The Migraine Sixth Sense
Hindsight is 20/20!
We know that abortive medications are always more effective if taken at the first sign of a migraine attack. Great. But how are we supposed to recognize those first signs? Prodrome symptoms can include a whole slew of wacky symptoms, including regular, everyday things like irritability and yawning. It can be really hard to decipher the difference between plain-old irritability, and migraine-induced irritability. To complicate things even further, if you have chronic migraine or comorbidities with similar symptoms, it can be even trickier to pinpoint a specific attack.
Lucky for me, I usually have some sense of normalcy in between attacks now, so I at least have a chance to pick migraine symptoms out of the crowd, but even then, I often find myself waiting until it’s too late. Once a migraine attack has really made itself known to me with some combination of nausea, head pain, and light/sound sensitivity, it’s easy to think back on the previous minutes or hours and attribute that strange feeling in my neck to prodrome, but when my time machine is on the fritz, what’s a girl to do!? By then the chemical chain of events in my brain is already in motion, and the medication will simply not be as effective.
My only moments of normalcy
Sometimes I am fairly certain that an attack is coming on, so, ever conscious of the dangers of medication overuse, I take a quick look at my planner to see how many triptans I’ve taken recently. Only one in the past week? Okay, time to pop another!
But wait, what’s that little voice in my head? Just wait a bit. Maybe this one won’t be so bad. Maybe it’ll go away on its own. Maybe some deep breathing, stretching, plus some food and water will do the trick. And like a fool, I believe this little voice for a while.
Maybe I believe it because I don’t want to take the drugs. Maybe I believe it because I want to have some control over my body in that moment. Maybe I believe it because my judgment is impaired by the impending attack. But unlike the mountain in the children's story The Little Train That Could, overcoming a migraine just by virtue of positive thinking HAS NEVER WORKED for me. I get really upset when other people suggest positive thinking and relaxation can have immediate super powers over a raging pain attack, so why on Earth would I believe this little voice?
The voice in my head
(Don’t worry. I cannot see dead people unless I’m at an open casket funeral).
It has taken me years to recognize this self-doubting pattern in the moment in order to change my behavior. Lately, when I find myself conscious of that little voice, I’ve been trying something radical and trusting my gut (literally) instead. A few things have given me the confidence to do this. The first was asking the question “have I ever been wrong about an oncoming migraine?” In early days, maybe, but after five years of dealing with multiple attacks per week, I am very rarely wrong. Another migraine-radar confidence boost happens in those times where I do medicate early. In the moments before the medication begins to work, the attack usually does ramp up a bit, and then the medication tones it down and I know I’ve made the right decision.
Developing a migraine sixth sense
Sometimes my sixth sense picks up on a general “off” feeling: maybe some light confusion and fatigue, but often it’s an all-pervasive, barely noticeable soreness or weight that fills my entire body, including my stomach. Sometimes I need to wait for at least a combination of two symptoms to feel absolutely sure that it is time to medicate and/or rest, but mostly I just know. This “sixth sense,” combined with trusting my instincts, allows me to treat attacks much more effectively.
Can you tell exactly when an attack is coming? Do you ever put off taking your medication in hopes that it won’t escalate?
When it comes to planning vacations or other events where travel is required, how much does migraine factor into your decision-making?