chronic illness, the breakdown comes faster. We don’t have to wait 30 years for the heart attack – we get the migraine attack right now!

Living healthy with migraine disease, and chronic fatigue, and a chronic sinus condition, seasonal allergies, allergies to pain meds, and irritable bowel syndrome, hypothyroidism, periodic anxiety and depression, looks like this for me:

1) regular and sufficient sleep

2) a diet high in fiber, organic foods, fruits and vegetables, and low in dairy, refined sugar and flour and food additives

3) vitamins, minerals and nutritional supplements

4) thyroid supplements

5) natural, bio-identical hormone replacement therapy

6) antihistamines

7) a humidified house

8) flushing my sinuses with a neti pot a couple of times a week

9) triptans for migraine attacks

10) daily stretching

11) daily meditation and relaxation practice

12) journaling

13) keeping a detailed wellness diary

14) regular exercise – at least 5 times a week

15) chiropractic visits every other week

16) a life coach to help me stay on track

17) keeping in touch with my medical team about what’s working, what’s changing, what’s next

18) keeping a regular work schedule and managing my time and projects to keep my anxiety level low

19) other stuff I can’t think of at the moment…

If I do all this, I am less likely to get a migraine. I am less likely to catch every cold that comes down the pike and turn it into a sinus infection. I am unlikely to have an ibs flare-up and I don’t fatigue easily and I feel serene… and then I think I’m cured. I think somewhere in all that was a magic pill and I can have a great big cup of coffee with a cheese danish and stay up half the night and work without breaks… until the migraine slams me down again.

Or even worse, I get sick anyway, even though I did everything right, or nearly everything right, and then I think, what’s the use of working so hard to stay healthy?

So, here’s my commitment: One day at a time, I will live healthy. I will do it for the rest of today. Tomorrow all bets are off… (just kidding!)

Oh, it just started snowing!

– Megan Oltman

Live well and prosper!

pill image courtesy of [O*] ‘BharaT
checklist courtesy of Jon-Eric Melsaeter
snowflakes courtesy of Lin Pernille

Tags: managing life with migraine, one day at a time, relaxation practice, self care, vitamins
Posted in Managing, Tips & Techniques | Comments (2)

It’s all in your head

January 19th, 2008

Gotta rant today. I’ve been hearing too much about blaming the victims lately. And when we start down the road of “it’s all in our heads”there’s danger ahead.

What migraineur has not heard that as a put down? “It’s all in your head!”  What people mean by that is, it’s psychosomatic, or it’s psychological, or snap out of it – you can control this.  Migraines are in our heads – and in other parts of our bodies as well. They are a series of rapid firings of a bunch of overexcited neurons – in our brains, which happen to be in our heads, not our elbows or our spleens. So what? Just because something is taking place inside our head, doesn’t mean we have control over it. Try snapping out of it! Try snapping out of depression, or anxiety, or worse yet seizures, or a stroke. Try not thinking of an elephant while you’re at it. We can’t even do that!

Is that a statement straight out of the mind/body fallacy or what? The brain is a bodily organ.  It controls the rest of the body, to a large extent, but that doesn’t mean it’s not part of the body. Just because we use it to think thoughts, doesn’t mean we can control its processes or malfunctions. We like to think we are completely independent in producing thoughts, but our thoughts are strongly influenced, if not controlled, by our emotions, and emotions are produced by biochemical secretions. You can’t think your way out of an illness. Or maybe you can, who knows, but I can’t, I’ve tried!

On the other hand, our bodies influence our brains. We put chemical substances in – foods, nutritional supplements, medications, that help or hinder our recovery, relieve or trigger our migraines. We walk and exercise and that affects our moods and our thoughts.  And keeping a positive attitude, doing things to take care of ourselves, reaching out for support and helping others – all these things can influence our moods, and our health. They should be part of our migraine treatment plan. But they won’t take away the underlying condition. I cannot think or emote or eat or exercise my way to a redesign of my neurons.

This kind of thinking is particularly damaging when it feeds into our own perfectionism and guilt about being ill. The next person who says that, you might say, “I can’t think myself well, but you can think yourself tolerant!”  After all, their prejudices against migraine are all in their heads!

– Megan
Laying low with a headache – keeping migraine at bay

brain photo courtesy of Gaetan Lee

Tags: blaming the victim, Migraine brain, Migraine pain, psychosomatic illness, tolerance
Posted in Rant | Comments (6)