I was in school.
I had
just finished my coursework
for my doctoral degree.
I had a headache
that just did not go away.
It impacted school. It impacted work.
I was taking something every 4 hours,
like whenever the next time I could take something,
I was taking it.
For me,
it was this sensation of confusion,
with exhaustion,
intense nausea, and throbbing head pain.
A great day
for me is a day
that I don't have to take any medication,
and I could just get up,
take the girls to school,
after work
take the girls to softball, with no pain,
and a bad day would be
not being able to get up from bed.
My nine year old tells everyone,
"Shh, Mommy's having a migraine attack."
Even the a dog just stands still.
Migraine is estimated
to affect up to 40 million Americans.
About 25 to 30% of
women will experience migraine
and about 9% of men.
It's considered by the World Health Organization
to be among the top causes of disability.
When you add up the number of days
that someone is disabled over a lifetime,
and then you multiply
that by the number of people
who have migraine,
you start to see
just how important
this is as a public health problem.
Our understanding of migraine has evolved
substantially over time.
Migraine is such
a characteristic disorder
that it was recognized in antiquity.
There are very clear
descriptions of migraine
in ancient Egyptian
writings, for example.
A lot of the ideas about migraine
reflect the society
in which they were developed.
I'm getting so weak.
In the last century,
migraine was principally
considered a disorder of nervous women.
Many of the treatments
that were employed
were sedative medications.
The idea that migraine was psychological
was highly prevalent.
However, once effective treatment
for migraine was developed
in the 1960s,
it became a little bit clearer
that perhaps migraine was in fact
something that was biological.
And of course this came in the context
of changing attitudes towards women.
Women have entered the work force.
The disability produced by migraine
is more obvious
and has a financial price tag
that perhaps was hidden.
Research has really changed
our perception of migraine.
It's much more than a headache.
It's a brain disease.
There are different theories
about what causes migraine,
how it's evolved.
In recent years,
we've honed in on this neuroinflammation
and this pathway
in which neurons are activated
and triggered
and cascade into the central areas
of the brain.
Migraine exists along a spectrum of severity.
There are people who have only a couple
of attacks a year
or maybe only a couple of attacks
during their lifetime.
And then there are people who have daily
or near-daily headaches.
The vast majority of people with migraine
are somewhere in the middle.
Migraine is a condition
that has many genetic influences.
This genetic tendency
to have frequent
headaches interacts
with environmental triggers,
both internal
and external triggers,
some of which are under a person's
control, others of which,
like hormonal fluctuations, might not be.
For me, it's the head pain, sensitivity
to light, sound, smells.
With migraine,
there's like this self-blame aspect
of like what did I do wrong to cause this?
You know, I would get questions like,
can't you just take something?
Or, there must be something in your diet
that you're lacking.
It's not always the case
that you have a headache
because you did something wrong.
Sometimes you have a headache
because just your internal threshold
for having headaches is low.
And sometimes it's breached.
Hello, how are you?
Good, how are you?
Good. Nice to see you again.
I think the most important thing
for doctors and patients
to realize
is migraine is a chronic illness.
Now we understand
that it needs to be treated.
It needs to be managed
just like we manage
high blood pressure and diabetes.
And I think that's been a turning point.
I'm excited about where we are
in terms of understanding migraine
and by the momentum that I see.
Today, there are treatments
that can help reduce
the number of attacks and treatments
that can be
helpful in stopping the attack
or making it much less severe.
But it can be challenging to find the one
that works reliably for someone.
One of the things I think
we don't understand
very well about migraine
is with any particular treatment
there are people who do beautifully
and have a wonderful response,
and people who, for all intents
and purposes,
seem to have exactly the same sort
of headaches who don't respond at all.
I often tell people
that treatment is a work in progress,
and that's not a cause for pessimism.
That's the way it is
with any chronic, multifactorial illness.
There's no one-size-fits-all treatment.
The treatment plan
needs to be constantly reevaluated
and sometimes changed
over a person's lifetime.
People who are suffering and are disabled
by migraine deserve to feel better.
I've learned to correct people
when they say, "You have migraines?"
I say, "No, I live with migraine disease."
Even that small thing
may help them understand like,
"Oh, that is different."
What are you taking my cookie for?
For me,
it's been a journey of acceptance.
My focus isn't
how do I get my migraine out of my life?
And it's more,
how do I live my life with migraine?