Migraine; Living with it for 70 Years: A Case Report

Abstract

In this article, the author shares his own story of living with migraine for 70 years. He describes how debilitating migraine headaches can be. He discusses medicines that are available to help prevent migraine headaches and to treat migraines that have already started. Almost none of these medicines were available when he got his first migraine headache at age 15. He is now an octogenarian and encourages anyone suffering from migraine to work with a physician to lessen the number and severity of migraines and essentially to take back full control of their lives.

Introduction

According to the American Migraine Foundation, migraine impacts over 37million people living in the United States. According to the Foundation, migraine is one of the most disabling diseases on the planet. It tends to be inherited. If one of your parents has migraine headaches, there is roughly a 50percent chance you will have migraines. If both your parents have migraine headaches, there is roughly a 75percent chance you will have them as well. Migraine is roughly three times more common in women than in men. Currently, there is no cure for migraine, but migraine sufferers can take certain actions to help their condition. The Foundation encourages all migraine sufferers to visit with a headache specialist if you have not already done so [1].

My maternal grandfather suffered from migraine. My mother said that when she was a grade school kid, her father would feel better if he could vomit during a migraine headache. However, he was not often successful at making himself vomit. She said she became skilled at sticking her finger down his throat and making him vomit. It became her job. My maternal grandfather died in his early 50s, and I was told the debilitating headaches contributed to his demise. My mother had a few migraine headaches, but they were not debilitating. Her mother did not have migraine. So, I had migraine on one side of the family. My fraternal grandparents and my father did not have migraine.

Migraine is a disease that can vary from person to person, so one migraine sufferer’s experiences will be somewhat different than another’s. I’m sharing my experiences with migraine over a 70-year period to give hope to migraine sufferers and to remind medical clinicians of just how debilitating the disease can be.

Scientists do not know exactly what causes a migraine headache. It is widely believed that for complex reasons, small blood vessels in the brain (and sometimes other parts of the body) temporarily change causing the aura and pain. Most drugs today prescribed to treat migraine encourage the small blood vessels in the brain (and elsewhere) to change back to their normal state in order to lessen or alleviate the pain.

My Personal Story with Migraine

I got my first migraine headache when I was 15 years old. I was a sophomore in high school. I didn’t know what was wrong with me at first. I had classic migraine symptoms: aura or lights; visual disturbances; and then excruciating pain on one side of my head; vomiting; pain even down into my thighs; and a feeling of just wanting to bang my head on the wall to make the pain go away. I described the pain to my parents, and my mother immediately thought I was having a migraine headache. She said her father had suffered from them terribly and that she had an occasional one. A visit with our general practitioner resulted in a diagnosis of migraine.

I had occasional headaches throughout the rest of my years in high school, and they got much worse in college. I discovered there were sometimes “triggers” for the headaches: including splashing cold water on my face, drinking red wine, eating cheese, eating acidic food like tomato soup, or food with preservatives (especially MSG), sunlight, flickering neon lights, to mention a few of my common triggers. For whatever reason, merlot wine did not seem to trigger a headache. Sometimes there were no triggers or explanations for the headaches such as when I would wake up in the middle of the night with an aura on one side soon to be followed by a headache. Typically, the aura would last about 20minutes before moving into a full-scale headache. Usually, the headache would last for several hours. The longest one was four days straight without relief. Besides feeling really awful, there is not much one can do but rest when they have a migraine unless they take prescribed drugs.

After college, the frequency and intensity of my headaches increased. Drinking coffee seemed to bring some relief after I had finished the vomiting phase of the headache, but coffee turned out to be a double-edged sword. After college, I started working for an organization that kept a pot of coffee hot all day long, and I started drinking more coffee. What I eventually discovered was that caffeine of any kind was a trigger for my headaches, but coffee with caffeine had become a major trigger for my headaches. Obviously, when I figured this out, I stopped drinking caffeinated coffee, but even decaffeinated coffee could be a trigger, some brands being worse than others. My migraines would cause loose stools, and I remember being at work where I would be sitting on the toilet and then getting up to turn around and vomit. Vomiting always made me feel better.

There was not much available in those days in the way of prescription drugs for dealing with migraine. One drug commonly prescribed in my youth was called Cafergot. It was a vasoconstrictor, and it caused arteries to narrow. It never gave me much relief, and it has been taken off the market as being too risky for any benefits it might bring. A big worry with Cafergot was that it might cause a stroke. I could not take it orally, so I was prescribed suppositories. In addition to vomiting and having diarrhoea, I was trying to push these suppositories into place. If they got warm, they would melt, so I had a supply at home and at work in the refrigerator. There was no privacy at work regarding my condition, as my co-workers knew what was in the refrigerator with my name on the little brown bag, I kept the drug in. My co-workers were gracious in understanding my condition and helping me as best they could when I had a migraine, but there was little they could do.

As I went through my mid to late 20s, I began to get a grip on my migraines. I avoided the triggers as best I could. I kept a journal of the foods I ate and when I ate. If I was late in eating breakfast, I usually would trigger a migraine. I found that eating more frequently in smaller quantities was helpful. I came to believe that migraine somehow involved an imbalance in body chemistry of some kind, and I still believe that to be the case today. I read a medical journal study about how taking aspirin on a daily basis worked for many migraine sufferers as a prophylactic against migraine. I started taking 81 mg of aspirin daily and that really worked to reduce the frequency of my headaches [2]. I found that it was important to break the cycle of migraine if I was to stay free of them. By the time I reached my early 30’s, I still got the aura, but I ceased having a headache following the aura. My auras last for about 20minutes and come with all sorts of visual disturbances, but I have not had a headache following an aura for the past 50 years. I am now an octogenarian.

The Calvary to the Rescue

There are over 20 different prescription medicines commonly used to prevent or treat ongoing migraine headaches. Entertainer Lady Gaga advertises Nurtec ODT (rimegepant) and implies she can perform a concert with a migraine after taking the drug. Nurtec ODT is used to prevent or treat an ongoing attack. Serena Williams advertises Ubrevely to stop an ongoing attack and implies she can play a tennis match after taking the drug. Triptans are a class of drugs commonly prescribed for migraine headaches. One form of tripitans is sumatriptan (Imitrex, Tosymra). Fremanezumab (Ajovy) is another drug frequently prescribed to treat migraine headaches. It is administered by injection. All of these drugs come with side effects and dangers, so the user must take them under a physician’s guidance [3].

Interestingly enough, ergotamine derivatives such dihydroergotamine DHE are still being prescribed, perhaps in part to their being cheaper relative to more recent migraine treatments. Bottom line, there are a calvary of drugs available to help migraine sufferers to either prevent migraines before they get started or treat them once they are underway. There is no need for a migraine sufferer to just suffer in silence and do nothing. There is some evidence (debatable) that untreated migraine may cause cerebellar lesions or subclinical cerebellar dysfunction in the brain. True or not, why suffer if the calvary can bring relief?

Acknowledgment

None.

Conflict of Interest

None.

References

• https://americanmigrainefoundation.org/resource-library/migraine-facts/
• (2019) Migraine Headaches? Consider Aspirin for Treatment and Prevention. New Desk.
• MC Kruit, MA van Buchem, LJ Launer, GM Terwindt, MD Ferrari (2010) Migraine is associated with an increased risk of deep white matter lesions, subclinical posterior circulation infarcts and brain iron accumulation: the population-based MRI CAMERA study. Cephalalgia 30(2): 129-136.