Monday, August 1, 2016

Migraines, and Working Through Them

The weather this week in our part of VA has done nothing but create headache, both literally and figuratively.  If you're one of the unlucky millions of people who suffer from chronic migraines, the constant shifts from hot/somewhat dry to blustery, stormy humidity and cooler temps would have you reaching for either Excedrin or exceptional amounts of ibuprofen, as I've been doing these last few days.


The world doesn't stop for a migraine, though sometimes our schedules allow us to sneak in a nap that helps dull the pain.  For those of us that make a living playing music, an ill-timed migraine can mean a bad performance or thwarted practice schedule.


What Makes a Headache a Migraine?

Migraines tend to not be acute, and rather progress through four stages over one to several days: Prodrome, Aura, Headache, and Post-drome.  Mayo Clinic has an entry that explains symptoms, but here's a synopsis.

Prodrome
- food and stomach weirdness, in what you want to eat or drink and how your body behaves
- sudden mood changes

Aura
Not everyone experiences aura.
- visual anomalies, in the form of zig-zag vision, flashes of light
- hearing phantom sounds, like music 
- difficulty speaking, perhaps accompanied by facial numbness
- limb weakness

Headache
- heightened, painful sensations of all senses
- throbbing on one or both sides of the head
- nausea and lightheadedness

Post-drome
- dizziness
- confusion and moodiness
- continued sensitivity to light and sound

A migraine is sadly an event in your life; there are headaches and then there are migraines, so if you're lucky enough to be unsure of which you deal with, chances are it isn't the latter.

Most recently, my plans to record a new video (which has since been done and is available here) were interrupted by a migraine that set in.  I lost two days completely, but managed to record half the piece while still in the Post-drome phase - nothing like playing Bach to keep you dizzy, confused, and moody, right?

In an informal survey, I learned I'm not alone in being unable to play when a migraine hits.  Some of us aim for soft sounds, while others know to just stay away...far, far, away.  If we're lucky, we're collaborating with people or studying with teachers that are sympathetic to our plight, and for that we are grateful.

Everyone is different in terms of their own symptoms and triggers, and everyone probably has their own method of dealing with a migraine when it hits.  Here's what I do.


Staying Productive in the Four Phases

Prodrome
Luckily, this phase doesn't completely interrupt life, other than the foreboding doom of what's to come.  I've found that drinking lots of water and eating healthy food, in addition to sleeping normally can ease the headache later on.  
It's also a time to get strategic about how to still get stuff done in the coming days. 

- Gather scores for study and mental practice.

- Pack in as much practice as you can now, to prepare for being unable to play for at least a day.  If you don't already have a detailed practice plan to get you through your playing obligations, make one up at this time that is realistic: ie, plan to lose more time than you'd like.  

- Gather notebooks if you compose, blog, or research.  You may not be able to look at a computer screen, but you might be able to write nice and slow.

- Gather hard-copy reading material.  Again, stay away from a screen.


Aura / Headache
Since my migraines [currently] have me experiencing auras during the actual headache, I'm placing them together here. Basically, this is the time when you feel the worst.  Can't eat, want to be in quiet darkness, and want to do nothing but sleep.  

Though I don't regularly deal with visual anomalies, I do hear phantom music.  It started a few months ago - whenever the migraine is settling in I hear a string orchestra that isn't there.  Sometimes it's an organ, but usually strings.  My layman's reasoning has decided it's because my auditory cortex is throbbing, or getting too much blood flow, and so it's replaying something I've previously heard.  My hypochondronical reasoning gets going, too, but let's not talk about that. 

Once past the terrible hours of the actual headache, some of these things may be possible.

- Slow reading and writing, around 30% of normal

- Mental practice, maybe try to learn notes while sitting up in bed or on the couch

- If you can look at a screen with the backlight all the way down, you might be able to slowly catch up on easy email.  Stress only makes these headaches worse, so skip the really involved ones.

- Try to find something to look forward to for when you feel better.  Make social plans, find a new recipe to try, plan a trip to your favorite bookstore, local museum, or market.  Having something positive waiting for you the *moment* you're able to do it is helpful.

- Move a little bit. There are certain yoga postures that can help ease pressure on the head and neck.  Personally, I find Extended Puppy Pose and Head-to-Knee Forward Bend very calming and distracting.


Post-drome
Practice at this time is a complete toss-up.  Sometimes it's possible, sometimes it isn't. I've learned, though, that if I can play, it isn't a time to perfect complicated passages, but rather a time to slowly learn new notes or practice something tedious, like un-flamming something noodle-y.

- Pad some rudiments or Stick Control, something that is almost brainless.

- Learn new notes without big expectations for yourself, and learn them quietly.

- If you can look at a screen, now is a time to type out anything you wrote, music or otherwise.  My last migraine stalled my recording plans, but I was able to edit a promo video for my new project, L+M Duo, because the program has a dark interface.  Since I couldn't leave the house (too bright and hot), I sat there for 8 hours completing it. 

- If you can tolerate sound, score study with recordings.  

Hopefully Post-drome doesn't last too long, and you're able to get back to it rather quickly.  My last one was about 24 hours, and I was able to record towards the end of it. 

If you're like me, chronic migraines are in your family history.  I grew up watching my mother suffer through them, and developed an understanding of how to care for yourself through them.  I also learned that an understanding family is very important, and I'm grateful to have that.  (Even the cat knows to not misbehave.)
Professionally, I've never cancelled a gig or class due to a migraine, but I have left the second it was acceptable, perhaps ending class early or escaping a gig before speaking with the audience.  


Hopeful Research

We still don't know what causes migraines.  The term trigger is thrown around to describe the tastes, smells, or motions that may play a role in their creation, but even they vary from person to person.  New prescription meds are available now that may not erase the migraine but shorten the Headache considerably, and reduce symptoms of the Prodrome and Post-drome phases.  However, these are generally incompatible with mood maintenance medications.

On July 27th of this year, researchers at Griffith University made a call for volunteers to undergo a study involving self-help treatment for migraines.  They're taking an 8-session treatment previously available to psychologists and teaching it to the volunteers. You can learn more about that here, and maybe even sign up! I'm greatly considering it, as prescription meds are my last, but perhaps realistic, resort.



Anyone have other suggestions on how to stay productive during a migraine? You can leave them in the comments below so we can all benefit. :)




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