Grading your migraine

Those of us that suffer from chronic migraine often find ourselves grading our migraines. How much pain can I tolerate today? Is it worth taking a migraine pill? Do I want to die? These are the questions we ask ourselves because for most of us, we only get so many treatments. Whether it be an acute migraine pill such as imitrex or axert or a long term treatment such as botox or topamax we all have limits. We also have to consider the side effects of such treatments. (For me, the Imitrex side effects are often worse than the migraine itself.)

Grading Scale

I have suffered from chronic migraine for nearly 20 years and for the last 5, I haven’t gone a day without headache pain. During that time, I’ve developed my own grading scale for my migraines:

  • Grade 1 – “Oh, ok. My head hurts. Time to get on with the day” – (no medicine taken–I deal with it)
  • Grade 2 – “Ouch, today is gonna suck.” (pop 700 mg of Excedrine and 800 mg of ibuprofen)
  • Grade 3 – *sigh* “Are you SERIOUS? Not today!” (repeat #2 three of four times during the day)
  • Grade 4 – “Lord, please make it stop!” (Pop an Imitrex. Take a nap. Be a zombie for rest of day)
  • Grade 5 – *crying* (Pop 2 Imitrex. Kick the dog. Yell at the kids. Go to bed. Pray for the Rapture)
  • Grade 6 – *thud* (Sara throws me in the car and takes me to the ER. Scott is a zombie for 3 days)

My Life

For the last 5 years, about 40% of my headaches are Grade 1, 20% Grade 3, 20% are Grade 4, 19% are grade 5 and about 1% are Grade 6. These numbers are of course relative–relative to the year. During my first 5-10 years of my headache nightmare, a Grade 3 would have been a 5 now just because I’ve gotten used to/better at dealing with the pain. Because of this extremely long period of pain, I can now function at between 80% and 100% for grades 1-4. At grade 5, I function at about 50% and at grade 6…well…You won’t see me much during these.

People often ask what a migraine is like and it’s become really hard for me to explain it accurately. Not because I can’t describe the pain, but because I’ve learned to live with it as is so often the case with migraneurs. I often wonder what it feels to NOT suffer from chronic migraine. I haven’t been functioning at 100% mentally for so long, I wonder what I could accomplish if I was. You see, even with all the pain, in the last 5 years I have finished my B.S. degree with a high GPA, I have learned 5 new programming languages but at what cost?

These things were required of me for my career and for me to be able to support my family, but it does take a toll. I find myself being able to maintain focus, function and often perform at a high level, but by the time I leave work, the strain leaves me wiped out for the evening. Typically when I leave work, my eyes feel crusty, I am irritable, can’t focus and want nothing more than a nap. For this, my family is wonderful. They have learned to be patient and work around my limitations but I yearn for the day that they don’t have to.

Consequences

About 15 years ago I worked with a guy named Bob Ramsey who had lived through a similar situation. I was 25 and he was 40 or 41. Like me now, he had lived for 20 years in constant pain and nobody could help. I always thought that he was just cranky and while he could be funny, he just seemed like life had worn him out. Unfortunately, I now understand how he could get that way. Even as recent as 6 years ago, I would have called myself an optimist. Some who could find the positive in everything and could laugh at things. My family will tell you that our dinner-table conversations have a reputation for being “EPIC!”. I was even considering writing a book.

These days I can’t concentrate enough to come up with the “witty” (Sara and the girls would say stupid or corny) thoughts. I’ve started that book 4 times and yet to get past the first page because I lose my focus. I have also become much more pessimistic. In short–I’m not the person I was 10 years ago. I try to be and sometimes I’m a very funny guy (IMHO) but more often than not, I fall flat.

Today, I try to be optimistic that we will find a solution to this, but I don’t hold my breath. Rather, I try as best I can to engage in activities that don’t require too much thinking or concentration. I’ve taken up woodwork (The Slanted Shed) and love rough-housing with my two goofy dogs. I mow the lawn, I tend garden, etc–anything to give my mind a break from thinking, because thinking hurts!

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