I thought it might be interesting to make a blog post describing what my migraines are like for what is “typical” or as close to typical as it gets
More than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider.
Many factors can trigger migraine attacks, such as alteration of sleep-wake cycle; missing or delaying a meal; medications that cause a swelling of the blood vessels; daily or near daily use of medications designed for relieving headache attacks; bright lights, sunlight, fluorescent lights, TV and movie viewing; certain foods; and excessive noise. Stress and/or underlying depression are important trigger factors that can be diagnosed and treated adequately.
Migraine characteristics can include:
Pain typically on one side of the head
Pain has a pulsating or throbbing quality
Moderate to intense pain affecting daily activities
Nausea or vomiting
Sensitivity to light or sound Attacks last four to 72 hours, sometimes longer
Visual disturbances or aura
Exertion such as climbing stairs makes headache worse
Approximately one-fifth of migraine sufferers experience aura, the warning associated with migraine, prior to the headache pain. Visual disturbances such as wavy lines, dots or flashing lights and blind spots begin from twenty minutes to one hour before the actual onset of migraine. Some people will have tingling in their arm or face or difficulty speaking. Aura was once thought to be caused by constriction of small arteries supplying specific areas of the brain. Now we know that aura is due to transient changes in the activity of specific nerve cells.
The pain of migraine occurs when excited brain cells trigger the trigeminal nerve to release chemicals that irritate and cause swelling of blood vessels on the surface of the brain. These swollen blood vessels send pain signals to the brainstem, an area of the brain that processes pain information. The pain of migraine is a referred pain that is typically felt around the eye or temple area. Pain can also occur in the face, sinus, jaw or neck area. Once the attack is full-blown, many people will be sensitive to anything touching their head. Activities such as combing their hair or shaving may be painful or unpleasant.
Diagnosis of migraine headache is made by establishing the history of the migraine-related symptoms and other headache characteristics as well as a family history of similar headaches. By definition, the physical examination of a patient with migraine headache in between the attacks of migraine does not reveal any organic causes for the headaches.
Prodrome Stage
I often can tell you that a migraine is coming. It’s not because I’m “doom and gloom”. It usually begins with dropping things, some mild shaking or a sudden onset of mood/attitude change that is unwarranted I often affectionately call this “the drops” as does my mother (who also suffers from migraines). At this point I take precautions through extra water, some good nutrition snacks and meals and complete avoidance of caffeine, chocolate or my other triggers. (I have a wide variety of triggers which is a whole other post by itself). In my office if I don’t catch my “early signs” my co-workers will often indicate to me that my eyes are “half-open” when they know is a sign of a migraine.
Aura Stage
While I take precaution there are a number of things that follow. First, there is a chance that I will not get the pain or aura symptoms (yay!). Unfortunately more often than not I start to get my aura. For me an aura ranges. Most of the time it starts with a loss of words, confusion or inability to complete sentences or stuttering over words. I start to lose my balance – crashing into walls, catching my balance on the counters or sometimes in severe cases falling down. Finally, I begin to see “flashes” of light before my eyes. They obstruct my vision almost 80% causing me to see basic shapes or colors – but limiting my vision to the point where I cannot drive, read or focus. This is often the most terrifying in combination with the other symptoms makes me feel as if that is what a stroke would feel like.
Headache Stage
Pain wise – I begin to feel a painful burning sensation in my neck and behind my ears. It shoots pain up the back of my neck and usually is accompanied with a throbbing sensation. The pain is sometimes also located above my eyes, through my sinuses, or on the top of my head. Often times it hurts to move, sit, stand or even lay down. The pain begins to affect my entire body, causing me to shake, sweat, and my heart races from the pain level.
Postdrome Stage
After the pain of a migraine subsides, the episode is not entirely over. I usually have a period of 12-24 hours following that leaves me feeling lethargic, slower in my movements and unable to think as clearly as usual. We often refer to this as a migraine “hangover” since the feelings that come with migraines seem to just hang out with us. Most of the time my balance and speech issues start to subside at this point, but I have noticed that if the migraine is exceptionally painful that the symptoms seem to last longer.
After a migraine episode, I often wonder when the next one will happen again. Mild symptoms such as the balance and speech often happen without pain (2-3 times a week). They refer to these as “silent” migraines. While they often cause speculation about me, I have found that being open about my problems and willing to talk has helped other understand what I am going through instead of resorting to secondhand commentary or rumors. Mild pain migraines often happen 1-2 times a week – but the high pain migraines may only happen 5 times a month.
