osodecanela: (Default)
In some ways I'm surprised this hasn't happened sooner. I went into migraine aura this morning. All I can say is thank G-d for caffeine.

I had my first migraine at 17. I didn't know what the hell it was at the time. I was at a dorm party my freshman year- wine & cheese. First time I drank red wine. And the last. About 45 minutes after I got there my vision went wonky. Suddenly, my visual field narrow dramatically, & what vision remained it was horridly distorted by zigzagging lines and flashing lights. On top of that the lights in the room hurt like hell. I thought I was going blind. About 15 minutes after that, suddenly I felt like someone had stuck in ice pick through my right eye. I remembered hearing someone behind me if I started to heave into the john, "He didn't have that much to drink did he?" At that moment it felt like my brain was about to spill out through my eyes.

I landed at the college infirmary, where the emergency doctor on duty branded me a migraineur, & mercifully put me out with a shot of morphine.

When I came to a couple of hours later, I was still in pain, but not nearly to the degree I had been. My head still throbbed, though dulled, but amen, my vision has returned to normal. Seeing that I was now awake, The doctor walked back over. "Feeling better?"

"Is this what being hung over feels like? I only had one glass of wine."
"No, this is what it feels like to have to ride out a migraine."

It turns out that not only was I rather textbook in my presentation, but I had had the good fortune to have been taken care of by someone who was a migraineur himself. What I had suffered was a textbook visual aura in less than half an hour from my very first glass of red wine. It turns out that red wine is a rich source of the chemical tyramine, which a good handful of classic migraineurs are sensitive to. Aged cheese, herring and chocolate round out the other large dietary sources. A wine and cheese party is a recipe for a tyramine sensitive individual to experience true misery.

I left the infirmary with a prescription for Cafergot, as well as a small stash of Tylenol with Codeine to deal with the 'aftermath' headache that went on for the next couple of days. Cafergot was a combination medication of ergotamine & Caffeine, which if taken at the very first sign of a migraine aura can abort the headache. Over the years I found for me it usually worked like a charm. In the early 90s, a newer & safer class of migraine medication came out, a class called the triptans.

I have found over the years that meditation, stress reduction, and adequate sleep will usually keep me from suffering migraines. I've also found that if I'm caught with out my meds when a migraine starts, I may be able to break the aura and abort the headache if I hit caffeine pretty hard. We're talking like a quart of strong coffee. Amen, that worked for me this morning.

I think I'm going to take it easy on myself today. I'm not in the mood to go back into aura.
osodecanela: (Default)
I was looking at my 3rd patient of the morning when his face disappeared.

I know this sounds somewhat Kafka-esque, but it's actually more Oliver Sacks. I was in migraine aura.

Instead of any functional vision, I was in the middle of a light show. When this happens to me I have about 30% of my visual field, usually on the right, so I cannot look at anything directly. I have no prayer of reading anything. There's no central funtional vision. Also, usually within a few minutes I get way photophobic, and need to dim all the lights.

Today, I popped a Maxalt and got one of my staffers to shadow me, reading stuff to me and depending on my hands to examine folks and give me the diagnostic stuff I need to diagnose problems. Fortunately, I was not in any pain, so it was just a matter of waiting for the meds to kick in and my eyesight to return to normal. This morning that took an hour.

Two of the four people I saw treated during that hour were also migraineurs, so they were familiar with my problem. Amen, this is not a common occurrence for me anymore; this was the first migraine I've had in nearly a year & this time it was just the aura. The Maxalt aborted the migraine before the headache started.
osodecanela: (Default)
Have I mentioned how much I dislike migraines?

The headache today was not nearly as bad as some have been in the past. Having no functional vision in advance of the pain is bloody annoying. I can function thru pain. I cannot function without my sight. All I can do is sit and wait. That's not something I do well.

I just read my post from this afternoon while I couldn't see. I'd turned on Dragon & had dictated to the computer, but had no way to proof what I'd dictated. Good lord! Not doing that one again! The post did not read well, not by a long shot. I just did an edit to correct the text.

Thank you all for your kind words; the headache, the photophobia, and amen, the visual limitations were gone by the end of the afternoon. My vision came back after about an hour. With sunglasses and dimmed lights I was able to get back to work. With sick kids to see and pelvic exams to do I had to get back to work.

Which brings me to the point of this post. I was reminded why I do this today. Once my vision returned I had 3 year-old Sergio to see for a fever of 103. When I walked into see him, he asked why the sunglasses. I explained I had a headache and he (the 3 y/o) said he hoped I would feel better soon. I truly have some awesome patients.

Migraines

May. 4th, 2009 03:00 pm
osodecanela: (Default)
Well this is interesting.

I'm in the midst of my first migraine aura in about a year. I was sitting here at my desk just about to start the afternoon when a phone call came. While on the phone, the flashing lights started in my left field of vision. Within a few seconds it affected almost everything I could see. No headache, but much photophobia & just a degree of nausea.

I saw two patients, both of them by braille. Fortunately they're two people I've known for a very long time. The first was in for a muscle tension headache. How ironic! Fortunately, I was able to press on several meridians & pressure points and give her a fair amount of pain relief. Those are all things I could feel for. The next was a man here for follow-up of alopecia areata. w/
With him I could feel the bald spots on his scalp with my fingers and actually feel new growth of hair in two of his bald spots.

Next was a signature for a pharmaceutical representative, who was detailing the very medication I had just taken, and which I am still waiting to 'kick' in. She actually had to put my hand on the place on her computer tablet where I needed to sign.

I hope this happens soon; I'm beginning to have some very severe head pain moment it feels to have an ice pick boring into my right eye and a vice stretched across each of my temples.

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