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  • Eli Stuart (they/them)

Migraines: More Than a Bad Headache

[Cover Image Description: A woman with brunette hair is centered on as she has her hand covering a good amount of her face, grabbing her face in pain, meant to depict a migraine in a visual form. End of image description.]


Chronic migraines go beyond just your average headache in both their occurrence and the symptoms that come with it. Dr. Elizabeth Cutter described migraines as “an episodic disorder, most commonly consisting of severe headache, usually with photophobia (light sensitivity), phonophobia (sound sensitivity) and/or nausea (at times vomiting).” (“How To Diagnose Migraine” published in conjunction with the American Headache Society or AHS).


Migraines follow a path different from most other headaches with 4 steps: Prodrome, Aura, Headache, and Postdrome.


Prodrome:

The first beginnings of a migraine that is marked by symptoms such as neck pain/stiffness, mood changes, nausea, and food cravings to name a few. This occurs from hours to days before the migraine attack.


Aura:

About 5 minutes to an hour before the headache, there are symptoms that tend to cause negative sensory effects. The most common aura symptoms include visual disturbances, such as seeing zig-zags, blindspots, foggy vision, and double vision, confusion, and numbness.

There can be other auras, however, dealing with things like balance/motor. I have an aura of feeling lightheaded or that I’m about to pass out suddenly. A family member of mine smells burnt toast leading up to the headache phase.

Headache:

The pain and step that most people think of when discussing migraines. The pain is generally described as throbbing and ranges from moderate to severe. It can last hours to days. Additionally, the migraine may resolve in one day, but the next day another migraine occurs.


Postdrome:

Called the “Migraine Hangover”, the next day or two following the end of the headache step is marked by fatigue, dehydration, loss of energy, and difficulty focusing.



So what does a migraine look like in practice?


A recent migraine for me looked like this:

I started feeling a little nausea or queasy with no known reason that morning (prodrome). I exited a building and got extreme photophobia, or sensitivity to light. It felt like there were multiple knives stabbing both of my eyes (aura). Then, the throbbing/pulsating pain came (headache) which is when I took my as needed medication. When I woke up, my migraine was gone. However, I still was very tired and fatigued (postdrome).


Of course, not every attack is the same, even in the same person, but these are the general stages and experiences in having a migraine attack.


What Causes Migraines?

If we are talking about how someone gets chronic migraines, the answer may lye with genetics. The closer the relation to someone who has chronic migraines in your family or the more relatives who have chronic migraines, the more likely you are to develop chronic migraines. For example, my Mom and Aunt both have chronic migraines. I got my first migraine at the same age my Mom was when she first got a migraine.

If we’re looking for how someone gets a migraine attack, that’s a bit different. With chronic migraines, I will have migraines that don’t have any other noticeable causes. However, things like the weather, stress, and red wine can trigger migraines. Weather changes in particular have caused my most recent migraines. Extreme weather changes also cause those without chronic migraines to possibly get a migraine as well.


Managing Migraines:

With chronic migraines, it is common to start with prescribed as-needed migraine medications. Generally, you would want to take as needed during or as soon after the aura stage as possible as the delay may make the medication defective (this has only happened to me once when I got a multi-day migraine, but is still good advice and I believe better safe than sorry).

If migraines are still occurring often and disrupting your day-to-day life, then you may be prescribed a preventative. This would be a medication you take daily (or multiple times a day) regardless of if you have a migraine. I do believe that the preventative I was put on decreased my migraine frequency (to be fully transparent: preventatives aren’t perfect, I've been on preventatives for about a year and I still get migraines occasionally. However, preventatives are better than no preventatives provided, providing there are not great negative side effects).


Prescriptions aren’t the only thing you can do to manage migraines. Even with as-needed medications, there are other steps to take to relieve and hopefully stop the migraine:


Ice:

Ice packs can help especially with the throbbing pain when used on your forehead. However, ice packs or something similar on your eyes may also help as migraines do connect with the optic nerves (related to vision), which is why auras are often visual.


Dark Rest:

When taking medication for the attack (prescription or over the counter), it is recommended to lie in a dark room. The point is not to necessarily sleep, but sleeping can be good as migraine attacks can often end in your sleep


Heat:

Migraines can also comes with neck pain, so a heating pad there may relieve tension and stress. Similarly, you can take a hot shower or bath (I’d recommend still in the dark or with minimal light like a candle or little lamp) to loosen muscles.




Sources:

My own experiences with migraines

















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