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Stealth Attack

It sneaks up, so quiet that I don’t know it’s there. It bullies my body until I awaken, dizzy, nauseated and gasping in pain. My only choice is to go back to sleep, but it’s never a restful sleep. If I’m lucky, I’ll wake in the morning slightly out of sorts, but without much pain. More often, I have to sleep at least an extra two hours and the rest of my day will be mediocre at best.

These were my thoughts when I was awoken by a migraine for the fourth time in the last five nights. (Yes, I do mentally blog in the middle of the night!) This happened a few months ago too, but I’m not sure when it was or how many days the night migraines lasted.

If only I kept a headache diary I might see if there was a pattern. I get so sad when I can look back at the month and see just how bad the pain was. Without a diary, it’s easy to fool myself into thinking the pain wasn’t so bad.

While I insist my migraines aren’t linked to my menstrual cycle, I did start my period on Thursday night and have had a migraine every night since then except for Friday. Hmm…

I really like the headache journal on Migraine Survival. Maybe today’s the day to try charting them again.

Do you chart your headaches? Is it helpful for you or just frustrating?

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Your Headache Stories: From Erin

Erin, who blogs at Through the Eyes of a Migraine and has recently hinted that she’s pregnant, shares her story:

On October 31, 1994 I was getting ready to go out trick-or-treating when I started feeling something that I had never felt before. I was flushed, nauseous and I had the most severe headache I ever experienced. I couldn’t tolerate light, sound, or smells. Everything hurt. All I could do was lie down and be as still as possible.

That was supposed to be the last time I went out trick-or-treating (my mom said I was getting “too old” to do that). I never got to go out that evening.

Ever since that day, my life has revolved around my migraines. I’m 24 now and still learning to live with this beast that controls my life.

I used to get one a month – which correlated with my cycle – until age 16 when I was put on the birth control pill. At that point, they nearly stopped. Then for some reason at age 21, they came back with a vengeance.

I started getting them 1-2 times a month. A year and a half ago I developed severe, chronic insomnia. This exacerbated my migraines even more. I started getting 2-3 times a week. Then I got them every day.

I saw a neurologist. Then another. And a chiropractor. 6 medications, a blog and 18 months later, I think I’ve finally found something that helps. I’m on Effexor, a very effective sleep aid and still seeing a chiropractor regularly. I’m working with counselors and psychiatrists to work through the depression and anxiety that I’ve acquired as a result of all this. I still have horribly bad days. But now I also have wonderfully great days. I can go weeks at a time without as much as a dull ache in my head. I’m now living a life that I had lost all hope for.

Somehow through all of it, I managed to maintain my job even though I was taking sick time without pay. I was commuting at least an hour one-way. I was going to school and working an additional job a few nights a week. How did I do it? I have no idea. But I do know that I couldn’t do it without my wonderful husband to support me.

Erin, I wish you a wonderful pregnancy that reduces your headaches. You’re in my thoughts. I misinterpreted the hint. Erin is not pregnant, but is considering trying in the near future. She’s still in my thoughts, of course, and I hope that when she gets pregnant, her headaches will lessen!

You can read previous stories from readers at:

If you’d like to share your story with readers (or just with me), please e-mail me.

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Migraine and Estrogen Officially Linked

A review of 643 unique journal articles related to estrogen and migraine establishes that the two are indeed linked. My initial reaction to this was “duh,” but stating the fact so plainly helps legitimize further clinical research on the topic.

The article concludes:

Epidemiological, pathophysiological, and clinical evidence link estrogen to migraine headaches. Triptans appear to provide acute relief and also may be useful for headache prevention. Clear, focused, and evidence-based treatment algorithms are needed to support primary care physicians, neurologists, and gynecologists in the treatment of this common condition.

In possibly related news, a study published in an oral surgery journal states that “the affective component of pain my be enhanced during the low-estrogen phase of the menstrual cycle in healthy women.” That is, women are more sensitive to pain from oral surgery when their estrogen is low. Perhaps the link isn’t only migraine-specific, but pain in general.

There’s tons of information available if you want to learn more about estrogen or menstruation and migraine. I recommend ACHE’s women and migraine section and their related newsletter articles (look under headache sufferer subgroups, then under women), and the National Women’s Health Information Center’s migraine section.

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Misery and Maybe Menstrual Migraines

“I’m about to get out of the bathtub, but I’m not sure if I can stand up. If I can I’ll come pick you up. Let me call you back in a couple minutes.” That was my end of the conversation when Hart asked me to pick him up from work yesterday — which was the second day of a horrendous migraine. It was one of those weird moments where I watched myself from afar, thinking how strange those words were. “Normal” people don’t lie in empty bathtubs until they can stand up.

I did make the drive there and immediately relinquished the driver’s seat to Hart. Then came the fun part. I needed to get “feminine care products” (I HATE that phrase, but that’s another subject). I couldn’t send my sweet hubby out on his own to differentiate between an extra-super minuscule maxi pad with wings and an ultra extra-long light-day invisible maxi pad. That’s just too cruel.

In the Safeway aisle, I could barely stand up and my mind was obscured by migraine fog. I stared at the shelves, dumbfounded by the options. Each brand has it’s own name for each type, and each type has some distinguishing feature that does nothing to distinguish it from the rest. There are helpful pictures on the packages, except that every picture is identical. It would have been easier to buy a car in my impaired state than to pick out a package of pads.

Why am I regaling you with menstruation-related stories? Because we all have those can’t cope moments where headaches or migraines or the associate neurological weirdness is just too much. And because I have the sneaking suspicion that some of my migraines are linked with my cycle. My doctors and I have all concluded that the two don’t seem connected for me, and birth control pills have never reduced the frequency or intensity of my migraines, so I’m wary that this is a red herring. But my symptoms have been changing recently, and I would be overjoyed if hormonal birth control could keep some of the misery in check.

Researching this topic, I’ve learned an important distinction. A woman with menstrual migraines only has migraines during her period. If a woman has migraines during her period as well as at other times of the month, she has menstrually related migraine.

Some other important information I’ve found: Studies indicate that menstrual migraine is related to the drop in estrogen that occurs right before a woman starts her period. Diagnosis of menstrual migraine is based on a sufferer’s detailed headache diaries.

That’s all I can handle writing about right now. The fall 2005 issue of ACHE‘s newsletter is devoted to hormones and migraine, so I have a well of information to draw from. But it will have to wait until I’m up to sitting at my computer again.

For more information on menstruation, hormones and headaches, visit the National Menstrual Migraine Coalition‘s site or see the National Headache Foundation‘s hormone topic sheet. Or if you know someone who is a member of ACHE, ask to borrow the latest newsletter.