Migraine, a.k.a. The Amorphous Blob

One of my biggest frustrations in trying to live well with migraine is how impossible it is to predict how I will feel an hour in the future, let alone next weekend. Thank goodness my friends and family have been so understanding when each and every plan we make is accompanied by a rain check clause. Reschedule is pretty much my middle name at this point.

It's not only the unpredictability of my schedule that gets my goat; it’s also the unpredictability of my symptoms. Just when I’ve settled into a routine of jaw pain, eye socket burning, full-body muscle tightness, and think I know what to expect, migraine throws me a curve ball! Whammo! Here have some nausea and a little left-eye pain too, because you haven’t had that in a while! As evidenced by the Migraine Girl’s hilarious and spot-on “completely unofficial, made-up migraine types,” migraine can rear its ugly head wearing any number of unpleasant faces.

But despite its penchant for nasty surprises, I think there may just be a way to find the silver lining in the very nature of this shape-shifting beast. If migraine symptoms -- as well as their frequency and intensity – are subject to change, that means that whatever fresh hell we might be facing, it most certainly will not last forever. I cannot remind myself of this logic often enough. It supports my go-to adage, “this too shall pass,” and helps me get through pain that can sometimes feel utterly unsurvivable.

It also means, that over longer periods of time, our overall level of disability is subject to change… maybe (hopefully!) for the better.

This is not a groundbreaking revelation, I know. Pain specialists and champions of “brain plasticity” have been saying for a long time that neurological pain pathways can potentially change over time.¹ The problem with this scientific information, however, is that it can feel like a very distant truth when I am bedridden with only an ice pack, bottle of peppermint oil, and my tears to keep me company. However, direct evidence that I have gained through personal experience, for all its subjectivity, is sometimes easier to latch onto.

In addition to helping me through moments of intense pain, the realization that my condition is an evolving one has important implications for my treatment plan. While we don’t want to go changing the foundation of our treatment plans willy nilly (too many changes can make it hard to track the efficacy of any one strategy), it’s important to recognize that changing symptoms might respond to different tactics.

In other words, we need to find ways to be as cunning and flexible as the amorphous blob that is migraine disease.

For example: it used to be that any kind of aerobic exercise would send my brain into a flurry of pain so great, I would soon after dread moving a single muscle. Three years later, I’m finding that I can tolerate both aerobic and strength-building exercise for longer periods of time, and that I am reaping the benefits in terms of migraine prevention.

Likewise, early on in my chronic migraine days, medication overuse had made the pain completely unresponsive to both over-the-counter medicine and triptans. Now that I have learned to manage the pain more through lifestyle/behavioral adjustments, a sparsely used pain medication can actually make a significant dent in the pain.

Even my response to manual therapy can change from month to month. Sometimes I can benefit from a deep-tissue massage, and other times it sends me into spasms! Deep-tissue needles in my jaw used to do wonders, but lately they’ve been sparking additional pain and triggering attacks. Since I have observed and accepted these unpredictable changes, it has become easier to respond to them in kind. Instead of “What now!?” I ask, “Okay body, what do you need today?”

If your migraine disease is anything like the tricky-chameleon that mine is, I hope that you can find joy in outsmarting it by being flexible and trying new and old things as many times as it takes to find strategies that work.

And no matter how static or dynamic your migraine symptoms might be, I hope you never ever, ever, ever give up.

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