A day in the life
There is this public perception that when a migraine attack ends, life goes back to "normal." Few people outside the migraine community understand that even episodic migraine can impact us so that "normal" life is impossible. There are things we do or avoid doing every single day in the hopes of preventing even one attack. Here are some of the things I do every day, migraine or not.
Consistent sleep and wake time are essential to maintaining the homeostasis needed to minimize the risk of migraine attacks. It is also important to get enough sleep, but not too much. The migraine brain functions best in that mythical "Goldilocks Zone" -- not too much, not too little, but "just right".
I carry a big water bottle all the time. Dehydration is a common and preventable trigger. So I try to stay hydrated. But hydration isn't just about getting enough water. When it's really hot outside or I've been sweating, I alternate water with Gatorade or other electrolyte replacement drinks to keep everything in balance.
Coffee, tea, soft drinks, and even some medications contain caffeine. In small, regular quantities, caffeine is helpful to me. However, too much will definitely trigger an attack. Not everyone is like me though. Some people cannot tolerate any amount of caffeine. Headache doctors recommend limiting caffeine intake.
Maintaining good nutrition is challenging. Food cravings and lack of appetite are strong prodrome symptoms that are difficult to resist. One of the ways I do this is by preparing smoothies full of wholesome produce. When I can't tolerate the thought of eating solid food, these nutrition-packed drinks give me the vitamins and minerals I need. Most of my food triggers are not wholesome anyway, so stocking my refrigerator and cabinets with healthy options eliminates the need to watch for food triggers at home. The bigger challenge is eating frequently enough to avoid triggering an attack from low blood sugar. I carry wholesome snacks with me when away from home, too.
I use pill boxes, alarms, and other reminders to keep on schedule, making sure I don't miss doses. Like many of you, I take multiple medications 2-3 times every day. Putting off or skipping a dose is really not a good option. This is especially true with bedtime doses, which must be taken at roughly the same time each night to ensure that I maintain a consistent sleep schedule.
Not every pill is a prescription medicine. Some are supplements that were recommended by my doctor. They are just as essential to migraine attack resistance as any other treatment.
Whether it's sunglasses, a wide-brimmed hat, or my new FL-41 tinted bifocals, protecting my eyes from strain is important. Eye strain is one of my oldest and most potent triggers. I take care to look away from any bright or flashing light. Even with these precautions, I still get extreme light sensitivity as a prodrome symptom. If you ever stop by my house and all the lights are off, you know a migraine is on its way.
Even between attacks, my ears are extra-sensitive. It drives my family crazy to constantly hear me complain, "Turn that down!" I used to use silicone ear plugs to dampen noises. Then my husband purchased a pair of Bose noise-cancelling headphones. I borrow them whenever the noise of life gets too loud. They weren't cheap but I think I will have to get my own pair soon.
This has been the most difficult lifestyle adjustment. Even my most supportive loved ones have a hard time accepting this. That's because I've spent most of my life ignoring the need to pace myself. Now that I have become more accepting of my limits I take things a lot slower. If I can get one task completed each day, then the day has been success. When I say that I need to stop, it takes others by surprise.
Even though I don't have anxiety, I am still frequently on the lookout for potential triggers. Reading labels and recognizing all the hidden sources of triggers has become a way of life. The list of "can't dos" is long. Often perceived as negative, I really don't mean to be pessimistic. I get enough attacks that can't be prevented, so when a trigger is avoidable, I will do so. When others ask, I explain that these "off limits" foods, sensory inputs, and activities are like allergies. If exposed, I really will get sick.
What about you?
How does having migraine impact your life even on attack-free days?
Have you taken our Migraine In America Survey yet?