The Migraine Brain

by Bernstein, Carolyn; McArdle, Elaine

  —Gemini, 11

  It’s very important for you to talk to your children about migraine. It affects them in ways you may not realize. Even if you bravely soldier through a migraine attack, your children are bound to know you aren’t acting like yourself. If you’re throwing up or moaning in pain, they may be frightened, worried, even believe you’re going to die. They may have to deal with feelings of disappointment when you can’t help them with homework or tuck them into bed. They may feel like your illness is the most important thing in your life—more important than they are.

  Give your children a chance to express their feelings about your migraines. You may be very surprised at what you hear. They may be angry at you. They may wonder why their mommy is sick when other mommies aren’t. Listen patiently and let them know you aren’t angry at them for having these feelings.

  At a level appropriate for their age, get them involved in your wellness, if they are interested. It may help them feel empowered and is also a wonderful lesson in facing illness and life’s other challenges. Suggest practical things to do that will help you feel better: “Please play quietly. Please answer the phone for mommy. Please get me a glass of ginger ale.” You can also play a brainstorming game with them when you’re well: “What will we do if you need a ride to a friend’s house and I’m in bed with a migraine?”

  The most important thing is to reassure them that when you get a migraine, you always get better. On the next page are some talking points for your child, which may be all he or she needs.

  Your children may ask you whether they will get migraines, too. Give them information appropriate for their age. If they are young, tell them children almost never get this kind of sickness but that if they do, you are an expert and you know how to help them. If they are older, tell them it’s possible they’ll get migraines since it’s an illness that tends to run in families. But reassure them not to worry because there are many new treatments for migraine that are really effective.

  Stay alert to the possibility of migraine in your child. I recommend telling your children’s pediatrician that you suffer from migraines and that you want to be vigilant about the possibility of your child inheriting them. Review Chapter 1 about abdominal migraines, which appear in children as young as one year of age. If your child gets stomachaches that can’t be explained, talk to your pediatrician about that possibility.

  Your daughter may begin having migraines when she starts menstruating. If she gets terrible headaches and cramps around her period each month, don’t assume it’s PMS. Talk to her pediatrician to get an accurate diagnosis and discuss treatment options.

  Here’s something you may want to read to your young children to help them understand your migraines:

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  Your Mommy’s Migraines

  Sometimes Mommy gets headaches that make her feel bad. Don’t worry. Mommy is a little bit sick but after I rest, I always feel better. Mommy is fine and I will be happy again very soon. You can help Mommy feel better if you play quietly and let me take a nap.

  When Mommy wakes up, I may not want to go outside to the park or ride bikes today. But that’s okay. Maybe we can read a story together or have a juice break. When Mommy feels well again, ask me to explain to you about my headaches. It’s okay to ask me any question you want. I want to hear what you think. And remember, Mommy always gets better. These headaches always go away, and we can have fun together again.

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  The Problem With “Soldiering On”

  “When I was growing up, my mother was a single mom because my dad died when I was three. She suffered from migraines a lot, but she never said to me, ‘I’m sorry, I can’t do that, I don’t feel well.’ I don’t have a memory of her being sick. She didn’t go to bed. It’s not that the shades were closed in our house or anything like that. We had a woman living with us as a tenant for while who got chronic migraines, and when she got one, life stopped. She was in bed with the shades drawn. But my mom, whether she just couldn’t afford to do that or it was her personality, she just pushed through it. I think it was just sheer Yankee will.”

  —Maggie, 45, financial consultant

  On the flip side of missing events because you’re sick is something that’s really common: powering on through a migraine no matter how bad you feel.

  “I think women tend to ‘soldier on’ through migraines—sort of half in the world and half concentrating on trying not to vomit from the pain. I can’t tell you how many times I woke up with a migraine but went ahead and showered and went to work, how many hours I spent behind the wheel of a car, how many times I winced through the grocery store under the horrible fluorescent lights, how many suppers I cooked, how many times I got up to care for my daughter in the night…all while having a migraine. I just felt like I had to. Who would do it if I didn’t?”

  —Maddy, 41, home-schooling mom

  Unless you are really fortunate, there are probably going to be times when circumstances prevent you from going to bed to recover from a migraine. Instead you have to fight through it and keep going. If you feel a migraine coming on during a particularly inconvenient time, give yourself a Migraine Break: Take five minutes to use your abortive meds or other abortive treatments right away, such as deep breathing. If that doesn’t work, take your rescue meds so you’re not in excruciating pain. Tell your family or co-workers what’s wrong with you. Even if you can’t go home to sleep it off, you don’t have to be Super-woman at that moment.

  How to Make Your Home Migraine-Free

  It’s your right to stay as migraine-free as possible. Make your home a migraine-free zone. This isn’t about being finicky or self-indulgent. You have an illness, and your goal is to get sick as infrequently as possible. Everyone in the family should be on board with that, since it benefits them, too.

  There are two prongs to making your home a healthy one for you. First, make it a pleasant place, as comfortable and relaxing as possible. If possible, make it a sanctuary where you can rest, meditate, do yoga, and use other relaxation techniques, a place where you feel happy, comfortable, and safe. If you have a formal dining room that’s rarely used, perhaps this can double as your relaxation room where you set up a space to meditate. Or get rid of the formal dining room entirely. Decorate your home in a comfortable, soothing way. Give yourself permission to have a space that you love and keeps you healthy.

  Get Rid of Your Personal Migraine Triggers

  Also get rid of any migraine triggers in your home—scented laundry detergent, dusty air, the smell of candles or air fresheners, fluorescent lights. Don’t use air conditioning if it triggers your migraines—some people can’t stand the smell or the recycled quality of the air. Try ceiling fans. For others, air conditioning is essential, since getting over-heated can trigger their migraines. Refer back to Chapter 4 on triggers and review your personal trigger list.

  Here are some practical things to consider as you maximize your migraine wellness:

  Home Office—Make sure your home office is ergonomically correct, with your computer work station set up to minimize eye and muscle strain. This includes a good ergonomic chair, your keyboard and monitor in the correct positions, a glare-free computer screen. Fluorescent lights, especially the energy-saving kind with the curly shape, may be migraine triggers in some people because they flicker, so make sure your lighting source isn’t making you sick.

  Bedroom—This is probably the most important room in the house for keeping your migraines at bay. Make sure you have a high-quality mattress. If dust is a problem, cover your mattress and pillows with dust-and mite-free covers. Add room-darkening shades; make sure any night-light is very dim. Dim your alarm clock or turn it to the wall so you can’t see it. Get shades for skylights. Replace venetian blinds with pull shades. Install noise-filtering windows (which are expensive), sleep with earplugs, or use a white-noise machine. Or move to another room that’s quieter. Don’t watch TV at night, as this disrupts good sleep.

  Cleaning Hous
e and Other Chores—Since strong odors are a serious problem for many migraineurs, use fragrance-free cleaning products whenever possible. Open the windows when you are using cleaning products so you inhale as little as possible (ammonia is a particular problem). If smells really bother you, go to the hardware store and buy a face mask to filter them while you clean. Use fragrance-free laundry detergent. Keep your home as dust-free as possible. The Swiffer is a wonderful tool for this.

  Bathroom—If smells bother you, use fragrance-free soaps, shampoos, conditioners, and other health care products. Don’t use perfume. If you get a gift of perfume, politely accept it and then later give it away. If the gift is from someone who will understand, explain that you can’t use perfumes.

  Floors—As carpets retain odors and dust, you may feel much better with hardwood floors or other noncarpeted floors.

  Kitchen—Keep the kitchen stocked with healthy foods, snacks, and water. Don’t have foods that trigger your migraines in your home, or at least make sure everyone in your family knows you can’t eat them.

  Lighting—Get rid of any lighting that triggers your migraines. It just isn’t worth it. Put dimmers on your lights (you can do it yourself if you’re handy, or have an electrician come in). Avoid fluorescent lights of all sorts; their flickering, even when subtle, may trigger migraines.

  What You Wear—Most migraineurs hate constricting clothes, and this is especially true for hats, headbands, or anything worn on the head. (I’ve never seen a patient come into the Women’s Headache Center sporting a tight ponytail.) If you need to wear a hat or headband, make it loose enough not to trigger or aggravate a migraine. For listening to music on your iPod or other portable music player, use ear buds instead of headphones. Many migraineurs find they get cold or over-heated very quickly. If you have this trouble, dressing in layers will help. Migraineurs often have cold hands—get a good pair of lined gloves, or use those small handwarmers that skiers use, which you crack open to release the warmth. For outdoor activities, you can use fragrance-free bug spray and sunscreen.

  Visitors—What do you do when someone comes into your home doused in strong perfume or aftershave? This is a sensitive issue, of course, and you should handle it gently. If someone’s fragrance is really making you sick, tell the visitor that you’re very sorry, but you’re “allergic” to perfumes (this isn’t technically accurate, of course, but sometimes its easier for others to understand) or be truthful and explain that perfume triggers terrible migraines for you. Ask them if they would mind if you sat outdoors. Or, if you know them well enough and it’s making you sick enough, you can ask if they’d mind washing off the perfume. You’re not being rude. You’re trying to avoid ending up with a pounding head.

  No Smoking—Asking people not to smoke in your home shouldn’t be a problem, since most smokers today are aware that smoking is unwelcome (as well as being illegal in many public places). Just tell the visitor that your home is smoking-free.

  Migraine Home Emergency Plan

  When your family is really counting on you, it’s awful to get a bad migraine. You’re genuinely sick, but they need you. What can you do?

  Since migraines can appear at any time, plan ahead with a “family emergency plan” that lets you focus on getting better while making sure your family is taken care of.

  Have food in the freezer so you’re never forced to make a frantic rush to the market while you’re sick. There are many healthy frozen dinners available now.

  Teach your kids to make simple meals for themselves, such as peanut butter sandwiches, turkey sandwiches, or a bowl of cereal.

  Have a neighbor or friend on standby to drive your kids to school or games if you are really sick.

  If You Have Small Children…

  “I was a single mom when my son was little, and when I got a migraine, there was no one to help out. So we’d play the Mountain Game. I would lie in bed with the lights out, and I’d bend my knees, and he’d climb on my knees. It was the best I could do. I’d try not to cry out if he accidentally kicked me in the face or head. And sometimes I’d have to bolt out of bed to go throw up.”

  —Fiona, 49, writer

  Moms with small children need a special emergency plan. You can’t just close the door and take a nap or soak in the tub with soothing bath oil if you have preschoolers running around. What are you going to do if a migraine strikes suddenly?

  Have a baby-sitter or neighbor as your migraine standby caretaker in case you absolutely must lie down in a dark room. Let them know you get migraines, and tell them you may need them in a pinch. Make a deal: You’ll baby-sit your friends kids when she needs you, in exchange for an emergency on-call status for times that you get a migraine.

  If possible, have a fellow migraineur as your emergency backup, someone who truly gets what you’re going through, so you won’t have to explain why your “headache” has rendered you incapable of driving the kids to baseball or to school.

  If you can’t get someone to take the kids:

  Have a bag of emergency toys hidden away—something new your child has never seen, which is more likely to distract him or her while you rest.

  Even if you’re against your child watching TV, this is the time to drop your standards. A Baby Einstein or other educational video won’t hurt your child, and being out of commission for a day is worse for both of you.

  What Do I Do If…

  I’m hosting my uncle’s fiftieth birthday party for seventy-five people, and I just know I’ll get a migraine. I always do when I’m stressed out. What do I do?

  Remember, you have a right to put your health first. You don’t have to suffer a migraine just because you don’t want to let other people down. If you’re going to get really sick, ask yourself whether it’s worth having the party at your house. Maybe someone else can host it. You can spend a little more to have it catered or held at a restaurant.

  To minimize your stress, think practically. Ask for help so you’re not doing it all by yourself. Delegate tasks. Hire a helper to serve the food or set it up, or hire someone to clean up afterward, so you can go sleep when the party is over.

  If you use medication, make sure you have your prescription filled and take your abortive meds as soon as you feel an attack on its way. Keep your other triggers at a minimum so you don’t end up with a “perfect storm” migraine—if red wine is a problem for you, this is not the time to have a glass.

  Sex and Migraines

  A young woman came in to see me but had a very hard time talking about her migraines. She could describe the pain easily, but when I asked when she got migraines, she averted her eyes. Finally, very embarrassed, she managed to say that she got migraines whenever she masturbated. I matter-of-factly explained that there was nothing wrong with her; she had orgasm migraines, which weren’t dangerous, and there were medicines she could take to prevent them. She was tremendously relieved.

  For some people, orgasm is a trigger for a migraine attack. It does-n’t happen to a large percentage of migraineurs but it’s common enough. These “orgasm migraines” can be frightening and are, at the very least, really unpleasant and inconvenient. A healthy sex life is good for your physical and mental health, so this kind of migraine is upsetting. The first time it happens, you may be worried that you’re having an aneurysm or a stroke. For the most part, orgasm migraines aren’t dangerous. However, you must tell your doctor, especially if you’ve never had one before. You need to have a medical exam to make sure there is nothing more seriously wrong.

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  Orgasm migraine doesn’t mean you are neurotic or don’t want to have a relationship with your partner. It’s a physiological response to sexual excitement, and there are medicines that can treat it.

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  The patients who come in to see me specifically about orgasm migraines almost always have a difficult time discussing it, but they have no reason to be embarrassed. They don’t occur because of the kind of sex you are having or something new that you tried. T
hey’re the result of physiological changes during sex, including chemical changes in the brain and increased blood pressure, although we’re not certain of the precise mechanism, and it’s a difficult thing to study, as you can imagine.

  If you get a migraine every time you have an orgasm, you naturally may find yourself avoiding sex. Because a happy sex life is a very important, wonderful part of being human, avoiding sex isn’t an optimal choice and will negatively affect your well-being and relationship with your partner.

  Fortunately, there are excellent ways to prevent orgasm migraines. The medicines you can take right before you have sex, include anti-inflammatories. If you have an active sex life and you get orgasm migraines frequently, you may want to consider taking a daily preventive medicine. See Ch. 9.

  Explain your headaches to your partner. Reassure him or her that it’s no ones fault you get them—it’s your body’s physiological reaction to sexual excitation. Reassure your partner that it’s not because you don’t want to be together or are avoiding sex.