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Archive for the ‘Managing’ Category

Is the Economy Hurting your Head?

October 27th, 2008

As you know from my recent posts, the costs of health care and our national tragedy of a broken health insurance system have been hitting me where I live lately. Of course I’m far from alone in this. In the current economic crisis, people are finding it harder than ever to afford the medications and health care they need.  In a study published on October 14, the National Headache Foundation (NHF) surveyed 270 headache sufferers on line recently, and found that more than three quarters of the respondents said they have cut back financially, and those cuts have impacted their headache treatment:

63 % admit they rely on prescribed medications for their headache.  However, since the economic decline, 29 % have either delayed or skipped filling prescriptions for headache medications due to financial set-backs.  Another 53 % switched to over-the-counter medication instead of their prescription medication to treat headache in an effort to save money.

Migraineurs are not alone in this, of course, the New York Times reported last week that prescription drug sales are down, and people are cutting back on life saving medications for many medical conditions. The NHF’s survey also found that people were cutting back on certain types of food purchases, and were not sleeping as well and feeling more stress due to their economic situation.  Sleep disturbances, anxiety and dietary changes were all cited as triggering increased headaches. Delaying or skipping filling prescriptions, or using over the counter medications as a substitute is a serious concern.  It’s easy for me to say to you – don’t cut back on prescription medications!  Find something else to cut back on!  If the choice is between snack foods and prescriptions, definitely give up the snack foods.  Unfortunately, many of my prescriptions have a $50 co-pay.  I could save a lot more money delaying a $50 co-pay than going without a $3.89 box of donuts.  Sometimes we are faced with real, terrible choices.  Sometimes we have to choose what to do without, and there may be no truly right answer.  I will not presume to advise you here – you must make your own choice. Some economic insecurity is very real.  Some people lose their jobs, can’t get loans, lose their investments, don’t have health insurance, and have to make terrible choices.  Please ask yourself whether you really need to forgo this expense, or whether it is just anxiety and fear for the future that is making your decision for you. The NHF has some suggestions for ways to afford your prescriptions:

Beyond the nuts and bolts of paying for the prescriptions, though, you need ways to manage your stress and anxiety.  I suggest snuggling a kitty if you can.  NHF has some good advice, picking up on some familiar themes here at Free my Brain, they suggest you practice relaxation techniques and include exercise in your daily routine. Suzanne Simons, NHF Executive Director, concludes with a great piece of advice: “remember that the financial turmoil we are currently experiencing is temporary. …[T]he situation will get better and keeping a positive outlook may help lessen the emotional and physical impact of these volatile economic times.” Remember that economies are affected by attitudes.  Refuse to give in to despair.  Do whatever you can to make things better.  And get out and vote for change!

– Megan Oltman

Hand on head image courtesy of Mr. Thomas/Christopher.

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Why Do We Try to Get Better? Living Inside a Goal.

October 6th, 2008


What are we getting better for?  What are we here for?  I realize these are big questions and challenging even for minds that aren’t screaming with pain, let alone those that cope with frequent Migraines.  They are central questions to creating and sustaining the will and optimism to keep pushing through the pain and discouragement that comes with a life with chronic illness.  Searching for the larger, deeper meanings, a connection to humankind, the world, the divine, is an important part of the human experience.  There comes a time in our lives when most of us wonder what we are here for, what our mission is, what we are uniquely put on this earth to do.  Be it spiritual, altruistic, political, creative, there is something that sustains us, that pulls us forward.

It is easy to lose sight of this when we struggle with pain.  Ending the suffering becomes important enough that we can forget there is more to it.  I don’t believe there is anything inherently ennobling in pain.  “No pain no gain” is a bankrupt philosophy.  People can achieve great personal growth out of learning experiences based in pain.  They can also become embittered, limited and frightened by pain.  People can achieve great personal growth without great pain.  There are no guarantees, no formulas.  My experience is that when we are living inside a known, expressed purpose or goal, it gives a larger context to our experiences that makes it worth moving forward, worth seeking out the learning, worth looking beyond the pain.

As a coach, I help people determine their goals for their lives – what possibilities they will create for themselves and the world, what they value most that they want to promote.  Of course if we are ill we want to feel better, but feel better for what?  Feel better so I can be a person who can squeeze every moment of enjoyment out of life, and give it to everyone around me?  That’s worth feeling better for!  You get there at least in part, and as much as possible, by living that way today.  So we talked a few weeks ago in this blog about having fun, because your life is NOW, not someday when you’re all better.  If your goal is to have a family full of love, have it NOW, today.  If you want to be creative, be creative now.

My goal, in its most recent expression, is to build lives in balance – creating wellness, joy and
abundance.  That means for me, my family, my friends, my clients.  It means that’s how I approach my politics, my community, my world.  It means that’s how I make choices about my day.  When I spend the whole weekend with Migraines, as I did this weekend, I need to think about what a life in balance looks like in that context.  For me this time it looked like staying in bed when I felt like I should be up and helping, taking medication when I didn’t want to, accepting that two beautiful October days were going by with me inside, inviting my children and my husband to spend time with me in my bedroom, one by one, since I couldn’t deal with them in a noisy group in the noisy downstairs.  It meant putting off this writing and some other work until today.  I’m glad my pain is mostly gone today.  But even gladder that I can be more active in pursuing my goal today.

Think about what you’re here for.  Your unique contribution, your humor, your helpfulness, your intelligence, your skills, your drive, your compassion, your biscuits, your strength.  Take care of yourself, your nervous system, your body and soul, so the world can have that, the gift you are.  Do what it takes to be well inside of that.  Get better for that.

– Megan Oltman

Night sky courtesy of Adan Garcia; summer field courtesy of Zenera/Serena.

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Chronically Ill? What Are You Doing for Fun?

September 22nd, 2008

Fun?  Megan, come on, what do you mean fun?  I get up, I take meds, I go to work, I try to make it through the day, I come home in pain and try to do the minimum I can to get by, feeding myself, family, pets, doing laundry, paying the bills, I collapse as soon as I can.

Fun?  Everything I used to do for fun is gone – I can’t… drink, smoke, go out in the sun, exercise, go to rock concerts, go to noisy/smoky bars… fill in the blanks.

Fun?  I can’t afford to have fun.  My money all goes to doctor bills, medications, co-pays, insurance premiums…

Fun?  Look, I can’t have fun when my basic responsibilities aren’t being handled.  I’ll have some fun after I’ve felt well enough to finish the taxes, clean the house, mow the lawn…

Have I covered everything?  Any other objections you can think of?  I want you to know I have lived my life at times inside of every one of those objections.  Who has been my biggest killjoy?  Not Migraine disease, chronic fatigue, sinus infections, nasty bosses, demanding clients or disbelieving relatives, but little old me.  My own biggest Killjoy.

But I am taking a stand for Joy, alive and well.  This is my life.  Now.  Imperfect as it is.  If I wait to
get everything done first and then have fun, two things will happen.  I will never get it all done, and I will never have any fun.

Do I want this on my tombstone:  Got it all done?  By the way, even if I want it, it’s never going to happen.  As fast as I can do something, no, even faster, the more stuff to do gnomes are creating more stuff to do.

And even if I give up on trying to get it all done, I also have to give up that I will have fun when I feel better.  What if I don’t feel better?  Sorry guys, but what if this is as good as it gets?  Don’t stop hoping and working and fighting, but I could die tomorrow.  This is my life.  Now.

So what do you do for fun?

What gets you up in the morning?

What do you look forward to?

Your life is happening now, imperfect as it is.

What restores you, restores your perspective, where is your creativity?

Laugh.  Play.  Laugh some more.


I’m crocheting a granny square scarf.  Kind of silly and retro-60’s but I enjoy it.  I am clearing my front porch little by little preparatory to stripping off the ratty old indoor-outdoor carpeting and painting it. I’m walking in the park every day I feel well enough.  Sharing books to read with my kids & husband.  Taking DVDs out of the library.  Mostly I’m concentrating on finding fun things for when I’m sick or my head hurts, and taking time for fun on the weekends, whether or not we’ve gotten through our house projects agenda.  And making plans with friends and family, not worrying whether we might have to cancel them.  Making them anyway.

– Megan

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Between a Rock and a Hard Place – How do We Choose?

September 19th, 2008

The first in a series of posts on Migraineurs making choices for our health care and our lives.

How do we choose? We are faced with choices on a daily basis. We lose sleep over them; they feel momentous, life-changing.  Rarely are they an Indiana Jones moment:

  1. if I step on the wrong step it will crumble below me and hurl me into the rat/snake/cockroach infested pit, or
  2. if I stake all on drinking from the gold cup my eyeballs will melt and I will desiccate into a human husk, so that the 2000 year-old crusader can say “he chose unwisely.”

Most of our choices change our lives more gradually!

For those of us with Migraine disease and chronic illness, choices often revolve around

  1. what treatments to try, and
  2. how to manage to make our living.

Most choices in life are reversible; we can change our minds, have a chance to learn from our mistakes.  Usually there is no one clear right choice.  In medical situations we often wish there was one.  How about the doctor coming to us and saying, “Well, Ms. So and So, here’s the choice

1. If you take this course of treatment it will cost you $2500 and you will feel worse for 2 months, 3 days and 16 hours, but then you will lose 30 pounds, become a natural blond, your Migraines will cease forever and you will never age another day.

2. On the other hand if you don’t take the course of treatment your fingers will gradually turn to pretzel sticks and crumble away, your brain will become a giant chicken heart and eat Philadelphia, your best friend will never speak to you again, and you will have a Migraine every day forever.”

I don’t know about you, but I’d go for the treatment.  And I don’t even want to be a blond!

Okay, I’m being extreme.  I hope I didn’t lose you there in all my silliness; there really is a point.  It is rarely given to us to know whether we are making the right choice, before, during, or after.  We have to weigh our options, but then we just have to choose.

Before I had my first child I fell and herniated a disk in my low back, causing two years of back pain.  Then I had a difficult labor with an erratic pattern of contractions, wearing me out without making progress.  After 18 hours of labor, I chose to use pitocin, a synthetic hormone, to stimulate the labor, and the pitocin made the contractions strong and painful enough that I felt I needed anesthesia.  I had to choose between taking pain-killers and having an epidural (where anesthetic would be injected into the dura, or sack, around my spine).  With an epidural there was a chance that my disk problem could become worse, even to the point of permanent back pain.  With pain-killers, if I ended up with a cesarian section, I would need general anesthesia.  The choice was to be awake for my daughter’s birth and risk disabling back pain, or to risk being knocked out for her birth with no back complications.  I chose the epidural.  I did have a cesarian; I was awake; and I did not develop any back problems from it.

My husband and I will never forget when I was lying in the birthing chair, pitocin-induced contractions sending me into ever higher spikes of pain and exertion, trying to make a choice in the panting moments between.  We were 31 years old, and we felt like we became adults in that moment.  If I had ended up with disabling back pain, I don’t know if I would have said it was the right choice.  To be awake and hold Rachel in the moment after she came into the world was a joy I did not want to miss.  That was what I chose.  But who can say if it was the right choice?

The choice I made recently was to start on Migraine preventive medication.  I spent at least 6 months making that choice.  It was a choice I was considering for at least 4 years.  Sometimes a choice needs to stew on the back burner of our minds.  In that 6 months I:
•    Found a doctor I could trust (which took several tries and months of waiting for appointments);
•    Did a lot of on-line research, and read about other’s experiences with preventives;
•    Recommitted to my meditation and relaxation program;
•    Tried magnesium and B2 supplements;
•    Tracked my Migraine numbers; and
•    Talked about the decision with my friends on and off line, my husband, my family.

Eventually, the choice just felt clear.

I will be returning to this subject of choosing in several more posts in the near future – if you’ve read all the way down here I’ve kept you too long already!  What I’ll leave you with today is to say that those times when you must make that life-changing decision right now are rare.  We usually have some time to make our choices.  Use that time.  Let things simmer on the back burner.  Let your subconscious mind do its job.  Will you make the right choice?  Nobody knows.  But you can make the choice with much less anxiety in the meantime.

– Megan Oltman

Pretzel sticks image coutesy of Windell Oskay; image of window at Mesa Verde is by me to illustrate being between a rock and a hard place – Mesa Verde is all rocks & hard places.  And amazing.

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How Am I? As Well As Possible, Thank You!

September 13th, 2008

AWAP has been making the rounds on some of the Migraine forums lately – so I googled it and got many choices:

Abused Women’s Advocacy Project
Any Word Any Page
Aftermarket Wholesale Autobody Parts
Animal Welfare Audit Program
All worthy choices, I’m sure, but…

I’m talking about As Well As Possible.  A wish for the chronically ill – not, “have a great day!”  But “have an AWAP day!”  Not “I’m feeling fine!”  But “I’m feeling AWAP!”  I sign off on notes and emails to my chronically ill clients and friends, “wishing you pain-free days and nights.”  It is my wish for them, my earnest wish, and it is my wish for myself.  But sometimes it’s unrealistic.  We must walk a fine line between powerful hope and attainable goals.  Between reaching for the stars, setting our sights high, and accepting the reality of our lives.  I work and strive for the day when my Migraines, and yours, are a thing of the past.  But if I expect that to be today, I may be setting us both up for disappointment.

When I was little, I was taught that when people asked how I am, I was to say, “Fine thank you, how are you?”  The explanation for that stock answer is that people are asking in order to be polite, and they don’t really want to know! Is that true?  Sometimes it is.  Every person I encounter in business, every acquaintance I run into in the grocery store, does not necessarily want to hear the details of my illnesses.  I don’t necessarily want to share and go into it with all of them either.  So what do I say?  I try to avoid saying “fine.”  I often say I’m okay.  Or not bad.  On those occasions when I feel great, I say I feel great.  (Hey, it does happen!)  But if I say I’m fine when I’m not, I’m perpetuating the invisibility of my illness.

With people in my life, I try to strike a balance between being real and being upbeat.

When we live with chronic illness it is very important to enjoy as much as we can of life.  To find the joy where we can.  And so for me to be AWAP means that I am living the best I can today, maintaining a sense of humor, being productive where I can, having as much fun as I can.  It means that I may be chronically ill but I am not overcome by it.

Sometimes my friends and relatives say, “How’s your head?” or “Having any Migraines lately?” or even “I hope you haven’t had any of those Migraines,” or “Migraines better?”  Of course people want me to be better.  I want to be better too.  When a friend is ill, we want them better.  What else can we wish them?  So I try to find an answer that acknowledges their caring, and acknowledges my reality.  Today I am As Well As Possible.  I am not in constant pain.  The on and off Migraines I’ve been having for weeks are off at the moment.  I have some energy and I am getting some things done.  My dishwasher is fixed.  My kids make me laugh.  The field is full of deep yellow goldenrod and deep purple asters.  I am grateful for my life.  AWAP

– Megan Oltman

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Can You See my Pain? Can I See my Pain?

September 8th, 2008

It’s Invisible Illness Awareness Week, a worldwide effort to bring together people who live with invisible chronic illness and those who love them.

According to the Invisible Illness Blog, nearly 1 in 2 Americans have some kind of chronic illness.  From heart disease to mental illnesses, cancer, lupus, chronic fatigue, Migraine and headache disorders and many others, people are suffering all around.   While our illnesses may be invisible, giving no outward visual signs, why are they so unknown to those around us?

The statistics on Migraine disease are staggering.

Given those numbers, why is this disease so misunderstood, un-researched, underfunded, and the treatment options so undeveloped?  Why do so many people, even doctors, think it’s “just a headache”? There’s enough for several more posts in answer to that question, but I think invisibility is one of the major reasons.

Think about the invisibility of head pain.  Unless someone is highly attuned to changes in our eyes and expressions, or the cue of hand to forehead, they will not know when we have a Migraine attack.  It’s not like they can see the hammer knocking us on the head!  Even more significantly, perhaps, it’s hard for others to understand how we might feel fine today, but be unable to get out of bed tomorrow.  It’s hard to understand the long term consequences of frequent or chronic pain.  Migraine can increase stroke risk, and Migraine disease can cause brain damage over time: this is recent knowledge.

There is much we can do to educate others, to explain to those around us, to rally for more research, to insist on accommodations at work and adequate treatment from doctors, emergency rooms, and insurance companies.  But I think one foundation of the problem lies in how invisible this illness even to ourselves.

Last week I practiced saying “I am chronically ill.”  I said it to a number of different people, and told it to myself in the mirror.   Big deal?  It is a big deal.  It is the reality of my life for most of the last 13 years, yet I have a very hard time accepting it.  I am a meticulous record keeper.  I keep a very detailed Migraine and Wellness diary where I track not only Migraines but my sinus infections, my fatigue, and my dizziness, among other things.  I can tell you that over the past 4 years, I have been sick, with my ability to function significantly reduced, 25% of the time.  It’s probably higher than that, because I have a lot of Migraines in the evening, but if I have worked and functioned most of the day, I have counted that as a well day.

I am one of the lucky ones.  Many chronically ill people are sick more than half the time.  Since I am in business for myself, I can set my work up to be flexible and take the time I need for myself.  My ability to meet deadlines and my income do suffer.  Imagine having a job, and needing to take 6 sick days per month.  That’s what my numbers translate to.

Those are the facts, and yet it is very hard to accept that I am chronically ill.  If you’re not sick every day, it’s easy to fall into denial again.  To forget that there are limitations to what I can do.  That even when I feel great I need to be very cautious and marshal my energy.   That things I used to do are not
available to me any more.  That I need to adjust the standards I have measured myself by.

I need to be as kind, forbearing, patient, understanding and loving towards myself as I would be to a friend who was chronically ill.  Why is that so hard?  I need to accept where I am without giving up hope, and while still striving to take better care of myself, get better treatment, do everything I can to be as well as I can be.

When I am caring for myself in this way (and I do manage it at times), it is easier for me to be real with the people around me.  To explain my illness, to help them understand.  I need to have my illness visible to me; then I can help make it visible to others.

– Megan Oltman

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When is it Time to Use Migraine Preventive Medication?

September 6th, 2008


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

3 or more Migraine attacks per month

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

Silent Brain Damage

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

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

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

So why wouldn’t you go on preventives?

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

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

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

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

– Megan Oltman

Embarking on the pharmaceutical unknown.  Wish me luck!

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

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

September 1st, 2008

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

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

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

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

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

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

– Megan Oltman

Dirty dishes image courtesy of Easternblot – eva.

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Physical Therapy (Again) – This Time for Migraine

July 29th, 2008

Past results not a guarantee of future performance.

I had my first physical therapy appointment yesterday, prescribed by Dr. Gerhardstein, my new headache specialist, as I discussed in Update on my Headache Specialist Visit.   The idea is to release tension in my neck and retrain me to loosen those muscles, and avoid straining them.  As I understand it, neck pain and tension lead to tension headaches.  The muscles in the neck connect directly with the fascia over the skull, so tension in the neck muscles will lead to tightening of the fascia, leading to that tightening-all-over-the-head pain of tension headaches.  Since my tension headaches almost always morph into Migraines, this should help reduce that trigger.

I took my first yoga class at 15, going along with my mother to the local Y, and I was proud of how flexible I was compared to the 30, 40 and 50ish women in the class.  Now I’m that 40-50ish woman and I’m not so flexible.  The physical therapist (who is about my age, I’d guess) must have said “at your age” at least 4 times in the course of a 45 minute session.  “Your posture is not too bad for your age.” “It’s common to have that kind of limited range of motion at your age.”  (And the one that really killed me) “You might still be able to tighten up those abdominals at your age.”

My mother always corrected my posture as a child and a teen, but when I went to college I took and then taught women’s self-defense classes.  I learned to stand tall, strong, and proud.  After my pregnancies I worked hard on tightening those abdominals back up.  It is a rude awakening that I’m slumping even a little, at my age!  I had to laugh at myself – she said she was going to assess my posture, I stood up straight (I thought) and prepared to receive my A+ and she said my posture was “not too bad,” and that my abdominals were weak.  Not too bad?  She might as well have given me an F!

Don’t get me wrong, I really liked her.  She applied moist heat and a TENS (Transcutaneous Electrical Nerve Stimulation) unit, then ultra-sound, then a gentle (Ahh!) neck massage.  Since the session yesterday I have been hyper aware of my posture.  Each time I go through a doorway I true myself up – ears over shoulders, head held high, abdominals in.  I did the yoga exercises she gave me before bed and the neck stretches in the shower.  I’m looking forward to my next appointment, later in the week.

Here’s what the rude awakening is.  The fact that I did yoga regularly as a teen and on and off in my twenties and thirties will not help me now.  The fact that I know how to have good posture, how to relax my neck, how to exercise my abdominals, none of that is the same as doing it, now.  The physical therapist doesn’t see the woman who did all that great stuff decades ago.  She sees the woman with chronic pain and stiffness in her neck.  She sees the limited range of motion, and treats that.  Thank goodness!  Being a teacher’s pet will not help me here!  Having been a straight A student has no relevance!  This is about a daily practice to help me live better and feel better, now.  In my 49 (and a Half!!!) year old body, not the 15 or 25 or 35 year old one I once had.

I wanted you to know about PT as an option for helping with Migraine.  I also wanted to remind myself, and you, to live now, in this day, in this body (the one you’re in).  Bring peace to this day.  Bring healing to this day.  And there is hope for those abdominals yet!

– Megan

Model of the head image copyright 1995 Buyamag Inc., yoga stretch image courtesy of Bandita.

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Posted in Managing, Medicine, Rant | Comments (1)

Handling Migraine Challenges: Helping Others Understand

July 19th, 2008


I’ve been asking e-course subscribers* what they find to be the biggest challenge in managing their Migraines.  Many of you have responded.  While I’ve written individually to everyone who responded, we all have so much in common that I wanted to share some of what I’ve gathered from your responses.  This is kind of Megan’s Dear Abby for Migraineurs.

We all know that we are challenged in many ways by Migraine disease, but the majority of subscribers included something along the lines of “helping others understand.”  How do we help others, the non-migraineurs who are important in our lives, to understand our disease, how it effects us, what we can and can’t do about it, and how it will effect them?

In reading all your responses, I see two issues in helping people understand.

The first is coping with those who judge us.  “Oh it’s just a headache she’s being a baby.”  “Oh so you have another of your little headaches?”  “Why do you always have a Migraine when I need you to do something?”

People have all kinds of reasons for judging.  Sometimes they want to feel superior.  They may want to distance themselves from you, your problems, your pain.  It’s almost a superstition at times; if they don’t sympathize, if they don’t believe in your pain, they can pretend it has nothing to do with them, that nothing like this can ever happen to them.  Some disability advocates refer to the non-disabled as “TABs” – standing for Temporarily Able-Bodied.  A potent reminder that disease and disability can happen to any one of us.

What can we do with those trying to feel superior?  We can think of nasty responses to put them in their place, and that can be a fun exercise when we’re angry.  The only thing I think is really effective is to speak our truth – tell the truth about what it’s like for us.  Some of those people will hear.  Some of it will sink in.  This is more about Coming Out of the Migraine Closet.  And if these people are not important to us, how much do we really need to do?  We can choose how far, and when, we want to be advocates, and we can recognize that not everyone will understand us, not everyone will be our best friend.  The job of advocacy takes a long time, and while I believe in educating people, it’s okay not to face down every single person every single time.

When important people judge us, the people that matter in our lives, I believe they do it out of pain.  There is the pain of what they lose to Migraine disease.  Our companionship, having fun with us, our help, our ideas, our input.  Our work and productivity.  There is the pain of seeing us in pain.  Of wanting to help. Particularly in the case of parents and life partners, there is the pain of wanting to be able to fix it, make
it all better, make it go away.  The pain of their powerlessness in the face of this disease.  When we can’t face pain, or understand it. we look for someone or something to blame.  “Why can’t you take better care of yourself?”  “It’s all in your head.”  “You have to learn not to stress out.”

The answer is in communication.   If people care about us, it’s worth doing whatever it takes to help them understand.  To sit down, at a time when no one is upset, and tell them what it’s like for us.  Give them information they may not have about this disease.  Teri Robert has a great resource, Understanding Migraine Disease and Migraineurs, which is a letter you can give to those who don’t understand.

But this brings us to the second issue, which I suspect is actually a bigger issue than what the others think.  First, before we can ask them to understand, we have to understand ourselves.  I think this may be the biggest ongoing challenge.  We have to understand, and accept, that we have a disease.  We didn’t choose it.  We didn’t cause it.  We may be scared, confused, upset, frustrated, worn down and in pain.  But we are not lazy, we are not malingering and we are not making it up.

Even more of you wrote about your worries about effecting others than about actual judgment from others.   “Feeling like I’m a burden on my family.”  “This disease affects everybody around me and it’s not fair. Neither for me nor for the others.”  “Having to stay in bed and my hubby having to take over.”  “I want my clients to be able to depend on me but sometimes I cannot be there and that really bothers me.”

We want to be useful, to be helping and participating with those we care about.  The first thing we have to do is to accept that we have a disease that will interrupt our lives, take us out of the action, make us rely on others.  Inside of acceptance, we can begin to see how we can help, what we can do.  Inside of understanding, we have options.

– Megan Oltman

*The Six Keys to Manage your Migraines and Take Back your Life – sign up for this free e-course in the upper right corner of this page.

Writing pen image courtesy of Toshiyuki IMAI; pointing finger image courtesy of Lisamarie Babik.

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Posted in Advocacy, Communicating, Managing | Comments (5)

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