Veronica With Four Eyes

How I Explain Chronic Migraine

Like many other people with migraines, I had my first ever migraine headache when I was around fourteen years old. While the medical conditions that trigger migraines are not always well understood, people in general know what a migraine is and the effects it can have on someone- head pain, sensitivity to light and sound, eye pain, and nausea, just to name a few symptoms. However, after I began experiencing more than 15 migraine headaches per month, my diagnosis was updated to chronic migraine, and I’ve noticed that a lot of people have trouble understanding what that means- they assume I have constant migraine symptoms, that my migraine headaches are more or less severe than other migraine headaches, or that I don’t actually understand what a migraine is. Here is how I explain chronic migraine, with the help of the Cleveland Clinic’s information page on chronic migraine.

What is chronic migraine?

From Cleveland Clinic

Chronic migraine is defined as having at least 15 headache days a month, with at least 8 days of having headaches with migraine features, for more than 3 months. Chronic headache begins as less frequent headache episodes that gradually change into a more frequent headache pattern.

Chronic migraine affects between 3 and 5 percent of people in the United States. Approximately 3 percent of people who have episodic migraine transform to chronic migraine each year.

From my own perspective

Here is how I explain how chronic migraine specifically affects me:

Chronic migraine is one of the comorbid conditions that I experience as the result of another neurological condition called Chiari Malformation. With chronic migraine, I experience at least 15 headache days a month, though some days I may experience more intense symptoms than others. While I do live with chronic pain from Chiari Malformation that can include a constant headache, I do not experience constant symptoms of a migraine headache.

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What are the symptoms of chronic migraine?

From Cleveland Clinic

Symptoms of episodic migraine and chronic migraine are the same. The difference is simply the increase in frequency of the number of headaches. Typical migraine symptoms include:

  • Head pain that is moderate to severe in intensity, worsened by physical activity/movement
  • Pain on one or both sides of the head
  • Throbbing pain or pressure-like pain
  • Sensitivity to light, sound, smells
  • Nausea/vomiting
  • Dizziness

Signs an episodic migraine is transforming to a chronic migraine include:

  • Having a growing number of migraine attacks
  • Taking more medication because of the growing number of attacks

From my own perspective

While some people only get migraines a few days a month or from specific triggers, chronic migraine is when someone gets migraines multiple times a month. The triggers for migraine headaches that are associated with chronic migraine aren’t more unique than the triggers for episodic or occasional migraine, but the migraines themselves happen more often, typically at least 15 days out of the month. The migraines come and go like typical migraine headaches do, they just come on more often.

How is chronic migraine diagnosed?

From Cleveland Clinic

Your doctor will take a detailed medical history. The doctor will ask about:

  • Your pattern of migraine pain, including when and how migraines begin; if they are episodic or continuous; how long the migraine lasts; if there are any triggers or factors that make the migraine worse.
  • Your description of the pain, including its location, sensation, and severity.
  • Other symptoms that accompany the pain, such as auras, lack of energy, stiff neck, dizziness, changes in vision or in senses, and nausea/vomiting.
  • Your current and previously tried treatments, including when the medications are taken, dosages, outcome and side effects and use of¬†alternative¬†or complementary therapies.
  • Your medical history including other health problems

From my own perspective

When I first started experiencing migraine headaches, I only got a few migraines per month. As I began to experience symptoms related to Chiari Malformation, the number of migraine headaches I experienced also began to increase. My neurologist had me keep a migraine diary so that I could better understand what was triggering the headaches and how I had treated them, as well as understand what symptoms I was experiencing. I was officially diagnosed with chronic migraine about a year after I first started experiencing symptoms, though it’s worth noting my Chiari Malformation was not diagnosed for another 3-4 years.

How is chronic migraine treated?

From Cleveland Clinic

Treatment of chronic migraine is focused on managing lifestyle choices and headache triggers, managing migraine attacks and providing preventive treatments to reduce migraine attacks.

From my own perspective

Chronic migraine is treated by managing or avoiding triggers, treating migraines and other side effects as they happen, and sometimes with preventative medication. In my case, I have a few different triggers for migraine headaches that include weather changes, storms/lightning, stress, certain foods/drinks, strobe or flashing lights, and others. While I can’t control the weather, I take steps to manage the other triggers such as avoiding foods or drinks that can trigger a migraine, finding ways to manage stress and overwhelming situations, checking for content warnings on media about strobe/flashing lights, and avoiding environments where there might be a lot of flashing lights.

When it comes to managing migraine attacks, I prioritize rest and spending time in a dark environment, as well as managing my symptoms in a way that works for me. While I would never tell someone to avoid migraine medication, I personally do not take any medication for my migraines (preventative or otherwise) because I am allergic to several different migraine medications and taking medication is simply not an option for me. I received disability accommodations for chronic migraine while I was in high school and college, as well as in the workplace, so people around me are aware of how chronic migraine affects me.

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Disclaimer

All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. If you believe you are having a medical emergency, please call 911 or go to the nearest emergency room.

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How I explain my own experience with chronic migraine and Chiari Malformation, with the help of information from the Cleveland Clinic website