Ugly Wedding Stuff: Dealing with Migraines

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From Cris Health-wise, I've been pretty darn lucky on the whole and have had very few illnesses - none that have been reoccuring. Unfortunately, The Boy has had his share of ick – specifically, migraines. He's been having them since he was a teenager and they are debilitating. Luckily, several years ago he discovered that he was allergic to chocolate (and red wine and Coca-Cola) – which were causing his migraines. Since then, he's cut them out of his diet and the migraines are long gone.

But some of you may not be so lucky. So I asked my friend Liz to stop by the bloggity today with her advice on handling migraines (during those stressful wedding planning months).

From Liz: You probably know me as the sarcastic bride-to-be who rants a lot about weddings (ok, in general). Despite all my ranting and raving and general carrying-on, there's one topic I tend to leave out when talking to all but my closest friends (minus the occasional comment on Twitter/the Facebook).

I have chronic migraines. Chronic, as in, occasionally 6 days out of a given week.

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Image Courtesy of: Doctor Exclusive

Weddings, new houses, and trying to navigate day-to-day life with another person are all stressful enough as-is and are enough to push many people into stress overload territory. Add in chronic pain to the mix, and it's completely overwhelming at best and debilitating at worst. On the day(s) you do feel well enough to function, the LAST thing you want to do is clean your house/work on wedding crafts/return your mother's call.

So, why write about migraines for a wedding blog? Well, according to the World Health Organization, it's estimated that 15-18% of American women experience a migraine headache each year. Regular social and work activity are reduced in nearly *all* migraine sufferers. In fact, recent medical studies have found that migraines have a negative impact on quality of life comparable to chronic depression and anxiety disorders like schizophrenia.

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Image Courtesy of: Housecall MD

If you're reading this blog, you're likely female and therefore 3x as likely to have a migraine as your male counterparts. If you suffer from them and are concerned a migraine might impact your wedding day then get yourself to a Neurologist - preferably one who specializes in migraines. There are a number of different approaches you can try to control them in advance.

I'm not a doctor, and therefore can't offer medical advice, but here's what I've tried over the years. Hopefully one of these will work for you:

  • NSAIDs (or your basic over-the-counter meds). These are your Excedrin migraines and the like. Ingredients in the "migraine" over-the-counter drugs are often no different than the regular formulas (check the box if you don't believe me). If you take them too often, you're at risk for rebound headaches when you aren't taking the medication. So, use these sparingly. If nothing else, there are way more effective options for you.
  • Prescription pain relievers. There are lots of these. In my experience, they usually don't make the pain go away, you just care less about it.
  • Triptans. If you hear about prescription drugs to relieve migraines, chances are good it's a triptan. Imitrex is usually the first one you'll try, but there are others. If you have a bad reaction to one, another triptan might work for you, so don't give up. Triptans actually make the headache go away. The thinking is that they constrict blood vessels in the head and reduce inflammation (thanks, Wikipedia!), halting the headache. Take them at the first sign of a migraine for the best results.
  • Muscle relaxers. A good amount of pain in the body is actually referral pain, meaning the place where you experience the pain isn't really where the problem is originating. For example, many of my migraines are triggered by neck pain. You may be prescribed a muscle relaxer with or without a triptan to try to get other muscles in your body to return to a more normal state.
  • Chiropractic care. Again, this assumes that the headache is caused by referral pain from somewhere else in the body. A chiropractor will make adjustments to your spine and other areas to try to return the body to a neutral operating state.
  • Preventive medication. If you experience 12 or more migraines per month, your doctor may put you on a preventive daily medication to try to keep migraines from occurring. The four kinds they typically try are: beta-blockers (which reduce blood pressure), calcium channel blockers (more heart meds), antidepressants, and anti-seizure medications. Typically, the preventives are tried in that order due to the severity of side effects. Most doctors will try A LOT before putting you on an anti-seizure medication, as it can have some pretty bad cognitive side effects. In fact, that's the only one of the four I haven't tried.
  • Botox. Yes, it has some legit medical uses. A doctor will inject Botox into the locations where you typically experience migraines. The Botox relaxes the area, preventing the migraine from developing. The downside? It's expensive (think $1200/visit) and you may need 2-3 treatments over 6-9 months to start experiencing relief. You'll likely need to continue getting injections every three months.
  • Physical therapy. Along with muscle relaxers and chiropractic visits, your doctor may send you for physical therapy if he/she thinks the pain is originating from another spot in the body, like your neck.
  • TMJ treatment. Links have been found between issues with the alignment of your jaw and migraine headaches. TMJ is typically treated by a dentist or orthodontist. I have a mouthpiece made by an orthodontist that is attempting to re-align my jaw and decrease the force caused by my bite. Braces or jaw surgery are other options. More bad news here – this treatment usually isn't covered by insurance. Dental insurance doesn't want to pay for it because they see migraines as medical, and your medical insurance won't want to pay for TMJ treatment because they see it as dental. Good. Times.
  • Sinus treatment. Migraines can also be caused by your sinuses. When they're inflamed, they can press on nerves in your face, triggering migraines. You may experience relief with either over-the-counter sinus/allergy medications (get the stuff they keep at the pharmacy – the stuff on the shelves doesn't work), or your doctor might prescribe something stronger. In more extreme cases, like mine, your doctor may recommend sinus surgery to open the passageways and reduce the pressure on your facial nerves. I had sinus surgery for my migraines in January of this year and have experienced some relief from daily headaches.
  • Migraine surgery. This is a new area and is rarely covered by insurance. The procedure was pioneered by a plastic surgeon here in Cleveland (shout-out!). He discovered that, after performing a particular face lift, some people found their migraines stopped. To qualify for the surgery, you must first respond well to Botox, so this isn't an option you can get right away. Also, it's surgically removing or severing the troublesome nerves and/or muscles, so it's not something to take lightly. However, there are indications that the surgery provides permanent relief.
  • Biofeedback. This is my latest attempt at killing the migraines. Electrodes are placed on your scalp and you go through a series of computer "games" designed to respond when your brain relaxes and puts out happy brain waves. The theory behind this treatment is that the brains of migraine sufferers overreact to stimuli and get in a pattern of kicking up migraines. The goal of biofeedback is to get your brain to operate in a more neutral, relaxed state, so that the stimuli will not trigger a headache. Once that happens, you can also be trained to use biofeedback to selectively relax muscles in your body. An overly reactive brain has also been linked to anxiety, sleep disorders, ADHD and more, so if you have any of those in conjunction with migraines, biofeedback might be a good solution for you.

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Image Courtesy of: Pensecola Voice

Again, if you have migraines, you don't have to suffer through them. There are lots of potential treatments out there, and a qualified doctor can help you find the best one to get you through your big day – and beyond!

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