Lessons learned from my migraine relapse

We all trip over from time to time.

We all trip over from time to time.

Recently my migraine’s came back.

In hindsight. The reasons were silly and reckless.

I drank alcohol, had a late night, ate trigger foods that I knew were borderline.

All up I probably stacked up about 5-7 different triggers against me.

100 day streak ended

It was enough reach my migraine threshold and so I had my first migraine attack in over 100 days.

I’d broken my best record. It was an amazing run. 100 days was the longest I’d been without a migraine in nearly 8 years.

I’d come off all my migraine medications and thought I was in the clear. Or at least, medication free and in control. To some extent I was.

But it was never a cure and I knew that. It required careful management of triggers, behaviour and lifestyle. Sleep, stress, exercise and diet were tightly regulated and importantly kept at consistent and sustainable levels.

I could still feel the migraine sensitivities on certain days when I didn’t get a good night sleep. Same with sensitivity to light and smell. They didn’t disappear. I still couldn’t go near fresh paint.

But overall my resilience had been so much better.

But I had just pushed it too far.

What happened after my first relapse attack was even more disappointing.

The floodgates opened

After I recovered from my first attack 2 days later I didn’t let it discourage me. I got on with things. Planning to be more careful, but still no need for panic.

Then I had another attack within that week. For what felt like a relatively minor infringement.

Within the following weeks I had 3 more migraine attacks. Things were rapidly going from bad to worse.

It was getting out of control. The resilience I had built up appeared non-existent. My migraine threshold had fallen back to square one. What had taken so long to build up was lost in a single attack.

It was devastating.

I couldn’t believe it. How could months and months of resilience be lost from just one migraine attack? I was in disbelief. Denial.

But with 4 migraines in less than a month I was quickly slipping into a downward spiral.

The decision was made to go back onto Topiramate. A preventative migraine treatment I had used before. But with my migraines now occurring at a rate of one migraine a week – costing me 2 days at a time and the whole week walking on egg shells this was an act of desperation.

This would at least allow some time to recuperate and figure out what just happened.

In risk of stating the obvious

I realised it is much easier to look upon another person’s situation as the third person, as a spectator and make observations.

It’s quite another matter to analyse yourself, objectively in the same way. Even if you believe you have the facts or knowledge.

During the time my judgment was surprisingly foggy, biased and emotional.

I could blame the heavy migraine drugs, the emotional despair of migraine relapse or others factors. But really, it’s just hard to see clearly when you’re trying to look at a complicated, multifactorial condition like migraine by yourself.

I had 2 things which really helped. A trusted doctor and my migraine diary. Both were absolutely essential in diagnosing the issue.

There are a few things that have become clear:

1) I’ve lost my work life balance.

Slowly and gradually I started working more as I began to feel better. To the point where I was working 12 hour days and regularly on weekends.

I run my own organisation which is inherently busy. It’s stressful in the sense that you don’t really switch off. But I love it. Nevertheless, it is an undeniable factor and something which needs to be re-calibrated.

2) I stopped exercising enough

Some people mention exercise is a trigger for migraines.

The only time I experience any issue with exercise is when I don’t do a warm up or warm down. Sudden intense exercise or drop offs can cause headaches (not so much migraines for me). So I always ensure a good warm up and warm down. Also drinking plenty of fluids to prevent dehydration is important for migraineurs who are exercising.

With those boxes ticked, exercise is my secret weapon. Exercise is amazing for stress or for whenever I am feeling "migrainey”.

It flushes everything out. The sweat and heart pumping just seems to reset everything and it feels great (especially when I finish).

I’ve noticed that it’s better with aerobic exercise. Strength or weight exercises are great healthy activities, but they don't give me quite the same clear head I get from aerobic exercise.

If I don’t exercise for 3 days I really begin to notice it. I don’t sleep as well. My neck and back stiffen from sitting down more and I feel more vulnerable to other migraine triggers.

3) I stopped meditating

It is surprising how taking 10-20mins a day to simply monitor your breathing can have such a profound impact after a few weeks.

My discipline dropped off once I was feeling good.

Meditation is a really important way of winding down at the end of the day and ensuring I get a good night sleep.

I simply observe my breathing. It brings about a state of calm and relaxation I’ve seldom experience elsewhere. It’s hard to describe but worth the effort.

4) My posture got worse

Due to the nature of my work. I am mostly sitting down at a desk. If sitting is the new smoking, then I am in trouble.

To add insult to injury, I have a poor posture. I slump and lean forward at the computer. Which puts strain on my neck and upper back.

Which is probably causing problems which are in some way leading to migraines. Certainly, there is a relationship between the number of hours I spend at the computer/working and the risk of migraine. Stress and posture are I suspect are feeding off each other.

5) I started clenching my jaw

The final issue which has arisen from all this is clenching.

It seems from excessive volume of work, lack of exercise and relaxation that stress has started to manifest itself physically with me literally clenching my jaw.

I started to notice it because in the mornings I would wake up with a really stiff jaw. Then during the day I realized I would clench my jaw at strange times… for example when washing the dishes, putting on my clothes, drying my hair.

This habit seemingly came out of nowhere and now I was doing it regularly throughout the day and probably more so at night.

Accordingly to my dentist, when you clench at night, it is several magnitudes more forceful. He has seen cracked teeth from clenching.

So cracked teeth are a real risk if I don’t get stress under control.

Here is the problem

I don’t feel “stressed”.

I’m not pulling out my hair, I’m not frantically running around yelling at people.

I’m just busy.

I’m busy doing stuff I love doing. That’s why I work so much.

I actually love doing it.

But my body is telling me it’s too much. The message is clear. Clearly I need to take my own advice. Easier said than done.

Particularly when you feel like your not giving 100% to something you enjoy.

And that’s what I realize is the most difficult part in all of this. It feels like if I don’t work as much as I am now, then I’m running at just 70%. Which goes against the values I was brought up with. To give something worthwhile your best effort.

But if there was ever a clear sign to find a more sustainable balance this is it.

It’s $600 for splint to protect my jaw.

That won’t stop the clenching – it simply deactivates the muscle strain so they can’t engage in the same way. So all tension, stiffness and soreness is mostly prevented.

That’s 600 reasons why I should work less, exercise and relax more. Afterall, work life balance is about finding a sustainable fit that works. And this isn’t working.

So what I am going to do? Well, its lunch time now. So I’m going to do some exercise.

What about you? Are you happy with your balance? What changes could you make to make things more sustainable?


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