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Biology 202
2001 Second Web Report
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A Day in the Life of a Migraine Sufferer

Jessica MIller

Each year over twenty-six million people nation wide are affected by migraines. Once thought to be a concentration of evil spirits in the brain, common cures consisted of everything from drilling holes in the skull, to inserting garlic cloves into the temples(4). Today however, scientists realize that this all too common occurrence is actually a neurological disorder, which can result in the disability of its victim for hours or even days. I myself have been a constant sufferer of migraines since the age of ten. The following is the day in the life of a migraine sufferer: myself.

I believe that the most appropriate place to begin is a brief look into my medical background. Since the age of ten I have constantly been struck with migraines, occurring more and more frequently as I age. Migraines can strike children as well as adults, however; typically the migraines become less frequent after early adulthood(3).Ninety percent of migraine sufferers also report having a family history of migraines, suggesting a genetic link(5).I, for example, know that both my father and grandmother to this day frequently have migraines and have since a very young age. Furthermore, even though I typically have at least one debilitating migraine per week, I am otherwise in perfect health. This is common among migraine sufferers; they are entirely healthy and therefore, cannot understand why they are showing such painful symptoms(3).Each day that I have I migraine it is a struggle to work, to move, sometimes even to breath. If caught in time, I can typically medicate myself before a full- blown migraine occurs, but often I realize to late what will soon occur. This was the case on April 1, 2001, when I received a classic migraine that left me in a state of suspended animation for over twenty hours.

The day began with stiffness in my neck and an ache around my temples and brow bone. Migraines are typically a long process, which begins slowly and climaxes in intolerable pain. The stiffness of my neck and facial muscles, as well as an irritated feeling in my scalp, are often the first warning signs of a migraine day. However, I chose to ignore the signs and ìtough it outî since I was late for class. Instead of my usual breakfast of dry cereal and water, I grabbed a cup of yogurt and a coke for the road. There are certain foods that are known to trigger migraines in frequent sufferers, for example foods containing tyramine (such as yogurt)>(5) .Also, changes in caffeine intake can also trigger a migraine, such as my early morning coke.

I rushed out the front door of my dormitory and took notice with joy of the unusually warm weather, which was a sudden shift from the cold rainy system that had recently been pushing through the area. The new spring weather, though invigorating to my senses also brought a change in the barometric pressure as well as the pollen count. Sudden shifts in air pressure and seasonal changes can greatly affect a migraine suffererís sensitive neuro-vascular system. Further, bright sunlight can provoke migraines, causing a tightening of facial muscles3).

During my early morning classes, due to the stress I was feeling over an up and coming test I put my discomfort to back of my mind. During the test my symptoms all but disappeared, as I concentrated all of my effort into conjuring up the correct answers resulting in an exhilarating high that left me totally forgetting that I had ever noticed any migraine symptoms. However, soon after the test, my symptoms returned with a vengeance, leaving me feeling tense and tired. Post-stress let down often results in creation of migraine symptoms, which may have disappeared during the height of stress. Stress is not the cause of migraines, but psychological issues can worsen migraines as they can with other conditions(5).

I sat listening to the lecture on Egyptian sculpture, finding it difficult to focus on the screen or on the words that I was hearing. I could hear the lecture, but felt as if I were only observing the actions of the class and not participating in it. This sense of disorientation that I was experiencing was probably a result of a great amount of blood being pumped to my brain at one time, thought to be a result of the sudden dilation of many small blood vessels in the brain, scalp, and neck(2).I went straight home and closed out all light foreseeing what was potentially a terrible migraine. I slept for two hours, until a knock sounded on my door. I opened it to find my friend Bonnie ready to go to the gym. Feeling a little renewed I grabbed my gear and we headed out. A half hour into my workout, I began to feel nauseous, as my temples began to throb and I could feel myself becoming weak. Exertion during a migraine period often results in the reemergence of symptoms, often increasing them beyond previous levels(3) .I said good-bye to Bonnie and told her I was hitting the showers. The warm water eased the pain that I was feeling and my stomach began to settle. Bonnie and I headed back to the dorm and decided to watch a movie and drink a few beers, in order to relax.

Bonnie popped in the movie and opened our beers. I sat back and enjoyed, resting my still slightly throbbing head against the wall. Half a movie and two beers later, I began to see spots in front of my eyes. This early warning system often called the aura period, typically occurs fifteen to thirty minutes before the full blown migraine(4).Each sound seemed to resonate through my head as if they were being beaten against it. I felt disoriented and sick at my stomach, but all I had been doing was relaxing, where could I have gone wrong. The first major problem is that alcoholic beverages, such as the beers I had been consuming, quickly work through the body and are known to multiply the effects of a migraine. The second reason is that the migraine never really went away, it was always apparent to various degrees, and as time passed with out medication the symptoms were only increasing(5).

I gave Bonnie a quick apology, and staggered across the hall to my room, not knowing whether I would make it to my bed before I succumbed to the building pain. In my room, I shut out all the light, closed my laptop and hid myself under the covers. As I lay in the darkness hoping for the salvation of sleep, the sounds of the anxious Blue Bus riders attacked my already throbbing head. Even the whirring of my laptop caused an annoying resonance in my ears. I covered my head with my pillow and soon I found the relief of sleep. I slept for the next fifteen hours, waking up refreshed and new the next morning.

Though I can easily explain how it feels to experience a migraine, an explanation of why it occurs is less easy to formulate. This question has been hotly debated in recent years, as the number of diagnosed cases increases. Three main theories have been created that though not confirmed each appear possible.

The first and most prevalent theory describes the migraine pain as the result of a lack of neurotransmitters. The size of the brainís blood vessels is controlled by neurotransmitters, which the brain sends along nerves, keeping the vessels at a constant size. During a migraine, it is thought that the brain fails to create an appropriate amount of neurotransmitters and therefore the vessels of the brain continuously expand creating a tremendous amount of throbbing pain. The two major neurotransmitters are that control vessel size in the brain are serotonin and norepinphrine, which accounts for the effectiveness of drugs which are serotonin specific re-uptake inhibitors in combating migraine pain(3).

A final and less publicized theory states that migraines are caused by a unique electrical disorder of the brain cells. Scientists believe that people who suffer very frequent attacks seem vulnerable to physical changes in the brain, which lead to chronic pain. New imaging devices allow scientists to watch patientsí brains during a migraine attack, and they are discovering sufferers have abnormally excitable neurons. These neurons suddenly fire electrical pulses at the rear of the brain, rippling across the top and back down to the brain stem, straight to important pain centers. The resulting pain comes from either the brain stem activation, or blood vessels inflamed by the rapidly changing blood flows(1).

The search for a cure for migraine pain is ardently sought, for not only do migraine sufferers feel the pain of migraines, but so do their families and even their employers. Each year, migraine sufferers miss 157 million work days as a result of migraine symptoms(2).This struggle I feel personally, for as a migraine victim I often must struggle through days in a haze of unendurable pain, often resulting in missed work and social time. As a result, people with migraines become more susceptible to another misunderstood disease, depression. This endless cycle of pain and self-doubt can be devastating to otherwise active and dedicated individuals. The major problem of both of these disorders is that too often they go undiagnosed(3) .

WWW Sources

1)News Article from Canadian Press, Interesting new ideas

2)Ninds, Lots of good technical information

3)Allocca, Biotechical site run by a doctor

4)MAGNUM, Short site with some history of the disorder

5)Food and Drug Administration site for Heading off Migraine Pain, Long article easy to understand

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