{"id":69349,"date":"2023-03-29T13:44:07","date_gmt":"2023-03-29T19:44:07","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=69349"},"modified":"2024-07-29T17:09:12","modified_gmt":"2024-07-29T23:09:12","slug":"migraine-self-care-a-battle-waged-on-all-fronts","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/migraine-self-care-a-battle-waged-on-all-fronts\/","title":{"rendered":"A lifelong battle with migraine, waged on many fronts"},"content":{"rendered":"
<\/div>
\"Melanie
Melanie Concordia hasn\u2019t let her long battle with migraine deter her from activities like rock climbing. Self-care is one of the ways she manages migraines. Photo courtesy of Melanie Concordia.<\/figcaption><\/figure>\n

Melanie Concordia was 8 years old, riding home on a school bus, when the pain made its first appearance. She had a headache, but it was far from an ordinary annoyance. Her head throbbed along with the jolting bus.<\/p>\n

Twenty-five years later, the experience stays with her. \u201cI vividly remember putting my head against the cold glass window of the bus,\u201d Concordia says. \u201cThat gave me some relief.\u201d<\/p>\n

The mysterious childhood headache was a harbinger of a disease that Concordia still battles. She is one of nearly 40 million people in the United States<\/a> who suffer from migraine, a chronic neurologic disease<\/a> that inflicts intense pain by releasing inflammatory substances that swell blood vessels.<\/p>\n

Migraines exact a powerful toll on people\u2019s lives. It is the second-most common cause of disability globally \u2013 and first among young women<\/a>. About a decade ago, Concordia was one of them. Her persistent, plaguing migraines drove her from the workplace and left her groping for solutions.<\/p>\n

She has rebounded. Migraines are still a strong presence in her life, but Concordia, an occupational therapist at UCHealth University of Colorado Hospital<\/a>, manages them with a variety of medications and treatments, exercise, diet, and physical and mental health therapy. She also helps to fight migraines on a broader front, through her work with the Alliance for Headache Disorders Advocacy<\/a>.<\/p>\n

\u201cI\u2019m always looking to get better and figuring out how I can chip away at my headaches,\u201d Concordia says.<\/p>\n

That stubborn commitment to fighting her disease has paid off, said her neurologist, Dr. Danielle Wilhour<\/a>, an assistant professor of neurology<\/a> and headache specialist with the University of Colorado School of Medicine who practices at the UCHealth Neurosciences Center \u2013 Anschutz Medical Campus<\/a>. Concordia works at a job she loves, travels and is a dedicated rock climber.<\/p>\n

\u201cIt\u2019s nice that she can do the activities she enjoys without fear that migraine is dictating what she can and can\u2019t do in her life,\u201d Wilhour said.<\/p>\n

Living with migraines<\/strong><\/h2>\n

Concordia stresses that migraines still shadow her. As an OT in the neurological intensive care unit at UCH, she sometimes has to work through them on the job. She credits her supervisors, who understand the challenges and unpredictable nature of the disease, for help with that. She also erects barriers to migraine by carefully maintaining a balance in her daily life.<\/p>\n

\"Skiing
Skiing is among Concordia\u2019s self-care activities that help her cope with her migraines. Photo courtesy of Melanie Concordia.<\/figcaption><\/figure>\n

\u201cI have to get enough sleep every night, stay on a routine, eat well and exercise,\u201d Concordia said. \u201cIf any of these lifestyle modifications are off or stressed, it can trigger a headache.\u201d<\/p>\n

For those who haven\u2019t had one, Concordia describes a migraine as \u201cthe worst hangover you could ever imagine, with a throbbing head, nausea and vomiting.\u201d In her case, a migraine causes sensitivity to light, movement and sound. Everyday life becomes a struggle.<\/p>\n

\u201cA migraine really slows you down mentally,\u201d Concordia said. \u201cI have trouble coming up with words and speaking as eloquently as I would like. It takes me longer to process things and respond.\u201d<\/p>\n

The \u201ctrajectory\u201d of Concordia\u2019s migraine experience began with episodic bouts that at some point became routine. A neurologist she had interned with in high school was the first to prescribe her a migraine medication, Maxalt<\/a>, which aborts migraines after they begin. By the time she got to college, the migraines were constant, but she could take Maxalt only twice a week. She moved on to Topamax<\/a>, an anti-convulsant used to prevent migraines. She had fewer migraines, but also endured side effects, such as tingling in her fingers and toes, weight loss and brain fog.<\/p>\n

\u201cYou have headaches less frequently, but now you\u2019re dealing with all these [other issues],\u201d Concordia said.<\/p>\n

Concordia earned her degree in behavioral neuroscience in 2010, but by 2014, the unrelenting migraines sent her to a low point. An attack she couldn\u2019t shake for two weeks severely degraded her job performance and she was fired. She had to move back in with her parents. She was 24, out of work and seemingly out of answers for dealing with the disease that tormented her. But the problem also forced her to confront her foe.<\/p>\n

\u201cI thought, \u2018If I can\u2019t work, what am I doing?\u2019\u201d Concordia recalled. \u201cI decided to just focus 100% on figuring this out.\u201d<\/p>\n

A search for migraine pain relief<\/strong><\/h2>\n

She had a neurologist, but with visits limited to one every three months, Concordia took on much of that responsibility herself. She pored over migraine literature, meditated, and undertook cognitive behavioral therapy (CBT)<\/a> and biofeedback to address the stress of migraine proactively. CBT, which focuses on helping people change unhealthy patterns of thinking and behavior, proved to be \u201clife-changing,\u201d she said.<\/p>\n

\u201cWhen you are in pain all the time, you\u2019re going to feel anxious about it,\u201d Concordia said. Participating in CBT helped her to change her thinking about migraines. Instead of focusing on the fear and anxiety of an impending migraine attack, she learned to redirect her attention to positive thoughts that she could control. She described the process as \u201cstrengthening pathways in the brain that can make migraines less strong.\u201d<\/p>\n

Her search for relief also led her to take up a ketogenic diet<\/a> \u2013 one that is low in carbohydrates, high in fats and moderate in proteins. When she first read about the diet in 2014, there was little or no evidence that it could positively affect migraine and plenty of opposition to it, Concordia said. She decided to try it anyway, with remarkably positive results that she described in a 2015 piece<\/a> for the website \u201cPain Talks.\u201d<\/p>\n

\"Dr.
Dr. Danielle Wilhour, a neurologist and headache specialist at UCHealth, treats Concordia\u2019s migraines. Photo by UCHealth.<\/figcaption><\/figure>\n

\u201cThe diet gave me pain-free time,\u201d Concordia said. She credits the regimen, which she continues to follow, with helping her to gain a measure of freedom from migraine\u2019s grip and begin to rebuild her life.<\/p>\n

Concordia also began Botox injections, an FDA-approved treatment for chronic migraines<\/a>, in 2014. After months of uninterrupted pain, the injections gave her 10 headache-free days.<\/p>\n

\u201cI thought, \u2018This is what it is like to live,\u2019\u201d she recalled. She now receives the treatments every 12 weeks from Wilhour.<\/p>\n

\u201cMost people think of Botox as something that relaxes muscles, which can help with wrinkles,\u201d Wilhour said. \u201cIt also works on sensory fibers to stop them from releasing the inflammatory [substances] that can trigger migraines.\u201d Wilhour added that Concordia also receives injections in the trapezius muscle<\/a> to help relieve neck and shoulder tension.<\/p>\n

\u201cIt\u2019s pretty common to see people with neck and shoulder problems that can lead to a migraine cycle,\u201d Wilhour said. \u201cHeadaches can cause neck pain and neck pain can cause headaches.\u201d<\/p>\n

A multi-pronged approach to managing migraines<\/h2>\n

Concordia\u2019s multi-pronged approach to managing her migraines, along with regular exercise to reduce stress, gave her a chance to think again about discovering her life\u2019s work.<\/p>\n

\u201cI reassessed what I wanted to do with my life,\u201d she said. In her mind, that was work that did not include sitting and staring at the harsh light of computer screens for long periods of time. The ideal was staying on her feet and working productively with people.<\/p>\n

In the fall of 2014, she shadowed an occupational therapist, \u201cfell in love with it,\u201d and applied to a school in Boston the following spring. She began work as an OT at UCHealth Memorial Hospital<\/a> in 2018 before moving on to UCHealth Medical Center of the Rockies<\/a> and then on to UCH in September 2021, where she fulfilled her desire to work with neurology patients \u2013 many of whom also have migraines. She uses her own unhappy experience with the disease to help them cope with attacks.<\/p>\n

Migraine self-care tips<\/strong><\/h2>\n

That desire to help others struggling with migraine led Concordia to advocacy work in 2018. She traveled to Washington, D.C. to attend \u201cHeadache on the Hill<\/a>,\u201d an annual event sponsored by The Alliance for Headache Disorders Advocacy. The gathering gives volunteers an opportunity to meet with members of congress and advocate for legislation to aid people whose lives are disrupted by headaches.<\/p>\n

The congressional \u201casks\u201d have included allocating funding for new headache research and additional Veterans Administration Headache Centers of Excellence (HCoE)<\/a>. Wilhour, who joined Concordia in the headache advocacy work in 2021, noted that veterans experience a disproportionate share of headaches from traumatic brain injury and concussions.<\/p>\n

This year, Headache on the Hill focused on supporting the CARE for Long COVID Act<\/a> and ensuring that the bill includes funding of research into migraine and other headaches, which are frequent symptoms of long COVID. In addition, advocates highlighted the need for a \u201cHouse Headache Caucus<\/a>\u201d to raise awareness about the damaging consequences of headache disorders and for an \u201cIndividualized Education Program\u201d (IEP)<\/a> that would afford school children with migraine access to the extra resources and help that is afforded other children with disabilities.<\/p>\n

\u201cIt\u2019s very powerful to do this type of work,\u201d Concordia said. \u201cYou meet all these people who have had experiences just as crazy or crazier than you. You see that \u2018I\u2019m not alone in this.\u2019\u201d She added that the experience has also shown her the importance of driving change by meeting directly with congressional representatives.<\/p>\n

Maintenance for migraine<\/strong><\/h2>\n

While she savors many satisfactions in her life, Concordia hastens to add that she is not free from migraines and is always on guard against the disease \u201ccreeping back\u201d into her life. For example, she recently added Nurtec, a drug designed to stop migraines from progressing, to her medication regimen \u2013 with very good results. She also strengthens her defenses with physical therapy; \u201chealthy distractions,\u201d like talking to friends, baking and taking baths; and applying essential oils to her head when she can\u2019t immediately lie down or rest.<\/p>\n

\u201cI\u2019ve been going through this process since 2009,\u201d Concordia said. \u201cIt\u2019s been very gradual, but I\u2019m much better off now, with the help of my neurologists, medications and lifestyle changes.\u201d<\/p>\n

The long dance with migraine has given Concordia some basic insights that might help those just beginning to deal with the disease. These include seeing a migraine specialist like Wilhour, and building migraine barriers or \u201cbuffers,\u201d such as exercise, CBT, and diet. As she put it, \u201cI try to make it not easy to have another headache.\u201d Most of all, patients must advocate for themselves, she said.<\/p>\n

\u201cI had to refuse to accept that I would be disabled or wouldn\u2019t be able to do anything,\u201d Concordia concluded. \u201cI had to pause and say, ‘how do I change my life to reduce stress, change my routine and make myself healthy enough for a migraine to not happen?’\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Melanie Concordia was 8 years old, riding home on a school bus, when the pain made its first appearance. She had a headache, but it was far from an ordinary annoyance. Her head throbbed along with the jolting bus. Twenty-five years later, the experience stays with her. \u201cI vividly remember putting my head against the […]<\/p>\n","protected":false},"author":2143,"featured_media":69352,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"on","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"Relevanssi image attachment filter Relevanssi index exclude","footnotes":""},"categories":[7],"tags":[184,372,212],"class_list":["post-69349","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-stories","tag-neurology","tag-occupational-therapy","tag-womens-care"],"acf":[],"yoast_head":"\nMigraine self-care: A battle waged on all fronts - UCHealth Today<\/title>\n<meta name=\"description\" content=\"Migraines are the most common cause of disability in young women. 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