Migraine

the day started off normally enough. i let the skylights guy, glenn, in at 9 and headed off to my 10 AM appointment in st albert. by 11:30 i was starting to feel the warning signs: a little tightness in the neck, sinus pain, a sore jaw. but we were out of coffee beans, and the shop was right there, so even though i was starting to feel migrainous, i made myself run the errand. which took longer than i expected. by the time i was driving back into the city, 12:15, i knew i was in trouble. or, rather, in retrospect it's clear i was in trouble.

the thing about migraine is, i start making bad decisions. poor judgment, not a visual aura, is the first sign of danger. and the trouble with poor judgment is that i don't recognize it as anything out of the ordinary. while this migraine is working itself up into a real state, i'm still living my regular life, acting as though i am my usual competent self. in this case, i'm wondering whether i should stop at the grocery store now or later -- and, as if it's the most natural thing in the world, noting at the same time all the possible places to pull off the road should i need to throw up. because by this time, vomiting is a real possibility. the pain in my right temple is hot. i keep thinking, in the back of my mind, that if i could just pull out my eyeball, things would get better. in the front of my mind, i'm trying to decide on the best route to my 1 PM physiotherapy appointment. i drive through intersections with my hand over my eyes. it occurs to me, briefly, to wonder whether i should be driving at all, but what are my options?

i suffered my first migraine when i was 8. i remember lying face down on the bed i shared with my sister and picking at the bright yellow chenille bedspread. the texture of the bedspread was troubling under the influence of a migraine, but what i really remember is how unbearable that sunshine color was. ever since, i have done my bedroom in soft, soothing colors. some people decorate for romance, some people for sex, some for the civilized pleasure of reading in bed or the less civilized pleasure of watching TV, but i have always decorated for migraine. we go back that far, megrim and i.

and my bedroom is where i want to be right now. correction: where i need to be. i don't remember the last ten minutes of the drive. i don't remember pulling into the garage. my sinuses are abscessed and my stomach is spasming. my right eye is watering. i know where i am now, i have been in this hell before. time for the rules, things i have observed when i am well and that i have promised myself i will believe when unwell. rule number 1 is that migraines give you bad judgment, so you have to follow the rules. rule number 2: make simple lists.

item 1: cancel the physio appointment. i am sheer will now, not body, not mind. i walk past the couch without looking at it. i am going to my study. there is a business card with the physio's phone number on it. i will pick up the phone and dial the number. i will explain myself efficiently and apologize. i will offer to pay for the session. i will rebook later. the phone call will not take long, and then i can get to my precious drugs. but there is a snag; i am asked to hold. "of course," i say, courteously. inside i am screaming. when the receptionist comes back i stumble over my name, then recover and say, professionally, that i have a 1 PM appointment with glenda, that i'm very sorry to call on such unforgivably short notice, but i am developing the sort of migraine that means i can't drive, let alone -- at which point the receptionist cuts in and says, "i get migraines too." "you do?," i say, "really?" under normal circumstances i greet these declarations with skepticism. lots of people use the term "migraine" as a synonym for "bad headache," the kind they take 2, maybe 3 aspirins for. it is emphatically not the same thing. today, however, i find myself weeping with relief. "then you know," i say. "yes," she says. "do you want to rebook later, when you're feeling better?" it is a tiny miracle; i am not alone in the world.

item 2: cancel my 2 o'clock meeting. how. i have no phone numbers. it requires email. email requires the computer. i do not let myself think about how it will hurt, because it must be done. i open the computer. i wince at the blue light. i squint. and then, using my touch-typist fingers, i key a perfectly chipper note saying why i can't meet, apologizing, and closing with the upbeat promise that i'll be back in touch as soon as possible. email cancellations -- and i've had to do a lot of them, i've grown good at them -- make me feel utterly fraudulent. i feel guilty. i think there should be more to show on the screen for the agony i feel. there is such a disconnect between my bodily experience and my verbal representation that people must assume i'm faking it. which in turn reinvigorates the bad judgment and makes me wonder whether i shouldn't soldier on. okay, i can't drive, but maybe i could just take a cab? at this point, i remember the first rule. this is why i am not allowed to think when i have a migraine.

item 3: drugs.

but before i can get there, glenn, the guy installing our skylights, appears at my study door. if the first mystery of migraine is that even after all these years i don't recognize when i'm getting one, and if the second is the guilt i feel at cancelling meetings when i am ill, then here is the third: shame. i am so ashamed to feel ill that i can't stand for glenn to know. i muster everything i have and ask, cheerfully, "how's it going up there?" his lips move in answer and there is sound coming out, but i cannot follow it. i have no idea what he's talking about. the veins in my head have dilated, and sulfuric acid is careening through them. mechanically, i follow him up the stairs. my drugs are upstairs. to follow glenn is to get closer to my drugs. he is showing me something: apparently he has plugged a piece of equipment into our bedroom outlet. i think he is asking whether this is allright. i don't know what the answer is. why wouldn't it be allright? but what if it isn't? it's too much responsibility. i nod, a bad idea. my brain hits my skull and i wince anew. i try to avoid talking. the less i say, the sooner i will get to my drugs. this migraine is a bad one.

when glenn leaves, i realize the severity of the situation. i am standing in the bedroom, my oasis of dark brown and cream. i need to lie down for 50 minutes. the drugs will start working in 50 minutes. but in the room next door, glenn is sawing a hole through the ceiling. it is very loud. what are my options? he and his helper are walking garbage out the front door. i will be seen if i lie down in the living room. the spare room is out: more skylights, saws, sawdust. the basement? no, the smell of cat litter will kill me. the closet floor. i could lie on the closet floor. it would be dark there and no one would see me. it would be hard and cold and i know there are nails sticking up, but it is my best bet. i fall onto the bed to consider how this will work.

i am lying on my right side, digging my fingers into my right eye socket. if i could just pull my eye right out ... i can feel dry heaves building, but now that i have taken an imitrex, i do not want to throw up. i try to figure out how long it will take for the imitrex to dissolve into my bloodstream. i wish i had an IV. i wonder whether i should go to the hospital, but now i can't move. now that i have fulfilled all of the jobs on my simple list, and collapsed onto the bed, i cannot move. i am bested. my stomach heaves again, dangerously. i wish i had taken some gravol before i lay down, but now glenn is in the bathroom where the drugs are. i must wait. my eyeball aches. i wonder if there is a world beyond the pain. i lie as still as i possibly can. i get smaller and smaller and smaller while the migraine gets bigger and bigger and bigger. it's ferocious now, and triumphant. it trumpets like a wapiti. it tramples like an elephant. it mauls me like a tiger. it laughs, it dances, it trounces and jigs. i lie even stiller, forcing my head down into the pillow. my hands reek of steel. i wish they were clean. i want to whimper, but that will hurt more. i am on the brink of tears, but crying will hurt more. i grind my fist into my eye socket and try to stop thinking. thinking, willing, deciding are all too much. the migraine has my head and my stomach and i give up my will. now it's just a matter of time passing.

i hear footsteps on the stairs. mo is home. i must have called her. did i call her? i dimly remember, but it is all quite jumbled. her hand on my forehead is cool. she brings me gravol. better, she leads me to the basement, where she has set up a mattress in the quiet cool. i fall asleep, eventually, and when i wake up i can roll over and take my fist out of my eye socket. the drugs are working. i will make it.

for hours afterward, my whole body feels like it's been through a wringer -- a literal wringer, the two metal rollers on an old-fashioned washing machine. i am a limp shirt. i am sore everywhere. everything hurts: my legs, my arms, my feet, my hips, my back. oliver sacks says this is the consequence of being hyper-toned before a migraine; hyper-toning is one of the prodromes he points to. i can't say that i've noticed that. my warning signs are too quotidian to remark, even after all these decades of acquaintance with migraine: excessive sleepiness (but who's not tired all the time?), lapses in judgment, a chill. in spite of our decades-long dance, every migraine is its own event. each one is a terrible surprise. though there is a certain pattern to the pain itself, migraine sneaks up on me more often than not. how can this be, after all this time? how can bodily agony take me unaware, yet frequently? how can my longest and most intimate companion come trailing newness? why can i not get used to migraine as a constitutive element of my life, a structuring influence? -- for that is what they are, even a stranger could see that. why can't i? i can't recognize myself with migraine. would i recognize myself without it?