There is a time bomb in my head. It has exploded thrice in a short amount of time. Friday night out to dinner with my wife and her father I started seeing strobes and lost vision, a clear precursor. We finished our dinner and my vision returned so I could drive us home – all the while I knew the massive head pain was coming. I got home and spent the next four hours in pain taking drugs to club the thing out of my head. Saturday wasn’t too bad with a yard sale in the morning and then a 90 minute bike time trial going well. Sunday was that epic run and about two hours afterwards I was seeing lightning strobes. This migraine was different from the rest. Normally I get visual strobing on my right side and I lose vision in my left eye. The pain is huge but dominant on the right side of my head. Sunday’s migraine was all left side and the feeling of my heartbeat pulsing in my neck and temples made me nauseated. I did the full cycle of meds, lost most of Sunday to being in bed, and hoped things were better. Monday was off, Tuesday was a swim, and it was about then I noticed that I have had an intense knot of tension on the right side of the base of my skull. I’m perpetually tight in my SCM, but this was much different. It made it so turning my head to the right was a painful experience. Wednesday I couldn’t shake a feeling of despair, fatigue, and overtraining. When I tried to run my left hamstring stated howling and I had to scrub the 75 minute workout because my leg wouldn’t allow it. I went home and did strength work instead. Later in the day when I spoke to Brian he said it was to be expected – we ran hard Sunday and he even had a rough day afterwards recovering from that run. I went on with my day, working for clients, picking up my bike from the shop after getting Julian’s race wheels put on and the drivetrain cleaned up for a weekend of training in Tempe on the Ironman course. I was sitting at a client’s desk at 6 when the visual strobing started again. I was supposed to drive to Malibu to work on the client’s home computer but immediately had to pack my things, make profuse apologies, and head home to tend to brain bomb number three.
I hate this feeling. I hate not being in control of my body when I am focusing all my energy right now on controlling my body. I am more disciplined now than ever before, waking early and training, researching the sport, immersing myself in training philosophies and the science of endurance training. And yet I am walking around with a time bomb in my head that explodes without a clear, known cause. My stupid human brain clutches for causation but it’s always confusing correlation with causation. Was it the Trader Joe’s electrolyte water? Was it the Powerbar gels? No. Maybe if I take Ibuprofen it will calm the muscle inflammation. No. Aleve and aspirin at first sign of trouble? No. Maybe bodywork will ease out the kink. No.
A migraine is a neurological event preceded by or causing a cardiovascular event. There are two classes of meds on the market to treat each cause. There are vasoconstrictors to shrink capillaries and reduce the vascular side which gives the brain time to calm down and stop misfiring. There are now many drugs in the triptan family to interrupt the neurological event – Axert works for my wife’s migraines, but not for mine. I’ve also tried Maxalt, Zomig, and Imitrex – none of which work on me. The only way I have reliably calmed the migraine is taking Midrin, Thor’s mighty hammer of Acetaminophen and Dichioraiphenazone a cranial vascular constrictor and mild sedative. Unfortunately, a Midrin cycle takes four hours – pills every hour knocking me out. Some people can function during a migraine. I want to die. Sleep in a dark, cool room is the only thing that barely feels better.
The psychological component of the migraine is pretty bad as well. There is a detectable plummet in serotonin levels in the hours before the migraine. This can manifest as the “doom and gloom” thoughts of a severe depression. In hindsight, this is exactly what was happening yesterday when I couldn’t muster the energy to go for that run. My brain was having an event and I attributed it to being fatigued from Sunday’s epic run. Under normal circumstances I would have been happy to run again after the success of Sunday, but something chemical was operating against that disposition.
There is a terrible selfishness to the migraine. Under normal circumstances I take care of a lot of domestic stuff and then there are my client’s ongoing technical needs. When I’m hit by a migraine everything collapses and I can only focus on my own needs – which are: medication and sleep. It’s only in the aftermath that I surface and see that I’ve ignored other people’s problems while tending to myself. Or worse, that my wife’s needs go unmet because she is taking care of me. No one is keeping score in this household, we take care of each other. But I want my wife to be happy and have her emotional needs taken care of. Right now there are a number of things weighing on her – family stuff, huge pressure in grad school deadlines, and an incredibly expanding work life are all pushing her to her limit. I want to be there for her, taking care of her because everything she’s doing brings more value to our relationship and lives. But the migraine shuts all of that down. Just like the tunnel vision precursor, the migraine narrows my emotional vision down to a tiny point where I can only see myself and my own selfish needs.
I can’t let the migraines stop me right now. Every workout counts, now in the final five weeks before IMAZ every single day has value and meaning. I am caught between trying to stop this migraine cycle and needing to “put the hay in the barn” as Brian likes to say. Joe Friel’s blog just told the story of a triathlete who missed 10 days of training to the flu 80 days before his big race and it cost him the Kona slot he was on track to win. Every day counts. Every workout counts.
But how do I do that with this time bomb in my head?