The tells and the pass

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I can pass for healthy. I know because while I have FM and chronic migraines no one at work can tell when I have a migraine. Which is always. And they can’t even tell when I have a pretty damn severe one. I fake it pretty good because I am in customer service so I have to. I have the finest fake smile you have ever seen. Natural, smooth, and honest. Because I am honest about being pleasant and happy. Just happens I am hiding all the pain expressions and behaviors that come with it.

So I can ‘pass’. At work. Not always at home where my spouse is more aware of my ‘tells’ that give me away.

We all have them. Although with chronic pain we are used to dampening those pain behaviors for various reason, we still have less noticeable tells. With migraines they can be quite migraine related.

Here are mine:

  1. Loss of the ability to communicate is a tell. Whether it is brain fog from the prodrome or aphasia from the aura… loss of communication that is quite noticeable is a tell.
  2. Rubbing my neck all the time is a tell. Because my neck hurts so damn much I just want to try and relieve the tension.
  3. Violent nausea and vomiting… big old tell. My relentless nausea has definitely been noticed by my co-workers as I lose weight and can barely eat. I have also thrown up but have been as discrete as possible about that. This one… pretty obvious.
  4. Vertigo is a tell but more precisely when it is severe or when I have a drop attack. A drop attack is sudden, and I will lurch to the side it is one often either falling or falling into a wall, chair or whatever happens to be there. Severe sudden vertigo, on the other hand, I will grip onto things and immediately find somewhere I can sit safely. It is a tell something is wrong.
  5. Then when the pain is climbing up into the 8 range lack of smiling, or difficulty maintaining a smile, lack of laughter, silence until I have to talk… is a big sign for me.

I think if people are not familiar with migraines they simply do not see the signs. Can’t recognize the tells. Think you are seriously ill, even though you explain it is just the migraines. Or don’t notice at all.



  1. This post hot SO close to home. I’m literally sitting in my car on my lunch break bc I can’t keep up the “I’m fine” act in the office. Great post, thank you!!!


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