Wednesday, 3 February 2016

Post 71: Grad School and Migraines

Yesterday I lost about three quarters of my productive work time to a migraine. It's the first in the month of February that I've had, and it was only the second day of the month. Living with a chronic health issue is never easy, and I admire anyone who does so immensely. Especially if they are attending grad school like me. It's take me a while to be honest with myself about my migraines and their relationship to my work—they have more of an impact than I was willing to admit at first. Grad school is one of those places where 'working the hardest' is implicitly a good thing. Obviously everyone works hard, but I recall thinking back to first year, where I was frequently the only or last person in my lab, and I felt good about that. It appealed to my sense of responsibility, and my idea of what a 'good graduate student' was all about. My perspectives on this have certainly shifted over the past 3.5 years.
Those are some wonderful January snowdrops (Galanthus sp.) in the backyard! 

Little bit of a backgrounder for those unfamiliar with migraines. Migraines are very different from the more common and ubiquitous 'headache'. As the Mayo clinic writes, a primary headache (a standalone event without an underlying other medical issue to cause a it, which is a secondary headache) is characterized by three main types, the most common of which are tension headaches, followed by migraine headaches and cluster headaches. A migraine has specific triggers, the most common of which include sleep irregularities, stress, alcohol (esp. red wine), missing a meal, strong cheeses, strong scents, significant fluctuations in the barometric pressure (more obviously seen as rapid localized weather changes). There are quite a few others, and I've mentioned the triggers that I'm particularly sensitive to.

With my migraines, I often have not only the head pain (which can be focused on one side of my forehead, behind my eyes, or simply as a generalized head pain), but also nausea, light sensitivity (photophobia), sound sensitivity (phonophobia), and sensitivity to touch. You may have heard descriptions from people who get migraines along the lines of "I get a migraine, and just shut myself into my room with the curtains pulled, lights off, and no stimulation." That's what a full-blown migraine can do.

For treatment, headaches can go away on their own, in the case of mild ones, or at least they can be very successfully treated with ibuprofen, the effectiveness of which has been shown to improve with caffeine as well. Ibuprofen does nothing for migraines.

Cute wooden owl in a Vancouver neighbourhood I passed on an early January friend visit! 
I have a very specific migraine medication that I've been taking for about two years now, and it is wonderful. I no longer lose whole days to migraines and migraine pain, though I have found that my migraines have changed in nature quite a bit. If I'm able to catch the migraine before it really takes off, then the medication usually does a good job of relieving the migraine within an hour. If the migraine's already well under way, like the one that I had yesterday, then I'm not so lucky and it takes anywhere from 1.5-3 hours to go away, and I need to really relax and take it easy.

What I've found trickiest is recognizing that the symptoms I'm experiencing are an oncoming migraine and not just a headache. The migraine medication that I use has a little bit of a price tag, at about $8.50 per pill. The name-brand one I used to use had a much higher cost at about $20+ per pill. So I'm not inclined to make the decision to take one lightly, considering the frequency of my tension/regular ibuprofen-curable headaches I'm prone to as well.

So, I get a bit of brain fog as part of the onset of the migraine. I find it difficult to focus. I usually get a bit frustrated with myself at that point, because I get a bit antsy and have trouble staying with one task. Usually the nausea sets in prior to the actual head pain as well, and I really notice that I start to squint a lot, and the photophobia can set in relatively quickly, too. But the migraine affecting my decision-making is the darndest thing. Simple things become difficult. Remembering where I put my migraine medication, and grabbing a glass of water take a lot of effort, and it's then that I really feel like an extra hand is useful.

This is Mingus. He's been on this blog before. He is a sweetie.
Also, not getting stressed because I'm unable to work is a challenge, too. I had a set idea about what I wanted to get done for the day, and now that needs to shift because I might be out of commission for 3-8 hours. It is a little bit frustrating.

Airing some of this out at a recent thesis completion group meeting in the late fall made one of my colleagues mention that a friend of his completed her PhD despite suffering from migraines as well. He said that she just knew she would have about 4-7 unproductive days a month where she couldn't work, and she'd keep those aside, and keep track of them. That made it much easier for her to manage her migraines and the lost time, because they were accounted for in advance, and expected. So she didn't have the guilt that I usually associate with missing work. I've tried to be a little bit less self-critical about my migraines. I've had them since childhood, and while aspects of my grad school experience have seemingly exacerbated them, they're not going anywhere, so it's been very important to learn to manage them and triggers for them as best as possible. I have to keep going with them!

So it's taken me a while to figure out the kinds of work habits that are effective for living and working with migraines. Prioritizing my thesis as the first (or one of the first) things that gets attention in the morning has been critical to getting as much done as I have so far. My migraines usually set in in the afternoon, when they do come on. Mornings, I've been told, are some of the best times to write, and I definitely agree.

There are lots of barriers to completing grad school, and I am determined not to let this be one for me, especially since I am very close to finishing up with this project. If you are a grad student struggling with migraines or any other health issue, mental, physical, or otherwise, know that you can get the help you need to help you succeed and finish up this big project in your life!!

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