Pain & Surprises.
From 1984 until about 2003 I would have a 54-hour migraine every 7-8 weeks.
I just lived with them, even though the intensity of the headaches would send the average non-migraineur to their doctor to demand an MRI. I tried hard to ignore them for what are probably the usual reasons. I never missed work on account of them; and it's not like they were violent cluster headaches, so why should I complain. My mother had been using Imitrex injection for several years, which changed her life, but no... no... mine just 'aren't that bad'.
I did nothing about my headaches until a boyfriend had to pull over on the Snelling Avenue exit off of I94 eastbound in St. Paul, Minnesota so I could lean out of the car and hurl my guts onto the icy February street.
That's when I went to a neurologist and started the Imitrex.
That worked pretty well, so I continued to use it. It wasn't perfect. I have a fast metabolism, so would burn through each dose in about 7 hours. It took 3 to get me through the average attack. Then there were the pharmacists who would treat me like a junkie. Finally I told one of them, "Look. There is nothing 'fun' about this drug. When "you" get a headache, you take aspirin or ibuprofen, right? Well when *I* get a headache, it's a needle stick in the thigh that makes me feel like I have road-rash on my hands and scalp. For an effect that feels... A LOT LIKE ASPIRIN." He still didn't get it. It was an injectible drug, so it must be something heavy. Whatever.
I moved to a larger urban area in 1998, where my doctor referred me to a famous local headache clinic. By then I wasn't thinking so hard about my situation, I just went. I really trusted that referring doctor.
They had me fill out a huge questionnaire, did an EEG, sent me out for an MRI to rule out anything pernicious (ignorance is not bliss, after all), and sent me off with a large manila envelope of instructions.
On the bus on the way home, I pulled out those instructions, and read that what was certainly a major contributing factor, was pretty much any fermented food. Any food I loved. Not only was I flabbergasted -- I had just drunk a large jar of icy- cold pickle juice, after eating the last Claussen the night before. I couldn't believe it. I was "so" sure the recommendation to change my diet was total nonsense, that I decided to slavishly adhere to their recommendations until the next headache. Then 8 weeks later when I spiked the next migraine, I could tell them how insane they were. So eight weeks become twelve, and still no headache. The next one I had hit after a summer hike when I became overheated. Um. Well. I guess that was a little embarrassing.
The headache clinic did also give me a prescription. I've used a few drugs over the years, the current best for me being Treximet. I'm not draconian about the special diet, but I am very, very careful about how much hard cheese, pickled stuff, salami, leftovers that have been in the fridge for awhile, etc. I consume. Overheating remains a trigger; caffeine headaches are a clear trigger. I do still get migraines, and when I do they still last 54 hours and are still terrible. What changed is that they don't happen anywhere near as often.
I used to see my headache doc once a year, but I haven't been since my precise doctor left practice last summer. If he's reading this he knows who he is (he laughed most satisfactorily at the pickle juice story), so I'd give him a big thank you for the manila envelope whose strange contents so drastically, and almost immediately improved my quality of life.
Which are you most sensitive to?