Migraines

I listened to a show about migraines today.  It was a podcast of the Diane Rehm show. I thought I would write about the topic.

Imagine having a migraine and not even knowing the word ‘migraine’, so you have no earthly idea what it is. I first remember having these awful headaches when I was in high school – it would start with a dot of light, similar to what you see from a camera flash. This dot didn’t fade away, but instead it grew, and flickered, and got to where it looked like what you see when you rub your eyes. Eventually, my field of vision was completely blocked, except for a little bit of peripheral vision on the sides. Sometimes the patterns were geometric; other times like lightning or aurora borealis. This would go on for a while, maybe twenty or thirty minutes, before subsiding. I would then have an excruciating headache, and nausea. After I threw up, I would start to feel a little better.

Of course, in a class at a Jesuit high school in Manhattan was not an ideal place for all of this to be happening. I did not know what it was, and I did not have the vocabulary to describe it accurately to anyone else, including my parents.

Once I felt one coming on while I was sitting in the gym at school watching a lunchtime intramural basketball game. I had figured out that, sometimes, I could fight it off, if I could just get away from any light. All I could do at this point was to sit there with my hands blocking my eyes and my eyes closed.  I felt a tap on my shoulder, and looked up to see the headmaster, Father McDonald, looking at me, very concerned. He didn’t ask me if I was all right. He just said, “Son, go see the nurse”. I went to the nurse and described as best I could what was going on. She decided to send me home (thanks a lot – 45 minute commute) but called home first to let my mother know I was coming. Those were the days when moms were home to be called.

Well, having been sent to the nurse by Father McDonald and having been sent home from school changed the situation. This could no longer be ignored as some whining from a malingering kid. But it didn’t matter – we still didn’t know what this was.  I was taken to see an eye doctor, an ophthalmologist, thinking something might be wrong with my eyes. The exam revealed I had 20/10 vision. I really did, and it stayed that way for years. When I was in the Coast Guard, I often could make out objects that others could only see with binoculars. But, that meant I didn’t need glasses, and there was nothing wrong with my eyes. So, no treatment options presented themselves.  One time I recall I was driving (with a learner’s permit) on Dune Road on Long Island, which I loved to do, and I stopped the car and said I was getting one of my eye things and couldn’t drive any more. That was pretty drastic.

I don’t recall exactly when, but at some point I read about someone who was afflicted with migraines, and from the description, determined that was what I was having.

I continued to have migraines while I was in college, but less frequently. After I got out of college, I stopped having migraines at all, until one day in April 1996, when I stumbled while jogging, fell, dislocated and broke my shoulder, smashed my face into the pavement, broke a front tooth, cracked some ribs, etc. A couple of hours later, I had a migraine in the emergency room while awaiting treatment. The dislocated shoulder was excruciating, and I assume there is a connection between that and the migraine, although it could have been the morphine they gave me. I’ve had them maybe once every couple of years since then. One time I woke up in the morning with one, which seems exceptionally unfair.

However, the migraines that I get now, thankfully not often, are different. There’s no headache, and no nausea; just the aura. I feel out of sorts for a while after the aura goes away, and still shy away from bright light, but I’m otherwise fine.

From listening to the Diane Rehm show, I learned that migraines are thought to be a brain disorder of some kind, not fully understood. In prior years it was thought to be a vascular disorder, and the treatment was a medication to constrict the blood vessels, which worked for some people but not for many. If I catch it in time, Excedrin Migraine seems to help. There are still relatively few treatment options, but there are at least a few doctors around who make migraines a specialty.