As brain cells swell during a migraine, they become starved of oxygen, which may cause brain damage — at least in rats — according to a newly released study. This damage may help explain other findings that people with migraine have a higher risk of stroke. Here’s an excerpt of the article on brain damage and migraine:
“They studied a process called cortical spreading depression, known as CSD, a wave of changes in cells associated with migraine, stroke and head trauma.
“They used a precise two-photon microscopic and oxygen sensor microelectrodes to look at the brains of live mice while they caused this process.
“They saw a swelling occur and the brain cells became starved of oxygen. The nerve cells were damaged — specifically the dendrites, the long, thin spikes that stretch from one nerve cell to another.”
This highlights the importance of using preventives rather than just painkillers during a migraine. Not having a migraine at all prevents other symptoms and the potential for brain damage. In contrast, painkillers treat the pain, they don’t keep the migraine from wreaking havoc on the brain. I’m not sure where triptans fall on this scale, but certainly aborting a migraine is better than having one.
Some good may come from having migraine. A study released last week found that migraine sufferers show less cognitive decline and memory loss than those without migraine.
However, that good news is muddied by other studies showing that people with migraine suffer from brain changes and a risk of brain lesions. Not to mention another new study noted an increased risk of cardiovascular disease.
How much more will it take for people to see that migraine isn’t just about headaches?
I made a crucial mistake when I created a schedule for myself: I based it on what I should be able to do, not what I can do. It kills me to realize that.
As I made the schedule, I kept thinking how absurd it is that I could only spend six hours a day on work or household stuff. Truth is, I’m lucky if I can get three good hours in a day right now. As hard as I try, I’ll never silence my inner overachiever.
I faced some facts last night. I’m in a horrible migraine and headache spell that began on Christmas Eve. I don’t get to decide that four months is long enough and that the migraines should go away now. I expect too much of myself even when I feel terrible. I’m so tired that implementing any treatment that might provide relief takes more energy than I can spare.
There were good revelations too. I don’t think I’m depressed, just tired, sad and frustrated. Purging the stuff from our house makes me feel better emotionally, if not physically. I don’t have to do anything I don’t feel up to doing. I’m thankful that we don’t have kids or even a dog.
I had a great 45 minutes this morning when I saw that it was sunny, bounded out of bed, showered and started this post. That’s all the peppiness I could spare. At least I’ll make a lot of progress on the baby blanket I’m crocheting while I’m watching baseball. And the sun is still shining — after a Seattle winter, literally is almost as good as metaphorically.
Can a doctor who has a headache disorder understand — and treat — your illness better than one who doesn’t? Is shared experience necessary for empathy?
“How could I possibly understand or help her, she seemed to be asking, if I had not personally experienced her pain?
“Her question caught me by surprise and made me pause. O.K., I’ll admit it. I’m a cheerful guy who’s never really tasted clinical depression. But along the way I think I’ve successfully treated many severely depressed patients.
“Is shared experience really necessary for a physician to understand or treat a patient? I wonder. After all, who would argue that a cardiologist would be more competent if he had had his own heart attack, or an oncologist more effective if he had had a brush with cancer?
“Of course, a patient might feel more comfortable with a physician who has had personal experience with his medical illness, but that alone wouldn’t guarantee understanding, much less good treatment.”
I avoided a severe migraine from Thursday to Monday when I was in Phoenix for a wedding. I was extra careful to nap when I needed to (every afternoon!), use caffeine when necessary and take lots of Advil (it was for cramps, but I’m sure it settled my head down too). I’m convinced that the nap is the crucial part of the equation.
The routine was so successful that I have a renewed commitment to get on a schedule. My main goals are to rest, exercise daily, eat wholesome meals regularly, and not stay up too late mucking about on the computer. All of which should ease my migraines. Here’s the schedule I spent the last two hours making:
8:30 – 9:30: Wake up, shower, eat breakfast, 15-minute yoga practice or drive to class
9:30 – 11:00: Walk or yoga class
11:00 – 1:00: Errands and household chores
1:00 – 2:30: Lunch and work
2:30 – 4:00: Relax and nap
4:00 – 5:30: Work
5:30 – 6:30: Make dinner
6:30 – 10:00: Play — eat dinner, spend time with Hart, see friends and maybe some more work (computer off at 10!)
10:00 – 11:00: Get ready for bed, 30 minutes of relaxing yoga, read
I already see flaws. I’d like to spend four solid hours writing for the blog on Mondays. I often have lunch with my friend and yoga teacher after class on Thursdays. Afternoon rest periods usually last two hours. In fact, there’s no way I’ll make it to 2:30 before I need a nap today.
Rigid adherence to the schedule is counterproductive, but I hope to achieve some balance in my days. We’ll see how it goes.
I’m woefully behind on my e-mail and responding to comments. If I keep the migraines at bay, I hope to get back to you all this week.