On migraines, medication and the upside of dark

I get migraines. Those of you who get them can skip this paragraph, the rest of you can read on for just a few more sentences. Migraines are a specific kind of headache that can be pretty debilitating. This isn't to say a tension headache isn't painful, but migraines can come with other sensory disturbances (this image reminds me of how the world looks during a bad headache), nausea, vomiting, etc. It can be pretty bad. There are certainly worse things, but on the whole, migraines suck. You can read what the Mayo Clinic has to say about them here.


I used to go through phases where I would get several migraines a week of varying intensity. I was generally able to work, but when I was in the midst of a bad headache I would be pretty much incapacitated - all I could do was lie in a dark room with a cold cloth on my face. If it happened when I was away from home I was pretty much screwed; I couldn't drive, I could sometimes barely walk. I was eventually referred to a neurologist who specialized in headaches and he changed my life. He put me on a medication called Topamax that decreased the frequency and intensity of my headaches; he also gave me an effective anti-migraine drug, Zomig, for use when I had a headache. I began to feel human again.


So why am I writing this, if I've been a migraineur for years and they are now largely under control? I've been thinking about the balancing act between medication and side-effects. It's tricky.


Let's start with Topamax. Before I started taking it I had multiple migraines of varying intensity every week. I could manage most with Excedrin, sunglasses and a baseball cap, but I looked like an idiot at work and warn't functioning well. Topamax meant that I stopped having so many headaches and most were minimal. But (there's always a but) Topamax has several potential side effects, one of which hit me hard. It can cause word loss. You know how every once in awhile you'll stumble while speaking and not come up with the right word? That happened to me all the time. And think about it. I'm a storyteller. Language is one of the loves of my life. This was a problem. Was it worth the trade off?


For awhile it was, the word gaps weren't so bad. Eventually though, I found I wasn't as sharp as I used to be, not as quick. So I began weaning myself down to a lower dose under guidelines from my neurologist. I'm now down to a low enough dose that I feel like myself again - I can make puns, I have a fuller vocabulary - but I'm getting more headaches. Is it worth it?


The easy answer is yes, all I have to do is a take a dose of Zomig. But it's not so easy. Zomig, if taken early enough, will stop the headache. But it often leaves me feeling cloudy for hours afterwards. Kind of like being hung-over but without the sticky mouth and headache. Is that worth it for no-headache?


I love being present in the world, aware of the colors, smells, sounds around me. But living with migraines and medication means I need to live in shadow sometimes. Bright lights, noises, fatigue, stuffiness, all of these can give me headaches. So a tendency towards migraines combined with a dislike of the medication side-effects has forced me to slow down, consider the shadows, look for beauty in the dim and, when I do take the meds and feel cloudy, accept that sometimes I need to move through the world as a different person. I'm trying to think of it as the judicious alternative to feeling slow and other-than-myself all the time. Another one of those unexpected gifts of the universe.


It's better than a kick in the head, anyway.


(c)2010 Laura S. Packer