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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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Myofascial Release: A Massage Technique for Tissue Relaxation

Myofascial release is one of the new therapies I’m trying now. The three sessions I’ve had have been mentally and physically relaxing. A severe migraine dropped to a mild headache after Saturday’s session. The relief only lasted an hour, but what a wonderful hour it was. I went into today’s session with a severe migraine and left with a mild one. Nearly three hours later, the pain is hovering between mild and moderate.

Never heard of myofascial release? Neither had I until a reader mentioned it to me. It’s a massage technique that uses friction and sustained pressure to release fascia. Fascia is a connective tissue that envelopes or binds internal body structures to support, separate and protect them.

Normal fascia is relaxed and stretches and moves easily. Injury, tight muscles, hunched shoulders and slouching contribute to tightening fascia. Effects are cumulative, so repetitive motions or bad posture stiffen fascia more and more over time. The therapy seeks to release the fascia, returning it to a relaxed state.

It may seem strange to target connective tissue to treat headaches. Is there anyone who has headaches or migraines, but completely relaxed muscles? Tight muscles indicate that fascia is tight, too. (That’s my take on it at least.)

Whether my constantly tight neck, jaw and shoulders is a result of my migraines or a trigger of them (or both), they are still sore. The therapy won’t cure my headache disorder, but it may reduce the intensity of my headaches. At the very least, it soothes the pain in my shoulders and neck.

As with nearly every alternative or complementary therapy, myofascial release is often called quackery. Whatever. It feels good and helps me unwind more than other types of massage ever have.

Physical therapist John F. Barnes, a practitioner and educator of the technique, has an in-depth explanation of myofascial therapy and fascia. (I know nothing about him as a practitioner or his clinics, but the explanation fits with what I’ve learned from my massage therapist.)

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Health Care Providers Aren’t Mechanics & You Aren’t a Car

I can’t count the number of times someone has told me — or I have said — “I just want a doctor/naturopath/acupuncturist/whomever to fix me.” Unfortunately, health care providers aren’t mechanics and bodies aren’t machines.

I stopped letting myself think that they were a few years ago, but seeing an example on my own body always refreshes the lesson. As soon as the massage therapist I saw this morning finished working around my left shoulder blade and switched to the right, my left arm and hand started tingling.

She moved my left arm around and massaged different spots to see which ones intensified or reduced the tingling in my arm. The culprit was deep into my left armpit and chest.

The sensations I felt today weren’t all that unusual, nor would any health care provider be hard pressed to figure out what was happening (I hope!). Still, I was reminded of the complexity of each person’s body and that none of us are identical.

These differences aren’t all inherent in your body, either. There’s the structural wear and tear, but your chemistry and neurology also change over time. It’s impossible to determine all the factors that contribute to each person’s headache disorder or what triggers individual migraine or headache episodes.

Health care providers have to compare existing knowledge from research to what patients tell them and what the physical exam and test results show. Given the incomplete knowledge and how everyone’s body differs, it’s clear that there’s no easy fix.

If you don’t respond to the first treatment — or two or five — that you try, don’t despair. You aren’t a car, but health care provider can still piece together an effective treatment for you. Very, very few of us are truly treatment resistant.

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Therapeutic Caffeine Before a Massage

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.

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Don’t Give Up on Finding a Treatment

In the last week, four people have told me that while they are comforted to know that other people have similar experiences with headaches and migraines, they are saddened to learn that their headaches may never go away. This is distressing as one goal for this blog is to encourage people to keep seeking relief.

It’s not as impossible as it seems. While I haven’t found a magic bullet for myself, the vast majority do find a successful treatment. Even after you feel like you’ve tried every possible treatment, you have probably only scratched the surface. There are so many drugs and drug combinations that no one has tried them all (including Paula Kamen and me).

Most folks with headache define success as having their headaches disappear. Doctors have a different understanding. A treatment is successful if a person’s headaches are reduced in frequency and intensity by 50%.

Don’t get angry yet. Many people become headache-free, some don’t. No matter how much education and knowledge a health care provider has, they aren’t mechanics. Unlike a car, uniform results aren’t possible. The human brain and body are too complex to expect that.

But you can get relief. Be aggressive, but give new meds time to work — which may be as long as three months. See a headache specialist, not just a neurologist. If he or she is dismissive, tells you your headaches are all your fault, or that there’s nothing left to try, see a new headache specialist. Take supplements that have shown some success for headaches (under the supervision of a doctor).

Visit a sleep specialist, even if you feel like your sleep is fine (advice that I need to follow myself). Getting good sleep can go a long way toward easing headaches. Talk to a nutritionist. Not necessarily about an elimination diet, but about giving your body the fuel it needs. Try massage and essential
oils. Take yoga classes that don’t focus on sweating and breathing hard, but on taking care of your body and nurturing yourself.

You will get discouraged. You will be exhausted. You will be frustrated. Keep trying; wherever “there” is for you, you’ll make it.