Chris Wise can count on experiencing up to five migraines per month, but it’s the two dozen or so pain-free days that often push him to the brink.
The 24-year-old online marketing director for Guideline Central has two young children, too few triptans covered by his medical insurance, and a career that demands long hours in front of a computer and performance benchmarks—regardless of his condition.
“If I don’t show results, I’m on the chopping block,” Wise says. So when he encounters a day without a migraine, he overcompensates with 16-hour work marathons and weekends with his kids at Disney World or Universal Studios, both hour-long drives from his Daytona Beach, Fla., home.
“We’re doing all of this crazy activity—going to a water park or theme park or museums—to make up for the fact that [my kids] are going to be stuck inside my house one day because I feel like crud,” he says.
There’s a temptation for migraineurs to do too much, to push too hard, to toss more fiery torches into the juggling act just because today is a day without pain. But there’s always the danger of getting burned by overdoing it physically or mentally, and subsequently putting yourself at greater risk for migraine.
For some people with migraine, there is a desire to push too hard on pain-free days to prove that they are not milking their situations on the days they physically can’t live up to expectations, says Robert A. Nicholson, MD, a clinical psychologist with the Mercy Clinic Headache Center in St. Louis. “People with migraine have active, busy lives, trying to balance family responsibilities, social responsibilities and work responsibilities,” Dr. Nicholson says. “On a day when they have a migraine, it is easy for them to become frustrated because of the migraine’s impact on their lives. In turn, on days when they are migraine-free, they want to accomplish as much as possible.”
But migraineurs should resist the urge to over-schedule themselves, and treat a good day as if it were delivered to their front door with a label reading, “Fragile: Handle with Care.” Here are six strategies you can implement into your life to maximize quality time without veering into the danger zone.
1. Stay the Course
A day off from a migraine is a lot like one of those snow days you wished for when you were in school: Sure, it’s a blast, but that doesn’t mean you can stay outside in the cold all day building a snowman. To manage their condition, migraine sufferers fastidiously arrange their lives to avoid potential dangers, so even a much-needed reprieve shouldn’t be an excuse to throw out your plan.
Dr. Nicholson likens migraineurs to diabetics who need to keep their bodies in balance even on days when their blood sugar is under control. “People with migraines may think it’s OK to not think about lifestyle choices on the days they don’t have migraine,” Dr. Nicholson says. “But I tell patients that, given the way the body is designed and has adapted to the environment around them, it’s important they be consistent with the way they live their lives.”
That means remaining vigilant of potential triggers—such as stress, lack of sleep or certain foods—and recognizing your limitations.
2. Dine, Don’t Just Dash
When you’re migraine-free and making the most of it by barreling through a shopping mall with bags in one hand and a cell phone pressed against your ear, don’t neglect a trip to the food court for lunch. Or, if you’re pumping numbers through an Excel spreadsheet like a CPA on Red Bull®, be sure to power down for 30 minutes to grab a turkey wrap.
Missing meals is one of the most common ways to spark a migraine, but this is easily forgotten by migraineurs who keep themselves too busy to stop and refuel. “There are some times when I recognize, ‘Hey, this is probably not going to be good for me if I skip this meal,’” Wise says. “That’s not always the case, though.”
MaryAnn Mays, MD, a physician with the Neurological Center for Pain at Ohio’s Cleveland Clinic, suggests patients eat a healthy breakfast in anticipation of a busy day. Consider packing snacks such as protein-rich almonds, fruits and veggies to nibble on while working to maintain optimal blood sugar levels.
“I often tell them they should eat six smaller, more frequent meals throughout the day,” Dr. Mays says. “That way they don’t have the big drop off with the decrease in blood sugar, which can stimulate a stress reaction internally and trigger a headache.”
3. Break a Sweat
You’ve heard it a thousand times before, but every day is another opportunity to rekindle your on-again, off-again romance with fitness. Like doing laundry on vacation, 30 minutes on the elliptical machine or even an extra-long walk with the dog might not be the most enjoyable way to spend your free time. But, according to Dr. Mays, it can positively impact the neurochemicals that cause headaches.
“If someone has had a day where they’ve been busy or stressed, later in the day they should end up with some exercises so that the endorphins kick in and you don’t get that big drop off in emotions and develop a stress ‘let down’ headache,” she says, adding that exercise early in the day can also help control headache frequency.
They don’t have to be Ironman-style workouts either. (In fact, unless you’re angling to join the cast of Jersey Shore, you should skip muscle-blasting, strenuous exercises and the requisite indoor tanning altogether.) Just keep it simple: When Wise gets active, he focuses on light cardio—some basketball with friends, swimming and bike riding. “It definitely makes me feel better and, in my opinion, doesn’t lead to so many headaches,” he says.
4. Develop a Migraine Bucket List
Downtime can be fleeting for migraineurs, so be picky about what’s worthy of your time. No matter how great you feel, there just aren’t enough hours in a day to reorganize the closet, finish those sales projections and trim the bushes. Bottom line: Migraine sufferers need to figure out what can realistically be accomplished in one day and plan accordingly, Dr. Nicholson says.
Migraineur and professional artist Evie Ryland likes to call herself a “spontaneous, free form-type person.” But she finds herself rising early and immediately organizing mental lists to fully seize her best days. As a published author and illustrator, Ryland requires a clear head to successfully draw or write, but the one or two migraines she endures each week dampen her creative mojo.
To compensate, Ryland works ahead on household chores and other time-consuming busywork to maximize the unimpeded hours she spends with her muse. “If I’m not feeling good, I’m not going to screw up sorting my laundry,” Ryland says. “So I focus on the bigger, more intense goals when I’m feeling good.”
5. Manage Expectations
Friends, family and coworkers can be tremendous assets for chronic pain sufferers, but missed holidays, last-minute cancellations and commonly held misconceptions about migraines can strain those relationships and become another unnecessary stressor.
“I detest making plans now,” says Ryland, who regularly has to reschedule a commitment to help an elderly friend with odd jobs around the house due to pain. “I think migraines are why I do things so spontaneously rather than making plans. You just never know if you’re going to make it or not.”
And if the neurochemical assault to the system wasn’t enough, there’s the inevitable guilt that accompanies feeling like you’ve let down those closest to you. So when migraineurs experience relief, they often feel obligated to overcompensate for their absences and leave little time for themselves.
Since time machines and cloning are the stuff of science fiction, a migraineur’s best remedy may be simple, direct communication. Talk with those closest to you about your condition in advance, make contingency plans like a doctor on-call would, and, perhaps most importantly, realize you can’t control everything and sometimes have to let go, Dr. Nicholson says.
“You can’t let their response cause you to feel guilty, stressed, worried or frustrated,” he says. “The fact is the only person you have any control over is yourself, and that’s really a hard thing to get. If some- one can get to a point where they can appreciate that, the conflicts will go away.”
6. Nourish Your Priorities
Twenty-four hours; 1,440 minutes; 86,400 seconds. That’s all the time you get in a single, migraine-free day— including sleep—so make it count.
People often spend too much time on things they don’t really value, and our technology-energized world makes it easier than ever to engage in activities that provide little satisfaction, Dr. Nicholson says. Before jumping head first into a barrage of activity, Dr. Nicholson says migraine sufferers should take a moment to discover what matters most to them and indulge in those pursuits.
For Ryland, that might mean taking out the sketchpad and doodling a picture of her dog Fuzzy Monster Truck. For Wise, it could mean hanging with the kids and going nose-to-nose with a killer whale at SeaWorld—separated by several inches of glass, of course. Whether it’s the siren song of a good book, dinner with old friends, a little work in the garden or scrapbooking those vacation photos, it’s up to you to decide how to navigate your mind’s calm seas.
“If it’s what you really enjoy,” Dr. Nicholson says, “at the end of the day, you won’t regret that time spent.”
Reader Responses
Perhaps u2’s Bono put it best: “it’s a beautiful day, don’t let it get away.” That certainly was the sentiment on the NHF’s page on Facebook when we asked migraineurs how they take advantage of a pain-free day without overdoing it.
- “Usually playing catch-up on the household chores that never seem to get done by anyone else in the house.” – Patsy C.
- “On those days my fiancé always tells me to take it easy and relax, but I don’t listen. I feel so empowered and want to accomplish everything when I’m not in pain, I can’t help it. When I feel like I’m borderline, then I proceed with caution.” – Janice H.
- “My favorite activity is to go to the barn and ride my horses. My least favorite activity is to do nothing because I am forced to do that when I have a migraine.” – Carla J.
- “On a weekday? I just try to do my job and remind myself, over and over, that I’m not in pain. You have to appreciate these brief moments.” – Pam D.
- “My favorite activity is to have a nice hot cup of tea and snuggle with the dachshunds under a blanket. They act like little furry hot water bottles.” – Amber P.
