Learning to Live Exhausted
Last updated: October 2020
I have migraines. There, I said it. I don't like to talk about them very often because I feel like they are a bit of an excuse. I mean, don't get me wrong...I understand how my migraines affect me. My husband gets the pain and my need to fall into a dark hole whilst hiding from my kids and any source of noise or light or responsibility. The reason I don't like to talk about them is because other people don't get the experience of having a painful, mind and body numbing experience. I get tired of saying "well aaaccctttuuuallllllllllllllllyyy.....It’s a migraine, which is different from a headache and no, water won't make it stop, but thank you for trying to help. Please go away."
Over the years, I have learned to identify my triggers. Loud noises, stress, exercise, (life?), hormones, weather, etc. All the usual triggers. If I don’t get enough sleep, it’s also a trigger. One that was really starting to get to me was exhaustion. I tried to compensate, because I felt like it was one of the few triggers that I could control, but it never worked. I was so tired, even bending down to tie my shoes was too much effort some days. I would go to the gym and meander, thinking that it would help. I cut out caffeine, I added more caffeine, I took extra B complex, I slept later, and I tried getting up earlier. When my PCM told me it was probably my iron levels, I added iron. Who was I to argue? It sounded plausible (I'm 29). I gave it a month and nothing changed. When nothing changed, I thought maybe it was my migraines, so I went to my neurologist. He said it was depression and that it often went hand in hand with migraines. He explained that depression causes disruptions in the sleep cycle and causes the person to wake up frequently throughout the night. He wrote me a prescription for an antidepressant and sent me on my way. Another month went by and I was still exhausted. I still wasn't waking up going "wow! I slept really well!" A quick check of my Fitbit sleep cycle would tell anyone that I suck as sleeping.
I was frustrated. Not only because I was sleep deprived, but because I honestly felt like I wasn't being heard. If I told my doctor (PCM or Neuro) that I was tired, they would say "here, take this pill" and tell me to go home. Finally, I had enough. I made an appointment with my PCM because I wanted a complete blood work. There had to be a reason and my neuro wouldn't order a complete review of my blood. The day of my appointment, I mustered up the courage to really give my PCM a piece of my mind, doing a pep talk to myself while I waited for him. Then I waited, and waited, and waited some more. 15 minutes past my appointment time and my Doc walks in, apologizing for being late but that he was studying my records. He explained that because this was my third appointment for fatigue, he wanted to make sure that there weren't any anomalies in my chart that had been over looked. I felt the pep talk and my built up courage sliding away. I told him what my neurologist said about depression and my PCM explained that it could be the case, but he wanted to really make sure it wasn't anything else. He sent me home with a sleep study referral. I laughed as I told my family because I tease my husband about his sleep apnea and here I was with a referral for testing.
Fast forward 4 weeks and I have a fancy new CPAP sitting on my nightstand! When I was testing, the nurse asked if I grind my teeth at night. I laughed and told her that my husband and dentist mention it. She said that is a symptom of apnea, or rather, the body's attempt to wake me up. Funny how it only ever caused me pain. She also said that waking up frequently and for no reason is a symptom. Again, I laughed and told her that I do that too! Shocking that I had never been tested before. That night, I tested positive for Central Sleep Apnea, which from what I've read, means that the brain stops sending signals to the body to breathe. It’s typically associated with prior CPAP use, but this is my first time ever being on one. I am not sure how that ties to my migraines, but I plan to do research in the future. All I know is that I haven’t had a migraine since starting on my CPAP. I sleep soundly and so much deeper than I had in the previous months. I don’t wake up at night anymore and I feel refreshed in the morning. I still feel tired, but it’s the kind of tired that you experience after not sleeping for 12 months and then suddenly start sleeping again. I know that it will go away in time.
In the past year, has insurance made it difficult to get your migraine treatment?