The Demon Migraine - Part II

Last week I mentioned that my mother has had migraines most of her life, but I thought I had dodged that bullet.

Then, at age 28, genetics caught up to me and hit me with migraines that haven’t let up appreciably for 24 years. I’m still luckier than most – I’ve had my share of trips to the hospital and bouts that last for days, but often I can continue to function at a lower level while I have a headache, rather than spending a day and a half in bed. Still, it renders me incapable of sitting at a desk in an office or working at a job outdoors. Think of this multiplied 300 million times to get a general idea of how many people have the same challenges, worldwide.

The most common question I get, when I report that I just had a migraine, or ten in a row, is “What caused that?” It’s a perfectly good question, but one that has no clear answer. There are causes, and then there are triggers.

source (I love that "Good Health" is represented by pretty matching hues! Maybe my brain is full of clashing colors.)

The cause of migraine can be from the muscles, blood vessels, nervous system, or a combination of all. It used to be common knowledge that the pain of migraine was due to the contraction of blood vessels in the head followed by a sudden expansion. Now that’s not so certain. Neurotransmitters figure heavily in the equation, but which ones, and what are they doing? Muscle tension can be a contributor, but which muscles and why are only some people affected by it? Everyone has their own theory; my assertion is that it is an as-yet unidentified combination of linked physiological mechanisms.

The triggers are both simpler and more complex than the causes. A trigger is, very simply, any stimulus which results in a migraine headache. Food, weather, sleep, light, stress, smells, chemicals, and exercise are a few of the categories of triggers. The complexity arises from the fact that there are thousands of potential triggers in our modern environment, each person has a different subset of triggers that affect them, and sometimes it requires extraordinary measures to avoid them. Bright light, for example, is something that is almost impossible to avoid in daily life.

And then there is the question of a cure. A lot of supposed cures are floating around out there, plus a lot of actual proven cures that work for some people and not others. There is a huge research effort to find new drugs or other treatments for migraine sufferers (interestingly, most of the research seems to occur in the UK), and almost every healthcare specialty has something to contribute to the migraine question.

Tie a crocodile to your head! Your headaches will disappear!

There is also a lot of misinformation, sadly, even within the healthcare industry. Some professionals have gone so far as to tell me there is no such thing as migraine per se, it’s just a tension headache. I had a personal trainer some years back who insisted that I had to keep exercising through a migraine because it was the only way I would ever get over them. That’s taking things a little too literally, I think! A TMJ specialist told me that I would stop having headaches and I would look much prettier if I used his jaw splint. Uh, what? One neurologist yelled at me because his favorite medication didn’t work for me. Another one kicked me out of her office because I hadn’t updated her headache calendar (in fact I’d created a headache tracking spreadsheet that I was keen to demonstrate, but that didn’t happen).

I can only assume that these are well-meaning people who want to find a solution just as much as I do, but they just can’t deal with the complexity of the problem, and therefore they insist that there are very simple answers. I do not believe there is any simple answer.

Still more next week in the Demon Migraine - Part III!

Katrina