Migraines

[dr_whom]

I get migraines occasionally. Not very often—probably on average two or three times a year for the past 15 years or so (though in the summer of 2005 it happened twice within three weeks of each other, not fun). They generally seem to happen in the late afternoon and evening on a weekend or vacation day, especially one on which my eating, sleeping, or caffeine-consumption schedule has been out of the ordinary, seemingly most often shortly after I've been under a lot of stress (but almost never while I'm stressed). But I didn't realize till a few years ago, when kepod suggested it, that migraines are what I've been having.

Migraines were always described to me as a kind of especially intense headache. And although my migraines do involve a headache (on only one side of the head, as advertised), it's not that intense, and it's definitely at most the third-most noticeable symptom. My migraines are principally characterized by fatigue and nausea, and the headache feels as if it's just a side effect of those. In fact, if I eventually actually throw up, the headache and fatigue go away too, which definitely makes it seem like the headache is caused by the nausea rather than vice versa. So the first few times, I thought what I had was just maybe food poisoning or something, and then for at least ten years thereafter I thought of it as "a stomach thing that happens to me sometimes, wait it out and it'll pass"—it definitely never occurred to me to connect it with what I'd heard about migraines.

After kepod suggested it was a migraine, I asked my doctor about it and she said if it was a migraine, ibuprofen would help; I should take it as soon as I realize that I'm having one. (I've gotten much better at catching them early—noticing in the afternoon that I'm unexpectedly tired and a little queasy and have a mild headache, before I start feeling really sick.) And it does! Ibuprofen makes the whole situation go away. And, well, ibuprofen is a painkiller; it doesn't treat nausea. (In fact, according to Wikipedia, ibuprofen can cause nausea.) So I guess this really does mean that it's the headache that's causing the nausea, rather than the other way around—it just seems really counterintuitive that that's the case.

(Also the last time I felt a migraine coming on I wasn't at home and didn't have any ibuprofen on me, but lowellboyslash had some Excedrin and that worked too. Except it turns out that two tablets of Excedrin contain more caffeine than I usually consume during an entire day, and I took them at 8pm. On the plus side of that, I got to see a beautiful sunrise.)

Comments

[inthelemonlight.livejournal.com]

Ooh, this is really interesting. (And also that last bit is the best.) I'm fascinated by how differently migraines can manifest; I knew a kid in elementary school whose migraines were pain-free but involved visual hallucinations.

I abruptly started getting migraines every few weeks halfway through my last year of high school. The worst one was in the spring, on the last night of the school's performance of Les Mis. I was one of two violists in the pit, and the pain was so bad that my parents had to take me home and I wasn't there for the last show at all. (I'd've felt much worse about this if the other violist hadn't been one of the music teachers...) Anyway, I talked to my doctor about it and we worked out that estrogen-based birth-control pills were not for me. Left those behind and have only had one migraine in the last ten years. (Later, my doctor and I tried progesterone instead, and that gave me mood-swings. Hormones are fun!)

[dr_whom]

I kind of wonder how the category of "migraine" became a natural class, given how many different ways they can appear.

[inthelemonlight.livejournal.com]

:D

[picklepikkl.livejournal.com]

Conclusion: hooray for kep!

[http://users.livejournal.com/little_e_/]

My husband swears that indigestion/some kind of digestive trouble gives him a headache. I suspect that at times either the food digesting is transforming into something not so great for you (that is, a mild food poisoning,) or the gut bacteria itself is putting out too many toxins (to put it crudely, bacteria poop, too, and our bodies have to flush that out, too.) So if things are out of whack in your digestion, I could see it releasing chemicals into your bloodstream that, in turn, make your head hurt, and throwing up, in turn, could improve matters.

[dr_whom]

See, that's what I thought for years was happening, but it turns out that painkillers relieve the nausea as well! Hence, migraine.

[tiamat360.livejournal.com]

yep, nausea is a common side-effect of migraine, along with auras. good on kep for catching that!

i get scintillating scotomas (acephalgic migraines), which are essentially the auras without the headache

[dr_whom]

"Acephalgic" is a great word. ("Scintillating scotoma" isn't bad either.)

Do you know how/why all of these different things fall in the same category of "migraine"?

[tiamat360.livejournal.com]

i believe the current understanding of migraine is that it is due to a phenomenon known as cortical spreading depression (basically a spreading area of decreased electrical signaling across the cortex), which in turn alters cerebral blood flow. the CSD causes the auras, while the changes to blood flow lead to the headaches. i'm not sure how the nausea fits in