My first introduction to the migraine was through my mother. I remember coming home from school to see her tucked away in her darkened room, recumbent in purple glasses, with an ice pack balancing on her forehead. When my mother had a headache, she became some kind of space alien—one awaiting an autopsy. She’d lay there lifelessly for hours, while everyone else in the house tiptoed around, avoiding the squeaky spots in the floorboards, waiting for our mother to come back to earth. After two Excedrin and a long nap, she’d come downstairs, squinting at the light and cringing at our voices, like she wasn’t acclimated to our atmosphere. Sure, I had had headaches as a child, but I couldn’t imagine the wrath of something so debilitating… until I had my first migraine.
I was about 16 the first time I experienced the sensation of an anvil shattering my skull, over and over again, to the beat of my pulse, mixed with an unworldly aversion to light, and the wretched curl of nausea. I was sure I was dying. I was sure it was brain cancer. And after an impulse double dose of Advil that did nothing to pad the pain, I was sure it would never go away. This is the new me, I thought. And to some extent, I was right. I never stopped getting migraines.
In the U.S. alone, 39 million people suffer from migraines. In order for a headache to be a migraine it has to, by the International Classification Headache Disorders Version’s 3 criteria, have two of the following: moderate to severe pain, be unilateral in location, throbbing in description, worsening with activity; and be accompanied by at least one of the following: nausea, sensitivity to light, sensitivity to noise. In about a third of migraine patients, there can also be visual auras. There are a few factors that make people more susceptible to migraines: if you’re a woman (women are three times as likely to get migraines than men); if a parent had them (more than 50 percent of migraines are hereditary); and, potentially, depression (some scientists believe that a lack of serotonin can cause migraines). Check, check, check—I came into this world, like many other women, with a predisposition for an awful lot of headaches.
By the time I got to college, I had figured out my own alien routine, which included three Excedrin, a bag of frozen corn, a satchel of lavender buds, and a heavy-duty eyeshade. I’d get one to three migraines a month and knock them out of the park with my trusty resources. My roommates would tiptoe around me as I waited for it to pass, and I’d be fine after. But as I started to creep into my late 20s, my migraines became less and less fazed by the amount of Excedrin pumping through my veins. Instead of being knocked off my feet for a few hours, I was out of commission for the entire day, or more.
I went to see my general practitioner about this, who told me I was probably drinking too much alcohol (I wasn’t), or not sleeping enough (I was), and said that I should cut down on cheese and double up on the Excedrin. She didn’t seem concerned with the frequency or intensity of my migraines, and so I tried not to be, too. But then one day, everything changed. It was Halloween, and I knew the moment I woke up that I was going to have a migraine. I had that achy pinch in the side of my neck, and that funny buzz around the back of my head—an ominous aura locating the exact place the anvil would later strike. But it was Halloween, and I wanted to go to a party—I had an outfit and everything. So I started with two capsules of Excedrin. The bottle said I could only take two every six hours, but four hours later, the anvil was making contact, and my doctor said I could double up, so I did—two more pills. And then three hours later that Excedrin-induced euphoric fizzing that took over the most terrible places started to fall flat. The pain was back, and it was only 6pm, and I had already reached my maximum daily dose. I took two more. And then at the party, I took two more after that. But the pain didn’t wane. My head was humming with tension, and after a while, that chaos started to travel down my spine and under my arms and in the backs of my knees. My pulse was slamming into my chest, counting itself at 130bpm, my legs were shaking, it was hard to swallow. On the way home I told my Uber driver that I might die.
Vowing to never idiotically abuse Excedrin again, I decided to see a specialist. I went to the New York Headache Center, a place that has a 90 percent treatment success rate because that’s all they focus on: headaches. I thought I’d walk in, give some blood, fill out some papers, and get a prescription for a cure. But when my blood tests came back mostly within normal range, and my MRI didn’t show a waxing and waning melon lodged in the back of my skull, a medical adventure began. With the help of Alexander Mauskop, M.D., clinical neurologist and director of the NY Headache Center, I embarked on a journey to find a migraine treatment that actually worked. When triggers can range from food to weather to hormones, isolating yours can feel like a shot in the dark. Together, we explored potential triggers (from cured meats and pickles to periods) and treatment options, encompassing Eastern medicine, futuristic mattresses, and every vitamin ever. I’m about six months into my quest to defeat my migraines, and while I still haven’t gotten it down to a science, I have found a few things that work, and a few things that I wish I could get a refund for. Chronic pain is expensive, but if you live with it, you know there’s no other choice. If you too suffer from the curse of migraines, these are some of the treatments you can discuss with your doctor. Keep in mind that what works for me, might not work for you.
Massage, Physical Therapy, Acupuncture
When I have a migraine, I crave massage. If I can’t afford a massage session, I beg my boyfriend to rub my neck or squeeze my head. If he isn’t around, I’ll use a face massager I bought called the FaceBlaster—it looks like a torture device, but it’s surprisingly gently and, at the very least, distracts you from the pain in your head. And while massage might alleviate some of the pressure, it doesn’t scare off the migraine or even really reduce its stay. Mauskop says that these types of passive treatments are not long-lasting. While a migraine sufferer might experience immediate relief, likely the effects will only be short-term. That said, if you have an injury or suffer from poor posture, physical therapy might help you to strengthen your core and the muscles around your neck, which could potentially reduce migraines. And, 60 percent of people who use acupuncture to relieve migraines claim that it works, but it must be used in tandem with other treatments.
Often migraine sufferers are deficient in magnesium, vitamin D, iron, and B12, so high doses of those supplements are prescribed when a deficiency is located during blood work. Daily pill doses were enough to help me minimize my migraines, so I never had to try the IV method. But for other patients, who are less responsive to oral methods, infusions work. Twenty percent of patients see big results with infusions, as the body is able to absorb more of the supplements than if they were taken orally.
I didn’t want to see a correlation between my favorite foods and my migraines, so I put off this experiment for a long time. But for many people, food is a big trigger for migraines, so I knew—especially when my blood work came back within the normal range—that food might be one of the culprits. According to Mauskop, pickled, dried, cured, smoked, and fermented foods all have sulfites and nitrites, which can trigger migraines. Dairy, caffeine, alcohol, and MSG also tend to be big triggers. The best way to eat for a migraine is to stick to fresh foods. But instead of going completely crazy and restricting yourself from everything you love, try a little at a time; that’s what I did. No cheese for a few days, no cured meats for a few days, a break from caffeine and alcohol, and so on. Keep a log of everything you eat so that when you get a migraine, you can easily narrow down the triggers.
A sore neck from an uncomfortable night’s sleep is a one-way ticket to migraine town for me. Over the last few years, I’ve added layer upon layer of cushion to my already pillow top mattress, under the impression that the softer my bed is, the better my neck is. But as it turns out, a firmer mattress is actually a better support system for a painful neck. And a mattress that helps to keep your body in-line while you sleep can minimize soreness. Some people like memory foam mattresses, but I run hot in the night, so that thick, unbreathable material wasn’t right for me. I recently switched to a Purple mattress, which is a class all of its own. The brand claims to have created the world’s first no-pressure mattress that stays cool all night and supports neck health, and though I was very resistant to believing that something arriving in a small gimmicky box could be helpful, it has changed my life. At first touch it’s hard, but when you climb onto it, the futuristic Hyper-Elastic Polymer material moves away from your body. It’s hard to explain how magical and sci-fi this bed is, so I would highly recommend trying it yourself. You get 100 nights from purchase to see if it's right for you before you commit to the $$$.
I am not very good at meditation. Or sitting still in general. I’ve tried all the meditation apps, I’ve tried classes... I still find it boring, and thus it does the opposite of de-stress me. But according to Mauskop, meditation is one of the most useful tools for migraine sufferers to have. Though it sounds a little bit too granola to me, considering the fact that he also runs a headache center that treats patients with much more potent things than meditation suggestions, I think it's probably a good idea to listen to his insistence that controlling your stress levels is an integral part of managing migraines. He also says that while a futuristic mattress might minimize neck pain caused by sleeping, it’s got nothing on the neck pain that’s caused by stress. When we’re stressed, he says, the primary muscles and nerves running through the spine, shoulders, and neck become strained and irritated. So learning to control stress through meditation is key to the migraine-treatment journey.
For me, Botox was never an option. Currently, it’s only approved for patients with chronic migraines, which means those people who get at least 15 a month. And then even after you get approved for being a chronic sufferer, it’s still an incredibly difficult process to get your insurance to cover it. And if you’re lucky enough to get it covered, it’s still expensive, and you have to get it every three months. That said, according to Mauskop, it is currently the most successful method on the market. It’s the only FDA-approved treatment of its kind and has a 70 percent effective rate on patients 8 to 99 years old. If you suffer from chronic migraines, you should talk to your doctor about Botox.
This drug is brand-new but already highly revered by professionals. It’s currently considered to be one of the most promising treatments on the market with a lesser commitment than Botox and longer lasting effect. However, it’s expensive and does not yet have the long-term trials built up that people like to see before injecting themselves with new medications. If you’re in that in-between place of infrequent to regular migraines that are not quite chronic, Amovig might be a great alternative to Botox for you.
Great for mid-level migraine sufferers who do not respond to Advil, Excedrin, or aspirin. If taken at the first sign of a migraine, it can be incredibly effective in warding it off completely. The majority of migraine sufferers rely on this class of drugs to manage their pain; the generic name is Sumatriptan.
Easy to find over-the-counter supplements that headache specialists recommend are: magnesium glycinate, vitamin D, vitamin b12, and CoQ10. But just because you can order these supplements off Amazon doesn’t mean that you should before getting your blood work done with a specialist. If you don’t have a deficiency, taking these supplements won’t do anything for you. A lot of us get these all of these nutrients from our diets.