I had a migraine today after going more than a month without one. It was a fairly severe one, and I’m still trying to understand why they sometimes break through despite the medication and routine that usually help.

What happens during a migraine

Mine tend to follow the same pattern. I get visual auras for about 30 minutes, with flashing shapes that look almost like a glitch in my vision. Once they fade, my vision is still blurry and bright lights feel painfully sharp.

About 15–20 minutes later, the pain starts behind my eyes. The pressure becomes unbearable, and I can’t focus or do much of anything. At that stage, I lie down in a dark room and wait for it to pass. I wore an eye mask today, which helped a little, and took my usual 2 Panadol and 2 Nurofen. The pain began easing after about 3–5 hours.

I avoid stronger medication such as Relpax because, although it works, it leaves my head feeling worse afterwards. Taking medication daily has been the best long-term solution for me, but it hasn’t stopped the migraines completely.

How I’ve learned to manage them

I used to get very nauseous during migraines, although that has mostly gone away. I still remember one of the worst episodes at school, before I knew how to manage them. The pain was bad enough that I went to the nurse’s office and ended up vomiting.

They moved me to the principal’s office because it was the darkest room available, then later took me to the boarding house so I could lie down in a proper bed. I wasn’t taking medication then. I started around Year 10 and have been on it since, gradually increasing from 1 tablet to 3 a day.

I wish I could get rid of the migraines completely. Sometimes they feel like a curse, even though I’ve learned how to manage them. The medication helps, but it also increases my appetite, which is an unwelcome trade-off.

Working as a software engineer makes things harder because screen time is unavoidable. Some people understand what a migraine is like and others don’t. I don’t expect special treatment, but when I have one, I’d appreciate people not being dicks about it.

They run in my family too. My mum gets migraines and has had a lot of benefit from a biologic injection. My sister gets them as well, though less frequently.

The routine that seems to help

I think the month without a migraine had something to do with keeping a consistent routine. The things I’ve been doing are:

  • Sleeping at reasonable times and avoiding early starts when I haven’t had enough sleep.
  • Working out every two days and regularly running 3km.
  • Cutting out excess sugar.
  • Keeping stress levels low.
  • Avoiding alcohol and caffeine.

I’ve never liked alcohol, so avoiding it hasn’t been difficult. Although drinking is part of social life, I don’t feel easily pressured into it. With caffeine, I’m glad I never developed the habit. I know I have an addictive personality, so staying away from coffee and energy drinks seems sensible for me.

Most of the time, I can deal with the migraines and they don’t stop me from living my life. I don’t consider them the worst condition I could have, particularly when I think about people with chronic illnesses or disabilities that are harder to manage. At least mine come and go.

I still think medicine will eventually find a permanent fix. If that became available, I’d be willing to pay $100k AUD to be migraine-free for life.

Looking for triggers

The main triggers I’ve narrowed it down to so far are insufficient or interrupted sleep, alcohol, caffeine, and stress. I’m also considering whether diet, too much screen time, neck or eye strain, and a lack of exercise or cardio play a part.

Other possibilities include changes in climate, pollen or other airborne allergens, and humidity. I’m less certain about those and am still trying to identify a pattern.

I’m going to Japan soon, so I’m interested to see whether anything changes while I’m there. If the migraines disappear, I might have to consider moving. Only partly joking.

For now, I’ll keep doing what seems to help and trying to understand the breakthrough migraines. I’d like the severe ones to be less frequent, even if I can’t prevent all of them.