I’m yawning as if I haven’t slept in days. I’m struggling to string a sentence together. I can smell gas. I’m desperate for hard boiled eggs and cheese.
And I know what’s coming next.
For me, these and a host of other miserable, mind-boggling sensations and symptoms are the first warning signs of a migraine and the endless days of suffering that will accompany it.
My first migraine struck when I was seven years old. I thought I was losing my sight, as I battled flashing lights, zig zags and blind spots. Next came excruciating head pain, accompanied by an hour of vomiting, watched by two very concerned parents. “It’s migraine,” concluded the doctor who was called out to the house. “She’ll be fine with a few hours’ sleep and some TLC from mum and dad.”
And I was fine, albeit after a few days, not hours. But that first episode set the tone for the next 43 years, during which countless attacks – sometimes lasting over a week – have transformed my usual bubbly, switched-on self into a gibbering wreck who can barely function. While they are less frequent now, one bout can still set me back for days, playing havoc with my work and home life. Rescheduled meetings, called-off tennis matches, cancelled social events, guilt about letting people down. That’s migraine.
The US Migraine Research Foundation estimates that a billion people worldwide suffer with this disabling neurological condition, which often runs in families and is more likely to affect men than women. And it doesn’t only affect personal lives: in the US, the economic cost of migraine, mostly from reduced work productivity, is believed to be more than US$13 billion (Dh47.4bn) a year.
Symptoms can begin a couple of days before an attack in what’s known as the prodrome stage, when food cravings, depression, fatigue and hyperactivity are common. Next comes the aura, when problems with vision, movement and speech can occur, followed by the attack itself: a crippling headache and nausea, arguably the most widely known symptoms of migraine. Once this has passed, enter the postdrome phase and more mood changes, ranging from euphoria to apathy. For me, this final stage is often the worst. Lasting several days, it feels like a cocktail of overindulgence from the night before and coming round after surgery.
In the UAE, the number of migraineurs – the medical term for sufferers – is on the rise, according to Dr Anandi Damodaran, specialist neurologist at Medcare Hospital. Around half of her patients have headache-related complaints, with migraine accounting for about 70 per cent of cases. “The pandemic has led to a considerable increase in stress and anxiety, which in turn has caused more people to experience migraine,” she says.
Dr Karoly Vadasdi, specialist neurologist at the Canadian Specialist Hospital, also believes that the last 12 months could have led to more cases. “Migraines have multiple triggers, including stress and anxiety, so it’s feasible that raised case numbers could partly be due to a very tough, emotional year,” he says.
Other attack-inducing factors include changing hormone levels during the menstrual cycle or pregnancy, a shift in weather patterns and sensory stimulation such as bright lights, smells or noise.
Migraine prevention and management takes many forms. It’s essential to identify triggers: a daily diary charting sleep, food intake, activity, emotional states and stress-causing incidents is a great way to establish a pattern of how and when attacks occur.
Simple lifestyle changes make a huge difference to sufferers’ lives. Adopting a strict regime of getting up, going to bed and eating meals at the same time each day – easier said than done, I know – can keep attacks at bay. A healthy, low-carb diet, regular exercise and making time for relaxation are also advised.
While lifestyle modification is recommended as the first step to migraine freedom, medicinal help, ranging from over-the-counter relief to preventative treatments, is also easily available, including the relatively new CGRP injections, which Dr Karoly Vadasdi describes as ‘revolutionary.’
“This treatment works by blocking a protein called calcitonin gene-related peptide, which is thought to cause inflammation and pain in the nervous system of migraineurs,” he says. “It can be prescribed by a neurologist, or patients can self-administer the injections at home, in the same way that diabetics have been doing with insulin for many years.”
Dr Karoly adds that it’s important to get a professional diagnosis for suspected neurological conditions. “Most people get headaches from time to time, which are usually not serious and disappear with pain relief,” he says. “But if other symptoms are present or headaches interfere with daily life, it’s time to get help.”
One alternative treatment for migraines, cryotherapy, is gaining popularity in the UAE. The treatment involves using extremely cold temperatures as low as minus 140 degrees Celsius and is more usually used to elevate performance, support recovery and trigger health and wellness benefits in the body, but Dr Sana Memon of CRYO Stay Young explains how it can also help migraineurs.
“Cryotherapy can be applied to the entire body or localized areas. For migraines we target the head and neck to reduce pain and swelling by narrowing blood vessels which, in turn, reduces blood flow to the area. The numbness means that fewer inflammation-causing proteins reach the area, resulting in less soreness and stiffness,” she explains.
In today’s digital world, we’re inundated with advice and information, but, as with any medical condition, it’s important to consult authoritative sources. A good example is MyMigraineMiracle , a series of books, podcasts and videos by certified neurologist – and migraine sufferer – Joshua Turnkett MD.
There’s also a host of Facebook groups offering advice, feedback, personal experiences and suggested treatments, including the Migraine Support Group UAE and the Chronic Daily Headache and Migraine Support Group.
My personal journey has been long, debilitating and, at times, desperate. But thanks to good medical advice, a healthy sleep, exercise, dining and relaxation routine, ever-emerging research and a very understanding partner, I believe I’m now closer than ever to being migraine-free.
Rebecca Rees is a seasoned writer and communications expert with a penchant for good food, keeping fit, travelling the world and giving abandoned dogs a home.