Hell week : 168 hours of migraine

So this past week, I discovered that I can now achieve week-long migraines. This is not a good thing.

It was particularly unpleasant since they've been infrequent after nearly popping my clogs in New Zealand; to me a migraine attack once a month is pretty damn awesome.

Friday I started the twinges. All the warning signs were there - sugar cravings, feeling ratty as hell, sharp spikes of pain over the right eye. I expected a not-so-nice Saturday, but again - once a month I can deal with.

Saturday and Sunday with both fairly low level; not worth breaking out the painkillers for. I could eat. Monday morning started with the migraine ramping up. Painkillers - even the big-boy versions - didn't touch it. Food was a no-go.
Tuesday it got worse. I worked from home in the morning, until the pain got so bad I basically threw up my toe-nails and logged off. By that evening, I was doing a great imitation of the dead girl from the Ring movies. The original version.

Then Wednesday came.
Did you know you can hallucinate on migraines? And not the usual funky light show either; full on OMFG there are spiders the size of frigging rabbits in the flat hallucinations. (I admit to throwing a shoe at the first one before I realised that no spider on the planet gets to that size. I'm just glad I missed the computer.)
The pain alternated between the usual spikes and the feeling that the right side of my skull was being crushed. My neck hurt. I couldn't hold things in my right hand for long, and my depth perception (never my strong point anyway) was away with the fairies, giggling gently and bouncing off walls.
A few of my friends wanted me to call an ambulance. I don't know how coherent I was, but here's the explanation of why I didn't, just in case:
Emergency rooms are busy (noisy), brightly lit, and full of strong smells. This combination on a killer migraine means I'd have to be unconscious before I go into one; I'd rather lick a cheese-grater than do that to myself. There's another reason: go to the A&E with a migraine and the automatic assumption is that you're a junky looking for a fix, or you're hung-over. That you look like a shambling, shaking corpse just bears that out. Most docs & nurses are doing their best, I know. Just not if you have a frigging migraine.
I called the non-emergency line, and the woman I speak to got very excited right up until I told her I was diagnosed with chronic migraine, at which point she acted like I ate her puppy.

I got an appointment with my GP, who was pretty worried and made an appointment with a neurologist for Friday.

The folks FaceTimed me, and probably wished they hadn't. I wasn't a pretty sight, and I wasn't very coherent.

Thursday passed in a daze of pain and nausea. I don't remember much of it.

Friday I ended at the neurologist. Stace came with me, which was good because I can get lost going to the bathroom at the best of times, let alone when I'm seeing double AND giant bloody spiders. I was twitchy.
I passed the mini-stroke test (yay, me), found out the hallucinations happen to other people too (relief), got given the contact info to book a scan to make sure the ole brain isn't going too pear-shaped, and got given a blocker injection into the occipital nerve, which had reached new heights of inflammation.

It hurt.

I said a few very rude words, and clawed a hole in the towelling over the bed I was resting my forehead on.

It hurt some more, and then I felt/heard this hissing, fizzing noise and felt something pop in the back of my skull.

The nausea started dissipating almost immediately. I ate solid food that night for the first time in five days; there was still pain, but it was fading back. I slept on my side since the back of my head was too sore to put pressure on, and I woke up Saturday pain-free for the first time in a week.

As of now, Sunday, I'm still pain-free. I'm craving sugar, and I've still got marks under my eyes, so I've no idea what will happen when the blocker wears off.

Let's hope that by the time it does this particular migraine has burnt itself out.

Migraine Hell Week: This is what happens when the Botox wears off

So last week, the Botox I'd had for the migraines wore off. In one of the worst cases of incredibly bad timing my body has EVER come up with, it decided to respond to this by sending me into pain convulsions, swiftly followed by an episode of blindness, in the middle of the working day, at my desk.

Now, the guys I work with are aware that I get migraines. They've seen me with mild ones. I normally know when it's going to be bad, that I need to get home and into the dark, and I'll make sure I leave before that happens. I thought this one was going to stay mild. However, it ramped up so hard and so fast, that in the 90 or so seconds of me thinking I needed to go home and taking a couple of painkillers for the trip, I was suddenly in so much pain that I couldn't walk, talk or think. I sat in my chair and trembled.
My team thought I was having a seizure. I suppose technically I was, but it was pure pain. There's not much else to it.

The shaking thing isn't new. I get it when it's a bad one, but I'm usually curled up in the dark and by myself, in private. If I whimper and cry there's nobody else around to witness it, to see that moment of horrible vulnerability. Having it happen in a public setting, with people I work with daily, was a moment of personal humiliation I'd like to never repeat.

My boss sat down next to me in the middle of this and asked if I needed an ambulance. I'm very grateful they didn't get one; an emergency room is no place for someone in the middle of a severe migraine attack. It's bright, it's loud, and the smell is overpowering. I don't even want to think about the agony involved. I couldn't answer for a while; the pain had locked my vocal cords. All I could do was a raise a hand so he knew I was conscious, and let me tell you, I've rarely wanted to pass out so badly.

Most of what followed is still broken into jagged little moments of memory. I know that I was half-carried, half-staggered into a dark office. I know I was crying. I know that shortly afterwards I lost my vision completely, and came pretty close to panicking; it's one thing having that happen at home. It's completely different in public, where you are vulnerable to everyone and everything around you. Thankfully, like the last time, the blindness passed in a few minutes.

They sent me home in a taxi. I stayed at home the next day with a pounding, throbbing head. I felt better that evening, sat in the lounge with Stacey, and managed to do the pain jitterbug all over the lounge carpet. No blindness this time, and Stace managed to get me to lie still and breath. It was a short episode, but it hurt. The migraine went from pounding to ultra-sharp; it felt like someone was trying to ram a long needle into my brain.

I felt okay the following morning and went into work. I lasted three hours before the panda-eyes of doom appeared and I got the shakes again. And then I lost my words. It's an interesting side-effect, that one. You lose words that you use every day. Your mind tries to find them and they just aren't there any more. As a bonus, you start slurring. The slurring starts off as a slight burr; and ends up sounding like you've just made friends with several shots of good-grade whiskey. The look of horror on my boss's face was impressive.
I refused a taxi - the previous episode had proved I'd get home faster on the train - and Stace met me at the station in case I had another pain-jitter attack. It was close, but I managed to not have it until I was back home and in bed.

Rinse, repeat, until Saturday, when I went into the migraine clinic again for more Botox, and an assessment of the diary I've been keeping.

Sunday I had ten hours pain-free. Today I've got a minor episode - functional, but not happy. It takes about 5 days for the Botox to kick in, so hopefully it speeds its merry way through my system.

Doc reckons I'm a good candidate for the operation which removes the muscle the nerve runs through at the top of the eye-socket, and moves the nerve at the back of the skull. He said I could reduce the migraines by between 80 - 90%, so there's hope that I can get my life back. I'm thinking about it, very hard. Apart from the issue of general anaesthetic and the risks of the op itself, the main barrier is cost. The NHS doesn't cover this, the op would take place in Berlin, and the charge is £7000. Seven grand is a LOT of money for me, particularly as the cost of Botox and a hefty dose of painkillers on a monthly basis has eaten up just about all my savings. This disease is expensive in every respect.

But seven grand to get my life back would be cheap, if I had the money. To be able to make plans to go out with friends and not cancel at the last minute. To be able to eat without throwing up from pain; I've lost a few kilos in the last week, and it's not a healthy weight-loss. To not walk around looking and feeling like an escapee from the Walking Dead make-up trailer. To not wonder just how easy it will be to one day miscalculate the pain-pills and accidentally overdose. You don't track too well with constant migraine; and if the pills don't dent it the urge to take more is huge. To be able to write, and work, and be pain-free for at least some of the time. To never see that look of helpless shock and horror and pity on the faces of your friends and colleagues again. To stop thinking dying might be a relief.
Yeah, seven grand - probably closer to eight if you factor in the flights and the stay in Berlin - it would be cheap.

Let's talk about hating chocolate, and triptans, and other migraine things

One of the most horrifying things about the whole migraine issue for me is that I've started detesting chocolate. The reason is simple: before the pain hits, I crave it intensely. If there isn't any chocolate around, I'll grab anything with sugar, but chocolate is my go-to fix. It means I've started to associate chocolate with an amazing amount of pain, and when I'm not craving it, I detest the thought of it. This is not a good situation. Yesterday, I found out why I have the sugar cravings, and a whole bunch of other things that hasn't come up in my research. 

I had the Migraine Clinic appointment yesterday. Thursday and Friday I'd been totally pain-free, so the end of the week was pretty good. On the way into the clinic, I had another attack. I'd known it was coming since Friday night; that awful taste of blood-soaked pennies had coated the back of my throat and mouth since about seven o'clock. 
When I found myself snarling mentally at the people around me at the station I knew it was about to hit. Mandy and Stacey were with me, and Mandy had the joyous experience of seeing a migraine settle in and start bitch-slapping me behind the eyeballs for the first time. Stacey has seen this a lot, and she's seen it worse. Mandy looked horrified. There must be something pretty bizarre about watching someone develop smudges under their eyes in the space of minutes (I've always been on the other side, which isn't much fun either) and start slurring their words/be unable to string a sentence together. While I wasn't quite channeling my inner zombie-panda chick - I didn't look like an ambulatory corpse for once - I didn't look healthy either.
On a mental level, it was so much worse for having two pain-free days. Two days out of two weeks might not seem much, but it gives you hope that you'll stay pain-free for a bit longer. Migraine is like the bully in the school-yard; the one that walks past and breaks your toy for no good reason, and then doubles back and rubs sand in your hair. Because it can.

So we went in to see the doc. Stacey came with me, because I wasn't sure how much I'd remember.

He showed us an anatomical model and asked a lot of questions, and did a lot of explaining. I talked him through the Botox I'd had previously, which now appeared to have stopped working.

What I learned

Medical science has no clue as to what causes migraines. There are numerous theories, and very little fact. They know it's a disease. They can track and expect certain reactions and changes. There is no cure. The test and possible operation (if the test is successful) is a management system, not a cure.

The nerves that come out of the eye-socket, and are connected to one at the back of the head swell to up to 300 times their size. They are inflamed. This also explains the times I channel my inner exotic-fish look and my eyelids swell up; the tissue in the eyelids is affected and swells as well. (I've had more than twenty years of medical professionals telling me this is an allergy. To be fair, it looks like an allergy. Still. Not impressed.)

I'm apparently a Phase 2 sufferer. (Yay, me. Because phase 1 is so ordinary.) What this means is that the nerves coming through the eye-socket have told the nerve at the back of the head to wake up and join the party. A couple of weeks ago I had an explosion in the back of my skull that knocked me over. I had a few seconds of thinking I'd either been shot or something had hit me. I had a lot of trouble thinking and speaking for the rest of the morning, and ended up at my doctor, who gave me triptans. More on the triptans later, but that was apparently the moment the nerve at the back of my skull joined in the fun. 

Everything I took as a warning sign is actually part of the migraine. The craving is caused by an insulin dip. That awful taste, mood swings (in my case, severe irritability), photosensitivity - this is already me having an attack. I just haven't reached the pain part yet. Ugh. Since those things can start up to two days before I get to the pain part, this means I'm almost permanently in migraine phase. Bloody. Hell.
As I told Doc, I can live with that. As long as I don't have permanent pain, I can function. I will happily look like I'm wearing Halloween make-up for the rest of my life if it means I don't want to curl up in a dark room and rock myself to sleep.

Triptans can cause migraines. The first one will knock back the pain, but most suffers will end up with a further, more severe attack a couple of days later. (Yep.) Whatever they do, these little pills actually cause more damage than they stop. I stopped taking them because they disconnected me. I felt like an automaton, and I hated it. It's no use being pain-free if you feel like a robot. 
I also had a tightness in the chest when I took one. I had a couple left in the container, and I've been ignoring them. The doc asked me about the chest tightness. Then he explained that if I took another one, I'd probably have a heart attack. In about 5% of patients they cause the heart to contract. Taking more than three could kill me. Since they were prescribed, I've taken about 5, so it's sheer luck I'm here to write this post. 
Stacey turned to me and held out her hand. I put the container into it and she dumped the contents into the dust bin behind Doc's desk. (The fact that I'd told her last week that if I die from a heart attack at least I wouldn't have any more migraines may have had something to do with this.) 
I am no longer taking triptans, because I sure as Hades don't need more bloody migraines.

Starting the test
The Botox I had previously was administered in little pockets around the forehead and eyes.

The Botox I had for this test went straight into the muscle around the nerve. A little on the left (so I don't look lopsided), the majority on the right. As everything is inflamed and swollen, this stung a great deal. Stacey held my hand, and I can tell you I squeezed pretty damn tightly.

Then I sat up and got more Botox in the back of my neck. This was distinctly unpleasant. The back of your neck and skull is vulnerable; letting someone stick a very sharp needle into it goes against nearly every instinct I have. It also bloody hurt.

It should take 5 days for it to affect the muscles. Part of me hopes it will kick in faster; I still have the migraine that kicked off yesterday. I'm functional (I can walk and talk), and as long as it stays at this level I'll cope, but constant pain is draining. There is also the very real fear that it will escalate; that I end up with another episode of blindness or unable to move without  wanting to scream.
If (and at the moment this is a very big if) there is a minimum 50% improvement in the severity and frequency of the attacks for the next couple of months, the next step is an operation to remove the muscles concerned. I have no clue if I'll get to that stage. If I do get to that stage, I have no clue how I'll finance it. 

But there is hope for a normal life for the first time in a very, very long time, and I'm clinging to it. 
And if it works, I can stop hating chocolate.

Interesting Side-Affects, or the Chapters the Other Me Wrote

Here's a bit of a strange one for you: I appear to written chapters I don't remember. At all.

The last bit I remember writing was a few pages after the last snippet I posted. I opened the document this weekend expecting to pretty much pick up from there. What I found were several chapters I'd written during the mild phase of migraine on-set/withdrawal, and I don't remember putting those words down.
They're pretty good - a few minor spelling hiccups that have been fixed, and it's obviously my writing, but I don't remember doing it. I was trying to figure out how to describe the hunters that have our two hawks cornered, and it turns out that's been done, and rather creepily too. (Well done, Migraine-Me.)

I've taken a look back through the work already down, and there are several bits I don't remember. Actually, I would have sworn blind I hadn't touched the PC on those days, since they match up to a couple of serious attacks in my migraine diary. And while it's still obviously me writing, those scenes have sharp, jagged little edges to them that are very interesting indeed, since I'm wondering if those word spikes correspond to the pain spikes.

At this point I'm not complaining, although it's a bit unnerving to realise part of me wants to write so badly that I'll do it subconsciously. (I do wish Migraine-Me would pay attention to spelling though; she's left a bit of a mess to clean up.) Those strange little scenes work well in the book, and although I may have to do a little more polishing to make sure the voice doesn't veer too wildly from place to place, I'm going to just read, edit and move on.

I haven't found anything in my research to indicate this is a thing for other migraine sufferers, though.   (I know the accepted term is migraneur. It makes me want to roll on the floor and bite the carpet, because it sounds like we have this fantastic adventure every time it hits, instead of praying for death and codeine, so I don't use it.) If anyone else has had this happen, I'd love to know. Otherwise I'll just have to accept this as some sort of apology from the pain gods and leave it at that.

One other interesting thing. I'm pain-free (yay, Botox!) but still noticing symptoms - the bruising under the eyes still appears, the hyper-sensitive smell and strange tastes still comes and goes. I can live with that. If I'm pain-free, I can live with that quite happily. I've had no light-show effects though, which correlates with the theory that those particular nerves are no longer being affected. I'm hoping that research eventually unearths the reasons for the rest of the symptoms, but my personal evidence suggests these are occurring in the brain itself, and not caused by the expansion of blood vessels against the facial nerves.

A moment in darkness

I haven't blogged since The Weeping Butcher incident, mainly because it's been a couple of weeks of excruciating migraine attacks, and trust me, you don't go near a computer screen during a serious one of those.

Every few years I seem to go through a cycle of increasingly severe attacks. It happens at various times, in various seasons, and it doesn't matter what I've eaten or drunk. In fact, looking back over the migraine diary, the only pattern is that there is no pattern. It's annoying. It makes my OCD hurt.

Straight after writing the butcher blog, I had the worst attack I've had in years. About thirty minutes into it I went blind. Not the white-out that I'm used to, where all the colour bleaches out of the world and I know it's time to pass out. This time, everything went black. No pretty coloured explosion or flashing lights either. Just straight to darkness.

It happened so unbelievably fast. One minute I was whimpering about pain at my cousin, and twenty seconds later I couldn't see anymore.

Stacey, bless her, helped me up the stairs and into my bedroom. I crawled onto the bed and waited.

I didn't panic because I'd heard of it happening to other sufferers, so I knew it was temporary. I know that because the blood vessels expand during an attack and put pressure on facial nerves that is the cause of the pain, and this particular attack was lodged behind my eyes, so I can assume that the same pressure impacted the optical nerves in some way. It was still pretty scary, and if I hadn't done the research I'd have been a screaming mess, but there's a big leap between reading about something and experiencing it. There is no way to prepare yourself for something like that. You can understand it intellectually, but having it actually happen? You end up clutching to the knowledge that it passes, that it will end, because other people deal with this. You cuddle up to it like a teddy bear, and hope to hell you aren't going to make medical history by being the girl that doesn't get her sight back.

The blindness passed in around twenty to twenty-five minutes or so. The actual migraine attack lasted 4 days, which is not my idea of fun. The first night was the worst. Couldn't sleep. Couldn't talk. Kept asking Stacey to punch me out (she wouldn't). I spent the night rocking gently with the lights off, praying for it to stop. I didn't particularly care if it killed me at that point, as long as it stopped; I was fantasising about someone just drilling a tiny hole over the eye socket to relieve the pressure. It made a week in the hospital with a broken leg look like a kiddies tea party.

The problem is, I can't even hide the mild ones - one of my personal symptoms is severe discolouration under the eyes. Mild attacks are light brown. More severe ones turn blue-black. During this particular episode, I looked like someone had used me as a punching bag.
It took until that Thursday before food stopped making me gag and I could eat. Friday was good. I no longer looked like Zombie Chick on Acid, and I could eat. Saturday was brilliant. Sunday I had another attack.

I decided to hell with it and called the nurse for a Botox appointment. I had it done the last time I had a cluster of attacks like this, and I was migraine free for a year. I have no idea why the pain relief lasts longer than the muscular effect, and the scientists are still trying to figure that one out. Karma obliged by letting me get some savings together, with a lot of help from others. (The jabs are pretty pricy, and it's £250 that I'll never see again, but it's still cheaper than spending a fortune on pain-killers and losing days.)

In the past week I've had two. The first I got over in about 4 hours, because I got a can of oxygen off of Amazon and used it. It helped. Didn't cure it, but I reckon it shortened it.

Yesterday I travelled up to Bournemouth, and heading back on the train I could feel the next one start. No oxygen this time, just take the tablets and sit very still and get back to London. Thankfully the last one was pretty mild, but I keep thinking back to that moment I went blind, standing in my kitchen.

Since  the start of December I've lost almost 3 weeks of my life because I just couldn't function, and I cannot carry on like this. I have an understanding boss, and brilliant family and friends, but that's not the point. Being unable to move for 4 days of my life is not an option. Going blind in my kitchen when I can prevent it, is not an option. Life is too damn short to spend it whimpering in a dark room.

At the moment, provided the snow doesn't mess things up, I get the jabs tomorrow. I can't wait.

Anatomy of a Migraine Attack

It starts off with a dull copper taste in your mouth, like you dipped a coin in blood and then tucked it between your cheek and tongue. You feel a bit cranky, a bit ... other. Almost hungover, but not quite. No pain yet, and if you are very, very lucky and realise what's going on and take a tablet immediately, it might stay that way.
(Most of the time you don't; no matter how many attacks you've had in the past. Part of it is selective amnesia; that taste is so faint to start with it's easily dismissed and it's not until the light show starts that you remember it, the way your teeth suddenly felt a bit furry and you were growling at the keyboard and ignored it as some weird irritation because you had to go shopping, and now you realise that that was your warning sign and ignoring it was a very bad mistake.)

Your vision starts to first blur, then double. The taste in your mouth is suddenly hot and biting. You have trouble stringing a sentence together. That sense of other, of being dislocated from your physical self is stronger. If you're in the supermarket at this moment, you watch your hands pull things from shelves and out of the fridge as though you are standing next to yourself.
There is still no pain, but there is a humming in your ears,  like being enveloped in a thousand flickering lights or surrounded by a cloud of mosquitoes and your face feels like it's just been slapped. The skin tingles and burns and fades to numbness around your nose and mouth.
You head for the till, rest of the shopping be damned, because now you know what's happening and you need to get home. You pick the self-serve scanner because you can no longer hear what people are saying to you properly, everyone sounds like they are under water, and the line there is shorter. This is good, because your sense of smell has just gone and thrown a party; the scent of the guy next to you with the deodorant that coats the back of your throat with a chemical taste; the sudden reek when someone at the back of the shop opens the milk and cheese fridge. You pass someone with meat in their trolley and all you can smell is blood and raw flesh.

You feed your money into the till and the god of pain hammers a spike into the space between your right eyeball and your occipital bone. It's a slice of white light that freezes you in place for a few seconds. Your vision clears, then begins to star-burst. If it wasn't for the pain, this would be pretty; fireworks exploding against the walls of your skull in dozens of colours. Especially white, for some reason. Everything goes to white.
When you grab your bags your sense of touch has changed. Plastic feels like silk, paper feels like steel-wool. Most of your skin feels like the pores have vanished and left only nerve endings, raw and screaming, in their place. You fumble your sun-glasses on, cloudy day or not - when you have one of these, it feels like you are under a spotlight from hell, and light can trigger an attack of nausea that will have you on your knees retching on the pavement - and lurch out of the shop.
And by lurch I mean there is almost no sensation of having feet. You have some dim awareness of moving, of the fact that your body is moving itself, but there is no sense of co-ordination. The lines of communication between hind-brain and limbs has diminished while your brain is clawing and screaming at the choking cage of your skull, which is suddenly two sizes too small.

You step into daylight and the pain god swings a hammer at the side of your skull. Sometimes you'll be lucky and he misjudges and gives you a nose-bleed. This is lucky because it seems to relieve some of that awful pressure, that sense that your brain has turned into a swelling balloon that rubs and chafes against bone. One day, you think/pray dully, one day it will find a sharp bit and pop and this will be done with.

You can no longer feel your face. That taste in your mouth is now burning liquid. You are aware that you are sweating because your shirt is clammy and stuck to your body and you are panting, ever so slightly. Like a beaten dog, collared to your pain and no way of pulling this tether loose.

You get into the blessed darkness of the flat, pull yourself up the stairs by the hand-rail - there is no way you can blindly trust your feet to get you there - and stumble into the bedroom. You pull the curtains closed before you take your sunglasses off and scramble for the migraine tablets. There is very little rational thought left at this point; if you bought anything that needs refrigerating it's just plumb out of luck, because trying to re-shelve anything would require co-ordination and is beyond you right now, and your vision is almost totally gone. The world is white, like an overexposed polaroid.

You lie in bed in the foetal position and feel the bed throb and wait for the pills to knock you out, because let's make this very clear - those pills don't cure a migraine. They don't stop it. You might as well throw a child's fishing net in front of a speeding juggernaut. What they do is take you away from it by removing you from the world of conscious thought, for the four hours the pills are in your blood stream. Once they wear off, you either sleep through the rest of it, or the pain wakes you up and you have to take more.
 Part of you mourns your plans for the day - the Skype chat, the writing, the t.v. show you had lined up - but it's a very small part. The rest of you wants oblivion, wants the world to go away, wants the mini-death of being unconscious.

You know that when this breaks you will spend a couple of days with hyper-sensitive skin, hyper-hearing and a sense of smell that would stun a blood-hound, and the fun risk of a rebound attack. You will wake up with crud - there is no other way to describe it - gumming your eyes together. If it's a very bad attack, you will occasionally wake up with blood in your ears and rimming your nostrils. You will have bouts of mild elation and depression, sometimes within minutes, and no way to know which one is coming up next.

There are some triggers you know about and avoid - high-cocoa chocolate, red wine. But the attacks lately don't seem to have a food trigger, happen during all temperatures, weather, times of year and day. The only pattern you can find right now is that there is no pattern, and if that doesn't kick your irony button nothing will.
A mild to medium attack will leave you slightly functional - you slur your words a little, you move very slowly, but you can do things. A bad one.. A full blown migraine attack leaves you begging for death. And if you get these on a regular basis, you will do almost anything to stop it. (Actually, strike the almost. You will do anything. Anything.)
Sometimes you start off with a medium attack and it fades, and then it comes back and stomps you into a little blubbering pile of pain and bile and nausea. It's like replacing a great white with a megalodon. Neither one is fun, and you can't swim away from either of them, and hello, over-kill.

If you have a condescending ass of a doctor, one who doesn't believe in migraines, you can discount any hope from that side. Friends and colleagues who have never had an attack wonder what all the fuss is over what they reckon is a bad headache, at which point you earn negative karma points by hoping they experience one in all of it's glory, and soon.
 Feverfew supplements help to a point, but it takes a few weeks to kick in, and although they help reduce the severity of the minor attacks, they don't touch the big ones, the ones that leave you wondering if the next time your brain will simply leak out of your ears and leave you a functioning cabbage. Botox injections helped - there was a whole glorious year of no attacks - but the odds of me being able to afford Botox right now are about the same of me wearing my underwear on my head and doing the can-can through a nunnery.

So you fade into darkness, you ride the tablet into unconsciousness and you know you will wake up checking your pillow and sheets for blood, checking your ears and nose and bleakly thinking about stroke possibilities and haemorrhaging and waiting for the next one.

And you hope you recognise that taste of blood and copper in time.