For Anyone Who Has Ever (or never) Had A Migraine

I’ve had migraines since I was about five, perhaps earlier. They have been pretty much the same throughout my entire life, increasing and decreasing in severity and frequency but the structure has remained the same, like a lingering bad smell. In my case, they seem to be partly genetic (thanks mum) but also, I’ve come to realise over the years, hormonal. All migraineurs (yeah that’s a real thing) know that it’s best not to get into discussions about triggers. Everyone has an aunty or a colleague or a friend of a friend who gets a migraine just thinking about coffee/chocolate/petrol fumes. You mention migraines to some people and they suddenly become neurologists with a solid understanding of the inside of your brain. As soon as anyone starts talking about triggers to me, I tell them that I generally only get migraines while I’ve got my period. It shuts them up.

There are also the inevitable questions about medication. “Have you tried paracetemol?” they ask. Yes, I reply, and many other things over the years. Nothing I’ve tried has worked sufficiently well, with the exception of Ibuprofen taken very early, which works some of the time. Another standard suggestion seems to be Sumatriptan, prescribed or sold over the counter under a different name, which apparently works for a lot of people. Not me though. Each time I’ve taken it I’ve ended up in a worse state than I was before, with the last time being a memorably bad trip involving fear, paranoia and gurning. The last thing my malfunctioning brain needs during a migraine attack are psychoactives.

There is a sliding scale of migraine sufferers. At one end you have someone who had a migraine once, 23 years ago. Or perhaps the person in your office who has migraines all the time but not so bad that they can’t sit and read the BBC news website on their computer (“it’s only the spreadsheets which hurt”). On the other end you get the people who are crippled and incapacitated by migraines, living half-lives characterised by tramadol and darkness.

I reside squarely in the middle. I am incapacitated by migraines, unable to function but mercifully, they are infrequent enough that it’s ok. I carry on around them, trying to not to make eye contact lest they realise it’s been a while since they last visited. Medication doesn’t work, although my experimentation is far from exhaustive. They last long enough to be thoroughly invasive but not long enough that I require extensive time off work. They are (almost) the most painful thing I have experienced but they have never yet hospitalised me. They disappeared entirely during both of my pregnancies. I’m squarely in the middle.

Everyone experiences migraines differently, there doesn’t seem to be a single symptom that is shared amongst all sufferers (how I hate the word ‘sufferers’. Even typing it makes my jaw tense). For me, the headache is the first and most obvious sign of what’s brewing. I feel it gently nibbling away at the back of my eye, not painful, not unpleasant exactly, just there. This is the time to act quickly, to scrabble around for ibuprofen, to take myself away from any screens, loud noises, bright lights, anything likely to accelerate the invasion. Sometimes a couple of ibuprofen will do the trick. I can still feel the migraine there and will be able to for the rest of the day but it’s caged and contained and life goes on.

This doesn’t always work though and within an hour I’ll know one way or the other. Can I carry on or do I need to get myself home? If it’s the latter and I’m not already at home, then driving is out of the question. On occasion, colleagues have taken pity on me and driven me home, the question of will I or won’t I vomit on their upholstery adding a little frisson. Otherwise I’ll have to take public transport where other travellers look at my slightly strange demeanour and swollen, watery eye and choose to sit next to the drunk man instead.

Once I’m home, the only option is bed. A sofa will do at a push but it needs to be dark, warm and quiet and in my house, you’re unlikely to find that on the sofa. So a darkened room it is, but not so dark that I can’t spot landmarks in the room, the only things that anchor my spinning head. The pain at this point has become intense, a thick stretch across my eye and into my temple, always on my right side, with associated tendrils across the back of my head and down into my neck. The only way to calm the headache is to push my fingers hard into the side of my head finding the exact pulsating soft spot in my skull. If I do this hard enough then lay perfectly still, I may get some respite, perhaps for long enough to fall asleep. Otherwise some tiny internal movement will start the throbbing pain again which will come back as a wave, making it impossible to remain still and forcing me into different positions to try and find some comfort. There’s no way out of this, no stop button and no reverse. There isn’t a medication I have yet discovered which will take away or even noticeably reduce the pain in my head.

At some point, the vomiting part shows up. It’s sudden and violent and intensifies the pain in my head further. I can usually be found kneeling on the bathroom floor squeezing my head shut to try and contain the explosion that’s going on inside it. I cannot speak, I can barely see. The good news is that this is as bad as it gets. The migraine peaks and I’ll soon be on my way down the other side.

So it’s fair to say, it’s not great. The only pain I’ve ever experienced that’s on a similar level is childbirth. A cliché I’ve heard plenty of times before but pretty accurate for me. Still, the pain is only part of it and not necessarily the most unpleasant. That would be the strange things that a migraine does to my brain. When I have an attack, I get trapped into a repetitive Mobius loop of song lyrics and OCD style counting. Obsessively counting letters, words, sentences as they scroll across my brain like a visual earworm. I see in pulsating, over bright detail the written words and every bit of punctuation from whatever the last song was I heard that day. I see it as a ticker across the inside of my eyelids, then as a block of text, then as a word cloud, each lending itself to a different way of counting. How many letters in the first verse? How many ways can that be divided up and how can the words be rearranged to form equal blocks of letters? The effort of this feat of mental arithmetic makes things worse I’m sure but there’s nothing I can do to stop it1..

Then there’s the strange sense of being unable to tune into my surroundings. There’s no physical impairment (and no aura since I turned 30ish) but somehow I lose the ability to really understand what’s going on. Faces are harder to read, words don’t make sense like they should and every input takes longer to process. At its peak, a migraine makes it difficult to put together a coherent sentence. It’s short-lived, thankfully, but disorientating and if I had never experienced it before I would easily convince myself I was having some severe neurological incident.

So where, would you say, is the worst place to get a migraine? Let me give you some suggestions. How about half way through an Open University exam? Or on a National Express coach from London to Sheffield? How about watching Moby at the V festival in 1999? The V incident was exacerbated by the fact that we had snuck into the festival and until later in the day, had no access to the campsite (hey, it was the V festival, I wasn’t going to pay to get in). After crawling around on the ground for a while, cold and incoherent, I found my way into the Krishna tent and lay down on a cushion while seemingly infinite Krishnas sang me a curative song and dinged some little cymbals. It didn’t work.

So what’s the good news then? Where’s the payoff? Well, there’s a little thing that most people don’t know about, properly known as the postdrome, colloquially the migraine hangover. For some, this isn’t all that great. Some people sink into a proper come down after a migraine, experiencing dizziness, further nausea, exhaustion, depression. Some people experience nothing in particular. Not me though. I am lucky enough, post migraine, to become infused with the overwhelming feeling that all is right with the world. Euphoria is possibly a bit strong but let’s go with it anyway. This euphoria generally leaves me washed up and grinning to myself, floating around the house proclaiming that it’s all just fine, actually. For a long time I assumed this was just a feeling of relative relief that the pain had gone away. It was nice to know that it has a name. It’s almost worth the migraine.

Notes

  1. If that makes me sound mad, just wait until I tell you that I do this all the time not just when I have a migraine! There’s something about the migraine though which makes it particularly acute and I am completely unable to shut it down.
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