As a lifelong sufferer of migraine headaches, I have always counted on the “migraine aura” to act as an early warning to me that one of these brutal headaches was coming. Both a blessing and a curse, the aura is a set of symptoms that many migraine sufferers (those who suffer from “classic migraine with aura headaches”) experience before the pain starts. Some of these sensations include blurred, spotty, or tunnel vision, light and sound sensitivities, and a “strange” or “tingling” sensation in the skin. Some sufferers also experience olfactory sensitivity, GI discomfort, and changes in concentration ability.
While the aura is very helpful to most as an early warning system that the migraine is coming, thereby allowing the sufferer to take their pain medication before the pain sets in and gain better pain control, it can be a very frustrating experience for the person about to experience a migraine headache. Lasting anywhere from five minutes to several hours, the aura is like a clock ticking away in your head. “It’s coming, it’s coming, it’s coming.”
But is there a better early warning of a migraine? Can a migraine sufferer see a migraine headache coming before the aura starts? I never believed I could, but recently, with the help of people close to me, I have become able to discover patterns and behaviors before the aura, often up to twenty-four hours before. Sometimes, even my early warning system has an early warning system.
First, most migraine sufferers have triggers. Triggers are things that occur either within or outside the body that have been seen to induce a migraine headache. Common triggers include food sensitivities (commonly aged cheeses, chocolate, and alcohol are triggers, but different foods affect different people), changes in caffeine consumption, menses and ovulation, increased stress, fatigue, changes in altitude, and barometric pressure highs and lows.
Identifying their particular triggers is the first step for any migraine sufferer to predict that a migraine may be coming before the aura begins. Some triggers, like foods and alcohol, can be avoided, but life is life and chocolate is chocolate, and even sufferers of the most severe migraines are likely to slip up occasionally, hoping that they’ll get away with it. Other triggers are either difficult to avoid, like stress, fatigue, and changes in elevation, or impossible all together, like their place in their menses cycle or changes in barometric pressure. However, no matter how unavoidable a trigger may be, in nearly all occasions, they can be identified and recognized, and taken into account.
Once a migraine sufferer knows that a trigger has been experienced, they at least know that they are in greater than usual danger of a migraine coming on. They will watch for the aura and be sure not to be anywhere without their medication. However, once the aura starts, the migraine is coming, and for most people, there is nothing one can do to stop it at that point.
I once believed that the aura was the only early warning of a migraine headache. However, in recent years I have detected a few things that tend to precede even the start of the aura. This discovery has helped me to learn how to begin to manage the migraine before it even begins, often reducing the severity or duration of the headache, and occasionally affording me the ability to actually stop it from developing.
The first and most significant early warning that I experience before the onset of a migraine is a dramatic change in my emotional status. Similar in some regards to PMS, I have found that on most occasions about 1-2 days before a migraine starts I become emotional, irritable, and very, very sensitive. I just can’t handle the slightest stressor. Small problems that I would generally breeze through are insurmountable. The problem is that this early warning starts so long before the migraine that for years I either failed to associate it with the headache, or more often than not, blamed “my mood” for the headache itself. It was not until I met my husband and had someone living with me and witnessing my behaviors that the correlation was seen, and my irritability was recognized as an early indicator of a coming migraine, and not the cause of it.
Changes in Sleeping Pattern
Another early warning of a migraine that I experience is a change in my sleeping pattern. Often before a migraine sets in, I will awaken during the night for no discernible reason and be awake for the rest of the night. The experience does not feel like insomnia. I am tired, I am not restless, my mind is not particularly busy or anxious about anything; I am simply awake. Again, in the past, it was always my assumption that the sleeplessness was the cause of the migraine, and not an early warning that the migraine was coming.
Tightness Inside the Head
The last early migraine warning that I experience is a little harder to describe, but I think that most migraine sufferers will understand what I am talking about. One physiological change in the body during a migraine is the constriction of the capillaries in the brain. This is why caffeine, which dilates the capillaries, is such an effective treatment for some migraine sufferers. Often unnoticed during a migraine is the “tight” feeling inside the head. The pressure and spiking pain tends to overshadow this more ambiguous feeling. I have nonetheless discovered that I not only feel the constriction going on inside my brain, but if I pay attention, I can often feel it occurring several hours before the onset of the migraine aura.
So how is this information helpful to migraine sufferers? Well, my experience has been that once the aura begins, the migraine is coming. I have not yet found a way to stop the headache’s onset post aura. However, the early warning signs are a slightly different story. Whenever I experience the changes in my emotional status, sleep, or feel the strange tightness in my head, I go into migraine management mode. I remove myself from stressful situations and remove all possible stressors from myself, and from my environment. I begin to drink caffeine, a substance I now use only for the treatment of migraines and am there for very sensitive to the effects of. I take a walk. I take a bath. My husband rubs my head, neck and shoulders. If possible, I take a yoga class. I practice the “relaxation exercises” I learned through biofeedback and try to release all possible tension from my muscles. If I can stay home from work, I do; if I can’t, I keep things as “low pressure” as possible.
What I have found most helpful in learning to manage the migraine before it starts is having other people in my life that know and can recognize these early warning signs. Unfortunately, and this is particularly true in the case of the emotional changes, once these early warning signs set in, it is easy to get entrenched in them and miss the bigger picture. Having someone who can gently say to the migraine sufferer, “hey, you seem a little sensitive today, do you think there may be a migraine coming on?” allows the migraine sufferer to take a step back, regroup, and start to manage the situation.
In my life, migraines are the most painful, disruptive occurrences, and they are disappointingly frequent. However, after years of observation and a lot of help from the people around me, I have begun to make a little ground against these vengeful headaches, and have learned to manage them more effectively. Be recognizing the early warning signs, I have often been able to positively effect the severity and duration of an impending migraine by getting the jump on the pain management of the migraine before it hits, and on some occasions I have been able to stop the monster from coming on altogether.