Other than oversleeping (was dreaming I was at a Dave Matthews Band show) and not realizing I’d have to scrape snow off my car, the morning started out well. I was only a couple minutes late to yoga and was really looking forward to the class. The migraine didn’t appear until class began. As it grew steadily over five minutes, I knew I wouldn’t last. Nearly in tears, I packed up to leave. I asked my teacher for the hug I sorely needed, which helped a bit.
I was early enough in the migraine for caffeine to help, so I got a latte next door to the yoga studio and headed to my car. When the music started in the car, I had to turn it off — that almost never happens. I sat in silence, wondering if I could make it to Whole Foods. No, probably not. I went anyway.
I was in a daze, but the pain had lessened. Although it took five minutes to find my misplaced cart (I’m not exaggerating), I made it through the store OK. Cook’s Illustrated and Real Simple magazines were my only impulse purchases. (My impulse control is severely impaired when I’m shopping with a migraine. Does that happen to you?)
Now I’m on the couch. The active part of my day is over, but it isn’t all bad. Reading isn’t make my migraine worse, so I’m grateful for the magazines. I’ll get to listen to my current audiobook, On the Road. I have leftover cherry cobbler. I have a backlog of Ugly Betty episodes. It could be better, but I’m not unhappy.
[P]reliminary research indicates that people who take in large quantities of painkillers containing acetaminophen [Tylenol] and ingest large amounts of caffeinated beverages may be at increased risk for liver damage. Migraine medications that intentionally mix acetaminophen and caffeine are also suspected of increasing the risk of liver damage when taken in large quantities. This would include over the counter medications such as Excedrin and prescription medications such as Fioricet. The danger is similar to that of consuming alcohol and acetaminophen, which scientists have warned about for many years.
Knowing how effective acetaminophen and caffeine are for many people with headache, the research deserves consideration. I’m especially interested what role drinking caffeine (or eating caffeinated doughnuts) may play.
Caveat: This study used very high doses of both caffeine and acetaminophen. Still, the potential toxicity of acetaminophen — with or without caffeine — should not be overlooked. Overdoses of products containing acetaminophen account for 40 to 50% of all acute liver failure cases each year in the United States. If you ever take acetaminophen, please read Toxicity and Tylenol to understand the dangers.
As with all of my abortives, I use caffeine no more than twice a week. Less than once a month I indulge when I need energy or really want coffee and the only decaf available is chemically processed. I stretch these rules when I’m traveling or have something big going on. Like when my niece was here last week.
I’ve been testing my caffeine boundaries in the last couple months anyway. I noticed in May that it didn’t seem to be working as well as it used to (and neither was Advil, my other abortive of choice). Before I realized I had a headache disorder, I drank caffeine when I felt a headache coming on, thinking that I was staying on top of caffeine withdrawal. Hart maintains — and I’ve come to agree — that the caffeine aborted migraines, not treated caffeine withdrawal headaches.
So I haven’t been as strict with my rules in the last couple months. Then when my niece was here, I was even more lax with my caffeine intake. After she left, the old guidelines didn’t kick in. And last night I had a horrendous caffeine withdrawal headache.
I assumed it was a migraine, even though it felt different than migraines that have been plaguing my sleep for the last year. I tried to sleep it off, but felt worse each time I woke up — not characteristic of my migraines at all. At 12:45 this afternoon, I finally acknowledged that I had a caffeine headache and dragged myself out of bed to medicate.
90 minutes later, I’ve finished my cup of tea. It took the edge off, but the dramatic soothing that caffeine brings to a withdrawal headache was absent. Maybe it was a migraine all along. In any case, I have a post written and now I can go back to being like the man who has been hiccuping for 45 years:
In a normal world, deliberately drinking caffeine before a massage is illogical. Yet it was the only way I enjoyed the massage I treated myself to yesterday.
Without much time between yoga and the massage I had scheduled yesterday, I went to Whole Foods for Kerrie-safe tuna salad. Instead of the usual kind that mom makes (which has none of my triggers), they had a fancy cranberry one with tuna, canola oil mayo, cranberries and red onion.
Halfway through, a large almond sliver reared its ugly head. Hoping it was an anomaly, a look through the remaining salad revealed tiny bits of almond throughout. That’s when I realized that Whole Foods always has two tuna salads — the kind that mom makes and a delicious-sounding-but-forbidden cranberry and almond one.
Whether or not the unknown amount of almond I had eaten would have triggered a migraine, I couldn’t risk it. Thankfully I live in Seattle and could get iced tea at the coffeehouse next door to the spa. Dressed in a robe and slippers in the serene environment, I sure felt strange with caffeinated tea in my hand.
I didn’t get a migraine. I also didn’t exactly relax during the massage. Instead I enjoyed figuring out which muscles the massage therapist was working on and why. And contemplated a career as a massage therapist for people with headache disorders.
Welcome to Kerrie Smyres' writings about chronic migraine, headache disorders, chronic illness & depression. Here you'll find coping strategies, resources, news & more to help you live a fabulous life with chronic illness.