Migraines have been a companion of mine for the last fifteen of my fifty years. Sometimes I can feel the tenderness creeping up on me, starting on one side of my head, an aching, throbbing pain that will become worse in a matter of minutes. I imagine an archer loading his bow and arrow, aiming, pulling back, letting go. Sensitive to light, to sound, I just want to shut the lights, crawl between my cool sheets, pulling the covers up over my head and lay motionless for hours.
Often the pain hits me like a bullet out of the fiery sky: no warning. It strikes me down and I find myself incapacitated. I have never gotten auras; sometimes I have wished for them because they sound romantic. Swirling colors of blue, red, and yellow mixed together warning one of an upcoming migraine – that’s what I imagine an aura to be.
The fierce pain is almost indescribable; shooting, bombarding, a knife twisting, turning, inserting itself into the temple on one side of my face. I close my eyes to shut out the light but that only makes me concentrate more on the pain. The normal sounds of the day; horns honking, dogs barking, reverberate around me and inside my brain louder than they should be.
I don’t want to move but I must for I am at work. I turn off all the lights in my office and close the blinds. Putting my head down on my desk, I try again to close my eyes. There is a playground across the street from my office; it is a nice day outside and I hear the delighted shrieks from the children as they run, playing. The noise is painful.
My neurologist, a kind Hungarian man who hugs me when I see him, prescribed Imitrex injection for me about ten years ago when nothing else was working. It has been a miracle drug. When I give myself an injection, it hurts, but only for several seconds and the sting is worth it. I know that 95% of the time I am going to get relief from the excruiating pain of the migraine which is just beginning. I feel the medication rush through my system – a hot flush races through my bloodstream – it is uncomfortable but a sign that the medication is working. My friends say to me, “I could never give myself a shot,” and I look at them knowingly – that’s what I thought at first.
On the rare occasion that the shot fails to relieve the pain, I am permitted to give myself a second injection after an hour. As I give myself the second dose, I hope, I pray, I wait for the hot flush through my system because if that second shot doesn’t work, I know I am in trouble. The directions that come with this medication clearly state that only two injections are allowed within a twenty-four hour period.
This unfavorable outcome happens more than I want. I dread, abhor the times when the second shot fails for I am caught in a whirlwhind of grey fog, swirling pain inside my head; already severe, and intensifying by the minute. A spike is drilling behind one eyeball, there is excruciating pressure, I am feeling each penetration.
It was still early one Friday morning when the second shot was unsuccessful. From my office I called my neurologist to ask him if I can give myself a third shot. I felt only desperation. He told me “I can’t officially give you permission to give yourself a third shot, but in Europe, the maximum daily dose is 18 mg. (each shot is 6 mg.). Call me Monday morning, let me know how you did.”
Because I was in so much pain and I still had to get through the work day, I debated for only a moment. Still I was scared – I didn’t know what might happen. I pictured myself falling to the floor writhing and foaming at the mouth, eyes rolling back in my head. Thankfully, about half an hour after the third shot, with that now familiar rush, the migraine abated, with no immediate ill effects. I was thankful and relieved.
At the end of the day though, I was exhausted and concerned about making the hour-long drive home from the office to my apartment. I imagined myself falling asleep at the wheel, having an accident. Parking myself in the main office for about an hour, I poured cup after cup of coffee down my throat.
The strong, dark drink saved me and I arrived home without incident. The next day, Saturday, I felt as if I was coming back from the dead. Unable to function, I lay in bed the whole day, worn out. My fat cat Zoe occasionally wandered over and sniffed my face, then apparently unconcerned, decided to leave me to my zombie-like state.
It’s weird – I know what my triggers are – stress, changes in barometic pressure, not eating frequently enough, and my period (the few thies that it shows up these days). But sometimes the migraines just strike out of nowhere and I’m left wondering, waiting and thinking; why, where and when?
Why did this come now, where did it come from, and when will the next one come? And the answer to all three questions remains as always; I don’t know. And I realize I will never know.