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Trying Ritalin for Migraine Prevention… and Loving It

Wait-and-see-if-it-goes-away is my method of dealing with house problems. Not because I want to see if a minor issue will develop into a major problem, but calling someone and meeting with a service person is an exhausting proposition when you have a migraine all the time. So yesterday when Hart told me the shower was backing up, he was astonished when I immediately asked if I needed to call a plumber. That’s just not how we do things around here.

Until now. Now my mind is clear(er), I have more energy, and my migraine pain is improving. Today is my fifth day on Ritalin (methylphenidate). My headache specialist suggested it after a number of patients reported a decrease in their headaches and migraine attacks after starting it for ADD or ADHD. Though I’m taking it primarily as a migraine preventive, the fact that it is a stimulant definitely adds to its appeal — the fatigue has been more debilitating than the migraine pain since I started cyproheptadine. The reprieve from my mental fog was entirely unexpected, but so, so welcome. Carrying on an intelligent conversation and following complex tasks without trouble is blissful.

Oddly, the frequency of the migraine attacks is still the same — of the five days I’ve been on Ritalin, I’ve had migraine attacks on four of them, including today. A couple times I wasn’t even sure I had a migraine. The pain was only at a level 3, but I was having trouble staying awake, which indicates a migraine attack for me. I was able to “sleep off” the worst of those attacks with hour-long naps. The overall throbbing pain I’m so accustomed to has diminished, so the pain is mostly localized and stabbing, but mild.

This is a strange and exciting new world and I’m loving it!

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Showing Others What a Migraine Attack is Really Like

Migraine Awareness Month Blogging Challenge #26: “From the Outside Looking In” — Write about what you think your family, friends and others think a day in life, a day with migraine disease is like.

This is the perfect time for me to reflect on what my life with migraine looks like to others. I’ve just returned from a long weekend in Minnesota, where Hart and I traveled for a wedding and to visit dear friends and family—many of his college friends, his sister, our closest friends from Seattle and my best friend from college. I spent much of the weekend in bed, though I made it out most evenings and managed to see everyone except my best friend from college. What was unique about this trip is that I was stuck in bed even though the pain never got above a level 6.

(Background: The longer people have known me, the less I have let them see how disabled I am. Counterintuitive, I know, but it has only been in the last three years that I’ve really let people see how sick I am. And by “people,” I mean everyone, including Hart. Including myself. There are many reasons for this, but two rise to the top of the list. First, I deluded myself into thinking I wasn’t as sick as I am by hiding from myself how debilitating the migraine attacks are. It was as if admitting how sick I was would somehow make it harder to improve my health. That if I couldn’t push through the attacks as I did for so many years, then something was really wrong with me. Also, I was ashamed of being sick and couldn’t shake the feeling that I was faking it. If being sick was a mindset, as I have so often been told, wasn’t my inability to get better a sign of weakness? Besides, how could a headache make me feel faint, weak and dizzy and make my knees buckle?)

I think most people I know understand that I am in terrible pain during most migraine attacks. I have been much more open about that aspect of the migraines in recent years and even began sharing my pain ratings. They also recognize the burden of nausea, because it is a relatable symptom, and photophobia, because I always wear TheraSpecs migraine glasses. [disclosure: I’m the co-owner of TheraSpecs]

I’m not so up-front about the less tangible autonomic symptoms—they are more difficult to describe and, even now, I’m still skeptical of their validity. Thursday night I was at the science museum with friends when my knees began to buckle and I thought, “Come on. Is this migraine really so bad that I can’t even stand up?” Yes. The answer is YES. Even I, a so-called patient advocate and the one experiencing the symptoms, could hardly believe it.

My college friend and I were scheduled to spend Friday together. It took me 30 minutes to gather enough strength to get out of bed. As soon as I did, my knees began buckling. I literally could not stand up. We rescheduled for Saturday. I awoke Saturday completely exhausted and nauseated, so I rescheduled for Sunday. Sunday I was so weak that I couldn’t even get out of bed. So I didn’t get to see my friend at all. The guilt is tremendous, especially because I still feel like I’m making up for being too sick to fly to go to her wedding three years ago. Also because I find it difficult to believe that the non-pain symptoms of migraine can be so bad that they keep me bedridden.

I’ve been struggling with this the last few months, actually. Even though I intellectually know better, I still tend to think of pain as the primary component of migraine. Since the pain has let up some since starting magnesium and, more recently, beginning to take Amerge at bedtime to reduce the severity of my middle-of-the-night migraine attacks, the autonomic symptoms have been more prominent. I assume they’ve always been present to the same degree, but pain overshadowed them. I can hardly grasp the impact of these symptoms myself—there’s no way I can expect my friends and family to understand them.

To answer the question, my friends and family probably think a day in the life with migraine is full of pull-your-hair-out pain, gut-wrenching nausea and recoiling from light. Some days are like that, though I’ve had far fewer of those in the last six months than the previous 10 years. Other days I physically feel like I have the flu and spend the day reading. Since I adore reading and migraine kept me from doing it for four years, those days aren’t too bad. Cancelling plans is particularly frustrating, though, because I think I should feel well enough to go out if I’m not in horrendous pain. (Should. Now that’s a word I’d like to strike from my vocabulary.)

These are just descriptions of my migraine days. There are similarities among migraineurs, but we’re all different. What are your migraine days like? Do your friends, family and coworkers see them as they really are or do you put on your game face?

National Migraine Awareness Month is initiated by the National Headache Foundation. The Blogger’s Challenge is initiated by Fighting Headache Disorders.

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Maybe Migraine Isn’t Always to Blame: Adventures in Hyperthyroidism

Since last summer, I’ve lost 15 pounds, eaten anything I’ve wanted without gaining weight, had night sweats, and have been even more intolerant to heat than usual. Nausea went from a rare problem to occasionally more debilitating than the head pain. It has barely abated in the last week.

As symptoms I assumed were migraine (nausea, nearly blacking out, fatigue) and depression (anxiety, restlessness, fatigue) added up, I had to wonder if something else was going on. Suspicious that my endocrine or metabolic systems were the culprit, yesterday I finally had the second follow-up appointment for the lump found on my thyroid in 2006.

With his wild gray curls, enormous smile and a Jerry Garcia tie, the endocrinologist won me over immediately. He listened to me carefully, felt my thyroid and sent me to the lab. In his words, had he been a betting man he’d put money on hyperthyroidism. Two vials of my blood will be tested for thyroid dysfunction and a host of metabolic disorders, including diabetes. The results should be available today or tomorrow.

I have to admit that I have my fingers crossed. I was about to write “I never thought I could be so happy being told I probably have hyperthyroidism.” Truth is, I’m thrilled every time there’s a clue something relatively easy to manage could be exacerbating my migraines.

I’m trying to control the nausea as much as possible as I wait for the news. Antiemetics have stopped the vomiting and I can keep down saltines and ginger ale. I’ve even managed some chicken soup. (Don’t worry, I’ll call my doctor if this continues.)

Baseball season started this week and I’m digging Netflix on demand, so I’m fairly well entertained. Sadly, working on the computer is still making me feel worse, so I’m not blogging, reading news, visiting the online support group and forum, or answering e-mail. In fact, 30 minutes on my computer is taking a toll.

I wrote this Wednesday morning and felt too sick to post it. Last night I drugged myself up and was able to eat real food. I feel better now than I have all week; I’d better get off the computer before I make myself sick again!

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Hiding Out With Bad Migraines

The last couple weeks have been so bad that I haven’t even updated my Twitter with my headache/migraine status. I’ve had some great swings — particularly after a massage — but they’ve only lasted a short time.

An irritating symptom right now is that I don’t get tired, but completely worn out, which then triggers the rest of the migraine cycle. With diversions like writing posts for when I’m gone in September, sleuthing for cat messes and packing for vacation, I have plenty of opportunities for exhaustion.

I apologize for whining. My bursts of energy ensure that I’m seeing a bright side and I’ve kept myself from being not not happy. But I’m still worn down from the cycle and am ready for it to pass.

I’m sorry if you’ve e-mailed me and I haven’t gotten back to you. You’re on my mind, but I just can’t get to it.

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My Niece, My Caregiver

My niece and I are having a terrific week, but, as predicted, I’m worn out and getting a migraine each afternoon. Instead of letting me push through, my niece has reminded me each day that I need to rest. She’s subtle about it, making it seem like she’s an excessively tired 12-year-old. (She’s not.)

I’m getting more tired as the week wears on — and she sees it. Yesterday she actually told me to lie down. This morning I told her I was too tired for the aquarium and she intuited that I wouldn’t be up for it tomorrow either. If she hadn’t, I would have said that we could probably go tomorrow even though I’m not sure we could.

Even with my afternoon naps, we’re having tons of fun. We’ve been out to eat four times already and are getting fondue tomorrow night. Doughnuts have been traded for cupcakes, the chocolate cafe and homemade cinnamon rolls. Not sure if we’ll make it to The Simpsons, but we have seen Harry Potter. We have movies to watch at home too. She’s not too into video games, so we’ve played board games (which Hart and I love) instead. We even made soap yesterday.

It’s a relief to write out all our activities. My niece isn’t acting bored, but I worried she was. Now that I’ve seen the list, I see she’s probably worn out too!