I Didn't See This One Coming

Weather changes. Increased pain levels.

A storm front came through last night.
Normally, I keep an eye on the weather and do whatever I can to reduce my controllable migraine triggers, so that a weather change won't take me out.

I didn't see last night's coming.

I had trouble getting to sleep last night. But, that's nothing new.
I had an increase in pain last night. Again, nothing new.
I had a few prodrome symptoms, but they seemed minor and I didn't heed their warning.
About an hour or so after I finally fell asleep, I woke to booming thunder and pain.

Even though the temperature drop and storms have long since passed, the throbbing pain, fatigue, aching, nausea, brain fog, vertigo... they all remain.

I didn't see this one coming.

Holiday Update & Triggers

Well, I've clearly not kept up with this month's blogging challenge. :-/ I am trying to get several posts finished up, so I can publish them here soon - it's just taking me longer to do anything right now.

I've been dealing with some migraine triggers - some controllable (time with family), some not (weather), and some in-between (sleep). I think I did well avoiding food / drink triggers, even over the holidays.

Weather - The weather has been a crazy roller coaster, and the frequent temperature drops have been difficult for my head pain.

Sleep - I've been having a different kind of struggle with sleep lately. Sometimes I wake up early and can't get back to sleep, and sometimes I sleep into the afternoon. Sometimes I'm up late, and sometimes I can hardly make it through the evening awake. This past weekend, for example, I slept a lot. Sunday, I was only awake for about 8 of the 24 hours, and I still felt so tired.

Family - No doubt, I've pushed myself quite a lot over the past few weeks, and I've been paying the price for doing so. But, I'm grateful for getting to visit with my sister (who was in town for a week), and my family (immediate and extended).

I've been trying my best to stay in the present moment, and to enjoy and be grateful for the time I have been able to spend time with loved ones.

This post was written as part of the National Health Blog Posting Month (NHBPM). Other bloggers will share their posts on this FB page.

Migraine Awareness Month Blogging Challenge #10: Taking An Important Step

My husband and I were able to attend our sister-in-law's ordination this past week. We drove down to Waco, Texas to attend the service and celebrate. We're so proud of her! She and her husband (Jeremy's brother) are now both ordained, and will be starting at a new church as head pastors this next week. We're so glad we were able to be there for such an important event.

I struggled through much of the church service, due to the shrill voice of an opera soprano singing and the volume of the organ. My dad had recommended that I take earplugs, so (luckily) I threw some into my purse. I put one of the neon pink/yellow earplugs into one of my ears (hoping it wouldn't be too obvious to others), and plugged my other ear (as needed). I probably should've put both earplugs in, but even wearing the one (in public) was a huge step for me.

I struggled with the ride back home the following day; but I was able to enjoy dinner with a long-lost friend, the ordination service, and visiting with family. And, I made an important step in caring for myself... even though it required wearing neon earplugs in public.

This post was written as part of the Migraine Awareness Month Blogging Challenge (MAMBC), which is initiated by www.FightingHeadacheDisorders.com and the National Migraine Awareness Month is initiated by the National Headache Foundation (NHF).

Migraine Awareness Month Blogging Challenge #8: Let There Be Light

Oh lights! I have to say that I've never been a huge fan of light, especially of flashing lights and the bright sun. But, since my migraines have become chronic, it's become more than just a dislike. Light sensitivity (i.e., photophobia) is a HUGE problem for me!

Our apartment is our "cave" - we have black-out curtains on all of the windows (and even then, it's sometimes still too bright for me). We don't keep many lights on either, and only use incandescent bulbs. I don't do very well with fluorescent lights, including the compact fluorescent lights (CFLs) that are being pushed for home-use because they use less energy than incandescent bulbs.

I limit my time outside, especially when my head is really bad or on edge of becoming really bad. I still try to get out some, but I do much better on cloudy days (with my sunglasses still on).

I try to choose the darkest booth in the restaurant to sit it (quiet, dark, and away from the crowd) - I then position myself to have as little view of windows, overhead lighting, etc. I can't stand overhead lights with fans... it gives a horrible strobe-like effect that makes me ultra-nauseous and worsens my head pain.

Sometimes, I keep my sunglasses on inside bright houses/apartments, restaurants, stores, etc... I don't really like to do it, but sometimes it can help (even if only a little).

I struggle with all the lights at night, when we're driving back home from somewhere. Even with my sunglasses, the headlights and streetlights just wreak havoc on my eyes and head.

If someone takes a picture that uses a flash, I'm doomed, and it's especially bad at night. The flash affects my vision, sometimes to the point that I can't see anything else, for at least 5-10 minutes (and usually takes much longer to completely go away).

Lighting has become a major struggle for me because I'm so very sensitive to it. I try my best to deal with it without it affecting others, but that can be difficult.

Here's a great resource for ideas to deal with photophobia:  Two dozen tips for light sensitive Migraineurs.

This post was written as part of the Migraine Awareness Month Blogging Challenge (MAMBC), which is initiated by www.FightingHeadacheDisorders.com and the National Migraine Awareness Month is initiated by the National Headache Foundation (NHF).

Migraine Awareness Month Blogging Challenge #4: June Is Bustin' Out All Over!

The best tips I have to offer others for having some summer fun despite Migraines are:

• Wear dark sunglasses and a hat
• Stay hydrated - water, water, water
• Keep snacks on-hand - keep your blood sugar level by snacking throughout the day
• Stay in the shade as much as possible (and/or spend time in air conditioning)
• Know your limits and listen to your body - if you start feeling dizzy and/or pain increases, take these signs seriously and immediately take action (remove self from situation, drink water, eat a snack, sit or lie down, etc)
• Pace yourself and plan rest breaks
• Always have your medication with you (for pain relief, anti-nausea, etc)
• Be mindful of the fragrance found in many sunscreen products
• Be careful not to get overheated, as this can worsen your migraine pain
• Have a "wing man" that knows about your migraines and can help make sure you drink enough water and will help you get out of a situation that has become "too much" for you
• Remember that you can enjoy time with friends and family, if you plan ahead and arm yourself with some needed items

This post was written as part of the Migraine Awareness Month Blogging Challenge (MAMBC), which is initiated by www.FightingHeadacheDisorders.com and the National Migraine Awareness Month is initiated by the National Headache Foundation (NHF).

Migraine Awareness Month Blogging Challenge #3: Just Shoot Me Now!

Today's prompt is to discuss my worst Migraine trigger(s).

Discovering one's migraine triggers can be very difficult, especially since they build on one another. So, something may not normally trigger a Migraine, but if I'm also dealing with a lot of stress and a weather change, even the smallest thing may be enough to trigger a big one.

Weather is a pretty big trigger of mine. It's somewhat inconsistent, but I almost always have difficulty when the temperature drops 10+ degrees. It's frustrating because I live in Texas, where the weather is a roller coaster. And, there's not really anything I can do to prevent it from happening. I just try to make sure that I have my migraine meds ready for the day before or the day of the weather change, and I plan on taking things easy for a few days around a big weather change.

Here's an example from last month (May 2012):

6 OBSERVED Hi  91.0° Lo  72.0° Precip (in) 0

7 OBSERVED Hi  89.0° Lo  66.0° Precip (in) 0

8 OBSERVED Hi  72.0° Lo  65.0° Precip (in) 0

9 OBSERVED Hi  83.0° Lo  60.0° Precip (in) 0

10 OBSERVED Hi  82.0° Lo  57.0° Precip (in) 0.22

11 OBSERVED Hi  75.0° Lo  60.0° Precip (in) 0.53

12 OBSERVED Hi  71.0° Lo  62.0° Precip (in) 0.01

I had increased migraine pain on the 8th (after the temperature dropped from a high of 89 to a high of 72). I didn't have a problem (in fact, some of the "better" days of last month) from the 9th through 12th, when the temperature stepped or tapered down.

This post was written as part of the Migraine Awareness Month Blogging Challenge (MAMBC), which is initiated by www.FightingHeadacheDisorders.com and the National Migraine Awareness Month is initiated by the National Headache Foundation (NHF).

Artificial Sweeteners

So, today is "Health Activist's Choice," so I'm going to actually finish one of the blog posts that I started a while back.

I've known that aspartame, NutraSweet, sucralose, Splenda, and any other artificial sweetener can cause problems for Migraineurs, but something that was mentioned in an article titled, Migraine Triggers: Artificial Sweetener, go me thinking...

I've known for some time that I'm sensitive to artificial sweeteners. But, my tolerance for migraine triggers have definitely changed since my auto accident in 2008.

I was thinking back to the years before the accident, and it occurred to me that I used to drink Crystal Light (contains aspartame) almost daily while I worked. I had headaches (I experienced migraines, too, but not frequently), but I always attributed it to long / unusual work hours and stress. I didn't notice any correlation with consuming aspartame.

I also remembered that I had told my mom a little while back that I used to get headaches when I ran - cross-country and track (middle- and high- school). What just occurred to me was that it might've, at least in part, been due to all of the gum I used to chew. I always had gum in my mouth when I ran and/or played softball. And, since the dentist was so concerned about cavities, I chewed the sugar-free gum... which has aspartame. I know I'm sensitive to aspartame, and I wonder if that's actually part of what my "workout headaches" were. It's an interesting thought.

I loved running so much (they helped me deal with every emotion - depression, anxiety, fear... and even happiness... I also thrived off the competition and I loved being able to push myself harder and reach my goals)... I guess I just dealt with the headaches. I should note a few things here... these were headaches, not migraines. I was still able to function. Even if they were moderately severe, they improved as I cooled down and re-hydrated after a run... my migraines don't improve with much of anything really.

Anyway, it's interesting to me how what we eat and drink can affect us so much. Even things like the type of gum we chew can trigger headaches in some of us (I don't even chew it anymore - between the chewing motion and the choice of sugar / cavities -or- aspartame... it's just not worth it).


This post was written as part of the Health Activist Writer's Awareness Challenge (HAWMC).

Reducing Holiday-Related Migraine Triggers

The theme for the December 2011 Headache & Migraine Disease Blog Carnival is: "Reducing Holiday-Related Migraine Triggers: Share your best advice, tips, and tricks for minimizing triggers while still fully enjoying the holiday season."

I've been wanting to write about holidays and migraines, so this gives me a great opportunity to share and to learn some tips from others. There's a great post that I think approaches this topic so well - Surviving the Holidays: Give yourself the G.I.F.T. of a stress-free holiday - Guilt must go. Importance rules. Family matters. Think ahead.

Since my main challenge is dealing with chronic migraines, I'd like to write about the holiday season... how there are a million different triggers that can present themselves... all in just a matter of weeks... and all wrapped in tinsel and twinkling lights.

First, let's take a look at 3 triggers that we have the ability to manage / control:  food, sleep, and stress.

FOOD
The holidays often involve get-togethers and parties, many of which will have foods / drinks that might be migraine triggers. Sometimes, you simply don't know what ingredients were used to prepare the foods provided at the event. Though there is no universal list of migraine triggers, there are foods / drinks that have been found to be common food triggers.

Tips: Try to keep your eating schedule - eat small meals throughout the day, make sure not to go too long without eating (don't skip meals). Eat around the same time each day, and keep your food portions consistent. Going all day with little to eat and then splurging at an evening dinner can trigger a migraine. And, if you're going to a party or dinner, offer to bring a dish... at least then you know that you'll be able to eat at least one thing there.

SLEEP
Just as holiday events can affect your eating schedule, it can also lead to disruption in one's sleep routine / pattern. We may find ourselves staying up later, sleeping in later, napping, etc...

Tips: Try to keep your sleep pattern - go to bed and get up at the same time each day, and refrain from naps.

STRESS
The holiday season increases stress for everyone, regardless of whether someone has a chronic illness or not. But, for those living with chronic pain, there is stress in: not knowing whether or not you'll be able to keep plans with others, missing out on special events, being around crowds of people, spending precious energy and money on gifts, etc. While stress may not be a migraine trigger, it certainly renders the individual more susceptible to his / her triggers... so, it's important to try to reduce stress levels.

Tips: Begin holiday planning and preparation a month or two in advance. That way, you can get a little done each week, and you'll still be "on schedule," if you end up having some bad days. Set aside time for yourself - take frequent breaks and retreat to a cool, dark, quiet room as you need to. It's also important to monitor how you're feeling, and take care of yourself.

Now, let's take a look at 3 triggers that we have a lower (or no) ability to control:  environment, travel, and weather.

ENVIRONMENT
There are some environmental factors that simply cannot be controlled (see WEATHER, below). But, the holidays introduce another set of environments that we often have very little control over. Stores have fluorescent lights, different smells, a lot of people, etc... Holiday parties / events have smells, noise, lights, foods, drinks, crowds... a lot that we can't really control. Often there is no way to escape these triggers or the migraines that they generate.

Tips: If you're going to a party or dinner at someone else's house, offer to bring a dish. If you know the person well enough, perhaps you can ask them if there's a cool, dark, quiet room that you could escape to, if you need to. You may also ask him / her to not burn candles that may be a trigger for you.

TRAVEL
Traveling to other cities / states to visit with family and friends is common around the holidays, but it can lead to increase in migraines. Holiday travel can disrupt our eating and sleeping habits, and raise our stress-levels.

Tips: The holiday season comes with short tempers / fuses and long lines. Keep in mind that everything will take more time during the holiday season, so pace yourself. If you find yourself traveling during the holidays:
Car travel - stay hydrated, keep your regular sleep and eating schedules, take frequent rest stops to get out and stretch.
Air travel - stay hydrated, keep your regular sleep and eating schedules, and take your headache medicine as a preventive (if air travel is a problem for your migraines).

WEATHER
Changes in weather can also trigger some people's migraines - possible weather change triggers include: changes in temperature, changes in barometric pressure, storm systems, humidity.

Tips: Sometimes, by knowing when there are weather changes coming, you can take your abortive medication and prevent the migraine altogether. Also, by getting or keeping other triggers under control (such as sleep, food, etc...), the weather changes may impact your migraine levels less.

THE PERFECT STORM
The holidays tend to be a perfect storm of triggers: food, sleep, stress, environment, travel, weather, and so on. Even though migraine triggers aren't the same for everyone, the holiday season tends to bring on a multitude of different triggers that can wreak havoc with many Migraineurs.


Tips: Try to control the triggers that you're able to. Determine what's most important for you and your family, and let the other things melt away. Be patient, pace yourself, and go with the flow.

Ultimately, remember that the holidays are not about the parties and the gifts. It's about celebrating the birth of our Lord, with our family and friends. We shouldn't feel guilty, if we can't muster up the energy to meet the expectations we have of the "ideal holiday scene." Living with a chronic illness places limits on what and how much we can do, and we must stop being so hard on ourselves for listening to and taking care of our bodies. Be patient, pace yourself, and go with the flow. 

NHF Regional Conference - Part II

Migraine Triggers

Dr. Frederick Freitag

Dr. Freitag recently stepped down as co-director of the Diamond Headache Clinic in Chicago, IL. His new position is at Baylor University Medical Center in Dallas, TX. He is very active in headache initiatives (including clinical research, lecturing, etc...).

Migraine Facts:

• 1 in 4 households has a migraine sufferer
• Migraine affects women more than men (3:1)
• ~30 million people in the U.S. have migraine
• 12-18% of the population have migraine (more than asthma and diabetes combined)
• If one parent has migraine, his/her child has ~50% chance of also having migraine
• 75% of migraine sufferers have neck pain/tenderness

Migraine is...

• Genetic - brain programmed to be sensitive
• Hyperexcitability / hypersensitivity of the brain
• Neurologic process
• Whole-body disorder
• Chronic systemic disease
• Attacks vary (between migraineurs and migraine attacks)
• May be progressive
• SULTANS --
  
  • (moderate to) Severe pain
  • Uni-Lateral
  • Throbbing
  • Aggravated by activity
  • Nausea or vomiting
  • Sensitivity to light and sound (environmental)

Premonitory Phase (can include any combination of the following symptoms):

• Fatigue
• Thirst
• Yawning
• Dizziness
• Increased energy
• Food cravings
• Frequent urination
• Poor concentration
• Hypersensitivity to sound
• Neck pain/tightness
• Blurred vision
• Irritability/emotional

Aura - builds gradually 5-60 minutes (usually visual)

Prodrome Phase ("Migraine Hangover") can include any combination of the symptoms from the Premonitory Phase

Comorbidities (more prevalent in people with migraines than the normal population):

• Depression
• Anxiety
• Bipolar
• Obsessive-compulsive disorder (OCD)
• Panic
• Sleep disorders
• Heart disease
• Irritable bowel syndrome (IBS)
• Fibromyalgia
• Stroke
• Obesity
• Migral valve prolapse
• Back/neck pain
• Patent foramen ovale (PFO)

Risk Factors (Triggers):

• Stress (or let down)
• Hormonal changes
• Diet (skipping meals; specific foods)
• Sleep disruptions
• Weather
• Head trauma

Food Triggers (not an exhaustive list):

• Additives - aspartame, MSG
• Vasoactive amines - aged cheddar, fava beans, soy products, left overs, lunch meats
• Other foods - long list of possible food triggers
• Alcohol - red wine, other wines/beers
• Caffeine

Protective Factors:

• Eat regular meals
• Standardized sleep pattern
• Exercise
• Stress management (biofeedback, recreation/have fun, massage)
• Post-menopause