8.10.2013

I get headaches.

I get headaches. I wrote this to explain a little better just what I usually mean when I say that.

Pain

It feels almost dishonest to call these rebellious spasms of my nervous system “headaches”--there’s pain, to be sure, but it’s nowhere near as intense as I've felt otherwise: sinus headaches or headaches caused by dehydration can hurt worse, and the (blissfully rarer) cluster headaches are a whole different world of pain. Still, though, it’s there.

With my migraines, the pain is a crackling and burning on the surface of my forehead and temple, with fingers of fire reaching inwards to poke at the squishy, malfunctioning brain stuff underneath. The skin of the area affected responds more sensitively to touch and temperature; it feels as though it’s connected to the rest of my nervous system through bare wires.

These pains and sensations are hyper-localized, and for the vast majority of the headaches I suffer from, their efforts can be felt as indicated in the highly scientific medical diagram below (where Data’s face has been replaced with regular old skin):
Paramount

Pressure and Tingling Nerves

There are distracting physical sensations besides the pain. A feeling of congestion spreads through the deepest parts of my sinuses, though only on that same left side. I suspect that it IS congestion of some kind, since nasal decongestants sometimes relieve this particular pressure.

Somewhere between pressure and pain is what happens around my left eye: a constant feeling as though someone has placed magnets of opposing polarity in the bones of my outer brow and in the hollow of my cheek. If I were drawing a cartoon of this, it would be of a “winking” skull, bones closing around the orbital. Weird.

Occasionally, feelings akin to “cold chills”--without the cold--will shoot down my left side, especially my neck and arm. Sometimes I ignore these sudden shots, but other times I immediately try to “twitch” them away; only rarely have I ever dropped something because of this, but when life is migrainish, I try to always double-carry breakable things with my right hand too.


My eye!

My left eye, bones imaginarily closing around it, is busy with other things, too. It will periodically tear up, usually when accompanied by sinus pressure. My blinking will sometimes ever-so-slightly fall out of sync, as my left eyelid begins to act “sleepy” and heavy, even when its twin across my face is just fine.

My subtly droopy, lazy eyelid pairs with another visual indicator that these internal states are a Real Thing: my pupils don’t react to light the same way, and the left pupil sometimes becomes measurably smaller than that of the right. This is called Horner’s Syndrome, and Wikipedia illustrates it with this lady:
From "Horner's Syndrome", Wikipedia
I can’t say I’ve ever noticed a difference in brightness between the images my two eyes bring in, though; I guess my brain is pretty okay at sorting all that out. Rarely my vision will get blurry in my left eye, but that is, I think, transient and unrelated to the Horner’s thing.


Light and Sound

My ability to make sense of the world’s lights and sounds is impacted at the height of these attacks. Bright sunlight doesn’t really affect me much more than it would on another day, but abnormally bright rooms and sudden changes in brightness do. Pinpoints of bright light, like flashlights or pulsing alarm clock lights in the dark, can lead to more pain and cascades of tingly badness.

Sound is interesting. Volume doesn’t seem to matter, but quantity does. When many people are talking, or when the ambient sounds of a room fill with shuffling papers, footsteps, clanking silverware, and et cetera, I can easily become overwhelmed and distracted by it, overreacting to sudden noises and unable to follow individual voices or conversations.


Imagined Light and Sounds

Calling this section “hallucinations” would be overkill, but the auras that sometimes accompany my headaches are disorienting and distracting, and interrupt whatever sensations I’m supposed to be processing.

As fun as it is to say “scintillating scotoma”, they’re kind of bizarre to experience; sudden arcs of pulsing light emerging from the corner of my vision, never defined enough to focus on. Oddly, these accompany my headaches more when I’m taking my migraine prophylactic medicines than when I’m not. If you don’t know what I’m talking about, they look a little like this (artists’ depictions from Wikipedia):


Mine are relatively mild; in a well-lit room I might not notice them at all. In dim light, they get noticed. More often, though, my visual auras look less like alien messages and more like everyday lights that never occurred. The three big ones:
  • Imagine candlelight coming from one room over, just out of range of your vision. Dim and flickering and persistent

  • Imagine that instead, one-room-over is home to a photography with a flashbulb. Sudden, bright, barely on the edge of your field of vision, and gone quickly

  • Close your eyes in a dark room and imagine a police car, siren lights on, parked outside your window (this is especially easy if you live in a neighborhood like mine.) Regular pulses of bright light that seem utterly real, until you open your eyes to pitch blackness.

Each of the above is, for me, completely congruent with its real-life metaphor: I can’t instantly tell (except by “playing the odds”) when these lights are real or imagined.

Another “crazy pattern of light” that sometimes happens when I close my eyes is definitely NOT congruent with reality: shooting, lingering, intersecting trails of light. The closest visual analog I can think of is the old Windows screensaver “Pipes”:
if the pipes were made up of streaking light.


Cognitive

Everything I've said above bundles together into a collection of discomforts, distractions, and annoyances. What causes me the most anxiety towards these attacks, though, is what they do to my ability to clearly think and communicate.

You may have seen a news clip a few years ago featuring reporter Serene Branson, who appears to suffer from a complex migraine attack with aphasic aura while on the air:




I’m fortunate to have never been struck that badly, but I do sometimes do show milder signs in the same family. Thoughts that seem fully-formed in my head stumble out of the gate when I try to speak them...my speech is full of stops and starts and “lost trains of thought”, and I sometimes end up sounding like a record played at the wrong speed. Powering through this to try to get out complete sentences and thoughts is a ton of effort, and wears me out quickly.

Strangely, this has seldom had any effect on my ability to communicate through type. I’m writing this essay now through a mild migrainous haze, and I guarantee that I would be less fluent if I were speaking instead.

That’s not to say that the associated cognitive problems are limited to speech; I’m utterly useless when it comes to other high-demand tasks, like reading complicated texts or remembering directions or performing any activity that requires a modicum of deliberation or patience (e.g. preparing a meal, playing an instrument, interacting with others with some degree of civility.)

---

Although I was headache-prone my whole life, I've only suffered from these attacks for the last 12 or 13 years. They used to terrify me, and in the past they (along with my very occasional cluster headaches) had a large impact on the directions I chose to take in my life. I’ve come to better terms with them since, especially since going through the process of ruling out more serious conditions such as brain tumors:
(my relatively normal brain, 2010)
Which is some small relief. As much as this is terrible when it’s happening, it always passes.