I have suffered with chronic migrainous headache since a road traffic accident in 2013. Before the accident I was not prone to headache at all. A car hit me from behind whilst I was cycling and was catapulted over the handle bars landing head first in the road. Thankfully, I was wearing a cycling helmet which saved my life according to the A&E medical team.
Starting to have migraine attacks
My first migraine occurred three days after the accident and I suffered severe headache pain, nausea, went pale white, slurred speech, became incoherent, impaired cognition and photophobic. I was weak and unable to walk in a straight line. At the time I was not diagnosed with migraine and did not start receiving any medical treatment for the terrible headaches I was experiencing.
I received physiotherapy and neuropsychology therapy sessions and it was not until a neurologist examination six months later that I started to receive treatment for headaches. I was prescribed with medication to regulate my sleep pattern (amitriptyline). Amitriptyline was increased in daily dose 12 months after the accident when I was examined by another neurologist who diagnosed me with migraine and recommended use of preventive medication in an attempt to reduce the frequency of my migraine which occurred two times a week.
Finding the right treatment
To try and reduce the duration of my migraine attacks I was prescribed sumatriptan combined with ibuprofen but was limited to how many triptan I could take in any given week. The triptans were a lifesaver from the point of view that the duration of migraine attack reduced to a few hours compared with lasting up to three to four days. The triptans do not stop the lead up time for a migraine attack and neither do they stop the 24hour to 36hour recovery period of feeling fatigued, washed out and unable to work, a bit like recovering from the flu.
I found eletriptan in 40mg doses combined with 400mg of ibuprofen was particularly effective for me. The challenge was to take it in time and was often reliant on my wife or work colleague telling me I was starting to show signs. I found myself frequently being confused not knowing if I was going into a migraine and able to make a simple decision.
Understanding my triggers
The lead up to the break out of my migraine seemed to be consistent with the same symptoms each time but the migraine were not regular in pattern. My treating neurologist towards the end of 2014 suggested I keep a migraine diary to try and find out what the triggers were. Over the years I have worked out that stress, concentration and fatigue, fluorescent lights and thunderstorms can trigger my migraine. I have not found that diet triggers migraine having cut out and re-introduced known headache dietary triggers.
Over the years, I was treated with various courses of preventive medications including amitriptyline, propranalol, sodium valproate and more recently topiramate. My migraine diary showed slight improvement from daily headache with migrainous headache approximately twice weekly, to nearly daily headache with migraine reducing to once a week on average.
In parallel with this course of treatment during times of the week when I was not suffering and not working, I found photography a great therapy and help.
I received EMDR treatment (eye movement desensitization and reprocessing) which was very beneficial at treating post-traumatic stress disorder but it was also hoped that it might reduce the frequency of my migraine. Unfortunately there was no improvement regarding migraine, even after a course of 12 sessions.
Managing the impact on my life
Migraine has been disabling and unpredictable, impacting heavily on my working week and attendance, lifestyle, family life and independence. My most recent treating neurologist, found via The Migraine Trust website, created a comprehensive treatment path for me.
Following the recommended course of topiramate for over 12months which seemed to reduce my migraine towards the end from typically once a week to once every one or two weeks, I was told to stop taking preventive medication for at least four months until the next review. Instead I should to try a course of vitamin B2 (riboflavin) and continue with the attack medication. During this time I also started to eat a lot of chillis and found the Carolina Reaper particularly helpful during the recovery phase.
Just after New Year’s Day 2018, things started to change when the frequency of migraine reduced further to the next migraine being in February, which has been my last migraine to date.
I have been told by neurologists that migraine is a constitutional condition that can remain dormant unless activated. My head injury activated my condition and once activated migraine remains active for the rest of my life. The challenge is to learn to cope with this and try and find ways that can help reduce the frequency and attack duration.
This does not necessarily have to come from medical treatments, and I believe that photography has been a contributing factor. Some of my work can be viewed in my gallery, typically taken after recovering from a migraine.
Moving on from the accident
I am not sure that I will ever be migraine free but I have now learnt to manage my life in a more balanced way reducing the triggers for my migraine which reduces the frequency of them.
My wonderful wife and children have been a great strength and help and my work colleagues have been very supportive and accommodating throughout my rehabilitation. I have gradually over the last five years been able to increase my work rate from nothing to three days per week and am about to increase again to four days.
In addition to my passion for photography, there has also been another unforeseen but positive outcome following my accident. I am a product designer and realised that there was distinct lack of available information about what happened during the accident that could have been beneficial in decision making and remedial treatment paths. Resulting from my accident, we have developed a thin film flexible printed sensor technology for helmets that registers force and impact data building a more complete picture of what happened. This data has a number of beneficial uses for individuals and companies, including being able to make informed decisions, potential to reduce rehabilitation time and the use of data leading to improvements in safety apparel that could mitigate injury.
The views and opinions expressed in this ‘Migraine story’ are those of the author and do not necessarily reflect the official policy or position of The Migraine Trust.