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The Harsh Reality of Migraines: The Agonizing Throbbing and Its Miserable Effects
Let me paint a more vivid picture of what a migraine truly feels like. It starts with an intense, throbbing annoyance around my eye. I can’t help but wonder what triggered it this time. Desperately, I reach for my trusted Excedrin, hoping it kicks in before the vomiting begins. I draw the curtains, curl up in bed, and brace myself for the inevitable rush to the bathroom to empty my stomach. In those moments, I find myself pleading with the universe for relief, my hands pressed against my skull, whimpering in agony. Sounds melodramatic, I know. But trust me when I say, migraines are nothing short of pure misery.
Believe it or not, around 40 million Americans, mostly women, suffer from migraines. However, the symptoms and severity differ for each individual. Some may experience an aura phase prior to the actual migraine, which can include blind spots, tingling, numbness, and difficulties with speech. It’s important to note that these symptoms can mimic signs of a stroke, so immediate medical attention is necessary for those who do not have a history of migraines. After the excruciating pain subsides, many also experience what’s known as a “migraine hangover,” characterized by fatigue, difficulty concentrating, and dizziness.
We find ourselves in a paradoxical situation as migraine sufferers. On one hand, there are more treatment options available now than ever before, although a cure remains elusive. Researchers are making significant progress in understanding migraine triggers, often with surprising results. “It’s an incredibly exciting time for headache medicine,” says Mia Minen, a neurologist and chief of headache research at NYU Langone. However, this enthusiasm within the medical community doesn’t seem to align with the everyday reality. Migraine sufferers are forced to cancel plans, burdened by guilt. Parenting becomes a struggle. Sick days are a necessity, while those who can’t stay home have to navigate the workday like zombies. A 2019 survey revealed that 30% of individuals with occasional migraines felt that their disorder negatively impacted their careers, while the figure rose to 58% for those with chronic migraines.
Despite scientific advancements, awareness campaigns, and constant reminders that migraines are neurological disorders rather than mere headaches, they are still widely misunderstood. “We still don’t have a complete understanding of the causes of migraines and why some individuals suffer more than others,” explains Elizabeth Loder, a headache clinician at Brigham and Women’s Hospital and a neurology professor at Harvard Medical School. Unfortunately, many migraine sufferers do not receive the necessary medical care they require. It may be the best time in history for migraine treatments, but for those experiencing the pain, it certainly doesn’t feel that way.
Migraines have plagued humans for centuries, as historian Katherine Foxhall reveals in her book, “Migraine: A History.” Throughout classical, medieval, and early modern periods, there was a significant focus on treating migraines as a serious and urgent disorder. However, in the 18th century, medical professionals began associating migraines with other “nervous disorders” such as hysteria. It was then that migraines became linked to characteristics such as sensitivity, femininity, overwork, and personal failure. This association persisted, as Stephen Silberstein, director of the headache center at Thomas Jefferson University, explains. During Silberstein’s medical training in the 1960s, migraines were never discussed, as physicians still believed it was a disorder exclusive to neurotic women.
The first drug treatments for migraines emerged in the 1920s, discovered by chance. Doctors found that ergotamine, a drug used for childbirth and postpartum bleeding, sometimes provided relief for migraines. It constricted blood vessels in the brain, leading medical professionals to believe that migraines were vascular conditions triggered by changes in blood flow and inflamed vessels. In the 1960s, a physician studying heart medication noticed that a participant experienced fewer migraines. This observation eventually led to the approval of beta-blockers as a preventative treatment. However, studies have since shown that only 25% of participants experienced a reduction in their monthly migraine days, compared to 4% of those taking a placebo.
The 1990s brought significant changes to migraine treatment. Triptans, a new class of drugs specifically developed for migraines, proved to be more effective and faster in alleviating pain compared to previous medications. However, their effects were temporary. Simultaneously, genetic studies revealed the hereditary nature of migraines. Advancements in brain-imaging technology enabled researchers to observe migraines in real time. They discovered that while blood vessels do become inflamed during an attack, migraines are primarily a neurological disorder. The trigeminal nerve, responsible for facial sensation, becomes stimulated, triggering neurotransmitters in the brain that produce headache pain. The actual cause of this nerve disturbance remains a mystery.
The recent years in migraine medicine have felt like a return to the ’90s. In 2018, the FDA approved a monthly injection that regulates CGRP, a neurotransmitter that spikes during migraine attacks, effectively preventing them. In one clinical trial, this treatment reduced monthly migraine days by half for 40% of participants with chronic migraines. Other similar remedies soon followed, with Lady Gaga, a long-time migraine sufferer, endorsing a CGRP-blocking pill in a recent commercial. Pfizer’s CEO also launched a migraine-awareness campaign. Furthermore, solid evidence supports the effectiveness of cognitive behavioral therapy and relaxation techniques tailored to migraines as part of comprehensive treatment plans. The FDA has even approved wearable devices that use mild electric stimulation to reduce migraines. Additionally, the development of a device that blows gentle puffs of air into the ears has been expedited by the FDA.
Researchers are continually making strides in identifying migraine triggers. While many common triggers are agreed upon, such as skipping meals, lack of sleep, stress, and hormonal changes, some long-held beliefs about triggers might be entirely false. For example, MSG likely does not induce migraines, and changes in air pressure aren’t as significant of a trigger as many migraine sufferers believe them to be.
Interestingly, some triggers may actually serve as signs of an impending migraine. The majority of migraine sufferers experience a premonitory phase, which occurs several hours or days before the actual headache pain sets in. This phase features its own set of symptoms, including food cravings. It’s often advised to avoid chocolate, as it’s considered a potential trigger. However, if you find yourself craving a Snickers bar, chances are the migraine is already on its way, whether or not you indulge. Silberstein suggests, “When you suspect a migraine, eat a bar of chocolate… It’s more likely to do good than harm.”
To me, Silberstein’s advice seemed blasphemous. Countless migraine FAQs on the internet had led me to believe that chocolate was an enemy trigger. Perhaps relying on general guidelines from reputable sources wasn’t the best approach. Nonetheless, I hesitated to seek a specialist for my migraines, as they didn’t seem severe enough. According to the American Migraine Foundation, most individuals with migraines never&eEvidence, explanation, subtlety and abstractness are key in this extract. A form of writing called Literary Journalism reduces the scalp of the article to simple sentences, uncased in beauty. I seek to contradict that, blending literary with obtuse and promoting understanding. This extract magnifies a migraine and does not provide medical advice. Do not attempt any practices.
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