My Migraine History and Experience

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My Migraine History

Hello, my name is Abdulrazak. I’m 30 years old from Kenya. I’m a medical doctor in Machakos County.

One of the not-so-fun things I inherited from my parents is their predisposition to chronic headaches- both my parents, paternal aunts have chronic migraines.

I’ve probably been getting once or twice weekly one-sided headaches associated with neck pain and visual disturbance since primary school- at least I can remember from class 7 onwards, that is at the age of 13. My mom used to give me Panadol after school, apply oil, tie my forehead and send me to sleep. Most times I would wake up well the next day.

Over the years they’ve transitioned from episodic to chronic very gradually, but it all got worse during my years of medical school.

The people Around Me

My parents have had their fair share of severe migraine headaches so for them I can’t fake being okay. My wife is very understanding. She let me into her life knowing I live with chronic pain.

She makes sure nothing disrupts my peaceful night’s sleep. We even at some point practiced sleep divorce hoping I will have few headache days. I will forever be grateful to her.

I appreciate my colleagues at work- some are my bosses now and have stood by me every single day even on days when I feel they might not believe what I tell them.

The Effect of Migraine on My Life

I don’t think about it most times because there’s nothing more I can do. I have missed many workdays and inconvenienced my colleagues. I decided to stop making plans for school- I have deferred several programs.

I decided to stop making plans with friends and family because 95% of the time, I would have to cancel them and I would feel really bad. I have had to adjust my lifestyle and forego my dreams because of migraines. I don’t work at night so I don’t interfere with my sleep pattern, I keep my phone and other electronic gadgets away at night. I avoid sugary foods and minimal caffeine. It just became a cycle of headache, medication, relief, depression.

Migraine is not just a headache but a disease. If we had a choice, we would want nothing but to be “normal”. Migraineurs miss appointments. We miss family gatherings. We request special changes to the lives of those around us so we can function. We spend most of our time in bed, hospital visits.  To control our disease, we are separated from our normal lives- our jobs, our ability to function, even from the people we love the most.

Our disease is invisible. It can’t be seen on Lab results or an x-ray film. With each test performed, our families hear the words “everything is normal”, yet we act as if we are suffering and are unable to perform even normal daily functions.

Our families see the dichotomy of a health care team’s statements that we are ‘normal’ that all the trusted and learned doctors and nurses toss about so easily and often with smiling faces, not the unhappy, depressed patient who insists there is still something wrong and they are in pain. Where does this leave us-the patients?

What I’ve Tried

I have seen several neurologists locally and even abroad. Extensive investigations were done rule out other causes of the headache.

I have tried many things: both medicated and non-medicated. For non-medications, I have tried Hijama cupping therapy, acupuncture, aromatherapy and psychotherapy.

For medications, I used multiple preventive drugs with some response initially and recurrence of symptoms later. I have previously been on Nebivolol, flunarizine, candesartan, sodium valproate, gabapentin, Botulinum toxin injections, amitriptyline and topiramate.

Am currently on a CGRP antagonist- Erenumab, a monthly injection at the 4th dose with better relief compared to the rest. For pain relief, I use triptans mainly or in combination with paracetamol. When taken early most times they work. The dilemma is the fear of getting medication overuse headache.

My Triggers

Honestly, I don’t even know. I guess it’s the most difficult bit- trying to figure out what they are. Mainly: disrupted sleep, oversleeping, sleeping less, drinking too much caffeine or no caffeine, straining the neck, weather changes, dehydration, stress.

“Your susceptibility to a trigger may vary from day to day- so your threshold may vary- and that’s because neurologically we are not the same from one moment to the next.” Vince Martin, MD

“Migraine lives its own life. You can have some triggers and you can avoid the triggers, but sometimes you just get the headache anyway. So don’t fall into the pitfall of blaming yourself for it. It’s not your fault. It’s a brain disorder.” Tine Poole, MD

Days Things Get Unbearable

Sometimes I can’t even take it an hour at a time. When am down with a severe migraine

headache, I just start counting to 30. And then I’ll count to 30 again. My mentality is that I can handle anything for 30 seconds, and when I get through that, I can make it through another 30 more seconds. I do that in hopes that I fall asleep through the pain too.

Be persistent. Be your advocate and just don’t give up. Try everything, you never know what might work for you, or at least give you a measure of relief.

Advice for My Fellow Migraineurs

Remember that you’ve been through the hours of a migraine before. You can do it again if you have to. You are the expert when it comes to how you feel and what you need. Take care of yourself at all costs. You cannot take care of others- not your family, not your colleagues, not your friends- if you aren’t taking care of yourself first. And on the days when people just don’t understand, remember that their lack of compassion isn’t about you, it’s about them.

–Shariff, MD