March 2008
Please don’t let me get pulled over. A field sobriety test would most definitely result in failure. It’s dark out. I’m driving with the controlled intensity of a criminal en route to a safe-house. I wear sunglasses, not as a disguise, but for protection from the severity of oncoming headlights. My knitted winter hat feels like a tourniquet around my throbbing head. The commute takes twenty minutes and I hope to complete it without having to pull over and throw up. I probably should’ve paid closer attention to the warning signs and left work earlier. After all, migraines don’t exactly come over me all at once like an avalanche. They creep in like a slow moving cold front, allowing me plenty of time to think about what may or may not happen to me.
I’m not sure what caused this particular migraine. Known as triggers, the list of actions or conditions that can set a migraine in motion is long and varied: fluorescent lighting, spikes in barometric pressure, aerosol fumes, chocolate, dehydration, depression, even worry over getting a migraine. I’ve had so many migraines under such contrasting sets of circumstances that I’ve given up trying to figure out what provokes my attacks. Every new day seems to bring with it the possibility for a migraine.
Earlier this afternoon, while performing my job as a dispatcher at the post office, I felt a mild current of activity in my right temple. Like a single snowflake, the sensation can melt away harmlessly, or signify the start of something substantial. I rubbed the area; it was tender and sensitive to pressure. Uh-oh.
I kept working, trying to convince myself that the tension building behind my eyes would ease if I stayed busy. But, as the trouble in my head continued to mount, it became obvious that a choice would have to be made. Like a school superintendent who wakes to falling snow, I must decide quickly whether the threat of accumulation is enough to order a complete shutdown.
When used as directed, my migraine medication usually eases the intensity of an attack - the caveat being that it must be taken at the earliest sign of encroachment to be effective. Along with the possibility of relief, however, comes a host of unpleasant side-effects - muscle stiffness, dizziness, fatigue, skin sensitivity - which must be endured lying down, at home. I took my pillbox from my backpack and considered the small triangle-shaped pill, then put it back. Instead of cutting my day short, spurred on by a mixture of duty and denial, I decided to gamble in hopes that my vexation would not escalate. It was the wrong move.
I no longer follow the word "migraine" with the word "headache" in conversation. Calling a migraine a headache limits the focus of its impact zone. The National Weather Service states that a snow storm becomes a blizzard when sustained winds of 35 mph or more reduce visibility to1/4 mile or less, and last at least 3 hours. Similarly, certain criteria must be met before a headache can be positively identified as a migraine. I was already dealing with throbbing pain, decreased peripheral vision, and rising irritability when my stomach began to get sick. With the arrival of nausea, my prognosis was no longer in doubt. This was not just a headache. I did indeed have a migraine.
The time was 4:30. Drawing on my vast experience with migraines, I figured I’d have about two hours before total incapacitation. My shift would end at 6:30. It was going to be close.
My torment intensified as I prepared the mail for the day’s final dispatch. The harder I worked, the faster my blood flowed, delivering swift concentrated punishment to my head and stomach. I was forced to stop and wait for things to calm, but that only served to throw me off-schedule. Surrender was imminent; soon I would need someone to drive me home. I left work shortly after six.
Having made it home without incident, I enter my apartment at 6:30 with a singular goal; get to my darkened room and into bed as soon as possible. My brother is working out on his Nordic Track in the front room.
"Can you feed the cat?" I ask him as I pass through. "I’ve got a migraine. I’m going to bed."
He nods and keeps on striding; he knows there’s nothing more he can do. I stop by the kitchen, grab two cold packs and a Tupperware bowl deep enough and wide enough to catch vomit hurled from a distance. My head is heavy and I stoop as though the ceiling has been lowered since this morning. Kozmo the cat weaves spirited figure-eights through my legs in an attempt to prevent me from exiting the kitchen, but I step over him and into my bedroom closing the door behind me.
I slip under the covers and place a cold pack on my neck, the other on my forehead. I close my eyes. Blue and gray spots appear out of the blackness, growing larger, they bleed into one another like a psychedelic screen-saver, colorizing my pain. I search my pillow for a location outside the migraine’s path of aggression and for a moment find peace. But before I get a chance to exhale, I’m buried under another wave of brutality. I wince and let out a wounded moan, a single tear rolls sideways down my face. It’s as if the pain is being administered by twisting throttle. There is a pulsing in my stomach, a reminder that digestion has shut down and is looking to reverse its usual order. I’m in the eye of a perfect storm; a swirling tempest of pain and suffering.
Sleep appears to be my only escape, but it’s hard to quiet my mind. I wonder if the guillotine was invented strictly as a device of execution or as an eighteenth century curative for migraines. I think of people I know who also live with migraines. Like survivors of calamitous events, we talk in closed circles about what we alone can understand, and find comfort in our shared suffering. I remember weddings, concerts, and holiday gatherings cut short - ghosts of migraines past. I recall some nightmarish road trips; startled chambermaids in Cleveland and New York, who entered darkened hotel rooms to find me motionless in bed; a sympathetic desk clerk granting an urgent plea for a late checkout in Toronto. When you travel, your migraines go with you.
Somewhere around 9 o’clock, I fall asleep.
When I open my eyes, the clock reads 12:02 am. Time for an inventory. I rotate my neck and lift my head off the pillow - no painful backfire. My stomach is settled and demanding food - another encouraging sign. I reach over and switch on my bedside lamp. The light irritates, but doesn’t hurt my eyes. I swing my legs out of the bed. My feet land amidst a pile of rumpled work clothes, lukewarm ice packs, and empty Tupperware. I’m exhausted, relieved, and resentful. It’s Friday night, just after midnight, I have to work in the morning. I didn’t get to workout, didn’t get to read or write, didn’t talk to anyone on the phone, couldn’t have visited a friend if I wanted; I dropped out completely. My brother has gone out. I feel like I should call someone, let them know I’m okay, that I am back. I did not bleed or break any bones, there are no outward scars. When it’s over, the migraine is simply a nasty thief of time. I can’t get even, and it’s pointless to hold a grudge, so I go to the kitchen for something to eat.
The next morning I’m back in my car heading to work, sunglasses on warding off daylight. Physically, I feel like a piece of wreckage in the aftermath. Mentally, I’m a little worried about a repeat of yesterday; sometimes these spells hang around like threatening clouds in a holding pattern. I’ve got the radio tuned to an all-news station. I reach down and turn up the volume as a man’s voice says, "A new study in the Journal of the American Medical Association finds frequent migraines are associated with an increased likelihood of brain lesions and may lead to brain damage." Somehow, this doesn’t surprise me.
*note: I have suffered from migraines since my mid-twenties - nearly twenty years. In August, 2007, I began treating them with acupuncture. Since then I have had exactly one disabling migraine, the one you read about here. I used to experience spells of up to three days about four times a year. As a result of my acupuncture treatments, my migraines are less frequent and less severe. This essay is intended not as a cry for help, but as an illumination of a horrendous malady.
