January Peaks

I have a chart that shows all of my Migraines going back at least four years. According to this chart, January is one of my peak Migraine months. Although January is typically a high month, this January has been in line with my last two month even with all of the weather triggers we've had in my area.

I think my Migraines are different right now probably because of the elimination diet. Although they are still in double digits, in some ways I'm kind of surprised my Migraine count is as low as it was so I have been reflecting back on the month trying to figure out what has been different. My total Migraine count is lower this January, but I know I didn't feel right many more days than my chart reflected for January. I realized that I don't record my Migraine symptom only days especially when it doesn't result in Migraine pain. This month, I seem to have had a few acephalgic or silent Migraine attacks as many days I have experienced Migraines without the headache phase of an attack.

I'm not sure that I've ever really experienced acephalgic Migraines before, but I'm starting to think that this is related to some of the foods I'm adding back in too. I'm considering the possibility that some of these foods might be stackable or cumulative triggers. We can have triggers of different strengths. Some can be strong enough to trigger a Migraine by themselves while others can be weaker and only trigger a Migraine when we're stressed or when we encounter them in combination with one or more other triggers.

If these foods are stackable or cumulative triggers, this adds a whole new dimension to the elimination diet that I really hadn't considered before. In general, these types of triggers could be tough to find, but while doing the elimination diet, it can put in different monkey wrenches that we have to be aware of so we can consider everything when determining if a new food is a trigger or to what extent it could be a trigger. Even taking this into account, I know that the elimination diet is still the best way, at least for me, to find my food triggers. I think we would be better off knowing all of our triggers and to what degree they would trigger us rather than not knowing about them at all or waiting to trying to discover them on their own.

I am also surprised my Migraine count is as low as it is because this January has been a very tough month given the record breaking amount of snow we have been hit with. We have had some 'nice' storms almost every week. It is to the point where we don't have any place to put the snow anymore and we may be getting another big storm this week. One thing my records show during this time is that the snow is a definite trigger for me. Some days I can even tell the day before that it is going to snow without even watching the weather reports.

Historically, I believe one reason January is a peak month is because it is one of the busiest times for my company. Everyone’s stress level is super elevated. There is so much that needs to be done in this short period of time and has to be completed to perfection. My group consists of very talented people who can figure out a whole array of things and can work through almost any type of obstacle which puts us at a premium for other groups to want to use our expertise especially during this time.

I've also been having additional stress around one of my sons lately. He's fine. Let's just say the momma bear in me wants to keep coming out where it's very tough to sit back and not do much except give him a little advice that I hope is right for him. It'll be a little while before we know how things go for him, but I will be ready to pounce until things are in a better standing. I'm also concerned about his Migraines throughout all of this. They were under such great control last semester that I would not like to see him go backwards because of his situation.

As you can see, with all of the weather, stress and other triggers going on right now, I am surprised that my Migraines are relatively the same as the last two months and not as elevated as history would predict they should be at this time. I do believe a large part of it is because of the elimination diet and becoming aware of many of the things I need to look out for with my food triggers.

Along with this is that I have been making many more of my own foods. Can you believe I never made my own spaghetti sauce before this? It's really not hard, but I use a very simple, bland recipe that I can add a little something more to every week. It’s really worked out great.

I know I am on the right track by doing the elimination diet. It gets real tough at times, especially in the beginning right before I could add back in new foods, but it has been so worth it for me the both times I have done this diet. When it gets tough is when it's nice to have friends and family to help you get through it with their encouragement while keeping your goal in mind - less Migraines!

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New Neurologist is like New Boyfriend

Sometimes I feel like a new neurologist is like a new boyfriend. What I mean by that is unfortunately for them, they have to put up with some of the old baggage we bring with us from our old boyfriends even if it's not in our best interest.

You know how it is, if we extend ourselves out too much or too soon, we might get hurt again. Never mind that we might be hurting ourselves or not finding our true love because we are holding back too much.

This could also be related to if we don't tell our new neurologist everything we should because they may jump to the same wrong conclusion that a prior old neurologist jumped to. This could be hurting us when our new neurologist should have the full facts about us so we can hopefully find that true magic bullet to help our Migraines. The other part of this is if our new neurologist is not going to listen to everything we have to say and jump to the wrong conclusions, isn't it better to find out upfront that they are not the right doctor for us?

Like many people, I have a lot of stress going on from everywhere. I don't talk about stress with my doctors because to me, it is just a part of life. I know that certain times of the year, my stress will be increased. I know that it can be increased at any other time without notice too and don't even think about talking about money.

I had an old neurologist that made it even harder for me to talk about stress today even though I never talked to her about my stress levels. With this old neurologist, she put me on an anti-anxiety medication alone and expected this to take care of my Migraines. She didn't seem to like when I called to say it wasn't helping and I needed something else before our next scheduled appointment. I also provided her with an interim solution which she reluctantly agreed to accept. Sometime later I found out that she was convinced my Migraines were caused by stress and could not understand why the anti-anxiety medication did not help. So you can see one of many reasons she is no longer my doctor.

With my current doctor, I have only casually mentioned stress once and only because my BP was very high for me during one of my visits where I was too stressed out to come up with something else. I have white coat hypertension during the first few appointments with any new doctor where I let them know upfront about it and my current doctor was no exception in the beginning. I have been well past my white coat syndrome with her.

I know I'm going to have to have the stress talk with my current doctor soon. I do believe, in addition to other things, stress is interfering with my Migraines to some extent, but I also believe that stress is an exasperating factor and not a direct trigger. I know when I have the stress talk with my doctor that I am going to have the bigger talk with her that is long overdue, but I need to be mentally ready for the talk. I really like my doctor and she has helped me in many ways, but I am going to have to have that general Is Stress a Trigger or Exasperating Factor talk with her too.

She has mentioned on a number of occasions how stress can be a big trigger especially for her; she is also a Migraineur. I have ignored these comments so far and not subjected her with my opinion or challenged her on that statement yet, but the time is coming that I feel I need to address it. I don't think I'm going to be comfortable talking about my stress with her until I let her know my opinion on stress and am able to talk about it intelligibly. My doctor has listened to me on many of my far fetched ideas in the past. She is smart enough to make up her own mind in many areas. As long as she is open to the idea and doesn't shut it down right away, that is all I can ask and I believe she will do that.

My doctor is also a member of the International Headache Society (IHS). The IHS had moved stress from their trigger list to their list of exacerbating factors a few years ago. I will mention that to her as well as a lot of the points that Teri Robert makes in her MigraineCast on Is Stress a Migraine Trigger which she also has as a transcript of the podcast written out.

I have a lot to cover during my next doctor's visit since so much has gone on since my last appointment. I'm not sure if I'm going to be able to have our stress talk then, but if I want to be fair to my boyfriend, I mean my doctor, no I really mean myself, then I am going to have to have this talk sooner rather than later.

Who knows, if I can open her mind on this one, she may even make a better boyfriend for some of her other patients...

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Impulsive eDiet

I've been doing a lot of thinking since my last doctor's visit. I've kept this long term monthly Migraine chart for almost four years. Prior to going to my last doctor's appointment, I was able to identify some seasonal Migraine peaks which I hadn't notice before. Another thing that I observed on this chart is that the number of Migraines I've developed was never as low as it was while I was doing the elimination diet even during my seasonal peak periods. I think I've seen this before, but was able to excuse it away as other things which is probably partially right.

Although I've been pseudo thinking about the elimination diet recently, I haven't been serious enough to try it again. I've always been someone who has to plan out everything I am going to do and definitely something as big as changing my dietary needs to have every detail planned out. That's what I did the first time I completed the elimination diet.

When I did it before, I tried to do everything as thoroughly as possible so I would never have to do it again. Before that, I had never done any type of diet and knew I would never want to do it again. This first time, I planned it down to the date I was going to start it, the Migraine medication I would change back to for it and my daily food menu. I read everything I could find on the internet and even bought a couple of books to read.

Anyway, I did something very atypical of me today. I jumped into the elimination diet again this morning as a spur of the moment thing. I started seriously thinking about it last night. I gave away the books I had originally used and could only do minimal reading online. I am nervous about the medication I am on now as I always want to nibble which is not a good thing while on any type of diet. Being a planner, this is very hard for me to just jump into, but I felt like I needed to put a stake in the ground and just go for it. Exhale. I know I need to do this again and I figured the sooner I started it, the better off I would be.

Using my suspicions and upon reviewing my charts, I finally came to the conclusion that I really have no choice but to find out if I have any additional food triggers. I really don't want to do this, but I have not been able to identify if I have any other food triggers even if I suspected them.

When I did the elimination diet the first time, I found a lot of good triggers. However, I believe I have developed additional food triggers since then. When I did the diet before, I chose one meal for breakfast, one for lunch and one for dinner along with a snack that I could have whenever I felt like munching. I am doing that again this time because I can't remember how I would have changed it up from the last time.

I want to stick with this basic diet for at least six weeks. Of course this is not the best time to do the diet, but there really never is a good time to start. Since I didn't even know until today, I haven't told anyone about it yet which usually gives me the inspiration to keep going. I don't want to deviate from the diet as I really want to figure out if I am missing any other foods or ingredients that I should stay away from. I am hoping it will be easier to add back this time because I know many foods I won't have to add back since I already know they are triggers.

The other thing that keeps running through my head that really shouldn't be is the reaction of two previous doctors I used to go to. I totally don't understand why, but they were both down on the elimination diet. I know it is ludicrous, but this type of ignorance always baffles me into thinking I must be missing something although I really don't think so.

I don't see how I can justify, even to myself, going to a better Migraine doctor than the one I currently go to if I feel there are still things I should be trying to get my Migraines under better control first. I feel that if I were to go to a different Migraine doctor today and he were to ask me about my diet, I would have to say that I don't know if I have additional food triggers. At that point, I think he would tell me to find out. Unfortunately, he would not be able to tell me what my food triggers are since there is no easy test to tell us. That would be real nice!

So I am jumping feet first into another adventure I have not prepared for. Although I have been down this road before, the road is very different than it was the first time I traveled it. I don't really see another choice for me right now, but I know I need to embrace it.

I know it's only day one, but I think I've already endured my first hurdles while food shopping this morning. Ready or not, I've just started it again...

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Vacation for Migraines

Have you ever taken a vacation to help with your Migraines? Wait, I don't think I asked that question right. Have you ever taken a vacation so you could work on your work from work to try to help with your Migraines?

That's what I did this week. OK, you can put that big "L" on my forehead now. I know it belongs there, but I had to take a week of vacation from work for a few reasons. I have not been able to catch up or even keep up with work so the thought of taking time off was a huge stressor until I realized I could get caught up during my vacation time on an overdue project and a couple of other things that must be done without having the everyday interruptions from email, phone calls and people dropping by with questions or giving me more things to do.

This big project was due in July so it has been hanging over my head for some time. Although it is due in July, I do not get the information I need to start putting everything together until July. There are also other extra things due that month that do not have the same wiggle room that this project has in due date, but the pressure is kept on until it is completed.

These are all in addition to the normal work we have to do too and it is virtually impossible to do during my already normally expanded workday. These projects reoccur annually. I believe this added stress is a big reason for my increased Migraines since it will exasperate the extra heat and weather triggers that come with the summer time.

With the rise in Migraines and symptoms during this time, I am not able to put in extra time at night or during weekends to work on this project either. By the time I get home, I am exhausted. On weekends, I need to physically rest up on one day and take care of home stuff on the other day. I wouldn't be able to function if I didn't do this.

During this vacation week off, I have been able to finish the majority of the project. After I return to work, I will still have about another sixteen hours of work left on it that could not be done during the week since it has to be completed in the office.

I will keep track of this week off to see getting more caught up has helped with my Migraines. I am now contemplating taking a week off in July every year so I can finish the project then, when I can be away from the office so it does not hang over my head as long.

I know I still deserve that "L" on my head, but I also feel like I've given up a lot more for my Migraines than a few vacation days especially if it does help put my head back on straight and allows me to stop being so stifled while I am able to move forward again.

What kind of things have you done that you really should not have had to do in order to help with your Migraines? Did it help?

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What We Do with What We Got

Migraineurs are remarkable people. Just think about it. Think about the everyday things you do while having a Migraine attack. What I find amazing is that your head is what controls you; what you do, how you think, how you act and so forth. Yet, we sometimes still manage to function even if it's not at our optimal level.

Sometimes at work, I can sit in my office getting barraged with questions from all different sources at the same time. I start to think about how it's no wonder I feel the way I feel. I am being asked to give complex answers while talking on the phone at the same time I am getting other questions by someone who is sitting in the office with me listening to the same call as I am, through email or instant messaging which are both popping up on my screen and a growing line of other people outside of my office.

I think to myself, does anyone really know how I feel right now? Would they really care? What would they do if they were getting bombarded with questions from only one of these sources and felt this same way? Am I stupid for still being here? (that's a rhetorical question) Could I really leave now? Should I leave now? Can I take a pill to help chill out my head which may also dumb me down more? You know exactly how frustrating all of this can get.

This is when I can have a little hissy fit to myself while shutting down email and instant messenger to give me a little more peace. I also point to the phone for the people outside my door to signify that I am on the phone and give other hand signals indicating that I don't understand what they want right now while making it clear to the person in my office that I need to answer the question asked on the phone and we can talk through their question or clarify things for them after.

I usually end up with a secondary internal tantrum. Why am I doing all of this? I can't get to anything else I need to do if I am always on the phone and always answering questions that I have others who should be answering some of them, but they want, no they demand the quick answer from me. Yes, that is my problem and I am working on it.

I know that Migraine is a neurological disease. I know Migraine is not caused because of everything happening at the same time or everyone wanting everything yesterday, but it certainly exasperates all of the triggers that are hanging around ready to fire off at any moment.

Think about what you do everyday while you have a Migraine attack; how you push yourself to do everyday things others don't even think about. This could include taking care of children, an elderly person, an animal, everyday work stuff and so much more. How remarkable is it that you do what you do when not only is your head pounding, but you have other Migraine symptoms you have to deal with at the same time.

This really is what my normal work day has been like recently. I've read a lot of other Migraineur's similar type of accounts. What is your day like? How do you handle it?

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Elevator vs Stairs - Stackable Trigger Follow Up

I had asked for advice a while back on an issue I was having with a stackable Migraine trigger. I was having problems when taking the stairs at work. I prefer taking the stairs up to the 4th floor rather than the elevator since I don't get much exercise plus I like taking the stairs, but it only triggered my Migraines sometimes.

Teri Robert gave me some questions to think about and Nancy Harris Bonk some alternative exercises I could try along with other things to think about around the stairs. So why do I bring this up again now? I wanted to share with you what I have been doing around this issue since I received their responses.

I was asked about my preventative medications, how often the stairs triggered me, what other triggers had to be present and if I could avoid any of them. I have had my preventatives tweaked a few times starting just before I posed my question and my doctor had added in dietary supplements. I'd been trying to keep track of different things that may have aggravated my walking up the stairs too.

I stumbled upon some of the other stackable items when I wasn't feeling well for a while and needed to take the elevator. Slowly different things started to sink in. It turns out that one of my biggest issues with the stairs is taking them up in the morning while carrying my super heavy laptop bag which I take home every night. This added too much extra exertion when I walked up the stairs in the morning. The stairs also have unprotected fluorescent lights which stack up with the extra exertion of walking up the stairs with the bag.

I can still take the stairs down and I take them up when I am not carrying heavy items. I feel so much better when I take the stairs, but would rather not do anything to trigger more Migraines.

I was given a link to 10 Ways for Migraineurs to Sneak in Some Exercise which gives some simple exercises that we can try to manage even on days we aren't feeling well. However, I just found out that I need to be careful if I follow item number 6, Park Further Away, on the sneaking in exercise list. I was also given another link on a study that showed Certain Exercises Won't Make our Migraines Worse. I've got to do something more about exercising since my pants keep shrinking. :-)

Someday I'll figure this disease out for me. I have to. Right now, I feel like I make some steps forward which is better than no steps at all.

Migraines, Football and Driving

I was hoping things would be better by this season, but they are definitely different which was to be expected given everything has changed this year.

Last football season, my son was a senior in high school where by the end of the season I noticed I would get a Migraine after all of his games. I know some of the triggers were the sun if it was during the day, the lights if it was at night and the loud bands (sorry band parents). I would wear a hat, sunglasses, would not sit near the band and drink plenty of water especially on the hotter days.

This year has a few more challenges. He is playing ball in college and I'm noticing even more triggers besides the increased noise level. I'm taking the same precautions that I did last year, but I'm sure part of the reason is that the high school was smaller and I was surrounded by my friends.

I'm finding the many different smells are affecting me that weren't there last year. The perfume, the hotdog smell and even the BO. I think every year I keep hoping my preventatives will help, but I'm not there yet and actually started a new medication this month. At least I have a competent doctor this year so hopefully I'll be where I need to be next season.

There are other obstacles to consider now as well which I never thought of before. His games are not as close to home as his high school games were plus I've been made aware of some common sense things that I really should have known all along.

Luckily my eyes were open to some possible ramifications if I were to drive while Migraining by a couple of well researched articles written by Megan Oltman titled Migraines and Our Driver's License and Migraines & Driving Don't Mix. Of course taking drugs and driving would be something you would think not to do, but since a Migraine is more than just a headache, it really would not be a good idea to drive straight home if I can't put off a game induced Migraine.

His school is not in my town, county or even the same state so I've had to build in extra time or even an overnight stay into my football day if I want to attend his football games. I know I always have the option of not attending, but if your child was involved in a high contact sport could you not attend? I didn't think so because neither can I.

At this point, I work harder to find the right preventative and to try to prevent the football induced Migraines. I have to go to his games because I want to be there for him no matter what plus it gives me that opportunity to see him without feeling like I'm crowding his college experience or at least that's what I tell myself. Plus when I come to his home games, we go out to dinner which he definitely likes to do.

Go to Work or Stay Home?

I came across an article on Somebody Heal Me by Diana Lee titled Migraines Cause Lost Productivity Whether Employees Come to Work or Stay Home which talked about an article about Going To Work With A Migraine? New Study Says Work Productivity Is The Same As Staying Home. This study was presented at this year's International Headache Congress in Philadelphia.

I found these statistics in the article from the study very interesting: The prospective study of 509 Migraineurs resulting in 1,527 Migraine attacks found that 28% of workday Migraines resulted in absenteeism while 11% resulted in a full day of work lost, 5% led to a late arrival, and 12% led to leaving work early. Presenteeism, staying at work with a Migraine, was observed in 62% of workday Migraines.

First of all, I will admit that I am usually a presenteeist. This is something I have struggled with almost everyday. Even before I realized that my just headaches were Migraines, I knew there were times I just couldn't function as well as I should. What was I supposed to do? Call out for just a headache and almost everyday? And because I had always worked through my just headaches, could I really change my patterns now?

I'm sure this is one of the roots of my Migraines, but given my situation, I find it hard to make another choice on a consistent basis especially since I bring in the only income for my family while I have two children in college. I am trying to work on doing what is best for me and my family. I have called out a little more, but it scares me every time I do and still makes me wonder if I would have been better going into work. Some days probably yes, other days definitely not.

Part of my perpetual cycle is because I am sort of part of the presenteeism statistic because when I know I am not putting in a full day of work on some days, I don't feel like I can leave until I have put in my honest day's work. How can I leave until I have worked a real day for my employer? It's also easier to work later because it gets much quieter and my head actually feels like it gets cooler or is not on fire and settles down more. I don't want to do the wrong thing for my employer and I don't want to do the wrong thing for me.

Do I go to work or stay home?

This is why I work so hard to find the right doctor so we can work together to find the right preventatives. We will get there. We have to. At least I wouldn't be asking myself this question as often.

Stackable Trigger Confusion

The more I have learned about Migraines, in a layman's sense, the more I feel I don't know about them and need to learn additional information. It seems triggers are one of the big keys to Migraines and what you do with your triggers is one of the most important factors for you as triggers can be very individual.

Right now, stackable triggers (podcast on triggers; transcript of podcast) are what is confusing me. Stackable triggers are triggers that don't necessarily trigger a migraine by itself, but can trigger a Migraine when we come across other stackable triggers or stress. What confuses me is that I'm not sure if I should just avoid stackable triggers all of the time too, that is if it is an avoidable stackable trigger. I would imagine this would be the prudent thing to do.

You see, I have a lot of triggers. Some are avoidable; some are not. I have gotten so much better about avoiding the triggers I can, but it does take time to break some old habits or to just not do something on impulse - without even thinking about it. Or worse yet, to do or eat something because you don't want to hurt someone else's feeling. This only ends up hurting you in the end. I am really trying to not play around with my triggers in general and stackable trigger limitations anymore.

I think these stackable triggers are still triggers even if they do not cause a full blown Migraine by themselves. I also do not know when an uncontrollable trigger may be lurking around and going to show it's evilness which will cause that dreaded Migraine. I can't afford the time or money that a Migraine costs any longer. I know how hard this is since I am faced with my triggers everyday.

One stackable trigger I find hard to give up right now is chocolate. It has always been my stress reliever. This is a time when I need my chocolate the most, but I also know I have to stay away from it if I want to get through this period of time. Talk about stress on top of stress!

I have a lot more to say about food triggers - just not right now. Food triggers have become a very sore subject for me; some justifiable, some not. I will not whine about my food triggers or whine because I ate something that caused me to get a Migraine especially if it was my fault. What I may do is complain about the number of food and other triggers I do have. But even then, I don't really like to complain unless I've just had too much to handle for too long or am just having a plain old rotten day. Right now, I should find out within the next month if I still have a job.

Now where's that chocolate when you really need it? Just kidding. That's not going to help me if I need to find a new job.