What I Mean When I Say “Migraine” + Dealing At Work

“Oh, I get headaches, too! I’ve got an IBUProfen, do you want one?”

The first thing I learned after being diagnosed with a chronic illness is that it is incredibly difficult for people to understand. When I say “migraine,” most people hear “bad headache.” But, migraines are so much more than most people can even begin to describe. And while you might mean well by offering an Ibuprofen to a friend or loved one who suffers from chronic migraines, chances are they’ve already tried most pain relievers on the shelf. The best thing you can do is offer your support and willingness to learn. So, today I’m going to pick through my migraine experience and share my defense plan that gets me through my work day in the hopes that it will help sufferers and friends alike.

If you have any questions, please feel free to ask in the comments!

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Migraines, Explained

We’re actually quite lucky here in the 21st century. Cavemen and 17th-century sufferers alike drilled holes in their skulls to alleviate severe pains and pressure. Trepanning, as it was called, is one of the more gruesome treatments people turned to, but consider the pain that a human body must be experiencing for this “solution” to even be a consideration! I can tell you from personal experience, pain can push you to a point where opening a 6-inch hole in your head seems like a good idea. But, pain inside your brain is inescapable; it’s not a bum knee that you can prop up, or a bad back you can ice. It’s all consuming and can distort your version of reality. It makes sense, then, that people have turned to electrotherapy, vessel ligation, and other incredibly invasive procedures to cure their migraines. What causes them, though? Why do people even have migraines?

What’s the Difference?

The main difference between an everyday headache and a migraine has to do with chemicals released by the brain. Tylenol lists 10 average causes including anxiety, foods, not getting enough sleep and others. Migraines, though, involve a domino effect that starts with vasodilation, which simply refers to the dilation of certain arteries. This causes the brain to create pain producing chemicals. Blood vessels swell and put pressure on nerves which “send pain signals to the body that are typically felt around the eye or temple region and can extend to the face, sinus, jaw, or neck.”

There is no known cause for migraine, although most people with it are genetically predisposed to migraine. If you are susceptible to migraine there are certain triggers which commonly occur. These include stress, lack of food, alcohol, hormonal changes in women, lack of sleep and the environment.

This vasodilation is what sets a headache apart from a migraine. It isn’t just a pain in the head. It’s like in-laws that show up with 15 suitcases, each full with a different hell that can pin you down and leave you feeling like you’ve been run over.

The Wall Street Journal  illustration by Bernard Maisner

A Myriad of Symptoms

No two migraines are the same. But, most people do tend to experience a range of intense migraine symptoms including “nausea, throbbing, photophobia, phonophobia, clamminess, and light-headedness.” The problem is that most people have never (thankfully!) experienced what it’s like to fight through an afternoon meeting full of brain piercing light and voices that sound like nails on a chalkboard.

Excedrin recently rolled out a series of amazing commercials that shed light on what it’s like to muddle through the complex array of symptoms while trying to live a normal, everyday life. You can get a sense of how photo- or phonophobia could multiply tenfold throughout your day. It doesn’t let up, and combined with intense nausea and pain, it becomes a debilitating chronic illness that can have even the healthiest of people bent over the toilet, dry  heaving the afternoon away. For those who live with migraines with aura, they experience three other symptoms that aren’t widespread. They include:

  • Visual symptoms (eg, flickering lights, spots, or lines) or vision loss
  • Sensory symptoms (eg, pins and needles or numbness)
  • Speech disturbance (difficulty putting words together)

What I Mean When I Say…

Hopefully, by this point, you’re reaction is something like “Holy shit this sounds like hell.” And it is. Migraines spin you around and make you feel like you’re boiling from the inside out. For some people, it gets worse. I drew that lucky lotto; having a neurological malformation means that I will live with chronic migraines the rest of my life. For those of us who suffer not only from one illness but from two or more, we mean more than we are saying when we say migraine.

It’s like experiencing a pressure that’s going to push my eyes out of my head, numbness that makes me feel as if my legs will give way, pain to the point where I’d gladly go under the knife, and sickening photophobia. But, that’s not even the tip of the iceberg. If I’m having a migraine then it’s likely that I’m also suffering from a Fibromyalgia flare; imagine making your way through that Excedrin video while walking on pins and needles. Literally. That’s what it feels like. The word “migraine” for me means having no energy, being unable to feed myself, slurring my words, and looking generally like I’m drunk.

When I have a migraine I can’t walk, I can’t think, I can’t speak. My first Chiari migraine left me completely speechless. I only remember screaming and passing out. It’s not pretty. We’re not faking, and we’re not saying migraine and meaning a simple headache.

My brain looks like the one on the right. Unfortunately.

Have a Defense Plan

Coworkers have made comments along the line of “you have sick time, you should use it!” Many chronic sufferers know that sick time is something to be hoarded like Smaug and his mountain full of gold. I don’t know how my health will be 4 hours from now, let alone 6 months. And because my body is already pretty wrecked, normal illness lays me out. So, I work through what I can and build up sick time. Sometimes that’s a doable thing, sometimes it’s not. That’s why you have to be prepared.

Make What You Carry Work For You

Carrying around an emergency room in your purse isn’t an option; grocery shopping with rolling luggage makes people stare. Which means what you carry has to pack a punch. I always carry five important things in my tote bag:

  • snacks – taking medicine on an empty stomach isn’t a good idea
  • pain reliever – Excedrin migraine in the travel size
  • Albuterol inhaler – breathing is good
  • roll on Icy Hot or Aspercream with Lidocaine – don’t carry stress in your shoulders!
  • and water in my tote bag – staying hydrated is key

Think of this as your “Point A to Point B” plan. What I carry needs only to get me from home to work, or from work to home.

When In Doubt, Stock Your Stash

Being at work with a migraine is another thing entirely. My desk is stocked with:

  • extra snacks – because memory loss is such a thing
  • caffeine – it’s often found in migraine medications because it helps reduce inflammation
  • a full-size bottle of Excedrin
  • rice warmers – heat also helps reduce inflammation with Chiari

The Excedrin website also recommends some things to help you cope with migraines during your workday, including practicing neck stretches at your desk and learning stress management techniques. I put all of my resources into an A5 table to help me document how often I utilize my plan, and how intense the migraine becomes. I’ve also created a blank table that you can use; simply print it off and write in your own plan.

Talk to Your Doctor!

I’m a librarian, not a doctor. All this comes from my 6 years of neurologist appointments, and a lot of self-propelled research. If you have migraines, make an appointment with your doctor and talk about treatments. I’ve also learned tons from other chronic illness sufferers; reaching out on social media is the only reason I haven’t gone insane already.

If you have questions, please don’t hesitate to leave them in the comments! 

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