Migraine is more than a headache – a rethink offers hope

I was diagnosed with migraine as a kid when I was 10. The doctor made me undergo a battery of tests including a contrast CT scan that consumed aj entire day, only to confirm at the end of the day that it was migraine. The migraines weren't even that debilitating but my mom was just being extra careful.

After that, I still got headaches at a good frequency and tried all sorts of specialists from orthos to opthalmologists, all of who checked their areas of the body and said I was perfectly normal. The one doc I didn't see was a gastro and this was a mistake.

Eventually I grew older and realised first that my headaches were always preceded by some sinus congestion and milk was a trigger of said congestion. So I switched to lactose free milk and that helped.

Eventually I realised that I was a chronic acid reflux patient, that a lot of small symptoms I had had over the years (a feeling of something stuck in the throat, congestion etc) were basically just the gut throwing up acid, or more accurately LPR/silent reflux. The reflux was the actual trigger of my headache. So my usual medication of Paracetamol, or worse, ibuprofen was actually making it worse in the medium/long term.

I switched my strategies to fixing the gut/acid reflux instead of treating the headache. The max I do nowadays is 325mg of paracetamol if I need to sleep and the pain doesn't let me. Ibuprofen is a nuclear option that I haven't resorted to in years.

The gut issue is still not resolved, I suppose years of damage to the oesophagus takes time to heal, so I'm still prone to reflux but I make do with a bland diet, avoiding triggers like milk and resorting to PPIs for short bursts during an attack. Oh and I also do the bending while swallowing trick that was on HN sometime back, which has helped immensely.

My headaches are mostly a thing of the past. Haven't had a debilitating one in years.

Yup - they can also give you migraines (or worse) if you introduce bugs into the "software", just as I was able to debug my problems away.

This is interesting. I frequently had them triggered by riding BART in the late afternoons in the winter, sun beating in through the dirty windows. Going through the tube (dark) and emerging in Oakland (raised track, clear view of the sky on both sides) had a double-digit % chance of giving me a migraine if my eyes were open at one point.

I can get them triggered by riding in a car in similar conditions, too, especially if the windows aren't squeaky clean. I frequently wonder why that is, something about the remaining spectrum of visible light when the windows are dirty?

Commenting to save this for post for later. I suffer from migraines regularly. I will try some of the suggestions here.

Same! My understanding of migraines is that it's something to do with blood pressure in your head. My hypothesis is that the visual disturbances are your blood vessels dilating and pressing against your retina. Then I think it can cause kind of a runaway feedback loop of some sort that causes the blood pressure to increase throughout your head, causing pain.

Thinking about it now, I wonder if the light trigger could be the bright light causing minor damage to your retina, potentially triggering an inflammation/repair response. The fact that it happens when going from dark to light suddenly, also makes sense, since your pupil is at its most dilated when in the dark, meaning the most of your retina is exposed/vulnerable. That might also explain why it always starts in the periphery; because the edges of your retina are likely less often exposed to light and potentially more delicate -- but would be exposed if you see bright lights while your pupils are fully dilated.

For me, I've found it's also closely related to irregular food or sleep. And I find eating something with sugar or drinking some water can reduce the likelihood of the visual disturbances becoming a full-on migraine. My hypothesis is that these things alter your blood chemistry/physics enough to interfere with the runaway feedback loop that results in increasing blood pressure. I imagine dunking your head in cold water likewise works because it breaks the runaway process.

But this is all speculation.