03 June 2011

Brain pain

Have you guys heard of Jill Bolte Taylor? Because if you haven’t, you really should know about her, or at least her experience, and her fascinating way of describing it. Jill Bolte Taylor suffered a stroke in 1996, well into her professional years as a neuroscientist. Years after recovering and recalling her memory, she was able to compose and deliver a play-by-play description of her stroke and rehabilitation, from the first-person neuroscientist perspective, in a lecture and a book she titled “My Stroke of Insight.” Here’s her TED talk, and you should listen. It is terrifying and at times hilarious and just completely fascinating.

A few weeks ago I was hit with a migraine so quickly and so hard, I literally felt attacked by my own brain. But even though the pain was nearly all-consuming, I actually thought at the time, “I need to use this experience right now to find the words to describe what this feels like.” Like Jill Bolte Taylor, I was unfortunately incapable of actually writing it down at the time, but I tried to commit it to memory so I could recall it accurately later.

Here is what happened one Thursday morning. I woke up at 6AM, which is just a handful of minutes before Mr. P leaves to teach the chil’ins some math. I walked from our bedroom to the living/dining room, where he was, to say goodbye. Just as I got to the room he was in, maybe ten seconds from the bed, my vision… quit. It started with my peripheral vision going black, then the rest of it. I stopped in my tracks, and Mr. P came over to hug me goodbye, but I didn’t say anything (except maybe “whoa”) even though I literally could not see him. I continued to just stand there as he left, and then… BAM.

Often I can feel a migraine approaching. My mother and I sometimes say that we have “a piece of a headache,” which makes no sense to those, obviously, who never have had a piece of a headache. What we mean is, there’s a dull ache, and it’s just in one part of our head, but it doesn’t feel fully formed or like a “real” headache, at least not yet. Sometimes I have a piece of headache for most of a day, or even several days, but if/when it starts to worsen into a real headache I try to stave it off* with some ibuprofen. This usually works and it’s how I can avoid the worst headaches.

* Any time I say “stave it off”, Mr. P references this song. Now it ends up stuck in my head whenever I use that phrase. And yours too! “And now you can count to three!”

Some unfortunate days I wake up with a headache, though. A few days prior to that Thursday Morning in question, I woke up around 4AM with a migraine. It sucked that the buildup to it happened while I was sleeping, so I couldn’t take any ibuprofen, but I could still lie in bed for two more hours half-sleeping. It was not fun when it was time to get up and stumble around and take some ibuprofen, but it was manageable.

What made Thursday Morning so different was the complete lack of indication that anything was wrong. Well, that’s untrue. I had about two seconds where my brain pain went from zero to sixty. It’s amazing how many times you can mentally scream “NO!” in two seconds, you guys! And then BAM, the excruciating pain, just under and back from my left temple, my brain’s favorite place to explode.

Imagine, if you will, someone driving a 0.5cm diameter nail (what? I don’t know the formal names for hardware sizes) into your head in that soft spot just above your left ear. Now imagine that time stops right upon impact, when the force is actually being applied to the nail by a hammer, so that the pain of impact is drawn out. That best describes what Thursday Morning felt like. It wouldn’t be accurate to describe it as the tip of a nail pushing on that part of your head, or the feeling of that nail in your head, because it doesn’t include the sharp force of the pain. That’s the killer, right there.

Have you ever been hit in the head hard enough to make your eyes water, or even cry? Once a softball landed on my head when I was on a pre-teen softball team and I hated myself for my eyes watering and crying because it hurt, but not that badly, and it was over anyway so STOP WATERING, EYES. STOP IT NOW. That sort of crying. I cry like that when I have a migraine badly enough, that involuntary pooling of tears that is a pure, primal pain response. But here’s the thing: I only cry from my left eye. The eye that is adjacent to the pain is the only one that waters. And here’s another thing. Remember how I said, in the nail metaphor, that it’s as if time stops? That means I keep crying because that metaphorical moment of impact is drawn out. So in addition to the nearly paralyzing pain, one eye has tears streaming from it. It is a catastrophic mess isolated on one side of my head.

Somehow through all that on Thursday Morning I made some coffee, and unlike most headache days I didn’t wait for the coffee to brew before taking ibuprofen; I filled my coffee cup with water to down the pills. After successfully pouring my coffee with a wicked case of tunnel vision, I made it to the couch and found that spot where my head can rest between two of the couch’s back pillows. This support is crucial because movement makes my head hurt more. That metaphorical nail is being driven into my head constantly, but any extra movement of my head, from walking or talking or just BREATHING, is like wiggling the nail. Did you wince? Yeah, exactly. And for the first time in my experience, the pain was so agonizing that I was on the verge of throwing up, so I was also terrified that I would have to get up and run to the bathroom. Which would hurt even more, and was also rather disgusting, and sounded just so freaking pathetic that I started to cry over the predicament with my other eye in addition to the involuntary tears from my left eye. But gently. DO NOT DISTURB THE BRAIN.

I stayed immobile just like that for an hour and a half until I felt like I could walk without my brain throbbing in revolt. Afterwards, all day and into the next day, I felt like I had been whacked in the head with a 2x4 at the site of the migraine. So basically, my head was sore and tender to the touch from an injury caused by my own brain.

I wanted to share this experience in detail for two reasons. First, because like Jill Bolte Taylor, the scientist in me is perversely giddy over parsing out all the symptoms and predicting the biology behind it. But also? I have a confession. For years I’ve heard people (mostly women) explain some shortcoming by mentioning that they suffer from migraines. Before I also got frequent migraines, instead of being sympathetic, I was just annoyed by this seemingly catch-all excuse. It is a headache. I get headaches. But I still do stuff and so why can’t you? Even to this day I am sometimes impatient because migraines vary in severity and yet here I am, working! Me and my migraine, going to work! YOU COULD TOO, YOU KNOW.

Jill Bolte Taylor’s lecture (as you know, because you listened to it as I suggested, right?) ends on a note that we all need to get more in touch with the part of our brain that is logic-free and thus sees the world filled with beauty and peace. So on that note, to function as a liaison between migraine sufferers and skeptics, to try to bring some harmony and understanding I say: Migraines are not “headaches”, they are brain attacks. They can take away your sight and knock you off your feet and make you vomit. I’m fortunate to at least understand why this happens, but if I didn’t it would be even scarier. I’m also fortunate that this happens infrequently to me, infrequently enough that I can manage mine only by keeping a sleeping/eating routine and ibuprofen. I understand now that others are not as fortunate. Now when someone starts describing their brain pain, I will think of Jill Bolte Taylor, and I will think of Thursday morning, and I will say, “I’m so, so sorry.” And most importantly, I will mean it.