The Varying Levels of Migraine

Wednesday afternoon:
Migraines have been an issue for me for a very long time. I have just about every “type” of migraine you can find, including what is listed as rather rare – The Cluster Migraine. Most of the time, I can tolerate them and/or they don’t stick around in such a way that drastically affects my life. I’ve had three MAJOR long-lasting migraines that I can think of and I’m dealing with the third one right now. It’s been going on for over a week and has ranged from a tolerable level where I could function, as long as I avoided computer screens, to landing me in bed after having taken multiple meds to just knock myself out. When it hit a week of this going on I called my Neurologist, who, of course, was out of town. Two days later, he’s back and he called me in Dexamethazone. I looked online initially and read the pamphlet and couldn’t find anything about using a Steroid to kill a migraine. Then, I finally found this article. And another one here about Steroid Injections for cluster headache.

I took the first dose of the Dexamethazone and it made me rather fuzzy headed; a descriptor that my husband always interprets to mean something similar to being drunk. In reality, it’s not so much like that but rather like the thought equivalent to blurry vision. My thoughts are blurry? Maybe. Four hours later and I’m a little less fuzzy. My right eye still hurts and the light from my laptop still strains it greatly. Yet, here I sit anyway. I don’t do well laying down and seem to want to continue to “do” despite the fact that much of what I’m “do-ing” only makes things worse.

Mostly, I think it has to do with the varying degrees of migraine. This is something that most people have a hard time understanding. I think my husband is used to it with me, because he’s seen me deal with it for so long. While people like him and other people I know only get occasional migraines that are so terrible that the only choice they have is to go lie down in a dark room, I get the full range of migraine pain. Like them, I occasionally get those terrible migraines that leave you nauseated and unable to do anything but go hide in a dark room. This particular migraine I’ve had for the last week has hit that level twice. The worst was on Friday. I’d already taken two Relpax that day and a handful of Tylenol and it wasn’t going anywhere. Then the nausea hit and I ended up taking 2 (or 3, I honestly don’t remember) Fennigrin and another Relpax. Eventually, the nausea med kicked in and did what I needed it to do: It knocked me out. Saturday, I woke up feeling what I call “a migraine hang-over”. My whole body felt like it had been run through the coal. It felt like a Fibro flare, but a little different. I’ve encountered this a handful of times after really bad Migraine attacks. The headache itself was minimal on Saturday, so I was hoping I’d finally beaten it. I hadn’t and Sunday it was back. Monday, I called the Neurologist.

But, back to the varying degrees.

Level 1: I’d say that 80% of the time I have a migraine I will continue to function fairly normally. I’ve dealt with enough pain, whether Migraine or Fibro or whatever, that there is a certain level I can just ignore. While this level of pain might be what others would call an 8 or a 9. To me, it’s a 5 or a 6. Nothing I can’t ignore, if I have good enough reason. However, it will get worse if I completely ignore it and/or if I sit and stare at the computer screen all day (ie. work).

Level 2: This is where it was for most of today. It hurts a bit more, maybe a 7 or 8, and I’m maybe a little bit nauseated with it. When it gets that bad, I’m more likely to ignore the computer screen, but not completely if I feel I have things I need to do. Also, at this point people who know me well can see the pain in my face. My mom is recovering from surgery and asked if I could come take her to the grocery store today. I did; however, I walked into her house and immediately she could tell I wasn’t feeling well.

Level 3: This is the go to bed level. If I’m smart, I will just go to bed here and be done with it, after taking whatever I can find to dull the pain and nausea. This is a 9 on the pain scale.

Level 4: This is a 10 (or higher). This is me doing my best to not puke before the nausea meds finally kick in. This is me trying to knock myself out because I was stupid and ignored the signs at levels 2 and 3 and allowed it to get this bad. This rarely ever happens by itself, but it has. I’ve had an occasion or two where a migraine has gone from 0 to 60 before I could even get my hands on something to take. But, most of the time, it hits level 4 before I ignored the earlier levels for too long. This is more likely to happen when I’m in the middle of a Cluster, or when I’ve been having a lot of Migraines, because I’m low on meds or because I’m just tired of bowing down to the pain in my head and want to “just get this done” before I stop.

I think those of us with Fibro can understand this a little more. We all have learned to ignore as much pain as possible before we give in, because we simply don’t have a choice. Unfortunately, we pay the price in return with pain later. We can acknowledge the pain now, or acknowledge the pain later, but we WILL have to acknowledge it at some point. If we are lucky, we can acknowledge a little pain now in exchange for not having worse pain later. But, we all know that there’s no guarantee of that, either. Instead, we live in the moment and do what we have to do and risk paying the price, if a price has to be paid. If I was smart, I’d be in the hot bath already, but this post was on my mind and I wanted to type it up before my head got fuzzy again or I just plain forgot what I’d been thinking about.

Thursday Morning
I woke up at 3:30 this morning and haven’t been able to get back to sleep. The pain in my right eye was terrible. I ate a little something and drank some coffee and it’s a bit better now (tolerable). By better I mean it’s better than it was at 3:30am, but not “better, better”. Thus begins day 10.