A postcard from my migraine

I’m describing this as a postcard because having a bad migraine is like going to another place. Those who don’t know much about migraine think it’s just a bad headache; and indeed you often hear people using “migraine” as a synonym for “headache”.

Everyone’s migraine is different. The basic definition of migraine is a severe headache, usually on one side of the head, sometimes accompanied by nausea and/or neurological problems such as photophobia, aura, disturbed vision, hypersensitivity to smell or sound.

I don’t know what it’s like for other people. I can only tell you what it’s like for me.

I’ve had a lot of not-very-bad headaches over the past couple of weeks, the result I suspect of the disruption of Christmas and new year. Migraine happens, according to a doctor I spoke to at the City of London Migraine Clinic, when the accumulation of triggers tips the migraineur over the edge. Triggers can be pretty much anything, but it’s generally agreed that stress, disruption, tiredness, overdoing it, alcohol, coffee, rich food – all hallmarks of the Christmas period – are among them.

I get runs of the not-very-bad headaches. They would probably turn into full-blown attacks if I didn’t hit them with the meds; one of my particular issues though is rebound – you can actually spark more headaches by taking medication to stop them. I talked about this issue with a specialist a while back and he agreed that for me, it’s probably less bad to take meds to stop them before they take hold and thus risk a rebound rather than succumb to a bad one that would take me out for a day as my preference is not to lose time to them.

A run of low-level headaches often precedes a bad one, though not inevitably. I’ve had a bad one today. As is often the case, I was woken by head pain at about 5.30am. I took the meds and went back to sleep, waking when the alarm went off a couple of hours later.

Usually, that’s it for an early-morning one. I often feel a bit groggy and might still have some pain when I get up, but in general, getting up, having a shower and washing my hair (there’s something particularly helpful about hot water on my head) and drinking a coffee (oh yeah, caffeine can be both a trigger and a panacea) will see it off.

I still felt pretty awful when I woke up – still with head pain and with an unshakeable sense that it was going to get worse before it got better. I should have stayed in bed as sleep can help a lot, but I hate losing time to a headache and I also worry that I might be suspected of malingering if I email the office and say “got a headache, not coming in”. In fact I’ve never done that – I’ve always gone in, mostly because it does usually lift sufficiently for me to go to work.

By the time I got to work, I knew it wasn’t going to go away. The head pain had gone – head pain is really only part of the package anyway – but I felt increasingly sluggish, as though I was trying to function from behind a thick pane of glass while at the same time swimming through thick, viscous treacle. Everything I did felt as though it was in slow motion. It was hard to talk – forming words and sentences becomes almost impossibly complicated and really too exhausting to contemplate.

The absolute hallmark for me, though, is visual stuff. The general malaise and bleh comes first, then the visual stuff kicks in. I get photophobic – I start finding the light very sharp and jangling. It becomes difficult, if not impossible, to look at anything that forms strong patterns of parallel lines – so escalators are difficult; steps are not easy; ranks of buildings are tough, books on shelves, the patterns on paving stones, Venetian blinds – the world is full of strong parallel lines.

I find fluorescent light almost impossible to keep my eyes open to by this stage (and that’s why I’m stockpiling tungsten bulbs – low-energy lighting is basically fluorescent light and I’m not the only person who has photosensitivity issues with low-energy bulbs), and that’s the point at which I cave in and head for home. I say “I can’t see” to my colleagues – that’s not quite what’s happening, but I’m really quite inarticulate by this point and it’s a shorthand for “I can’t keep my eyes open because the light in here is so sharp and bright and I definitely can’t look at a computer screen any more because letters on a page become those strong, contrasty parallel lines I have trouble looking at”.

It’s a horrible place to be and it feels like a place that’s separate from the world that everyone else is inhabiting. I find the inarticulacy particularly distressing, because I’m usually very articulate – I feel handicapped by my absence of ability to express myself, and I get weepy and desperate. Desperate in an inchoate way – it’s an overwhelming sense of distress and a powerful desire to be home where it’s safe, where I’m in control of the environment and where it’s quiet and dark.

The whole world becomes a hostile place, but one I’m disconnected from. Noise – voices, iPod earbuds hissing, Tube announcements, people chatting, the squeal of Tube brakes – becomes oppressive, yet distant. It’s like stumbling through a film set that I’m not part of. Smells become intense and everything is hard to look at.

This really distressing stage gathers pace quickly – I can be ok and coping one minute, then falling off a cliff into the migraine place the next. It usually peaks at about lunchtime. It takes me about an hour to get home; by the time I get home, the drugs are starting to work and being away from the difficult environment of the office and having walked to and from the tube stations in fresh air has helped a bit, even though the outside world is a pretty difficult place to be.

I go to bed when I get home and I sleep. It’s a heavy sleep that’s hard to wake up from, but it’s only for two or three hours and I usually feel better when I do finally wake up. That’s when I start to return to the world I usually inhabit. I can feel pretty coshed after a migraine; counterintuitively, there’s also sometime a huge sense of relief, almost euphoria, that it’s over which goes hand in hand with feeling as though I’ve been hit by a steamroller. This is technically known as the postdromal phase of migraine – it’s a very distinct phase and for me can last a day or more.

Right now, 12 hours after I got up feeling pretty rubbish, I just feel shattered. I think it’s over; it probably is. Time to come back from my sojourn in the land of the migraine.


I’m crap

It has been far too long since I blogged. I’ve found it very difficult to come back and read my entries about Blossom, and the wonderfully kind comments have in some ways made that worse. Losing her was very hard, harder than I ever thought it would be.

However, it’s definitely time to come back to the blog. So what’s been happening in the past few months? Well, apart from the Christmas and new year festivities, I’ve rejoined the ranks of the gainfully employed by getting a staff job at the Guardian, where I’ve been freelancing off and on for three-ish years. I’m now production editor of Guardian Weekly, which is published in various sites around the world once a week. I’m in charge of making sure the paper product actually happens and gets to the print sites in the US, the UK and Australia.

I’m still going to be contributing to Guardian Technology, though I haven’t written anything for them for a couple of months. However, I want to keep my hand in and now that I’ve got my feet under the table in my new job I’ll be sorting through a pile of ideas.

Otherwise … Daphne is getting bigger and more enchanting every day. She’s going to be spayed this week and will be able to go outside once she’s recovered from the procedure, which is a Good Thing as she’s very bright and clearly rather bored having exhausted the possibilities of indoors.

Now that I’m back, I’m back, and will update regularly.

Blossom – the last post

Blossom was put to sleep this morning. It was the bleakest thing I’ve ever done.

She fell off a cliff on Tuesday morning. I’d been desperately sad all weekend trying to get her to eat. She’d eat a bit of tuna from my hand and then look at me as if to say “I know you want me to eat, but I’m just not up for it.” The sadness seemed to ooze from every corner of the flat as she faded, yet continued to be her lovely self.

On Monday I took her into the vet (if you are in west London, Paws Inc in Dawes Road, has the kindest and most compassionate staff I’ve ever seen) who thought it was worth giving her steroids. He thought the steroids would boost her appetite and have the added bonus of working on the tumour, and indeed when she came home she was absolutely great: she went straight to her dish and chowed down on some tuna, then proceeded to hold court with the friends who had come round to see me – and her, of course. I was elated, and went to bed with her purring next to me, thinking we’d turned a corner and that she might well get what the vet described as “three to six good months”.

On Tuesday morning, I heard her give out a loud meow about half an hour before I got up. I called her, then ignored it, as she often was pretty vocal in the morning. When I got up, I found her staggering, drooling, pawing at her mouth, trying to walk and obviously very frightened. I got dressed and took her straight round to the vet, fearing the very worst. Before we left I carried her round the flat saying goodbye to her sunny spots, cosy corners, favourite nooks, the garden, the sofas, the bed; all her places. I knew she wasn’t coming home.

I thought we’d probably have to put her to sleep there and then as she was in a bad way, stunned by whatever had happened to her, frightened and holding her head very oddly. The vet thought she’d had a stroke or that the cancer had got into her brain: I thought she’d had a stroke too, but he asked me to leave her with them.

She spent the last two days of her life on a drip. I didn’t see her on Tuesday or Wednesday: bastarding work. Simon, the vet, says she perked up last night, that she was sitting up and purring and engaging with him and I so wish I’d seen that.

When I went in with John this morning, though, it was absolutely clear that she’d come to the end. Something awful had happened to her in the night and she just lay on the table. She knew, I think, that John and I were there, but she barely responded to our voices. In the end she just slipped away without any fuss, so peacefully. I’d been very frightened about watching her die and in fact there was nothing to be scared of – if anything, it was a relief. The vet was sad, too – he’d spent a lot of time with her and he had really thought she was rallying and would be able to come home for a bit this morning.

I miss her. I miss her desperately. I keep seeing her out of the corner of my eye. I keep looking in the places I always found her: on the white sofa, on the blue sofa, on the bed. I keep expecting her to come in through the catflap with a cheery chirp. There is a huge Blossom-shaped hole in my flat and in my heart.

A classic Blossom moment - she slept in the oddest places

A classic Blossom moment - she slept in the oddest places

More on Blossom

Blossom is still at the vet, where I took her yesterday morning after she crashed badly. We had been on Monday evening for a steroids jab, which the vet hoped would stimulate her appetite, and indeed when we got home she was noticeably brighter and went straight to her dish and chowed down on some tuna.

Not that she hadn’t been quite bright throughout the past difficult few days since she’d been diagnosed with the tumour: the most heartbreaking thing of all has been the fact that she’s been absolutely herself, but fading gently as she was eating so little. The vet was optimistic that the steroids would give her a boost and that if she responded, she’d have “three to six” good months left.

However, yesterday morning it all went horribly wrong. When I got up, she could barely stand, was staggering, drooling, pawing at her mouth and holding her head very strangely, and clearly very frightened. I rushed her round to the vet, whose first thought was that she’d had a stroke or that the cancer had got into her brain.

Later in the day it transpired that her potassium levels, which were low anyway, had fallen and he thought that that could well have produced the terrifying and distressing symptoms. She seems to have picked up a bit on the drip and she’s eaten a bit, but this evening I am not confident that she’s going to be coming home with me tomorrow. The vet says that she’s ok in herself, her temperature and colour is good and that she seems to be all there, but she’s not very interested in food: she might be “turning her little nose to the wall”.

Yesterday before I took her to the vet I carried her around the flat saying goodbye to the bed, the sofas, the sunny spots, the garden, the cosy corners. I am getting used to the idea, but my heart is shredded at the thought of losing her.

Update on Blossom

She’s not improving; she’s fading, and it is breaking my heart. She’ll have a few bites of the cod I am poaching for her in milk and a few chicken treats, but I can see that she’s getting weak and she’s so thin.

She’s not in pain, which I suppose is a good thing, but if she were the situation would be more clear-cut: I would have her put to sleep. I think I will have to do that this week anyway because she’s eating so little. Soon she won’t have the energy to purr and to chat to me. Her meow is still there, but it’s quieter. I keep hoping her appetite will revive and she’ll eat something a bit more substantial and so turn a corner, but it’s not going to happen.

Just as I think I’m getting used to the idea of her going it hits me again how very much I don’t want to lose her.

Blossom – an update

Took Blossom to the vet this morning and the vet gave her a good lookover and we talked about how she’d been recently. He thought he felt a mass around her stomach, so I left her with them for an x-ray and blood tests.

The flat felt very empty without her during the afternoon – even when she’s asleep I know she’s around. Which tells me that when she goes, I will definitely get another cat.

However, we’re not there yet, fortunately. The news isn’t great: she has a tumour in her liver/spleen area. The vet said they’d need to do a scan to work out whether it’s on her liver or her spleen, but I don’t think there’s much point in nailing that down as the vet and I agreed that what we should focus on is her quality of life. The good news is that it isn’t in her chest at all and the vet said he thought she’d withstand an operation, but he agreed with me that there’s not much point putting an 18-year-old cat through an operation. Clearly, if she were younger or if it would buy her another five years, I’d do it, but nothing is going to buy her another five years and I just don’t want to inflict the stress, pain and fear of an operation on her.

So she’s got some special food and has had some drugs that should spark off her appetite and certainly since she’s been home she’s been much more interested in food. Which is great – if she eats normally until the tumour starts making her life much more difficult, then we can have some good time together.

She was very wiped when she came home, though – she’d been given a very heavy-duty cocktail of valium and ketamine for the xray, and was pretty much out of it when I picked her up. When she got home she started coming to and has been staggering around a bit. The drugs have been wearing off all evening and she’s just (at 11.30) started purring, which is hugely reassuring, but I’m not surprised she’s trashed: I’ve seen humans on ketamine, and she’s a 3kg cat.

I don’t think she’s got much time left, but with care she should I hope have a good remainder of her life. When it starts going irreparably downhill, we’ll make the final trip to the vet, but I hope to have her with me for a bit longer.