I’ve tried every preventive medication on the books; herbs and supplements; Botox; acupuncture; occipital nerve injections; ayurvedic medicine; diet restrictions; chiropractors, osteopaths and massage therapists. None of it made a significant or long-lasting difference and some of the drugs had unpleasant side effects I couldn’t tolerate.
Things I’ve found helpful include biofeedback (basically, teaching me how to breathe in a way that calms my body down, which you could also get from meditation), yoga, a strict bed time so I get enough sleep (especially important when you get menopausal related hot flushes and insomnia), and the TENS (transcutaneous electrical nerve stimulation) machine called CEFALY. This can be applied to the forehead and buzzes the scalp with an eye-watering intensity, until you get used to it. It can be used preventatively but I find it most helpful to cope with protracted migraine attacks that last for days and don’t respond to any other pain relief. I’ve worn it at work and even at the movies, with surprisingly few quizzical looks. Quirky fashion can be fairly unremarkable in Wellington.
One thing I’ve wondered for many years is how much my work environment impacts migraine. The frequency and intensity of my migraine attacks increased around the time I started working in an office. Interestingly, before this I’d been working in hospitals as a junior doctor, by a million miles the most stressful job I’ve ever done. And yet under all that stress and sleep deprivation, I only had an occasional migraine. Was it the change in job type that brought on the migraine attacks – exposure to computer screens, poor posture from sitting at a desk all day, a sedentary lifestyle, lack of exposure to sunlight?
At the end of 2020, I took time out to investigate these questions, taking a break from work and spending five and a half months walking the length of Aotearoa/New Zealand, on the 3,000k Te Araroa trail (our national through-hike; literally the long pathway). Apart from the time I spent documenting the journey online through my Tramping with Migraine blog, which I did via my smartphone, there were no computer screens; no deadlines, zoom calls or team meetings; plentiful sunshine, fresh air, and physical activity; and the biggest stresses of the day were planning where to stop for the night and what flavour of ice cream to eat, if we happened to pass by a shop.
It was an incredible experience but the migraine attacks did not miraculously disappear. I had good days and bad days, just like when I was at home. There was comfort in the routine and simplicity of walking the trail, where the superfluous is revealed and life reduces to the necessities of food, water, shelter and rest. But I still had migraine attacks, just as frequently but perhaps not as severe, although at least 2 lingered on for days, adding pain in the head to the other pains accrued from so much walking.
I learnt many things from Te Araroa, but in relation to migraine, it confirmed to me what I already suspected – there is no easy fix to this condition. If anyone tells me that this is the magic potion/device/diet/programme that will cure me, I take it with a hefty dose of caution. The cause(s) of my migraine attacks remain elusive but there are almost certainly more than one.
However, I also learnt from Te Araroa that I am more capable and resilient than I previously believed. It was the hardest physical challenge I’ve ever undertaken, and equally a mental and emotional challenge. It gave me confidence in myself and faith in the future, that I can and will manage, even if the migraine attacks never retreat.