The headache stage of a migraine is brutal, I think we can all agree to agree on that. But sometimes we do not even get the headache phase. And sometimes with treatment the headache phase can be milder in intensity. And it is Other symptoms that are mind-blowingly intense.
Like what, you ask?
I am in the midst of a bout of vertigo that is severe. I thought I had tamed it yesterday down to mild but then it roared back into gear today once more making it hard to walk and function. Now it is just getting back down to moderate, thankfully. But severe dizziness. Woozy. Imbalance. Trouble walking. Drop attacks (when you are walking and suddenly the ground feels like it drops beneath your feet causing you to actually stumble or fall to ‘catch’ yourself’). Vertigo. Unable to move my head much due to sensitivity to the motion. Difficulty standing because I get so damn lightheaded I feel like I will pass out. And it has been Days of this. I have no capacity to focus. No ability to drive or function. This level of vestibular migraines is disabling. I seriously hope it is not a regular occurrence because my vestibular migraines were well controlled with Sibelium, a calcium channel blocker and this is the first serious one since I have been on it. Still was getting it mildly and some mild to moderate dizziness. But Not This Hell. Now vestibular migraines do not necessarily come with a headache. I haven’t had a headache with this migraine all day. And the last few days I have had a migraine headache on some of the days, but not all of them. It is also unpredictable in duration. I have had vertigo bouts last seconds. Little surges of it. I have had it last months, constantly, before treatment. It can be triggered by motion. Sudden movements. Driving. Elevators. Escalators. Pretty much any motion can trigger an attack of any intensity and duration. So, yeah, vertigo can at times be a problem just as severe or more severe that the pain.
Cutaneous allodynia is when there is painful sensation on the skin, sometimes like a light burn and sometimes intense and excruciating, that are not from stimuli that would normally provoke such pain. With migraines it is very common in the scalp and neck, but I have had it scalp, neck, back, arms and thighs. I have it now on the back by the shoulder and it has been flaring there off and on for months. It is Insanely Painful. And there isn’t much I can do about this pain. You can take a triptan for a migraine and maybe get some relief… potentially right? Allodynia there is no relief from a pain that Can be relentless in intensity. It can be mild but it can be Severe. The intensity I have going on right now is just so severe. I’d do anything to get some relief for it, but there is nothing I can do.
There is evidence to suggest having allodynia could be an indicator someone may go chronic. People with chronic migraines are more likely to have allodynia. There is also evidence its presence may affect treatment; as in it is a predictor of poor responding to triptans and other things like opiates. In other words, you have this Beast and it will make the migraines harder to treat as well. And that is adding insult to injury really. It gets on the list for the added severe pain it brings to the picture and for complicating our migraine treatment.
Here is the thing with nausea and vomiting. It can be some nausea that responds to anti-nausea meds and then there is Insane Nausea and violent vomiting. When I was first diagnosed with migraines I would get violent vomiting. I would start and couldn’t stop. Just keep going and going and going. Until I felt dizzy. I also recently had the pleasure of Insane Nausea that didn’t respond to Zofran, and every other single thing I tried from ginger, to peppermint to Gravol. And I lost 30 pounds from it and my inability to eat from the nausea alone. I spent a year like that, unable to eat barely anything. Sick all the time, fighting the nausea, fighting to keep my food down. Yeah, nausea can be worse because it can be relentless as well.