Managing Migraines for travel and life
This piece is for anyone suffering from migraines, travelers or not. First, know that I have two proven solutions and a third possibility for you, one over the counter, the other prescription and the last involving diet. Second, this is my personal experience, and not a doctor’s recommendation. I write about what I know and what works so you can potentially benefit.
I have to state right up front I fell in to the doubting Thomas category regarding about migraines, as in, what were they, did they really exist or was it all in the person’s mind? As I write in my novel, In a Moment, Lindsey Gordon, the main character, realizes that she “mocks what she doesn’t understand, and then you get to experience it yourself.” This came from a place of knowledge, and it was migraines.
In hindsight, I figured that God, in his infinite wisdom, finally decided forty years of ignorance was enough, blessing me with migraines starting at age 47. For three years, I’ve been a part of what I call the suffering club. Over this time, I’ve learned how to manage the headaches, and when I’m a really, really good girl regarding my eating, I can almost entirely eliminate them. But alas, I don’t always have that kind of discipline: I travel. I eat. I’m a slightly eccentric author, and succumb. Because of this, you, the reader, are going to get the deep dive so you can travel and potentially a life free of migraines. If this isn’t possible for whatever reason, you can manage (and ideally eliminate) your pain so you can experience all this world has to offer.
Migraine vs headache
Headaches (for me) were throbbing, dulling points of pain, which varied in location. I could always continue to work at the office, travel, sleep or exercise, and generally rid myself of the pain with a couple of Ibuprofen. (As a side note, Aspirin would make me nauseas. Ibuprofen didn’t give me that side effect). When the headaches increased in intensity, it moved to what qualifies as a migraine. Mine have always started with a jabbing point in my right eye, which progresses to a complete wash of over my forehead, left eye, then and down the base of my skull. I’d need to lay down, using cold ice packs on all areas , black out the room, then endure until it retreated.
Solution 1: Caffeine pills, specifically, Vivarin
The short-term, immediate and most cost-effective solution are caffeine pills. In particular, Vivarin. Now, before you shout at me that caffeine causes headaches, and that caffeine withdrawal can actually make the situation worse, I will agree with you, but only to a point, and here’s why. If you are traveling and you need to get rid of the pain, run right into the nearest grocery, convenience or drug store and pick up Vivarin. Full stop.
This immediate solution was gifted to me by my husband on an overseas trip when I started to moan. Initially, he suggested an energy drink (which I hate), and I declined. Then he gave me a Vivrin, and within minutes, the headache eased up.
Caffeine pills increase the size of the blood vessels and associated flow of blood to the brain. The increased circulation has an immediate effect (within 15 min). The was my solution for two years, prior to breaking down and seeing a doctor.
I found that Vivarin worked better than any other brand available, and I’m not exactly sure why. I’d test out others when Vivarin wasn’t available, but found most made me nauseas. I have no explanation for this, only that my system wasn’t compatible with these other brands. Trust me, I’d love it if my head responded to all brands equally, but it just doesn’t. Also, it’s relatively inexpensive and over-the-counter, so you can freely travel with these pills across borders. Even today, I keep a handful of tablets in my purses and jackets just in case I run out of my prescription, haven’t been eating as healthy as I should, or both.
Sleep deprivation and “the bounce back headache.”
The first is obvious. The more caffeine you push ingest, the greater the jitters, irregular heartbeats and inability to sleep. This was intense for me because I haven’t ever consumed coffee or sodas, two primary sources of caffeine. I’d be up for hours (and hours and hours), but eventually addressed this by taking two Melatonin pills each night. After about thirty minutes, I’d start to wind down. For those unfamiliar with Melatonin, it’s a natural sleeping supplement. It’s a godsend.
The bounceback headache
This was an unfamiliar term to me until the day I filled my first migraine prescription medication. After the pharmacist heard my headache-to-migraine journey, he said, “You will really like these (the pills). All the benefits of removing the pain without the bounce back headache.” Users of caffeine pills can attest that the bounce back headache can be can be as bad, or worse than the original. Just as the caffeine pills work to immediately rid the headache, if you go off the pills just as immediately, (thereby constricting the blood vessels) the system goes into shock, and yes, the headache returns in full force.
The step-down approach
If you are going to use caffeine pills, plan on the step-down approach by gradually reducing your dependency on the pills. If you started with two pills, go to one, then a half, then a quarter. It may take a day or two (depending on the severity of what you started with), but you can still function. This is better than going cold-turkey and putting yourself in more danger (for irregular heartbeats—jacking your system sky-high, then dropping like a bomb is extremely unhealthy).
Caffeine withdrawal is akin to sugar withdrawal, which has been compared to withdrawal of serious drugs, such as heroine and meth. In fact, a dear friend who nearly died from a diabetic sugar withdrawal told me (from the hospital) that the doctors told him sugar withdrawal is 20 times greater than the closest drug. That said, I had surgery, used Oxycodone, and as soon as I could, went off it. In my haste, I ignored the doctor and went cold turkey (after about three weeks on the stuff). For two days I experienced headaches, cold sweats and fever-like symptoms. It’s the closest thing I can compare to going off caffeine.
Summary for the quick fix
If you need a quick fix, are on a budget or honestly don’t want to take the plunge with a prescription (which I don’t blame you, I resisted for over two years), then this is a solution that has worked for me, and may give you relief. Just use the pills properly and know what you are getting into.
Solution two: the prescription, Riztriptan Benzoate
The crossing point for me from Vivarin caffeine pills to prescription was when even three or four pills weren’t killing the pain. With that much caffeine in my system, I was having diarrhea (say it with me: awesome!) and I increasing worried about my irregular heart beat. Even so, I didn’t want to become “one of those people” who were dependent on a prescription. I tried every alternative I could: acupuncture, every natural remedy known to man, alternative healing…nothing worked, but even then, my obstinate, persistent self overruled my rational brain.
It was then that the Big Man pulled out the stops. One day, the migraine was so severe, I’d taken three or four caffeine pills, gone to bed, holding two ice packs, one against my eye, the other on my lower skull. It still felt like needles were going directly into my eye. All night I suffered and cried. When I woke, I was blurry, but functional, somewhat annoyed I seemed to have a dark spot on my right eye that wasn’t going away. Two days later, I finally got out of bed (this had occurred over a weekend), and the same black spot was present, everywhere I looked. My husband laid down the law: I was going to see a doctor.
The doctor listens, examines my eyes and explains the blood vessels were constricted to such extremes vessels that one literally popped in my eye. In other words, this “jelly” as it’s commonly referred to, won’t ever leave. It’s here to stay, in my vision, for the rest of my life.
This is the generic version of the brand name migraine drug Maxalt. Instead of paying $800 for Maxalt, I pay $10 for Rizatriptan with my insurance co-pay. However, when I’ve not had insurance, it’s $40 for 18 pills. Can we say massive savings?
I’ve never used another prescription, so can’t speak to alternatives. That said, I have friends who use other brand name pills but don’t seem to have the same result.
The first benefit is the pills start to work in about fifteen minutes, almost the same as Vivrin. When I feel the onset of a migraine (again, usually over my right eye), I take one pill, which are chewable, tasting like mint. While the warning says it induces drowsiness, I’ve never experienced this side effect, nor have I noticed feelings of impairment. Sometimes, I’ve felt a little less energetic, but this hasn’t ever stopped me from exercising after an hour or two (unheard of, even with the Vivarin). For someone who went from a debilitating, two-day cycle of migraine to normalcy, this is nothing short of the Red Sea parting. Further, as promised by the pharmacist, I’ve never experienced the bounce back headache, nausea or other issues.
Quantity. Rizatriptan, and all drugs in this category, are in the same category as Oxycodone, so it’s regulated. That means doctors usually prescribe 8-12 pills per month, yet migraines can happen randomly, and in my case, 15-20 days per month. The pills worked great, I just needed more. The only (legal) way to do this was go back to my physician, which I did. But prior to that, I called my insurance company.
The right number
After a (long) discussion with the representative from Blue Cross Blue Shield, I learned the initial prescriptions are 8-12 is because: “Over the years, statistics have shown that if you need more than 12 pills a month, you have something seriously wrong.” It was explained to me that “seriously wrong,” meant some sort of brain ailment. Well, I wasn’t in that category, and the woman was sympathetic.
“My migraines were so bad,” she explained, “I had to get shots directly into my head once a month for three years.” Imagine my shock at hearing this. The representative told me I needed to visit with the doctor and request 18-24. If the doctor signed off, I could get my pills.
I figured 24 might be overkill, but 18 was nearly three weeks. That’s what I did, and what I’ve been doing for about 6 months now. Let me tell you this: By the end of the 30-day cycle, I am counting the pills and monitoring what I eat because I can only get the refill on the exact day noted by the doctor.
Summary for Rizatriptan
Excellent solution, has changed my life for the better, and in my case, zero side effects.
Solution three: manage your diet
While I was thrilled, overjoyed and beyond ecstatic to have my old life back, I have never been comfortable with the notion of being on pills for an extended period of time. So, for the last six months, I’ve continued to search for a way to naturally heal my body.
One day, my next door neighbor (she, a doctor, married to a doctor) asked me if I was “open-minded,” and would consider an alternative view of headache solutions. Of course I said yes, and she gave me a book that focused on healing through foods. When one is desperate, one will do pretty much anything, and I was at that point. To make a long story short, I read the book over the weekend, spending lots of time on migraines and the solutions therein. Very specific recommendations were made to reduce and/or eliminate migraines. Further, it listed the primary culprits of migraines, along with inflammatory culprits. The book is The Medical Medium by Anthony William, Chapter 10 is solely on migraines, and page 131 lists triggers.
The list of potential triggers is long, and by process of elimination, I’ve narrowed down my personal “triggers” for migraines. This includes non-organic meats and sugar: more than a couple tablespoons, two days in a row overloads my system. Now this may sound like a lot, but it’s essentially one can of Coke, a bowl of cereal or cookie, or even some ketchup. Sugar is in pretty much everything. Regarding meats, when you are dining out, you can never, ever guarantee where/how the meat is sourced.
Nonetheless, I got culinary religion and started eating like a rabbit. While I continued to have dairy and eggs, I eliminated meat and sugar, which means most breads, unless I made it myself. Guess what? I’d still have one or two a month around my period, and that was it.
Food to kill the migraine, not just prevent it
The few times I did get a migraine, I held off taking the pill, and put a few of the recommendations to the test. I juiced up celery, cilantro, apple and cucumber. That’s all I drank/ate for the space of four hours. After the first hour, the migraine reduced to a headache. By hour three, it was a dull throbbing. Hour four, I felt like a million bucks. Seriously. That afternoon, I was walking the dog.
It’s not always possible to stop and juice up. On local trips, I take my juicer (which I purchased on sale for $125 vs $300), but honestly, it’s a real pain in the fanny to be trekking the juicer with me, going to the grocery store etc. so do my best not to eat trigger foods. Nonetheless, when I’m home, and I’m all stocked up on celery etc., this is my go-to solution.
Summary for dietary changes
A healthier lifestyle is nirvana, what we all strive to achieve. If you are searching for a natural route, I would definitely spend the money on the book 1 and 2 by Anthony William. They are worth it. For me personally, note I said “strive.” I’m not a no-sugar gal, or vegetables only, and because of this, I know that I’m making a choice to try certain foods, or live on the edge that may trigger a migraine. In the end, my lifestyle is probably 80% congruent with my body-chemistry, and 20% living on the edge. For that reason, I have my prescription handy, and as a fail-safe, the Vivarn. In addition to taking your camera and book on your next trip, include at least one of these items. Your head and traveling companions will thank you!