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Why I’m Doing Better, Part 1: Climate & Medication

After my recent glowing posts, many people have inquired why I’m feeling better. I’d like to give you a clear, definitive answer, but migraine is never that simple. There are a number of factors, from climate and medication to exercise, meditation and forgiving myself for being sick. I’ll talk about the first two today and the others, which have probably had a greater impact on my health and suffering than medication, later this week.

Climate
Moving to Phoenix, away from the clouds and rain of Seattle and the ever-changing weather of Boston, has had the biggest influence on my migraine frequency, duration and severity. Storms and clouds have been rolling through Phoenix the last week and I’m on migraine day six. Though migraines aren’t always present when there’s weather, particularly if I’m on vacation, the correlation holds about 90% of the time. I wonder if the issue is barometric pressure changes, though Seattle’s barometric pressure is relatively steady, so parts of my hypothesis fail there.

Indomethacin
I began taking this nonsteroidal anti-inflammatory drug in June because the sand-in-my-eye symptom pointed to the slight possibility that I had an abnormal presentation of hemicrania continua. This rare headache disorder is completely responsive to indomethacin. Though my headache pain lessened, it did not cease, which means my diagnosis is still migraine. My doctor kept me on a daily dose of 225 mg of the medication, though he warned that it is not recommended for long-term use as it is hard on the stomach. I’m sticking with it for now because it is the only medication on which I’ve noticed a decrease in the frequency and severity of my migraines.

Discontinuing Wellbutrin and Lamictal
In 2005, I was prescribed Cymbalta, Wellbutrin and Lamictal for depression. I stayed on them far longer than I intended, especially considering that I was still majorly depressed while taking them. I finally went off of them this summer after determining that my dizziness, tremor, hot flashes, fatigue, cold hands and feet, mental fogginess, nausea, and increased pulse were not migraine symptoms, but medication side effects. I believe Wellbutrin was the culprit, but I wanted to stay off all three if I could. When my depression symptoms returned, I went back on Cymbalta. I’m happy to say that the depression is at bay and I’m not experiencing any other side effects.

Namenda
I’m in love with this medication, which is an Alzheimer’s treatment that is used off-label for migraine. I don’t know if it has had an effect on the migraine severity or duration, but it has cleared the mental blah that has plagued me as the migraines worsened. I credit Namenda with returning the mental wherewithal necessary for me to resume blogging and restoring my sense of intelligence. The feeling dumb aspect of migraine, which is not addressed frequently enough, has been one of my most limiting symptoms and has caused the greatest loss of my sense of identity and purpose. Did I mention that I love this drug?

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Sleuthing the Connection Between Migraine Episodes and Weather

WeatherSpark is a super-easy way to investigate the role weather plays in triggering your migraine episodes. Using current and historical data from a variety of national and international sources, WeatherSpark creates clear, detailed graphs based on the weather conditions you choose. Options include amount of sunshine, amount of cloud cover, precipitation type and amount, pressure, humidity, and more. For any of these factors, you can get data from specific days, months or years, or an average over multiple years. And, my favorite feature, three locations can be compared simultaneously.

Words are inadequate to describe the awesomeness of WeatherSpark. Get thee to the site and check out the beautiful graphs for yourself!


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Cloudy Weather & Rain a Migraine Trigger

Clouds equal migraines for me, it’s that simple. In my six years in Seattle, I refused to recognize that I felt better when I was visiting Phoenix or vacationing at a sunny destination, always thinking it was because I took medication while traveling or forced myself to do more than I did at home. Moving to Boston in 2009, where the weather changes regularly, and keeping a headache diary forced me to admit the connection between clouds and the severity of my migraines.

In the 14 months I lived in Boston, a “good day” meant I had between one and three hours of feeling well enough to be off the couch. On average, I got this respite twice a month. In the “good” time, I’d go to the farmers’ market, get groceries or, occasionally, treat myself to a trip to the arboretum. Sometimes I’d do housework with glee (cleaning and pleasure had, until last year, been mutually exclusive). Rarely was I able to make a doctor’s appointment on my own. Hart would have to leave work to take me. Running errands was an epic accomplishment. Hell, shaving my legs was nearly as exciting as a night on the town (an impossibility for at least five years.) Except for the five Dave Matthews Band and six Phish shows, which I absolutely refuse to miss because they are so restorative, I had no life.

The best news I’ve had in 10 years is that I’ve finally found an effective treatment. Hart and I are moving to Phoenix. To all of you whose migraines are triggered by weather, I’m sorry to say that my remedy is so extreme. He and I are fortunate to have grown up there. Our friends and family are there. Our roots are there.

Wait, I should say they are here. I’ve effectively moved, living at my mom’s house for the last three weeks. Hart will visit in a couple weeks, then join me at the end of January. To make this move happen, Hart will be leaving his dream job. He’ll stay with the same company, but his role won’t be the same. While we’d both rather this not be the case, the prospect of getting a life (and his wife!) back far outweighs the cost.

My solution is nowhere near perfect. I’m far from migraine-free in Phoenix and the background headache is ever-present. Even with the sky a brilliant blue, I still have a migraine every day. But each migraine is a distinct episode. That is, they end. Whereas I’m used to one migraine running into another, happy when I have even an hour-long break, the ones I have in Phoenix often only last six hours. Sometimes a Midrin, a naproxen and a nap will reduce the duration to two hours. I leave the house nearly every day.

Yes, that’s right, I leave the house nearly every day. I’m not exaggerating to say it feels like a miracle.

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Sunny Weather = Fewer Migraines? The Everlasting Hunt for Triggers

Seattle from Kerry ParkYummy food, Rock Band, neighborhood walks, warm weather. Mild chronic daily headache levels and nothing more than moderate migraine symptoms. That’s what the last four days have been like for me. I’ve been so happy.

Is the convergence a coincidence? The good mood and beautiful weather certainly go together; the mild pain and weather do, too. On the big question, if mild pain and great weather are related, I have no answer.

Most people with migraine — I don’t know about other headache disorders — will tell you that weather is definitely a trigger. Researchers and headache specialists agree. Unfortunately, data are sparse and self-reports of headache pain and weather connections are inherently flawed. According to a Mayo Clinic neurologist,

Several studies suggest that weather changes trigger migraine headaches in some individuals. Study results indicate that some people who have migraines appear to be more sensitive to weather changes, such as changes in weather patterns, temperature, absolute humidity and barometric pressure. The mechanism by which these factors may trigger migraines in these individuals isn’t known.

There’s no clear evidence of a link between weather changes and other types of headaches.

Changes in weather patterns, temperature, absolute humidity and barometric pressure are potential triggers. Anyone with migraine is prone to a migraine episode from any change in weather? A little vague, isn’t it.

This is no different than saying I’m more likely to trip on a curb when the sun is shining than when it isn’t. Finding a reason should be easy. Some possibilities: I spend more time on sidewalks when the weather is nice. I’m looking around and not paying attention. Or the shoes I wear when it isn’t raining don’t fit as well as my winter shoes. Or the sun is so bright I can’t see the step. Or there are so many people in the crosswalk I can’t see where I’m going. Or the coffee I had made me shaky.

You get the point. Isolating variables in everyday life is impossible. Maybe two or three parts of my tripping scenario are to blame. Could be just one or something altogether different. I could trip on a Tuesday and again on Saturday. Unlikely that they will have the same cause.

I understand all this rationally, but still want to know what’s triggering my migraines! I’m second guessing every possible angle. Funny that when my chronic daily headache or migraine is bad I search for a reason. And when they are good, I search for a reason. Sounds like someone has control issues.

I cannot change the weather and I haven’t had any luck in tracking its relation to my head. Even if I could know when the weather would trigger a migraine, I don’t know if I’d want to. I don’t care if I can predict a migraine two days in advance. I can’t change it and I’ll spend the interim anxious it will hit any moment.

Have you found a strong correlation between weather and your migraines or headaches? Is it useful information to have? Answer on the online support group and forum or leave a comment below.

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Frequent Migraines + Cold, Dreary Weather = Hibernation

I’ve had intermittent bouts of inexplicable sadness since I returned to Seattle after Christmas. Always worried I’m going to slip into a clinical depression, Hart and I watch closely for warning signs. How I’ve felt just doesn’t fit the profile, but I’m rarely sad without reason unless I’m depressed.

Could being cooped up in my house with migraine after migraine, and not seeing or talking to friends and family have something to do with the so-called inexplicable sadness? Hmm.

I’ve hidden from the cold, windy, rainy weather that’s descended upon Seattle. It seems colder and wetter than usual, but maybe I’m revising history. My scalp hurts when rain, even the slightest drizzle, hits it. Wind or extra-chilly air increase my head pain.

Yesterday was warm and sunny (that’s Seattle-speak for 50 degrees with a light wind, a sun-shaped glow behind the clouds and a few visible blue patches in the sky). My head wasn’t any better than it had been, but I was in such a great mood. I walked a couple miles, did some grocery shopping, went to two appointments and had dinner at one of my favorite restaurants. That’s more than I did in any week in January!

I went into hibernation without even realizing it. Eventually sitting in front of the cozy fire became oppressive — the opposite of the comforting home it usually is. In the name of keeping warm and not exacerbating my head pain, I withdrew from the many activities that make my life good. I thought I was taking care of myself, but was making things worse.

I emerged into the world yesterday and it was glorious. The weather won’t hold, of course, but I hope the glimpse of sun will keep my new perspective in place.