A question of debilitating migraines

The most frequent type of migraine I get is sometimes preceded by a unshiftable headache starting about a day before and/or hyperactivity. More frequently, on the day before the onset of the migraine proper, the main symptoms are thirst and significantly decreased urinary output. Then as the migraine starts, I get visual disturbances, usually a bright, multi-coloured zigzag arc that starts as a dot and increases in size. It is restricted to one side of the visual field. That can last up to fifteen minutes. Once it fades, the headache starts.

I am then useless for about day or two. Well, more useless. During the visual disturbances, I can't read or cope with bright lights. Fortunately they don't last all that long. But the headache is bloody awful and there's nowt to do except take it easy.

When I'd get the bad kind in my teens, I'd get the visual symptoms first--like pressing the heel of your hand against your eye until you see yellow patterns, only in a jagged line across your vision. Then I'd feel nauseated, and the headache would start. Like having spikes driven behind my eyes. Couldn't stand light at all. Hurt to even move my head--rolling over in bed was excruciating. Nothing seemed to help as far as aspirin or Tylenol--I'd just have to wait it out. For hours. They'd sideline anything for me--there'd be nothing I could do but lie in a darkened room and try not to move. Or throw up.

For me, there were triggers. Eye strain, pre-menstrual bloating, caffeine. The migraines largely went away after I got glasses at the age of 15.

A few years ago, I started getting the non-headache version, with the same triggers. First day of period (usually), too much caffeine, eyestrain. Now, I don't get the debilitating headache or nausea, but do get the visual symptoms, and my eyes stay sensitive for a day or two after. The visual symptoms pass in about half an hour or so--I lie down until it's over if I can. Don't interfere with much, although I had one recently in the morning, it went away, and then came back after I ran with my running group. I was able to drive home cautiously,but was ready to pull over if the streaks in my vision interfered with my driving.

Hope that helps.

I can't really do much when I have a bad migraine. At work I'd just have to struggle through, which made lectures a bit of a chore for both me and the students. Otoh, staff meetings were a lot shorter because I'd have that 'I'm not going to put up with your shit' look on my face. (If only I could manage that all the time!)

I think if I had to make a complex and rapid decision, I'd be able to do it. My reason for saying that is* the urgency and focus would overcome the pain. But depending on the nature of the situation, the visual disturbances might have an impact.

That's me, of course. I'm not known for my exciting life. If I read a story in which a bad migraine left someone befuddled and/or slow to react, I'd totally buy it.

*probably wishful thinking

I've had a few of what they call silent migraines - painless, but with auras and balance issues. Had one once while I was driving andhad to pull over and call for a pick up because I had patches of vision blockage, and couldn't make sense of what I was seeing. (Plus there was the vomiting.)

I've had the painful ones twice - just enough to know that they're not like a headache, a bad headache or a thumping bloody headache. They're like a different species.

People tried to convince me that I had migraines, because I had visual disturbances that included jagged, colored lines across my field of vision, but I have learned that those are caused by glaucoma (Intraocular pressure) and are treatable as glaucoma. Some people claim that the eye pain/ headaches from glaucoma are the most intense pains that people have.

http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/symptoms/con-20024042

Gah. I certainly never tried to do anything in that state. If the house were on fire, or someone threatening my kid? Damn right I'd do my best to fight through it. I think what would drive me is the thought that it's just pain--unlikely to kill me on its own. But if there's a villain, he/she is probably going to win.

King Neptune said:

People tried to convince me that I had migraines, because I had visual disturbances that included jagged, colored lines across my field of vision, but I have learned that those are caused by glaucoma (Intraocular pressure) and are treatable as glaucoma. Some people claim that the eye pain/ headaches from glaucoma are the most intense pains that people have.

http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/symptoms/con-20024042

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Eek. I hope you've got that sorted.

Helix said:

Eek. I hope you've got that sorted.

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Yes, and I hope that you also do, if pressure is causing the migraines, and it is one of the most common causes of migraines.

I used to have menstrual migraines. Nausea accompanied the headache. It was unusual in that tylenol worked for me. But if I didn't take it soon enough I would be in bed all day with pain and nausea.

If I woke up with the headache, that almost always meant it was too late to abort it.

King Neptune said:

Yes, and I hope that you also do, if pressure is causing the migraines, and it is one of the most common causes of migraines.

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Eye checks are free here and I get them regularly. I don't have glaucoma, I get migraines.

http://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/dxc-20202434

I get migraines somewhat predictably as a "let down" after adrenaline (meeting a deadline, making a presentation). The pain is so intense that usually I throw up. I actually hope to throw up, because that shifts some chemical balance enough that I can drift to sleep, and in decades, I have never gotten through a migraine without "sleeping it off." My relative gets migraines so painful that he presses and punches his own forehead, hard enough to bruise, to briefly redirect his nervous system to another source of pain. You ask, if you *had* to do something, could you? If Freddy Krueger were ten feet from me, probably I would react, but the pain is so bad, I can't fathom an answer. That said--no migraine today, and no worries. Best wishes as you write.

I can see why trepanning was popular in the past. Sometimes it feels that the only solution is to cut out a piece of skull to relieve the pressure.

I have some food triggers. For some reason if I eat too much sweet potato, for one. I've gotten a bad one after drinking an aged red wine.


The red wine was at a New Year's dinner with family. I ended up having to go to bed.


One of the sweet potato times it was at a resort in Maine. They served handmade sweet potato chips that were delicious. I ate a *bunch*! And then I was laid up for about two days. It was awful and I missed out on a lot.


I get nausea and pain, no visual disturbances. If Voldmort was coming for me I could move or whatever but I'd be throwing up a lot. Squinting, crying, and probably biting off the heads of anyone trying to interact with me.

I think Tami Hoag's FBI investigator in Night Sins has debilitating migraines for which she gives herself injections.

I've had a variety of migraine types all my life (with or without headache). The longest headache lasted 6 weeks and felt as if a large cat had bitten into the top of my skull and were dragging me through the days. I could feel that headache in my sleep.

As a child, I felt that my head was breaking open, but just to the point of cracking the bones. I recall mostly a profound longing for the splitting to finish and release the pain, and endless seconds flowing on and on. Movement added a burning quality to the pain.

As an adult, my hands, feet, and face get ice cold before any headache starts--warming my circulation can help, or even derail the cycle. I get sensitivity to light and sound...the pain from light is pervasive (and makes it hard to drive, because impulse to close my eyes), but the staccato of even ordinary environmental noises or talking is excruciating. Like a nail driving into my temple.

I can function, but in a very slow-motion, economical kind of way. I can think and mark time, but prefer not to. When the dogs see me lie down on the floor at intervals while I'm supposed to be efficiently feeding them, they're pretty good about waiting me out.

If I'm at work or some other non-optional thing, I usually get an earworm on a loop...phrase from an annoying song, etc.. That hurts after a while as well.

Migraines. I gets them.

When I was in school (read: high stress) I got them regularly, every 2 weeks or so. I also have migraines start under certain light conditions, usually related to flickering lights. My physics lab room had lights that triggered migraines. Every week for an entire semester. No other clearly identifiable triggers, but sometimes light from computer monitors will do it too. I had to get work to switch out monitors three times before I found a brand that didn't cause them.

My migraines tend to last a LOOOOOONG time. Wiki says 3-5 hours, but mine last 6 hours to 5 days. That physics lab induced killer migraines that lasted 3-5 days each, and I had them every week. I had 3.5 months of more migraine days than non-migraine. I woke up crying from pain in the middle of the night a few times. Doc called them "suicide headaches" and dude, seriously, it was close. If you'd told me drilling a hole in my head to release the demons would have helped, it wouldn't have taken much to convince me.

I get aura as well. Mine usually start with what I call "visual disturbance". That scene from the Bale Batman movie where he takes the blue lotus and things kinda visually shake... that. Light gets those drug-induced tracers after them. Strange floaty things in my vision, my peripheral vision blank spots expand and I get a kind of tunnel vision, or sharp-sided blurry areas that move or stay still like the picture of the field in this link; driving is terrifying. I've also had aura with no other symptoms, which is creepy as all hell. I hear a pop, then an amoeba-like shape forms mid-vision (the shape has a thick outline that is coloured red, yellow, green, blue, and has sharp geometric shapes like frost on a window), and grows until it gets past my peripheral vision; then I sleep, and it's done; 45 minutes from appearance to nap, usually a couple hours nap.

I get pressure at the base of my skull. I usually wear a stretchy headband with an ice pack back there, which helps with that pressure. This precedes the pain, and sometimes things stop at pressure.

Nausea comes with all of this. And sometimes verbal issues. I remember trying to read my kid a bedtime story when he was like 6... I was saying all the right words, but they came out in the wrong order. Completely jumbled. I had to put my finger under the word and focus closely on each and read it individually. I couldn't read a sentence or it would garble. Guess how fun it was trying to study with that going on.

They started coming regularly when I was in my early 30s but mostly started just after puberty, peaked in school (late 30s), and I had a few doozies up until last summer (next paragraph for that). They still have the nausea, visual disturbance, verbal confusion, and light/sound sensitivity but they tend to be only the pressure in my head than pain, and they last only a day or two. I mostly manage them. I've just kinda learned to live with it. Mostly because the meds that I used in Canada and that I know work aren't covered by my insurance (okay, seriously, fuck this "you can't have those perfectly good meds that you know work unless you pay some ridiculous inflated rate because it's not covered by your insurance company" shit). If they every get bad enough again, I'll just pay the $200 a pill.

Also, in the years I smoked weed regularly, like 17 to about 30, they were rare and mild. Then I had a kid, and started being a grown up... last summer I got a medical weed permit and they're back to being rare and mild.

mccardey said:

I've had a few of what they call silent migraines - painless, but with auras and balance issues. Had one once while I was driving andhad to pull over and call for a pick up because I had patches of vision blockage, and couldn't make sense of what I was seeing. (Plus there was the vomiting.)

I've had the painful ones twice - just enough to know that they're not like a headache, a bad headache or a thumping bloody headache. They're like a different species.

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I've had similar experiences. I occasionally get a silent migraine. The trigger seems to be spending a day out in bright sunlight along with being hungry and dehydrated, though it's not frequent or reliable enough to know what other factors might influence it. I'd get these bright light patterns out of the corner of one eye or other other--like diamond chains of light or flashes, and dark patches in my visual field and a sort of compressed feeling, as if my skull were being squeezed, but no nothing more than a mild headache and no nausea (I'd always take 2 ibuprofen and a Benadryl and drink a lot of water when this happened, which might have helped keep the headache pain down). The visual symptoms would usually last 15-20 min, and I'd be pretty useless at that time. Couldn't see well enough to work at a computer or read or drive (fortunately, one has never hit me in the middle of a class or while driving), and I feel a bit like a space cadet for a while. Once the intense visual disturbances fade, I can function better.

I used to get an occasional painful migraine when I was much younger--adolescent and young adult. These might be triggered by heat stress or too much time spent out in bright sunlight without sunglasses/protection, or on one occasion, weird allergies after spending a day cleaning a very dusty (and possibly moldy) house. In these cases, I didn't always get an aura first, but the headache was excruciating. Far beyond the worst tension, or even sinus headache pain. It feels different too, as in the pain was in a different place (not the band around the head as with a tension headache, or behind the eyes and in the forehead as with an eye strain or sinus headache). For me, migraine pain wasn't always symmetrical. It could be concentrated on one side of my head, or feel like a stripe down the middle, or slightly off to one side, of my skull. And there was a high pitched humming in my ears. I never vomited with one, but the pain was enough that I'd feel nauseated (so eating or taking pills were off the table at that point) and not be able to think or function well. The pain was so intense I was sometimes tempted to bang my head against the wall.

If there were an emergency, I'd probably be able to deal with it, though there'd likely be a price for that later (as in feeling even worse). I wouldn't want to have to do normal work in that condition. If it happened when I was teaching a class, I'd probably call it early if a lecture, or retreat to the staff lounge and let the students have a free lab if it were a lab.

Fortunately, none of these agonizing migraines lasted more than a few hours. I feel genuine sympathy for people who have them regularly or for whom they last longer. Ugh.

Helix said:

Eye checks are free here and I get them regularly. I don't have glaucoma, I get migraines.

http://www.mayoclinic.org/diseases-conditions/migraine-headache/symptoms-causes/dxc-20202434

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Me neither. I've had regular eye exams throughout my life, and they've always checked for glaucoma. I think it's unlikely I would have had un diagnosed glaucoma when I was younger (and I had most of the migraines in my life, and all the agonizing ones, when I was young) and not had it affect my vision by now (decades later) either.

One time I remember getting one that interfered with a desired activity was, when I got one of these super nasty migraines when I was a pre-teen at a girl scout camp (I got the worse headaches of my life in junior high, so I'm guessing hormones might have also played a role (though I had a relatively late menarche and didn't start until my first year of high school). This one seemed to be triggered by the long day out in the sun thing paired with a horrible stench that came from the creek flowing through the campground (a sulfur/rotten egg smell). The scout leader didn't "believe in migraines." She insisted that there was no such thing, and they were just people with headaches being melodramatic. She was a nice lady, but kind of ignorant of the ways of science. She (and this should amuse or horrify our Australian members) also thought a Kookaburra was another word for koala (we had a song about a kookaburra in an old gum tree we used to sing at camp), and never believed me when I said no, it was an Australian bird species. I was often told I was wrong about scientific things I knew more about that many grownups back then : /

She could tell I was in agony from my "imaginary" migraine, though, so she called my mom to come get me.

I get the auras, sometimes without pain, sometimes with a full-blown headache coming hours after.

In my case, it's like a hook grabs my entire field of vision and jerks it sideways.

Relative had "cluster" migraines that caused pupil dilation and required both meds and oxygen to weather.

Marlys said:

When I'd get the bad kind in my teens, I'd get the visual symptoms first--like pressing the heel of your hand against your eye until you see yellow patterns, only in a jagged line across your vision. Then I'd feel nauseated, and the headache would start. Like having spikes driven behind my eyes. Couldn't stand light at all. Hurt to even move my head--rolling over in bed was excruciating. Nothing seemed to help as far as aspirin or Tylenol--I'd just have to wait it out. For hours. They'd sideline anything for me--there'd be nothing I could do but lie in a darkened room and try not to move. Or throw up.

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Wow! Exactly my experience, during my late teens and early 20s. Thankfully, these disappeared by the time I was about 22 or so, although in very rare occasions I still get the visual symptoms; but it never seems to progress beyond that, and they dissipate in a couple of hours. But it's hard to describe to somebody who has never experienced these episodes just how misery-making they are. They would wreck me for about two days. Even after the nausea and sensitivity to light were gone, I was so fatigued I could barely move enough to go to the bathroom for another day. And eating was out of the question for about two days as well.

Migraines are NOT headaches. They are an entirely different syndrome, still not well understood by the medical community. Today there are some medications that help, I am told, but back in the 1960s when I had 'em, nothing worked. I just had to get into a dark room and lie down and suffer for 24-48 hours. It happened to me five or six times a year. And those visual symptoms just scared the crap out of me, because I know what they portended.

caw

caw

King Neptune said:

People tried to convince me that I had migraines, because I had visual disturbances that included jagged, colored lines across my field of vision, but I have learned that those are caused by glaucoma (Intraocular pressure) and are treatable as glaucoma. Some people claim that the eye pain/ headaches from glaucoma are the most intense pains that people have.

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Eye health professional, checking in.

The visual disturbance caused by high intra-ocular pressure (IOP) isn't the same as that caused by ocular migraine (aka: visual aura migraine). The vast majority of glaucoma doesn't cause any symptoms (pain, vision change etc), which is why it's so dangerous. PSA: Get your eyes checked regularly, people! The type of glaucoma that gives instant pain (head and eye) is acute closed-angle glaucoma, which is far (far, far) less common than the regular chronic type (the one without symptoms ... until you realize you have tunnel vision).

So ... migraine severity and type will differ from person to person. The "classic" migraine gives the visual aura warning ~ 20-30 minutes before the headache* hits. The aura differs between people, but always hits both eyes (it's one of the way we differentiate between someone having migraine aura or showing signs of a retinal detachment). Some people get zig-zags, some get flashes, some get weird geometrical patterns, I used to get windmills and my vision used to get almost super-focused. Lights are too bright. You might feel mildly nauseous. And then 20-30 minutes later ... bang.

I know when I used to get classic migraines (in my mid- to late- teens. They were caused -- ironically given my career-choice -- by poorly oxygenated contact lenses) I'd rush down to the nurses office at school as soon as the visual symptoms started. She had a darkened room with a couple of cots. I used to end up there every Friday afternoon. The headache was agony. I couldn't do anything for the few hours it lasted. Even putting my head on the pillow would hurt. I certainly couldn't have done anything in that time -- completely debilitating.

FTR, I got to uni, changed to disposable contacts (because optometry student ), and never had another migraine. It does make my job easier now when people report migraines, coz I understand what they're talking about!

If you want to really mess someone up, give them a cluster migraine. Women are usually more prone to migraines than men (because of hormonal triggers), but men are more prone to cluster migraines. Those are the worst of the worst, and have been known to make people suicidal.

Visual aura migraines (the one without the headache) are really common though, if my patient base is anything to go by. For most people, the vision goes whacky and they might feel a bit "off" or nauseous, but they can still function much as normal. Most people will pull over if they're driving though, for the duration of the vision disturbance.




*Calling a true migraine a "headache" is like calling a bad cold "the flu". It's an entirely different species of thing.

Mine are triggered by stress and with weather systems. (I also give up caffeine periodically, and the first two or three days as my body adjusts includes coming down with a super-nasty headache which may or may not qualify as a caffeine withdrawal migraine?) I'm fortunate that I don't get migraines with every weather system moving through--- I don't pay enough attention to be able to predict "this" one will trigger something, while *that* one won't--- and I'm also fortunate that I don't get them coming and going. I do have a friend, though, who has some other medical issues, and when she gets weather migraines on top of it all--- she's wiped out for days at a time. She especially has those experiences in our Texas late winters/early springs, where the weather is in a constant state of flux.

My husband also gets weather migraines. Sometimes one of us will get them as the weather system comes in, and the other will get them as the weather system leaves. But mine are more in my forehead; like Marlys described above with the spikes analogy, DH describes his as white-hot ice picks being driven between a certain point in the back of his skull to going through his eyes. I rely on Aleve for my migraines, because acetamenophin does nothing for them; naproxen does nothing for him, but he has 800g tablets of Tylenol that he'll take. Both of us are a little reluctant to take medication. I got out of the habit when I was pregnant, and just would power through it all. He doesn't want his body to adjust to his meds, and thus require even heavier doses to be effective.

I never got the visuals, like the starbursts or the auras, with mine. But when it gets really bad, you just want to sort of smoosh your head against the wall to even out the pain by applying solid pressure. If there was a way I could take my head off, and then put it back on when it was all over, I'd be all about that. So when I'm finding myself in a bad way, I force myself to drop what I'm doing and try to get a nap, and hope that it will be over by the time I wake up. DH rarely has that luxury, though, and he powers through his. He has an eyepatch that he likes to wear, and heat really helps him--- the heater in a car, a hot shower, a heating pad, or maybe a rice bag. I can't imagine trying to put heat on mine... ewww, no thank you. I know some people swear by massaging the base of the thumb, where it's part of your palm, but that never worked for me.

I can't really remember ever regretting having missed something due to a migraine. If there's something that I need to do, I'll do it, but I just want to get it over with and get back to not being distracted from feeling awful. That's not to imply shoddy work--- I don't want to be bothered a second time to redo something that wasn't done properly the first time. I just want to do it fast, and right, and get back to what I was doing before. (Like smushing my head against a wall.) I'll probably be a bit brusque, especially with people who are in the way, or interfering, or asking for attention but not getting to the point. I do find, however, that sometimes when I accept my suffering and give it a purpose--- I'm Catholic--- it will often play out unusually quickly. So that's always a pleasant surprise.

blacbird said:

Migraines are NOT headaches. They are an entirely different syndrome, still not well understood by the medical community. Today there are some medications that help, I am told, but back in the 1960s when I had 'em, nothing worked. I just had to get into a dark room and lie down and suffer for 24-48 hours. It happened to me five or six times a year. And those visual symptoms just scared the crap out of me, because I know what they portended.

caw

caw

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Given that migraines impact balance, vision, speech, I am of the opinion that they are along the lines of a neurological event. They're like a stroke, but more like a micro stroke, or a pico stroke; or maybe a long, shallow or mild stroke that our brains can recover from quickly.