It started when I was 16 years old, the intense headache that would lead to me eventually purging or throwing up, and it got worse over the years, peaked at early adulthood and through out my 20s, worsened during pregnancy, and now it still hits me occasionally once or twice a month. As I grew older I have gotten better at managing it and recognizing it earlier and thus treating the migraine before it intensifies. The pain is always and have always been on the same location on my right side temple. At one point I did went to seek professional medical treatment with a neurologist who put me on a daily dose of medications which included anti-depressants, in short I had to stop after 2 months due to unexpected adverse side effects ( which I will share separately in another post).
In general, migraine is caused by inflammation of the blood vessels at the head, or over reactive stimulation of the sensory nerves, and can be genetic or biology (in my opinion). I also do think there may be a link to migraine sufferers with a higher pre-disposition for depression and anxiety. Below I’m sharing what are my migraine triggers and how I managed them.
Hormone level increase
Starting in my teen years I would get migraine a few days or the day before my monthly period would come, due to increase levels of estrogen and progesterone . This explained also why when I was pregnant with my girls, and especially in my 3rd pregnancy for some reason, I had pretty bad migraines. Due to the fact that I was pregnant, I couldn’t take any medications stronger than paracetamol, as the other stronger pain medications were not proven to be safe for unborn baby. At current since I am still breastfeeding and have no monthly cycle, the migraine episodes now are few and manageable.
Strong smells, be it from someone with perfume, or the smell from the washed laundry with clothing softener can also set off a migraine in me. This is the reason why I don’t wear perfume, and we don’t use laundry softener or any handwash with strong smells at home.
Lack of sleep, stress, and anxiety
For me if I am mentally fatigue with anxiety and stress, migraine occurs. I recall vomiting at the KLIA airport entrance the night of my flight to Korea for a work trip (and made a bit of a scene there). Also on my first day at work at my first job, after graduation, I barfed on the floor of the training room during a job introduction training by company HR.
Since I am reminiscing on my migraine induced vomiting episodes, I have also vomited into the trash can at a government clinic during one of my pregnancy check ups when I couldn’t hold it in long enough, due to the common bathroom was occupied. Another time was when I got my medical leave from work due to a migraine attack and I had to take a Grab car ride home, and during the journey home I was extremely nauseated, it did not helped that the car was heavily perfumed. When I finally made it home and walked into my front porch I immediately vomited in front of or house entrance, which I then had to clean by hosing down before I went inside. Other places include birthday party events, condominium restrooms and so on. I apologize to all the cleaners that had to clean up after my mess.
Bright lights, sounds and crowds
After events which involve interaction with many people and some degree of loud sounds, lights and stuffy rooms , I may tend to get a headache and eventually , migraine. I recall having a bad migraine attack back in my university years, after a live Switchfoo concert, and also after big social events. On a side note, thinking back now I think being a natural introvert, when I was younger having social interactions did made me mentally tired, as I had to ‘keep up’ with the energy of those around and I tend to overthink. I preferred one to one or small group conversations, which to this day I still do. Socially awkward then, and probably now to to an extent, only difference now is I care less and am less bothered, thus protecting my brain from overthinking. One benefit, at least to growing older. It’s either the aging or the having kids, or both.
Certain foods with strong lingering tastes such as raw garlic can trigger a migraine for me. Others include too much caffeine, and citrus foods such as orange juice or lemon juice, even too much ribena can lead to headache/migraine. Others are chocolate and milk, and strong flavoured chinese soups like bah kut teh broth, however I am still on the fence whether MSG content in the soups are the cause for the migraine. Another is excessive (this is no surprise) alcohol, so I do take with caution. What can help is to keep a food library and record down what you ate before you had your migraine attack.
My only effective treatment for migraine is either to take my list of painkillers, most of which can be obtained from pharmacy or prescribed by doctors, and these are not generic paracetamol tablets. For the list of pain medications, it ranges from caffox (cafergot), to the stronger Arcoxia , others can include Synflex and celebrex (bear in mind these are not to be taken during pregnancy and also take with caution during breastfeeding) .
I had a myriad of painkillers I take to stop the head throbbing pain. The safe and generic paracetamol is unfortunately not effective enough to relieve migraine episodes.
Alternatively is to sleep in a dark and quiet room, usually with my head under a pillow, and apply slight pressure to the migraine area. As you can see, the ‘sleep it off’ method is not really practical with 3 kids, or when I’m at work and out and about, so I tend to go for option no 1 with medications. Even with medications, I need to be really sensitive to recognize when it’s the ‘real deal’ migraine coming and treat it early before it worsens, as the medications work better when taken early on. In my case, it is really difficult to work with the pain and I will end up vomiting and purging, so early recognition , medication and prevention is how I manage it.
The medical treatment did not work for me in 2015, and since the episode of medicating with anti-depressants did not have a good outcome, I am more careful to seek professional treatment in the future. Till I find a better solution, this is how I cope, and it’s working for now. I have been recommended to do meditation previously by a doctor, but I’m skeptical about treating myself with methods that I can’t understand how it works.
Each person with migraine will have different experience and triggers. One important thing to mention is that you need a good support system of family /friends who understands your condition, and in my case its my husband who has been there to care for me (if he happens to be around during my migraine episodes) when I am down with a migraine, from cleaning up my vomit, to taking me to the car to rest off the migraine (or wait for the medications to kick in) when we are out, and to take over the kids when I need a nap in the daytime.
Parting note, I want to say I feel for anyone who have medical conditions not only migraine but those who have endometriosis, back/joint pains, vertigo, psoriasis etc and I hope you get the support and treatment necessary, and I do hope as a society we will be more mindful of the many among us who have health conditions and to ask ‘How can I help’ instead of ‘ Whats wrong with you’. Empathy, is not a weakness.
Thanks for reading.