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Archive for the ‘Managing’ Category

The Weather Report inside my head (Sinus and Migraine locked in competition)

March 16th, 2008

Sniffly with a chance of coughing?  Yesterday’s migraine has transitioned into today’s sinus infection.  You don’t really want to hear about the nasty greenish glop going down the back of my throat!  I seem to have two major weather systems duking it out in here.

I’m going to try to make sense here, but the brain is not quite up to par today, so no promises.  It’s hard to think with stuff pressing on the brain – whether that’s from the inflamed blood vessels of a migraine or from blocked up sinus cavities.

I’ve been wondering for some time about the sinus/migraine connection.  In a thought-provoking article, Sinuses giving you a headache?  It’s probably Migraine! Teri Robert tells us that ” nearly 9 in 10 people with sinus headache symptoms likely are suffering from Migraines,” and Migraine not only causes pain in the sinus area, but can lead to nasal congestion as well! According to a research study  presented in 2004 at the 46th Annual Scientific Meeting of the American Headache Society (AHS), “real” sinus headache is only present when there is a sinus infection, which typically involves fever, lots of green or yellow mucus, and swollen lymph nodes.I have to say, as one who has clear and obvious Migraines, (pounding pain in one or both temples, with extreme light and sound sensitivity) and clear and obvious sinus infections (with the green glop of doom, swollen glands and fever), the study raises as many questions as it answers.  To quote Teri Robert further:

Ironically, researchers believe a few of the people in the study may have acquired sinus infections as a result of having a Migraine. Lengthy Migraine attacks can lead to swollen nasal membranes and closed off sinus passages, creating the perfect environment for an infection, said Dr. Eross.

I had one neurologist (not a headache specialist) tell me my sinus problems are probably Migraine.  Without asking any further questions about my history, it sounds like he read the research, but I don’t think he was giving me useful information.  I don’t generally have those suspect sinus “headaches,” I have months of recurrent infection symptoms.

This is the essential chicken and egg dilemma.  Do my Migraines lead to sinus infections? Does the pressure and swelling of infection trigger Migraines?  Both look likely from my own history.  My internist is intrigued by the question but has no answer for me.  I’ve got my hopes pinned on the headache specialist appointment in June.   What difference does it make?   If I can work out a good preventive regimen for either ailment, I’d love to have it help both!

In the meantime, I try to live in the way that will best take care of both the sinuses and the Migraine brain, which for me involves avoiding dairy, keeping my supplements up (including magnesium and B for the head and C and zinc for the immune system), eating in a way that takes care of my gut (high fiber, not a lot of processed foods, using a pro-biotic supplement), keeping my nasal passages moist with a neti pot and saline spray, and using relaxation to keep the ole brain calm cool and collected (more or less).

Megan Oltman

Free my Brain from Migraine Pain, Free my Head from Sinus Dread?

Vitamin photo courtesy of DRB62/Daniel R. Blume

Gargoyle photo courtesy of ClatieK/Katie Claypoole

Tags: American Headache Society, migraine, sinus infection, Teri Robert
Posted in Communicating, Managing, Medicine | Comments (1)

What can I do with my hair?

March 15th, 2008

A frivolous topic, I know.  Can you tell I’m laying around in post-drome, not quite well enough to be up and doing but well enough to be bored?  This is dangerously close to a self-indulgent pop culture style mag question, but please indulge me!  When you’re a red head you spend your whole life with people commenting on your hair, so I guess it becomes an obsession.  What is the right hair length for a migraineur?  Is there such a thing?

The photo I most often use professionally and for an avatar online is about 4 years old.  I’m going to have to change it soon for a more recent one.  But lots of my online friends know me looking like this:

Now it’s not that I don’t look like this, but I grew my hair out over the past 3 years and now it’s quite long, almost as long as when I was a hippy-dippy teenager!  I also stopped coloring my hair, at least for now, I’ve got white wings on the red at the sides.  Hey if it’s good enough for Bonnie Raitt, it’s good enough for me!  The problem is, my hair weighs a ton!  And it’s hot on my neck.  I like to wear it up, or braided, or back, in hot weather.  But if I have a migraine, or I’m in post-drome, my scalp is tender and I can’t stand the pressure of putting it up.  Even the weight of it pulling on my scalp when it’s down makes me nuts.

So now I look like this (a not very great picture of me last spring break) but my hair has gotten even longer.  I hate to chop it all off again after spending 3 years growing it back.  I’m also pushing 50 here and I’m not sure the face holds up to a short haircut any more!

So, what’s a migraineur to do?  I don’t want this disease to dictate anything else in my life!  But days Iike today I sure want to chop it all off.  It hurts to even think about washing it.

Please leave a comment and let me know how you deal with your hair!

Megan Oltman

Migraineur Fashion Central?

By the way, Mom says I should cut it!

Tags: hairstyle, Migraine triggers, scalp sensitivity
Posted in Managing, Silliness | Comments (5)

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

Tags: Migraine abortive medication, sumatriptan, triptans
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.

Tags: managing life with migraine, time management
Posted in Managing, Tips & Techniques | Comments (5)

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!

Tags: Migraine management, relaxation practice, relaxation techniques
Posted in Managing, Tips & Techniques | Comments (2)

“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!

Tags: Breaking the Headache Cycle, Ian Livingstone MD, Migraine attack, Migraine preventive medication, reactive nervous system, relaxation practice
Posted in Books, Managing, Medicine, Tips & Techniques | Comments (2)

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)

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
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