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Migraine Attack “Coulds, Shoulds & Woulds”

“All you have to do for the next few minutes is just be,” instructed the yoga teacher as we settled in for the end-of-class meditation. Instead of leading me into meditation, this guidance started me thinking, What would happen if I let myself just be during a migraine?

What if, instead of thinking about everything I should or could or would be doing, I allowed myself to be in the migraine. I don’t mean to wallow in the migraine or dwell on it, but let it be what I’m doing in that moment. If I were at dinner with friends or at a yoga class, I wouldn’t be thinking of my to-do list. Even though a migraine attack is unpleasant, unplanned, and unwanted, there’s no requirement that I stew and ruminate through it.

To be clear, I wouldn’t just be lying around, hanging out with the migraine. I could read or watch a movie, take a nap or talk with Hart — whatever I need to do to take care of myself. The point is to not think about what I’d be doing if I didn’t have the migraine, but accept that fact that I have it and make the best of it.

Much of the frustration during a migraine comes from obsessing about what I’d rather being doing. This fruitless churning doesn’t make the migraine stop sooner or take care of any chores, it just upsets me. Why not sidestep the frustration and aggravation by giving myself permission to just be?

This isn’t always practical or possible during a migraine, of course, but I can at least try it. Maybe the lack of fighting, the lack of stress will help the migraine pass more quickly and I can get back to my life a little bit sooner than if I’d obsessed over how much I was missing.

Since I drafted this post 18 months ago, I’ve put just being into practice. The transformation is amazing. Even when the symptoms are bad, attacks are way less stressful. Jon Kabat-Zinn advises, “You can’t stop the waves, but you can learn to surf.” I’m still wobbly, but I think I’ve learned to surf.

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Three Good Things Each Day

Listing three good things that happen in your life each day can boost your mood and increase your happiness in just a few weeks, according to research. They don’t have to be grand accomplishments; small things that make you smile are just as powerful.

When my migraines were at their absolute worst, life felt bleak. Despite my normal ability to see the good in even the smallest things, I couldn’t see anything good in my life. Experience had taught me that if I was going to succeed in finding relief, I’d need a better attitude. I was so sick, though, that it needed to be an easy, low-effort attitude adjustment. So I challenged myself to think of three good things that happened each day.

I can still picture myself in bed in the bedroom of our Boston apartment — a spot I could stay for days at a time, save for when I got up to go to the bathroom (I spent a lot of time daydreaming about how great a catheter would be) — mentally listing my three good things before I went to sleep each night. At first, they were miniscule: I enjoyed a podcast, my meds and water were in easy reach when I needed them, I survived another day. Then they got a little bigger: Hart and I laughed together, my new headache specialist was kind, I identified a trigger. In time, I no longer had to force myself to see the good, I was noticing it frequently.

Still, I continued with the practice. It had become a sort of meditation or, if I were into that sort of thing, a prayer. Consciously attending to the positive in life reinforced my ability to find good things no matter what was happening. Despite this, I eventually fell out of the habit. To get back into it, I issued a sort of challenge to Migraine.com readers to list their three good things on a forum thread each day of November.

Will you join us? Not necessarily on Migraine.com, but in listing your three good things each day, privately or publicly, written or mentally. It’s a simple technique that’s surprisingly powerful.

My three good things for today: 1. I wrote this blog post, 2. I ate pasta made from semolina flour without it triggering a migraine, 3. I appear to have gotten the smoke smell out of the microwave, so I may not have to replace it. What are your three good things today?

My Migraine.com article, “What are your three good things?,” explains some of the research and you can post your three things on the Three Good Things forum thread. A good, more general, summary of the practice and research is at Find Three Good Things Each Day.

 

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Migraine Documentary in the Works

Out of My Head migraine documentary Kickstarter“Out of My Head,” the documentary that the Migraine Project is producing, looks to be an excellent film detailing the intricacies of migraine in an engaging, thought-provoking way. The filmmakers, director Susanna Styron and producer Jacki Ochs, have interviewed top experts in the field and many people who have migraine. The trailer includes top-notch information and illustrative descriptions of symptoms. As professional filmmakers, Styron and Ochs are working on what looks to be a high-quality film.

Neither Styron or Ochs have migraine. You may be surprised that I find this encouraging. To me, it signals a deep commitment to telling the broad story of migraine and its impact, rather than only the story of one or two people. I also think it provides an advantage in creating a film that appeals to people without migraine, which improves the chances of raising awareness. That’s not to say they’re disconnected from the emotional landscape — they’re both motivated by their love of people with migraine, including Styron’s daughter.

“Out of My Head” promises to be an excellent film that reaches a wide audience — the filmmakers have a distribution plan that includes screenings at film festivals, educational institutions, medical schools, clinics, hospitals and patient/advocacy organizations. But it’s not quite ready.

The Migraine Project is doing a Kickstarter campaign to fund the work necessary to finish the film. As I type, they’re $13,224 away from their all-or-nothing goal of $92,000, which they must reach by 6 p.m. MST on . Please watch the trailer and read about Out of My Head on Kickstarter and consider making a donation if you’re able. It’s an impressive project spearheaded by experienced professionals that I believe will result in an excellent awareness-raising migraine documentary.

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Migraine Research Excitement (With Reservations)

“This is potentially a very big deal,” I wrote about the study linking seizures and migraine in the brain. To be absolutely clear: this study’s findings could also be nothing at all. In science, a single study doesn’t prove anything other than the topic might be worth further investigation. Whether or not this particular study turns out to be pivotal research remains to be seen.

What I’m excited about is all the different ways scientists are looking at migraine. Important discoveries are announced frequently. Researchers are making connections that further the understanding of what’s happening in the brains of people with migraine, which will ultimately lead to more effective treatment.

I’m excited to see the discoveries as scientists look at migraine in new ways, but migraine research is still woefully underfunded. Part of the reason this research linking seizures and migraine caught my attention is the possibility of migraine being linked to a disease that’s perceived as real and life-changing. Seizure disorders are still stigmatized, but at least people get that they’re a brain disorder. Wouldn’t it be great if more people understood that migraine is, too? Not just for patients facing the stigma in their everyday lives, but the influence it could have on how research funding is allocated.

Migraine knowledge is fuller than it was when I began writing about it almost10 years(!) ago. I’m still hopeful about the future, but we’re taking baby steps when we could be making strides.

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A First Visit to a Headache Specialist

It’s been 12 years since my first appointment with a headache specialist. Going with Hart when he saw a specialist for the first time a few weeks ago provided an interesting perspective.

Hart had a spike in his migraine frequency significant enough that we were both worried. (We figured out it’s due to an unrelated med change. He stopped the med and his migraine frequency has dropped. Phew!) Seeing my specialist seemed like overkill, but I didn’t want to mess around with unfamiliar providers who could be lacking current knowledge. As a compromise, he saw someone in my specialist’s practice. We have both been impressed with everyone we’ve encountered in the practice and this doc was no exception.

Noteworthy information:

  • Oral meds, even the dissolving ones, have to go through the stomach before reaching maximum efficacy. Nasal sprays or injections provide the fastest possible treatment.
  • Triptans are most effective when taken before the pain is moderate or severe. All the numerous headache specialists I’ve seen have told me to take triptans as soon as I know a migraine is coming, whether there is pain or not. I recently learned that some people only find them effective if they are taken once the head pain has began. This doc confirmed that when to take triptans is an open debate, but that for most patients he recommends as early as possible, head pain or not. He did say patients can test them at different times in the early migraine (while the pain is still mild) to see when the drug is most effective for them. (The question is whether or not you’re willing to risk a worse migraine now for the potential of less severe migraines in the future.)
  • The first preventives the doctor recommended were magnesium (400 mg) twice a day and riboflavin (400 mg) once a day. Amitriptyline was next if those don’t work. I expected the doctor to recommend amitriptyline, but was pleasantly surprised that he said to try magnesium and riboflavin first.

It was a straightforward appointment that went exactly how I expected a first-time visit to a headache specialist to go for someone without chronic migraine. I just wish more people got such care from the start of their migraine treatment.