My version of a mild attack

Image courtesy of FrameAngel at FreeDigitialPhoto.net
Image courtesy of FrameAngel at FreeDigitialPhoto.net

It started last night with a twinge of a cluster shadow that was stopped quickly with some Tiger Balm. As it eased up, I started yawning uncontrollably for about five minutes. That’s a reliable warning sign that a migraine attack isn’t far behind. Every time I start yawning, a migraine follows within 24 hours. It’s a prodrome symptom I can count on, aura or not. I really expected to wake up in the middle of the night with a migraine or cluster attack. Fortunately I was able to get a full night’s sleep on the CPAP.

I woke up a little before 8:00 a.m. Tired but not hurting, I got dressed, ate some breakfast, and checked email. After breakfast, I turned my attention to a load of laundry and a sink full of dirty dishes. By 10:00 a.m. I began to feel a slight tug to the left of my head. My neck was stiff, too.

I think to myself, “…wonder how much time I have before it starts?”

Within 10 minutes, a heavy heat descends over the left side of my head. It spreads up over the nape of my neck, wrapping itself around my temporal lobe, boring into my ear, up over my forehead, and ending with a dull throb of the blood vessel under my temple. It feels like a vice-grip is squeezing only the left side of my head. It feels distorted and shrunken smaller than the right side. There is an invisible drill boring holes in my forehead and the back left side of my skull, just above my neck.

Absently, I realize some heat would feel good on my neck. So would my TENS unit that’s within reach, so I grab it first. “Thump, thump, buzz. Thump, thump, buzz,” the unit does its work on my tender neck. I turn the intensity up so that it hurts just a little. That counter-irritation is just enough to cut the pounding in my forehead in half. Relieved, I silently hope this attack won’t require one of my precious abortives.

I ponder the intrigue as I realize the right side of my head is completely unphased. It’s as though there are two of me. The right side drives me to share this story while the left keeps closing my eyes because even the tiny amount of sunlight peeking through the shaded window is too intense. My stomach churns as my throat clenches from the waves of nausea. Parts of my body are too hot, while others feel freezing cold. Allodynia sets in when my hair starts to hurt. I turn my attention back to the TENS unit. Its rhythmic vibration is a nice distraction from the neurological thunderstorm crashing through my brain. I think I will take a nap now and let it do its job…

An half-hour later I open my eyes, uncomfortably aware that although the storm in my head is quieter, there is still much more to go. It’s time for Amerge before this thing decides to ramp up again. Besides, it’s after noon and I need some lunch. Maybe that will make it better.

Within 20 minutes, the familiar side effects tell me the medicine is starting to work. The left half of my head feels clamped down as vasoconstriction eases the throbbing pain. The drug has been absorbed into my circulatory system and carried across the blood-brain barrier. Deep inside my brain, it binds to the Type B and D serotonin receptors, stopping the rapid free fall of serotonin characteristic of a migraine attack. It also goes to work turning off the chemicals that are triggering inflammation of my trigeminal nerve. I know this is occurring because the painful grip around my ear is gone. It will take hours to bring the chemical levels back to normal. Meanwhile, the electrical storm continues, albeit somewhat subdued.

Amerge will hang around like a hall monitor for the next 24 hours, keeping my brain chemistry in line. It has been a reliable protector from subsequent attacks. I believe that it deserves most of the credit for the reduction in attack frequency by calming down my brain and keeping it calm until the storm passes.

It’s 3:30 and I am back to where I started at 10:00 a.m. this morning. My neck is stiff and sore. There is a moderate level of throbbing pain on the left side of my head, mostly concentrated in the back left side. I still feel nauseous and dizzy. My depth perception is off. I am tired and weak. The attack isn’t quite over, so rest and relaxation are the order of the afternoon. I take a moment to gather a few things and head for my “migraine cave” (aka my bedroom).

It is cool, dark and quiet here. A heated Bed Buddy is wrapped around my neck while the soothing aroma of my own special “migraine blend” massage oil permeates the air. I took a moment to rub some into my scalp, neck, and around my ear before I climbed into bed. It’s worthless as a preventive, but not bad for a comfort measure. I will probably be here all afternoon and evening so I may as well be comfortable. I really do have almost everything I need, right here in this room. A small microwave sits on top a dorm-sized refrigerator/freezer. All my ice packs and a bucket of ice fill the freezer. The fridge is stocked with water and my rescue medications. An old milk crate sits on the floor next to it full of Bed Buddy wraps, heating pads, and ice bags. The toilet is clean and close by if the nausea decides to trigger any vomiting. Our roomy shower is easy to get into if I need the pounding vibration of hot water to ease the pain. My phone is charged and within reach should I need to call for help.

Within minutes, my eyelids get heavy. Pushing away the laptop, I surrender to sleep. Two hours later I emerge from my cave. The last traces of migraine have disappeared as the sun set and darkness envelopes my world, yet I can still feel the presence of Amerge, forcing my brain to behave. I scoop some chili from the crock pot and share conversation with my husband about the day. Soon it is time to start work as he prepares to leave for a meeting. So here I sit, telling you about the first attack this week. As attacks go, this one is pretty mild. The pain has stayed below a 5 and the other symptoms haven’t made me vomit yet. I’m just glad it’s my daughter’s day off so I’m not needed to watch Baby Girl. Today would have been much harder if she had been here. I wonder if my “mild” attacks look like anyone else’s. What do you think?

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