Coping, Meds & Supplements, Treatment

Adjusting to Life WITHOUT Constant Migraine

I always imagined that if I found relief for my migraines, I’d be over the moon and ready to take on the world. Instead, I am cautious and disoriented. It is difficult to believe the magnesium will keep working — or even that my current good spell is the magnesium at all. I wake up each day having no idea if I will have a migraine or a headache and, if I do, what level of pain I will be in. Migraine has been entirely dependable and I’m a bit lost now that I can’t count on it to always be present.

When I awoke around 5 a.m. yesterday to a level 5 migraine, I felt not exactly relieved, but sort of comfortable. Like, after a week of the uncertainty of different head pain and unusually low migraine levels, I was in a familiar place again. Not that I was happy to be there, just that there’s comfort in a well-known situation.

But even that comfort wore off as I realized I didn’t know what to expect from the migraine. Will it worsen? What symptoms will I experience? Will pain be a major factor? These are not questions I typically ask, but I have felt so much better the last few days that I was acutely aware of every aspect of the migraine and concerned what it might mean. The most worrisome question plaguing me was: Am I back to the place where migraine is my default state?

Before I began the mindfulness for health course I took four years ago, I met with the instructor privately for biofeedback. She mentioned that she had just gotten good news on medical test results, but didn’t want to get swept up in thoughts about the results. She said she “didn’t want to be tied to that outcome.” I was puzzled by this and didn’t really understand what she meant. As I have become more familiar with the practice of mindfulness, I have revisited that conversation, never more so than the last week as I attempt to grasp magnesium’s effect on my migraines. The idea is that the teacher could celebrate that she’d gotten good news, but didn’t want to assume that the news would always be good in the future or that her happiness was dependent upon the news always being good.

Not being attached to the outcome relates to the Buddhist idea of impermanence — a concept that I was heavily invested in just last month when the migraines and depression were wearing on me. I kept telling myself that although it felt like the misery would never end, it would eventually lessen. I reminded myself that my migraines had been better as recently as November and that they would lessen again. Now I’m working with the flip side of impermanence. Just because magnesium is helping me now, it may not always help. The fact that my migraines have lessened significantly in the last nine days does not mean I am out of the woods forever.

A friend asked if I was floating around the house in bliss when my pain was at a level 2. Well, I was cooking and dancing and marveling at how little pain I was in, but I was doing so with great care. I don’t trust that I’m going to continue feeling this good. I’m still afraid I’m going to discover that this good spell is an unrelated fluke and the magnesium isn’t really helping at all.

Please don’t think I’m ungrateful or that I’m not thoroughly enjoying this respite. I am uncertain is all. I’ve learned to live with severely debilitating migraine. The possibility that it might no longer limit me so much is overwhelming and seems a but suspicious. I don’t want to get too excited for fear of being let down. Though I dread being wishy-washy, the phrase “cautiously optimistic” captures my attitude exactly.

Coping, Mental Health, Resources, Society, Treatment

Mini-Medical School from UCSF’s Osher Center for Integrative Medicine

University of California San Francisco faculty members and other experts discuss current issues in health and science. Presentations from the last five years are available online. Some of particular interest include:

Coping With Stress

Brain, Mind and Behavior

Complementary & Alternative Medicine

UCSF’s Osher Center for Integrative Medicine runs the mini-medical school program.

Chronic Migraine, Treatment

My Jaw’s Contribution to Migraine & Chronic Daily Headache Triggers

jaw triggers headaches migrainesEating itself often seems the trigger of migraine attacks, not the particular foods I eat (although certain foods are clearly problematic). I’ve explored blood sugar and thyroid angles with no success. Though I’ve had jaw pain forever, I never put the pieces together that jaw tension may be the problem. Fortunately my physical therapist figured it out.

As an outrageously stubborn Type A migraineur, my jaw is locked almost constantly. It has been sore to the touch for as long as I can remember. I’ve worn a mouth guard at night for more than 10 years and even had TMJ surgery* in 1997.

Physical therapy has yielded some key information: The PT’s work on my jaw provides far more immediate relief than when he focuses on my neck. My fascia is healthy, so muscles are the main variable. The tightest, most-difficult-to-relax spot on my neck is where the jaw muscles connect. Ideally, relaxing my jaw will also relieve some neck pain.

Jaw relaxation was a success at my first biofeedback session. Doing it on my own since then hasn’t been so productive. I relax as much as I can, but wish I had the visual feedback so I could know I’m training my muscles correctly.

Treatment plan:

  • Learn to relax my jaw and monitor the problematic spot on my neck in individual biofeedback sessions
  • Avoid crunchy or chewy foods (for a short time)
  • Cut all food into kid-sized pieces
  • Learn to chew up and down rather than in a circular motion
  • Continue to see my massage and physical therapists for jaw work
  • Use self-massage and acupressure to further treat muscles

A guide to jaw and face self-massage is one of my tools. The instructions are clear and graphics show where to focus each technique. The first page of Healing Self-Massage also teaches face and jaw massage. (Full-body self-massage is covered on the next page. I haven’t tried it, but it looks good for overall relaxation.)

This may be a major piece of the puzzle. I’m so confident I’m not even fretting it won’t help. There’s a lot of work before I find relief, but having a concrete and relatively easy-to-implement treatment plan will help. Maybe I’m setting myself up for a fall. At least it is a fall I feel good about.

*My jaw was better for two months before returning to its usual state. I’ve since learned that particular surgery borders on malpractice.

Coping, Treatment

Biofeedback Session: “Mindfulness-Based Wellness” & Electromyogram Biofeedback (Sans Hand Warming & Beeping)

I went to my first biofeedback appointment yesterday expecting to learn to warm my hands. I admit I was dubious, even though research supports the efficacy of temperature biofeedback for migraine and other headache disorders. Warming my hands? Is that really all it takes to get my mind off the pain? I was happy to learn my biofeedback provider uses a different type called electromyogram (EMG) or muscle biofeedback.

The Talking Stage
My story was first, then she detailed the nature of chronic pain, including recent studies showing the brain’s involvement in pain. She also gave an overview of mindfulness-based stress release, which her approach is based on. The main tenet is to be engaged in the moment without focusing on pain.

Hooking Up to the Machine
She hooked me up to the machine with electrodes on my jaw and neck, my problem areas. The monitor showed the levels of electricity, which indicates tension, in each area. A green line indicated a good relaxation level; the red line showed what to work on.

Learning to Release Muscle Tension
At first the readings for my jaw and neck were both above the green line and most spiked beyond red. Following the provider’s continuous instruction (given in a low, calming voice), I tried to consciously relax my muscles. She advised me to look at my brain as if it were the sky and the pain was just a passing cloud — the idea was to think of the big picture of my brain and my life, not just the small portion of it that is pain.

What’s Next
The session was interesting and I’m eager to learn more. Turns out the therapist is teaching an eight-week class on tools for mindful-based wellness, including meditation, gentle yoga, recommendations for incorporating techniques into your life, and a lot more. Signing up was a no-brainer! Course concepts are so similar to individual sessions that I’m going to start with the class. I will definitely have an individual class at the end of eight weeks so I can see what I learned and what I should work on

There are far too many components of this to cover in one post. Expect more on mindfulness-based wellness and biofeedback. If there’s an aspect you’d like me to cover, leave your thoughts here or on the online support group and forum. You can also contact me at kerrie [at] thedailyheadache [dot] com.

Mindfulness-Based Wellness and Stress Reduction Classes
Jon Kabat-Zinn developed the techniques that my biofeedback therapist and many others use. Hundreds of providers offer individual sessions or classes. Check the Center for Mindfulness in Medicine‘s website to find a provider in your area. One place even offers online classes.

Interested in the class I’m taking in Seattle? The spring session starts Thursday (yes, this Thursday!); the next course will be offered in the fall. Classes are held at Swedish First Hill. Call (206) 215-6966 for details or to register. Please introduce yourself to me if you take the class — we can get lunch and chat.

Chronic Migraine, Coping, Treatment

Biofeedback for Headaches & Migraines: Overruling My Personal Demons

Biofeedback is the most highly regarded non-drug treatment of headache disorders and migraine. The top results from Googling “biofeedback headache” are reputable mainstream organizations and publications. Research and anecdotal evidence back it up.

And yet I’ve never tried it. Yep, I’ve tried nearly every other treatment under the sun, including three surgeries, and never tried this simple, effective, noninvasive treatment. I’d like to say that in some visceral way I wasn’t “ready” for biofeedback. That’s a cop out.

The truth is that if it works, all these years of suffering will have been in vain. You see, when I was in high school, my doctor suggested to my parents that I try biofeedback. The simple version of the complicated story: the treatments were too expensive and insurance didn’t cover it.

With tears streaming down my face, I admitted to Hart last night I was afraid to try biofeedback because if it works, I will have wasted so much time. “Have the last 10 years been a waste?,” he asked. Of course not, but they have been terribly painful.

I have left a message to make my first biofeedback appointment. Before I called, I had to rationalize to myself not trying it. The best I’ve come up with: If I’d continued the trajectory I’d set, I’d be married to my work, climbing the ladder in a corporation that cares nothing about bettering the world. Please let me hold on to these exaggerations and wild assumptions. They’re the justification to keep from hating myself.

I haven’t had a single biofeedback session and yet am trying to let go of what might have been if I’d tried 15 years ago. As usual, I’m ahead of myself. Now I need to breathe — and gather more information. What are your experiences with biofeedback? Please leave a comment on this post or on the forum thread, Biofeedback — Have you tried it? Did it work for you?.