Wednesday, September 28, 2016


We are 10 min. north of Santa Cruz, California, on a magnificent stretch of Hwy 1, heading toward San Francisco on our way home to Washington State.  Looking out to sea, I spot a blue black slice slipping under the off-shore wind waves followed by the unmistakable blow of a second whale.  I feel a moment of supreme satisfaction.  Even though I didn't get my whale watching tour, I got my own wild sighting.

My husband and I had an opportunity to go whale watching.  It would have been a fantastic thrill to be out on the ocean with a knowledgable pro boat guy in a very large inflatable, but I knew that my head and neck would never tolerate the pounding of a small boat in the open ocean accompanied by a voluble monologue from her story-telling captain.

This last week visiting my son and daughter-in-law has been lovely.  They have accommodated us in every way possible way, putting us up, cooking, entertaining us and hanging out yakking around the back-yard fire pit as we watch a possum and then a skunk amble down the fence line a few feet away.  Still, 9 days away from home, and my headaches have begun to amp up.  I awake almost every morning in pain, which I keep at bay with abortive and pain medication and my electro-magnetic device, the SpringTMS.

On Wed., the afternoon before we plan to head home, a friend shows up a couple of hours before dinner.  I am dozing, contented, in the back-yard hammock, the sun warm and relaxing.  A rope tethered to the fence allows me to give myself a swing now and then.  I stay put as the shadows creep over me and then wander indoors to meet the new guy.  Jake hangs around for dinner and conversation until 8 or 9 pm.  My head is buzzing, circuits fried by the end of the evening and, consequently, I am in no way ready to leave in the morning.  I need our last evening to be just us and Andrew and Jenny.  We end up stretching our stay out one more day.
My nervous system is super sensitive.  Among the many sources of upset for me are people, noise and high-energy conversation, even with family and friends I love.  I can tolerate short shots of intense interaction, but if it goes on for too long without breaks and space in-between, my comfort level drops, and I begin to feel overwhelmed.  I experience a sort of mind-body split, caught between competing desires.  Even as I desperately want to participate, my body longs for a break, a quiet spell lying down, away from it all.



Like nearly all people who suffer from severe migraine, I am hypersensitive to a wide variety of stimuli including the following:
  • Changes in routine, medication and weather
  • Traveling
  • Noise
  • Flashing or flickering light, eye exams
  • Dental procedures 
  • Too many people for too long
  • Emotional stress
  • Anxiety
  • Not enough space or time between activities
  • Fatigue
  • Smells including cigarettes, gasoline fumes, wood smoke, nail parlors and more
  • Alcohol
  • Late or missed meals
  • Illness or infection 
  • Heat
  • Intense movies especially on a large screen, Imax or 3D
  • Too much computer or TV time
  • Acupuncture needles in my head
  • Neck massage in the occipital area
Any of the above may tip me over the edge and trigger a migraine or, eventually, a spike in frequency.


Conversely, hypersensitivity in other forms may herald the onset of a headache, not the cause but a warning or prodrome. If I tune in to these feelings as they arise, I can sometimes prevent the actual headache using the SpringTMS.  These include:
  • Anxiety
  • Depression
  • Irritability
  • Euphoria
  • Fatigue
  • Mental cloudiness
  • Lack of focus or motivation
  • Short-term memory problems
  • Super-sensitivity to a variety of stimuli
  • Muscle spasms in my neck, shoulders, back
  • Earache

Aura and headache

Once or twice a month, I experience a classic visual aura, a half-moon, zig-zag pattern of scintillating light.  While I can't avoid the aura, I can sometimes abort the headache with the SpringTMS.

During the actual headache, pain is often accompanied by nausea and sensitivity to many of the same basket full of irritants that trigger my headaches.


After my headaches wind down, I am left feeling limp and spaced out.  I am mentally hungover, stale, lethargic and fretful at my inability to apply myself.  My concentration is poor, my mood often low, my nerve endings still buzzing with irritation to noise, lights and action.

Real Time

What this all means is not suffering one day sick in bed but three days enduring a host of disturbing sensitivities and symptoms.  Having an episodic or occasional migraine is painful but not too disruptive to your quality of life.  Having chronic migraine, that is 15 or more days per month, is profoundly difficult and destructive.  One headache with all associated symptoms bleeds into the next leaving scant time to recover my equilibrium and energy.  Coping is a constant seesaw between succumbing to the pain and pushing myself to keep moving.

This headache begins Thurs. with fatigue and lethargy.  My two-year old grandson, Lucas, arrives at 9:00 am.  We play with magnets and play dough, pick late-summer grapes from the arbor and take a short walk before lunch and then, thankfully, a midday nap.  Afternoon requires a 30 minute drive to a physical therapy appointment, but the trip home is tough.  Driving with less than full concentration is a poor idea, but more than I would like, I find myself behind the wheel when I would be better off prone.  What do you do when you are symptomatic roughly half your waking hours and still want and need to function?  Practically, the answer is....... the best you can, which is not optimal.  

Friday, I awake with a headache, not a crashing, 5-star misery but medium-grade head pain and a churning gut.  I pop a naratriptan when I get up, swill two cups of black tea and, foolishly it turns out, eat my usual bowl of steel-cut oats for breakfast in hopes this will all go away and I can carry on.  By 10:00 am my gut is churning.  In a valiant attempt to keep going, I hop on my bike and take a short ride to the neighborhood coffee shop for a chat with my friend, Stephanie.  I am happy to see her, but my attention is split between talk of our sons, writing and politics on the one hand and my roiling stomach on the other.  By the time I return home, I'm feeling better so I make myself a taco for lunch, another mistake.  My belly in revolt again, I head out for a scheduled hair cut.  By the time I get home, I'm done for.  More than ready to give up and give in to my fatigue and nausea, I head for a nap on the futon and, later, a supper of apple juice, banana and toast.

Today I'm in day-three, recovery mode.  This time I'm not doing too badly, concentrating well enough to write, eating a bland diet, enjoying a fine fall day as I look out the window at leaves beginning to turn color on the vine maples, apples ripening on my semi-dwarf tree, clouds beginning to clear to the southwest.  But I'm still in slow mo.  The challenge will be not to overdo it and set my sensitive nervous system up for yet another migraine tomorrow.

Monday, August 8, 2016



I live my life in staccato, each day discrete and disconnected from the last, separated by episodes of head pain and nausea. Thinking, the other day, about this particular piece of my struggle with migraine, a memory came to mind - of a zoetrope, a 19th century optical toy my husband built years ago for our kids. It consists of a cylinder with vertical slits and a series or strip of individual pictures drawn on the inside. Looking on from the outside, when you spin the cylinder at just the right speed, the serial images run together appearing as figures in continuous motion. But the real truth? Slow down or interrupt the motion of the cylinder and the action reverts to disconnected, individual images.


Now, as I sit here writing, after a few morning hours of productive, concentrated work, I suddenly become aware of my right neck and shoulder beginning to knot into a tight muscle spasm.  I stop what I'm doing to check in with myself, a body scan to see how my individual parts are fitting together.  I feel a kind of density on the right side of my face and a tiny throb in my temple.

I stop writing mid flow and get up to treat myself with the SpringTMS in hopes of preventing an impending migraine.  I check my calendar to see how many pain pills I've taken this week, look at the clock to see when I can take one that will get me through the afternoon and an early evening concert, tickets already bought and paid for with maybe a 50/50 chance that I'll actually be able to go.

It's complicated, living with pain that comes and goes in unpredictable fits and starts.  I am an English tutor, a grandparent who babysits.  I write, draw and paint.  I like to walk and swim, do yoga and travel, go to the movies and meet with friends.  I still do these things but with an impaired sense of rhythm.  I cope with my splintered life by having a strict order of priorities.

Babysitting and tutoring usually come first because they involve a commitment to other people as well as myself.  In order to pull this off I reserve 2 of my headache abortives and 2 pain pills per week, only 2 because taking more pills risks rebound, which would ultimately lead to even more frequent headaches.  The rest of my routine is subject to frequent cancellations.

Episodic pain has eroded my ability to build on skills and develop interests, leaving me hanging on in frustration instead of making calm choices with the freedom to follow through.  I have a perpetual sense of being unfinished in all things.  Often I have to beg from Peter to pay Paul.  If I push my energy envelope today, tomorrow may see me in bed or on the couch.  I may start a drawing, a weaving or a written piece and have to abandon it for days.  I return to projects disoriented, searching for my original inspiration.  These frequent interruptions undermine the sense of continuity in my days and weeks.


What if?

But what if I could view my pain breaks differently?  In fact, the most recent suspension of my writing allowed for a different take on things when I returned to work.  Instead of seeing a series of frustrating, interrupted moments, I began to envision water flowing over and around the rocks and snags, but flowing nonetheless, a continuous stream shrinking and swelling, slowing down and speeding up with the seasonal runoff, changing channels during floods but forever moving with its own sense of direction.

While an imperfect solution, this imagery gives me a little distance from the frustration and also reminds me that we all have obstacles of every shape and size, whether it's physical pain, divorce, financial troubles or family problems.  My challenge, ultimately, is to develop a certain acceptance of the obstacles and a respect for my own way of flowing around and through them. 

Wednesday, July 13, 2016

Facing My Fear

And making it to my son's wedding

It's May, and my youngest son's wedding is just around the corner.  Noisy, crowded social events often precede a severe migraine headache, and I'm afraid of ending up in bed, missing one of the most important days in my son's life.

Andrew and Jenny are getting married in Sayulita, Mexico, a destination wedding with 52 guests.  I'm excited and looking forward to the event, but a part of me is already anxious about coping with the physical demands of travel and the social demands of a high-density 5 day party.

I've been doing better lately, but that can change in a heartbeat.  Given the right - or wrong - set of circumstances, I regain consciousness in the wee hours of the morning with a feeling of dread, an ice-pick pain in my temple and nausea gnawing at my gut.

Two days before the wedding, a harsh 3 am alarm wakes us to catch a 5 am flight, which will set us down in Puerto Vallarta after multiple plane changes.  In L.A. I get a text from my son asking about our arrival time.  We coordinate plans to meet up at the airport and share a van ride to Sayulita.  We're looking forward to seeing him and pleased to get a sliver of family time before everyone else arrives.

Mexican customs features a magical red/green button.  We push the button.  A green light, and the customs agent waves us through and out the other side.  Searching the swarm of noisy travelers and hawkers, we find our driver holding a sign with my name.  Fifteen minutes behind us, Andrew, Jenny and family swim through the throng, greet us with hugs, and we all climb in the van.

Forty minutes later we bump down a narrow dirt road in Sayulita and spill out of the car into moist, salty air at beachfront Las Hamacas, our hotel and the site of the festivities to come.  There are 6 tall houses, 3 bedrooms and therefore multiple families in each house.  While most of the guests are arriving tomorrow, some few are already in residence, lying around the pool or wandering paths bordered by palm and banana trees.  We're gratified to be sharing with Ivan, my son's old high-school friend and his young family, who have already settled into our house.  Still, sharing accommodations with others means less privacy, less personal space and more social requirements starting early in the morning and continuing until bedtime.  My easily over-stimulated nervous system needs time to calm down, and I will be getting less of it.

It's already 6:00 pm, the evening of a very long day.  I'm happy we've arrived in this verdant little ex-pat beach town with no major hitches, but I'm tired and need to eat soon.  As we stroll down the beach to find food, my stomach flip flops between hunger and pain.  The fish tacos taste good, but I still have butterflies in my gut.  As the sun sinks into the water, we wander back toward our room to chill out and read. I am edgy and unable to relax into the rhythm of a warm Mexican night. Not even the geckos skittering across our wall and chirping from a hidden crack amuse me as they usually do.

On our first day (and everyday thereafter) I crawl out of sleep early with a dull headache and creeping anxiety. I use my SpringTMS to treat my headache and go back to sleep for a couple of hours. I get up with a dicey stomach and the fear that I may already have contracted a Mexican intestinal bug.

The wedding is tomorrow, so today is open. We take it easy, hang out around the pool greeting newcomers as they roll in from New York, Calif., Arizona, Florida, Washington State and elsewhere. Several come with kids in tow, and by mid afternoon the pool is full of families.  My older son Ben and grandson Liam show up and move into a downstairs bedroom. We are now 5 adults and 3 kids age 5 and under. Lunchtime is a spontaneous group get-together. We sit on benches, digging our toes into the sand at a shady beach restaurant. Later dinner is with Ben and Liam, who is tired and cranky. Things are just getting underway. The group is high on anticipation and shared experiences, but I'm already feeling crowded and overwhelmed.

The next morning is a headachy, intestinal repeat, and i'm convinced the only recourse is to quit eating for 24 hours. I hang out on the patio with Ivan and family and play with the kids while enjoying the tropical birds and trees hanging over our 3rd floor balcony.

At 10 am, Andrew and Jenny and our two families meet on the beachfront lawn for a wedding rehearsal. I'm calm and engaged in the moment, thinking only of the ceremony and those of us involved. The rehearsal is brief and fun. There's a lot of good feeling flowing around. We will gather at 5 pm for appetizers and drinks. The ceremony is at 6.

When everyone takes off for lunch, I stay behind swilling a coco frio to stay hydrated and give myself a little sugar. I'm torn and sad. The quiet is a relief, but as always, I hate being left out. My head and gut calm down, and time to myself brings the dawning recognition that fear is magnifying my symptoms. While I have had migraines since childhood, anxiety entered the picture in recent years when headaches began to occur almost daily. Now, re-evaluating symptoms gives me some options. I increase the dosage of one of my medications. I begin to use some of the tools I learned practicing meditation. I name the emotion. "This is just a feeling of fear." I breathe deep into my belly, consciously following each breath in and out, reinforcing it with visual imagery.

50 chairs and a simple flowered arch on the sandy beach in front of the hotel set the wedding scene. Jenny, in a beautiful short dress, is barefoot. Andrew, in linen pants and a white guayabera, wears flip-flops. Everyone else is beach casual in everything from shorts to cocktail dresses. The ceremony is conducted by friend Pete with vows composed by the couple. The reception is on the lawn next to the beach, the sound of surf singing in the background. A couple rolls cigars; tacos al pastor are sliced from a flaming spindle of pork topped with pineapple; the churro vendor serves up flutted tubes of pastry squeezed from a tube into a deep-fat fryer. Kids frolic, tightrope their way across a short wall separating the lawn from the beach, box with the wedding beer koozies over their small fists and line up to take their blind-folded turn at pummeling the piƱata.

The next 5 days ease into a slow pace of pool gatherings, communal meals and one of the best parts for me, swimming in the ocean. We take a golf-cart spin into town, eat dinner under a tree filled with iguanas and buy a coco frio to take back to Lucy, the 6 year old next door. We watch my grandson take his first dog paddle into the deep end of the pool, sit on the terrace reading comic books and playing checkers with the kids. A little green lizard zips by on a low garden wall. While early-morning, low-grade headaches, anxiety and tummy troubles still plague me, I'm no longer running so scared. I've reached a detente with my body and emotions that carries me through this important family event. I've learned a lesson in facing my fear, respecting it and moving on.

Friday, April 29, 2016

When I'm 64 ..........

Aging and migraine

When I get older losing my hair
Many years from now
Will you still be sending me a valentine, Birthday greetings, bottle of wine?
If I'd been out till quarter to three Would you lock the door?
Will you still need me, will you still feed me
When I'm sixty-four?
                    The Beetles

Now that I'm older plenty of hair
Zero years from NOW
Will you still be sending me a valentine, Birthday greetings, bottle of wine?
If my head is knockin' with terrible pain Will you bring me tea?
Will you still need me, will you still feed me 
When I'm sixty-four?

When I was younger

I have had migraines since childhood, but my headaches really began to ramp up during my child-bearing years.  In my early 30's they began to interfere occasionally with my work as an occupational therapist. The headaches happened infrequently with my first pregnancy, but by the time I was carrying my second baby, they were a persistent problem.  Things improved after my son was born, but the headaches slowly, almost imperceptibly became more frequent and more disruptive to my family and work. They had begun to be real interruptions in the flow of my days.

I can clock my slow, downhill slide over the next few years by the 5 leaves of absence I took to try and get a handle on the persistent pain.  Our basement clinic at the hospital had florescent lighting with no windows to the outside world.  At the end of a 5 or 6 hour day, I usually went home with a headache, which slowly resolved over the next hour or two.
After a few years, I moved on to work in the public schools.  Even though the job was part time, I rarely made it through the day without the onset of a migraine.

I also worked on my off days, evenings, and weekends doing production weaving and teaching weaving and craft classes to adults and children.  When I arrived home in the afternoon, I had two young children of my own to care for.  It was a productive, interesting time but difficult because I was juggling pain and fatigue as well as work and family.  Years later, Jeremiah, a teenage friend of my son, remembered often having to tone it down because I was in the throws of yet another migraine.

In 1991 Imitrex came out as the first designer drug aimed at aborting migraine headaches.  Having failed to respond to any of the preventative medications prescribed, I depended on Imitrex to keep me going for years.

In 2000, I went back to school and got a certificate to teach English as a Second Language. I got a job at the local community college teaching English to immigrants.  It was profoundly satisfying work but a continual struggle to perform well.  After 11 years, I retired early when I began to feel that my headaches were impacting my teaching.  Leaving a job I loved was a blow, but I'm proud that I made it to age 66 before having to 'hang it up.'

Over the years........

I tried and failed to find relief from several major first-line medications including Verapamil, Nortriptyline, Depacote and Topamax.  I also began to have adverse reactions.  Nortriptyline precipitated episodes of tachycardia. Naprosyn caused itching and burning in my hands and feet.  By 1998 or 1999, I was using Imitrex daily. My doctor advised against this and prescribed beta blocker, Atenolol, in hopes of preventing my escalating headaches.  Atenolol tipped me over the edge into a serious depression and required yet more medication.

Over time my specialists prescribed a total of at least 30 medications aimed at preventing migraines.   The results of this chemical barrage were short term or no benefits on the one hand and increasing side effects on the other.  These ranged from the usual including sedation, fatigue, dry mouth, hair loss, nausea, constipation, diarrhea, anxiety and insomnia to the unusual including loss of taste, breast enlargement, inability to do basic mathematics and visual anomalies.

Now that I'm older

The doctors all told me, 'Hey, good news.  When you get older (specifically, when you go through menopause), your headaches will go away.'  Sadly this did not happen.  As I began perimenopause, things really began to go south - and then they got worse.  Proving them wrong was not satisfying.  Actually it pissed me off for a long time.

Doctors want to help, and their answer is usually to prescribe drugs that have a track record with other patients.  While understandable, I have found little acknowledgment in the medical community that things change with age, and more drugs on board may make things worse instead of better.  Now almost 70, I've learned I can tolerate and benefit from some medications at a low dose.  Other drugs make my health and my headaches worse. I've also learned not to rely on doctors to sort this out.

With age, headaches have become more frequent but less painful.  Auras happen more often.  My pre- and post-headache fatigue has increased, and my stamina decreased.  Unreliable short-term memory and word-finding difficulties drive me crazy.  Many of these symptoms are common to migraineurs, but age, in combination with medication, accentuates the problems and makes them harder to tease apart.  And as always, my headaches continue to change.

Now I'm in the process of very slowly weaning myself off low doses of Baclofen, Klonopin, and Remeron.  I still use Naratriptan as an abortive and Fioricet for pain, both about once or twice a week.  Since January, I've been using the Spring TMS device, which is helping to decrease the pain and reduce my reliance on prescription drugs.

I find the more time I spend outside and around the water, the better I feel.  Yoga, meditation, art,  walking and bicycling, time with friends and family all feed my spirit.      

My father's question

The year I was born, my father was diagnosed with multiple sclerosis.  He suffered from fatigue, double vision, numbness in his hands, difficulty walking during exacerbations and, no doubt, other symptoms I was unaware of.  But he continued to work in a demanding career as a civil engineer until his late 50's, share in raising 2 daughters, play golf, do woodworking and, in short, carry on as best he could.

Not long after he retired, when I was a young adult, he asked me if I thought he was a failure.  I was shocked and found his question puzzling and incomprehensible.  I answered, "No, of course not."  But I didn't ask him why.  Now, I think I understand. In the face of debilitating illness, no matter how hard we try, we can't pull off a life not impacted by pain, weakness and fatigue even though we feel, against all odds, we should be able to do better or do more.

I struggle with a level of regret around the things I can't and now won't be able to do in my life.  I have a definite sense that time is short.  Achieving greater self acceptance and peace around my own personal triumphs and defeats throughout a life with migraine is, I think, the most important task for me now.

Thursday, April 7, 2016


New in January 2016

This new "machine" is a portable, single-pulse Transcranial Magnetic Stimulation (sTMS) device.
It has been approved by the FDA "for acute treatment of pain associated with migraine headache with aura."  From the manual, "The SpringTMS is intended for self-treatment and delivers a non-invasive, brief, single pulse of magnetic energy to the back of the head.  This creates a brief electrical current in the brain intended to stop or reduce the effects of migraine headaches."  These mild electrical currents excite and depolarize neurons in the brain.  They inhibit CSD or cortical spreading depression and thus have the potential to terminate aura and subsequent headache.

I have chronic migraine with aura, but my auras occur 1 to 4 x monthly while my headaches are a near daily occurrence.  While the FDA has approved the sTMS for migraine with aura only, some studies cite evidence that it is effective for migraine with and without aura.  

The sTMS became available for rent from eNeura Inc. by prescription in the U.S. in January of this year.  The cost is approximately $250.00 per month.  While I am in the process of applying for coverage from my insurance company, there is no guarantee they will agree to reimburse me.  Representatives from eNeura have been accessible and cooperative in working with me on reimbursement request.  The eNeura nurse/ patient representative is also readily available by phone to discuss the finer points of using the device and answer any questions that may arise.


In consultation with my doctor, I've worked out a treatment regimen.  I use my zapper, as I call it, in the morning and in the evening for prevention.  I deliver 3 pulses each time.  When I have a headache, I give myself 3 consecutive treatments or pulses. If the headache doesn't go away in about 10 minutes, I repeat once or twice with another 3 pulses. I try to use the device as soon as I feel a headache coming on.

The treatment doesn't hurt.  You only hear and sort of feel a "thunk" inside the mechanism.

The sTMS was approved in Britain for use with patients with migraine with or without aura and became available in Jan. 2014, a year earlier than in the US.  Post market studies show optimal dosing for symptoms in the range of 10-12 pulses per treatment day.

So far so good

I've now had my SpringTMS for three months so this is a preliminary report.

The good news: there is no doubt that it is aborting my headaches most of the time.  My headache journal supports this conclusion. When I do have a headache, I treat with the sTMS fairly quickly, and the headache usually goes away.  My use of abortive medication has decreased from 3 or 4 times a week to once or sometimes twice weekly.

I'm less sure whether or how much regular use of the device is acting to reduce the frequency of my headaches. This will become more obvious in the next few months.  I'll keep you posted!

On days when I use the SpringTMS multiple times to abort a major headache, I still sometimes feel the after effects including fatigue and depressed mood the next day, but I'm more or less functional and not in pain.  While my energy may be low, I can still do routine activities.  This is a huge difference.  I now feel like I can engage in activities that I wouldn't consider 2 months ago.  I am thinking about taking a writing workshop in June and an art class in July.  Since this requires not only sustained attention and tolerance for being around groups of people for hours at a time, but also tuition, I just haven't been willing to make this kind of commitment for a long time.


In February we spent 10 days in Melaque, Mexico, a trip that had to be postponed in December because I was just feeling too lousy.  In spite of coming down with a Mexican cold, my headaches didn't spike and I was able to enjoy swimming, walking on the beach, sampling the food and practicing my Spanish.  I had no trouble traveling with my zapper although it kicked off the scanner as it went through security, and I had to step aside for a more thorough inspection.  Word to the wise:  keep it easily accessible in your carry-on luggage.  I did take the manual and my prescription with me as documentation; however, no one seemed concerned or asked for my papers.

Room with a view

Thursday, February 11, 2016

Gut Problems Feed Headache

The Fall

Both in terms of season and headaches.  In late September, early October, I was doing well.  I had some weeks of 4 headache-free days in a row, and I was feeling pretty good. Then something happened to my belly, and I've never been quite sure what caused it.
Rocky descent 

I went to the symphony with friends.  In the middle of the performance high in the nosebleed section of the balcony, my stomach began to hurt and I was suddenly tired and sleepy.  It was all I could do to keep my eyes open.  After the performance, I went home and crashed and didn't get off the couch for days.  I couldn't eat much.  I was nauseated, my stomach hurt and I had persistent diarrhea.  My digestive tract was in full scale revolt.  I assumed I just had a stomach bug and waited for it to go away.  Days turned into weeks which turned into months of nibbling at a bland diet and going to doctors.  I lost 15 pounds.  My headaches spiked to near daily events.  Not being able to eat normally was a knock-out punch.  I felt so lousy, weak and anxious that we had to cancel our December trip to Mexico.  My creative brain tanked.  I couldn't bring myself to write, draw or weave.

I had no fever, nor had I taken antibiotics recently, two diagnostic clues that might have indicated a serious infection.  All lab tests came back normal.

Winter heading towards spring

On December 1st, I went for my first visit with a new acupuncturist.  Slowly time, diet and her treatments helped me turn this thing around.  It bears mentioning here that I never let my acupuncturist put needles in my head.  I learned the hard way that it triggers a migraine.  Finally within the last 2-3 weeks, the severity level and the number of days between headaches have stretched out enough that I am out of rebound range in my use of abortives and rescue meds.  Now almost 3 months after this malady set in, my stomach and gut have decided to behave themselves, my anxiety is down, and my energy level up.

My family was together for Christmas when my son confirmed that he and his girlfriend were truly getting married soon (although they didn't yet know quite when) .  By the end of Jan., I was feeling good enough to go ahead and rebook our winter vacation to Mexico for mid Feb.  Of course, soon afterward, they sent out the evite for a May wedding in ........ Mexico.  Two trips is not a bad thing!  

Digestion and headache

So what happened?  It may have begun with a virus and what my gastroenterologist called post viral syndrome.  But I also had some stomach trouble off and on last summer, which leads me to consider other possibilities.  I am extremely sensitive or frankly intolerant to many medications.  One theory is that I can no longer tolerate one of my headache prevention meds.  My stomach was signaling me to reduce the dosage.  I do know that when my gut is happy, I have fewer headaches.  Conversely, when my digestion is messed up, my headaches become more frequent.

There's a lot of interest and research in western medicine right now on the subject of the gut micro biome.  It turns out that what goes on at the microscopic level, the bacteria we carry around in our intestinal tract, is implicated not only in diseases like diabetes, obesity, heart disease and inflammatory bowel disease, but also in rheumatoid arthritis, autism, alcoholism, multiple sclerosis and, yes, migraine.
The gut and your migraine brain communicate via the vagus nerve, endocrine and immune pathways. And the communication travels both ways, gut to brain as well as brain to gut.

What does all this mean in terms of what we put in our mouths to nourish ourselves and cure our ills?  Can we use this information to improve our health and reduce our headaches?  Well, the jury is obviously still out on this score, but here's what I do and why.

  • First I'm keeping my eye out for more information via current scientific studies and research.
  • I have quit taking isometheptene and I'm slowly weening myself off another of my meds under my doctor's watchful eye.
  • Whenever possible I avoid taking antibiotics, which strip your gut of helpful bacteria as well as the bad bugs they're designed to take out.  I have a primary care provider I like (an MD), as well as a naturopath who has prescriptive power in Washington State.  He often knows effective alternatives to antibiotics.  
  • Years ago, I had food allergy testing and the one and only thing that popped up was a clear intolerance to eggs borne out by the fact that they make me very constipated when I eat them.  So I don't.   
  • I take L-glutamine which also seems to help my gut.
  • I take probiotics and eat foods that supply prebiotics which, evidence suggests, help digestion and protect you from harmful bacteria.
  • I take a tablespoon of ground flax seed daily.
  • I don't eat much prepared or packaged food, and when I do buy the odd bag of chips, package of crackers or boxed soup broth, I shop for the one that has the shortest list of ingredients, the one that leaves out the sugar, salt, thickening agents or preservatives.
  • I eat a lot of vegetables which, fortunately, I like.  My latest easy, tasty veggie is stir fried or steamed greens including kale, cabbage, beat greens, chard and spinach and more.  When my gut is behaving itself, I eat a lot of uncooked greens in salad too.

Here are a few tips from Dr. Christiane Northrup, a good source of information on ways to take care of yourself.

And from Michael Pollan in his book, "In Defense of Food."  Pollan looks at American eating habits and what he calls the culture of eating in this country.  He comes up with some great, well-researched  guidelines that deserve our attention.

Thankfully, I can finally eat again with the best of them, including tacos and enchiladas, rice and beans as well as #3 spicy Thai.  I'm looking forward to eating whatever I feel like when we touch down next week in Melaque, Mexico.  My strategy for staying healthy in Mexico?  Lots of limes, garlic and mineral water as well as my regular dose of probiotics.  Avoid the street food, and choose restaurants that are busy turning over a lot of meals every day.

Hasta luego y buen provecho!


Saturday, February 6, 2016

Family News and migraine

What's goin' on 

Andrew and Jenny are doing a kitchen remodel.  There is lots of discussion around paint colors, what it will feel like to tear that wall out and open up the kitchen to the living room and just when this is all going to happen.  Since for us, this is a vacation to Santa Cruz, we ride our bikes, walk on the beach and talk about which route to take this time driving our van north towards home.  Book and movie recommendations are always a topic.  Friends Jacob and Sally are getting married and we're all invited to the wedding in Poulsbo, Washington.  Andrew and Jenny are getting married in May in Sayulita, Mexico.  The foundation of Ben and Leslie's new house has been poured.  The kids are coming over on Sunday.

Notice there is no discussion about headaches, neither my son Ben's nor mine.  This is almost always the case.  I don't usually talk much about all my head pain because while my life seems virtually consumed by it, I feel as if it's probably a bore for everyone else.  And in fact I'm bored with the topic myself.  This in spite of the fact that my headaches have become near daily events and Ben's have spiked recently.  He functions as a nurse with dull daily head pain which sometimes spikes to severe pain by the time he clocks out.  For both of us the pain pattern and frequency fluctuates with the season, stress level, ambient noise, whether or not we get a good night's sleep and more.  Of course sleep is at a premium for my son with a pre schooler and a toddler at home and a new house under construction.

When Ben and I are together with the kids busy playing, that's when we usually check in to see how the other guy is doing and offer up any new or interesting information we've come across.  Here's what's happening for me right now.


I'm in a pretty good place emotionally right now.  My mood usually tracks with my headache frequency and season of the year.  My headaches are currently less frequent thanks to recovery from recent illness and relatively new treatment options.  And while the February winter weather is oppressive, we're finally headed out for 10 days in Mexico starting next week. 

When my headaches are out of control and I can't do the things I like to do, I am downhearted and at least a little depressed.  It's hard for me to maintain a positive attitude, and against all logic, I struggle not to blame myself.  Self blame is quite common among those with chronic illness.  Articles abound on the internet about how frequent and counterproductive this is.  One of my favorite authors on the subject, Toni Bernhard writes about this negative emotion and how to get beyond it.  Find her blog, Turning Straw into Gold, at the address below.

Mid winter in the Pacific Northwest is wet, cold and gray.  The "monsoons" start in mid to late October.  The weather warms up in the spring, but the rain and gray skies often continue through June.  I usually do ok until after holidays.  Then I run out of patience, and my mood slides into the gutter like the rain on a wet day.  If I can stay active and engaged with friends and family, I do better.  But if I am flattened by headaches, my mood deteriorates.  I can tolerate one or the other, headaches or Northwest winter, but putting up with both is a killer.

Current Meds 

Preventatives:  Baclofen, klonopin, mirtazapine, zyprexa and CBD cannabis capsules
Abortives:  SpringTMS and naratriptan
Rescue:  Fioricet w/ codeine,  cannabis via vaporizer for pain, nausea and sleep
Sleep:  Zolpidem

I'm very fortunate that medical marijuana is legal in Washington, because nothing else except narcotics touches it for conquering pain and nausea while waiting for the abortives to work.  The downside is you can't travel legally out of the State with it, and I certainly can't take it to Mexico, our February escape destination.  In anticipation of traveling, I have spent the last two weeks weening myself off marijuana to see how I do.  Not bad, just less comfortable.  Poor sleep is actually the worst of it.

I spend hours nearly every week staying on top of any and all headache news that hits the national media, reading any peer reviewed scientific articles I can get my hands on, checking in on the blogs to make sure I'm not missing any new possibilities, learning more about diets that seem to be working for others, seeing specialists including, right now, my headache guy, an acupuncturist, and a mental health provider.  I log in hours every month or two haggling with my insurance company over medication coverage. While I share some of this information with my husband, much if it is filed away or filtered for personal use inside my own skull.  It's a world of feeling and information that tends to live within me alone.  Here's just a little bit of the latest 

Current and future possibilities

Spring TMS

This device involves transcranial magnetic stimulation to abort a headache.  It rents for $ 250.00/ month and will likely not be covered by the vast majority of insurance companies.  It just became available in late December.  I got mine 3 weeks ago.  It's early days, but the frequency of my harsher headaches is down, and I'm not using quite so much abortive medication.


A device that delivers electrical stimulation to the vagus nerve in the neck - to abort or prevent a headache.  Available in Canada but not in the US even though this multinational company is headquartered in the US and FDA drug trials have taken place here.  It's a pricey little devil at approximately $ 475.00 (Canadian) for a limited number of doses.  Then you have to send it in for a recharge of the device, which no doubt will be accompanied by a monetary recharge as well.  There is no information on when this baby will be available in the U.S.


Migraine vaccine, CGRP Antagonists

This pharmaceutical is not really a vaccine but acts kind of like one.  There is a lot of excitement about the drug in medical circles.  For me, it's hard to get excited about a "solution" that is still undergoing FDA trials and is, at the very least, 3 years from market.  On the other hand, my son is holding onto the possibility that this new approach will solve his migraine problems.  Truthfully, at age 69, I just don't have that many years left, while he does.  Aging changes your perspective and the quality of your hope.

When it becomes available, either monthly or every 3 months or so your doctor will inject humanized antibody CGRP to prevent headaches.  So far, research looks promising, but it's a long wait if you're having near daily headaches.  There are FDA drug trials I'm looking into, but chances are that I won't meet the requirements.  For the most part, those over 65 don't qualify for a drug trials.


The Cefaly is a (tens) transcutaneous electrical stimulation mini machine that targets the trigeminal nerve.  I bought my Cefaly in Canada where it is approved as both a preventative and abortive device.  Settings may be different for one prescribed and purchased in the U.S.
One push on the button of my Cephaly activates a 20 minute session that is designed to abort a migraine.  Push the button twice for a preventative session, three times for a relaxation session.  This device worked for me for a while, and then it was no longer effective as an abortive.  I gave it to my son who thinks it is helping to reduce intensity and frequency of his headaches.  Purchase price:  $349.00.

Emsam transdermal patch

This medication is an MAO inhibitor, a drug for depression that has a long record of successful (for some) off-label use to prevent migraine.  It comes in pill form with an extensive list of dietary restrictions that are necessary to prevent serious drug/ food interactions.  The new patch doesn't have these restrictions.  Available now.  Pricey at $1200.00 per month.  My insurance would pay half, so at 
$ 600.00 per month, I haven't leaped up to try this.  Neither have I crossed it off my list entirely.  When I told my family about the patch and the price, my sons offered to help with the payments.


This procedure involves threading a catheter (no needle) up your nose (waaaay up) to access a ganglion leading to the trigeminal nerve.  When on target, the doctor injects the anesthetic marcaine.  Repeat 2 or 3 times and you may get some lasting relief.  I tried this, and it made things worse giving me a nasty sinus-like headache which was minimally responsive to my usual abortive medication.  No repeats for me.


I am really at the end of the long list of medications that act to prevent migraines.  Due to age and genetics, I tend to have exaggerated side effects and poor response to many pharmaceuticals.

Alternative treatments

While I'm always open to new ideas, the most common so called alternative treatments have had no impact on the frequency and severity of my headaches.  These include massage, physical therapy, acupuncture and Chinese medicine, chiropractic and naturopathic treatment, biofeedback, cognitive behavioral therapy, herbs and supplements, essential oils and the migraine diet.  Massage feels good;  acupuncture helped with carpal tunnel and digestive issues; biofeedback has helped with relaxation and gut problems; physical therapy exercises are healing long-term achilles tendonitis and yoga helps me to feel better overall.  None has touched the headaches.  I continue to see a mental health counselor to help me cope with chronic pain and stay open and curious about new ideas and approaches.

Last spring I began meditating, which does seem to reduce the severity of pain on some days.  This little chink in the brick wall of head pain is significant, so I continue to explore this path.  In the 1970's Jon Kabat-Zinn, a Buddhist monk working with others at the University of Massachusetts Medical Center, developed  an 8-week course for those with chronic pain.  Since then it has morphed from one class to a mindfulness movement.  Last summer I took the class, Mindfulness-based Stress Reduction, which borrows from the traditions and practices of Buddhism, yoga and progressive relaxation using meditation, breathing, movement and stretching.