Suzanne Collier

This is a piece about my personal experience of migraine in order to raise awareness for the Migraine Trust.
 
 
The 18^th May 2006 will go on record as the worst day of my life. I woke up and had no feeling in my right-hand side, from my face down to my right leg; I could hardly stand up and my right arm felt like it was hanging off me. I realised after a few moments that I’d lost muscle control in my mouth and could not talk or swallow. Somehow I got to casualty and they whisked me straight through.  I could instantly tell that the Doctor thought I’d had a stroke; I also thought I’d had a stroke and when they asked me, “Do you usually talk like this?”, “Do you usually hold your head like that?” I was unable to reply other than in unintelligible mumbles.

 
One month earlier I had been in a minor car crash with major consequences, in that I hadn’t known I’d had concussion, and had completed a full day’s work on the day of the crash, even though my car had been damaged enough to be towed away.   It was two weeks later, when I couldn’t stand up with dizziness that I was told that I’d had concussion, was given some anti-inflammatories and painkillers and told to get ‘complete rest’.
 
The hospital gave me a CAT scan and for four hours I lay on a trolley in casualty thinking the worst: I’d had a stroke and my life would never be the same again. All the things I’d wished for and my hopes and aspirations for the future would never happen.  It was a terrifying and awful time and I felt very alone. The realisation that you can’t use your right leg and arm and no one can understand what you are saying, maybe forever, is devastating.
 
Finally, the Doctor came and spoke to me, as he was talking I realised that my speech had started to return, as had some of the feeling in my right-hand side – I now had a bizarre mix of pain, numbness and pins and needles. He said he “wasn’t sure what was going on, but I hadn’t had a stroke, nor was I in immediate danger of having a stroke, but I needed to see a neurologist”.  I went home, emotional, confused and staggering around like I was drunk.  Although my speech had returned to some extent, I was unable to articulate very well, I was slurring my words and my brain did not appear to want to communicate with my mouth – my mind would say one thing and my mouth would speak differently.
 
Five years on and I now know that was a basilar migraine^[1] attack. In 2011 I had over 100 basilar attacks, although thankfully none have been as severe as that first one. My attacks now are likely to consist of losing the feeling in my right-hand side followed by the mix of numbness, pins and needles and pain, throbbing pains in my head, slurring of speech, giving the appearance of being drunk, a decreased level of consciousness, nausea and dizziness. The main part of the attack lasts 4-6 hours but the dizziness can last for 8 hours and the numbness may linger for days. After every attack I go into the ‘hangover’ or ‘jet lag’ stage, where I’m usually unable to function as I would wish. In addition to the basilar attacks, I live with a permanent migraine which is now on a low level and I have pressure pains in my head. My concentration and my short-term memory are both poor.
 
I also have balancing problems and every basilar attack affects my balance and I’ll usually stumble or fall. Working on your balance is a nightmare – the exercises you have to do basically disturb your balance and make you feel sick, with the hope that you are training your brain to recalibrate properly. I’ve a long list of balancing exercises to do but as they make me far worse, (they trigger the most awful vertigo), I find myself having to make a clear plan to do the exercises rather than as and when I feel like it. Every day I stay in bed my balance decreases by 10%, so a prolonged migraine attack can affect me in more ways than one.
 
Everything seems to be a trigger:- caffeine, chocolate (although I’ve conducted a risk assessment – Bounty Bars are safe – they really are ‘A Taste of Paradise’), cheese, too much citrus, alcohol, processed foods, tiredness, lack of sleep, loud music, flashing lights, the cinema, too much TV, too much fun. Yes, even going out and just having ‘fun’ can be a trigger… It’s like if I do too much of anything my brain ‘shuts down’.  The trick is to balance my days and activities. My diary is planned to manage my migraine and I rarely do anything on two consecutive days and if I go somewhere I am usually the first to leave. I avoid my triggers as much as possible and have a huge list of other foods which might also be potential triggers – I’m currently working my way through them.

The treatment I get for my migraine is a Greater Occipital Nerve block (GON) into the area I refer to as ‘my bruise’. This is the place where I must have hit my head in the car crash – five years on and I still have a huge bump on the back of my head.  I call the GON my ‘Frankenstein Injection’ as it feels like you are getting a power pack or an upgrade.  At a recent consultation (with Dr Anish Bahra at the National Hospital for Neurology and Neurosurgery in London) it was recommended that I get bi-lateral blocks to see if this helps with the migraine aura and then to try Flurnarazine.  I have never got on at all well with any of the recommended medicines, – Propanonal, Amitriptyline, Nortriptyline, Topiramate – which is why the GON was initially given.  The injections have made a huge difference to the level of pain; previously I would have a pain level of 6-8 almost every day, now the pain level is usually 1-3, but nothing has helped with the aura. I have Maxalt Rizatriptan for the most severe attacks, which I use maybe once a month.
 
My life is almost unrecognisable from how it was before – I used to have a very busy day job as a Sales Manager, juggling lots of projects, going out all day and meeting clients and I had my own small business too.  Now I work part-time from home running my business and planning my working days around my attacks.  I used to be so reliable but now my friends and family – all of whom are positively brilliant – know that I may cancel things at the last minute.  I miss about 70% of things that I wish I could attend.  On the MIDAS^[2] headache scale I score 76 out of 78 points.
 
One thing that I have heard conflicting opinions of, is how much of a stroke risk is a basilar attack?  I’ve had one consultant tell me that the only way of knowing whether it is a migraine or a stroke is ‘if I get better’ and another tells me that my stroke risk is nominal.  I also wish I knew how to cure the ‘hangover stage’ quickly – sometimes this can feel worse than the attack itself.
 
As to my future, no matter what labels are given by the hospital, I always believe I will get better and I will WIN this.  I may modify things in my life but I refuse to give up. I’m trying to cycle again as part of the balancing exercises. My dream is to be well enough to cycle the C2C – 140 miles from Whitehaven to Tynemouth. When I do this you’ll be the first to know. Life deals you a hand of cards; this may not be the hand you want but you need to play them as best you can. I like to think I’m doing that.
 
If you’d like to know more about the work of the Migraine Trust or make a donation please visit http://www.migrainetrust.org/
 
If you work in the book industry and would like to make a charitable donation, BTBS The Book Trade Charity would be grateful for your support:  http://www.btbs.org.uk/

© Suzanne Collier 2012.  All Rights Reserved.

1. ^[1] International Headache Society – information on Basilar Migraine http://ihs-classification.org/en/02_klassifikation/02_teil1/01.02.06_migraine.html ↩
2. ^[2] Midas Headache Score – Migraine Disability Assessment Score – https://docs.google.com/viewer?url=http%3A%2F%2Fuhs.berkeley.edu%2Fhome%2Fhealthtopics%2Fpdf%2Fassessment.pdf
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