Miss Migraine: How to travel in a group if you get frequent migraines

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. This post appeared first on my blog of the same name on August 8, 2012.

Travel is one of my passions, but before I go anywhere, I have to plan for myself and my migraines.

I’d been planning to write a travel tips post, but Diana Lee beat me to it with her excellent “Traveling with Migraine Disease: Top 5 Tips” article on Migraine.com, as well as with a post on her blog, Somebody Heal Me, so I decided to tackle group travel instead.

When you tour with a group, whether it’s with your school, church, for a medical missions trip, or a guided tour somewhere with people you don’t know, the rules are different. There’s often a set schedule of places you have to be and times you have to be there. Activities and sight-seeing are planned in advance, which can be both a blessing and a curse.

Family ancestor temple in Ky La, Vietnam

Members of my Vietnam travel group enter a family ancestor temple in the village of Ky La, outside of Danang, Vietnam.

Group Travel Pros:

  • Unless you’re leading the group, the work of planning and scheduling has been done for you. All you have to do is show up! This equals less stress for you.
  • Your group leader will take care of you. Regardless of your age, the group leader is in charge of making the trip successful, and a good will ensure that her travelers are well taken care of and enjoy the sights. She might be working hard (and getting paid for it), but you’ll be having fun.
  • You’ll likely do things you wouldn’t have thought to do on your own, or do things that are slightly out of your comfort zone. This will help you bond with your group mates and make awesome new friends.

Group Travel Cons:

  • If you’re out in the middle of nowhere (or even just taking a bus tour of a city), it may be difficult or impossible for you to get back to the hotel if a nasty migraine strikes. A good group leader, however, should be prepared for emergencies like this.
  • If meals or restaurants are pre-planned, you may not have a choice in what you eat. This can be a con for anyone, especially if you’re in a foreign country and find you don’t like the cuisine! Talk to the leader about food requirements or allergies you may have BEFORE you go.
  • Someone on the trip is going to get on your nerves, under your skin, and make your head hurt worse. It’s going to happen. There’s no way around it. Deep breathing and polite avoidance are the best strategies.

I’ve been on plenty of group trips, many of them to foreign countries like Vietnam, Mexico, and New Zealand. Despite the inevitable annoying person or two, I think the pros far outweigh the cons. In Mexico, I helped a group of doctors and nurses fix cleft lips and palates by translating for them. That’s not something I would have done on my own. But as migraine patients, we do have to take precautions.

Here are my tips for group travel:

  1. Tell the group leader about your disease and give him/her a list of ALL your medications, even over-the-counter ones and herbal supplements. This allows your group leader to help you when you’re in pain, and help medical professionals help you if there’s an emergency. Do this well in advance of departure. While on the trip, Let your leader know when you feel a migraine coming so she can help you manage it.
  2. Make yourself a “migraine kit” and keep it with you AT ALL TIMES. This should include your medications and anything else you need to prevent or relieve pain. For example, I have a sachet of lavender that I keep with me to avoid triggering smells. Other items might include ear plugs or noise cancelling headphones and your MP3 player, an eye mask, or snacks.
  3. Stay hydrated and avoid alcohol and too much caffeine. You may not be able to control everything on the trip, but you can control how much water you drink. Staying hydrated at least reduces one possible trigger. Avoiding excess caffeine and all alcohol also reduce the chances you’ll get an attack. It might be hard when everyone else is toasting and having fun at dinner, or when travel fatigue sets in, but the consequences of missing part of the trip because of blinding pain aren’t worth it.
  4. Get as much sleep as possible. When I went to Vietnam, some nights we were out late and then had to wake up early in the morning, and I had no control over this. The best I could do was take advantage of every opportunity for sleep that came along. Often this meant missing out on evening activities with my friends, but being well-rested and having less pain was a worthy trade off. If there’s a long plane or bus ride during a time you’d normally be sleeping, consider taking something to help you sleep, like Benadryl or an OTC sleep aid. You could even ask your doctor for a few sleeping pills like Lunesta. Talk to your doctor or pharmacist before you take anything to make sure there are no interactions.
  5. Be flexible! This is travel. You’re probably going somewhere you’ve never been before, and with a bunch of people you may not know. Something’s going to go wrong at some point: a museum will be closed unexpectedly, the bus will break down, someone will get lost or be late and put the whole group behind schedule. It’s important to remember that all of these are out of your control. Don’t stress yourself out about them or think they’ve ruined the whole trip. Expect to have fun, but be willing to let that fun come in whatever form it’s going to come in. You won’t get to do everything you want to do, but enjoy the things you do get to do.


Miss Migraine: How supporting local agriculture helps my migraines

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. This post appeared first on my blog of the same name on August 10, 2012.

First, I chop the potatoes and add them to the broth. Then I peel the carrots, slice them, and send them in after the potatoes. Next comes a whole miniature purple cabbage and a medium yellow onion, roughly chopped. Then two fennel bulbs chopped willy-nilly and and a small, fat zucchini that had been hiding out in a corner of the fridge and was nearing the end of its edible life.

Organic vegetable soup

A bowl of Whatever-I-Have-In-The-Fridge-Soup. Photo by Kelly Lynn Thomas.

I love the rhythm of chopping and slicing vegetables, the knife in my hand, moving up and down, the steady collisions with the cutting board. The fennel is the most difficult to attack. Layers fall away as I work at it, preventing an easy pattern. The rest require varying applications of pressure: the knife slides easily through the zucchini without much help from me, but I must push it down to separate each slice of carrot.

All of the vegetables and herbs come from Kretschmann Organic Farm. Each week, we get a box of fresh produce and other goodies delivered to a pick-up spot in our neighborhood. We don’t know what we’re going to get in advance, and we can’t pick anything out (though we can order extra things like blueberries, peaches, chicken, beef, cheese, coffee, etc.). To me, this is a relief. It means fewer trips to the grocery store, becuase we only need to buy dry goods, and we can buy them in bulk. It also means less time spent in the grocery store.This translates to less energy expended and less stress, and less of a chance for the harsh lights, strong smells, and screechy carts to exacerbate my migraine.

Looking at the soup’s color, I decide it needs more orange. Three more sliced carrots go into the broth. I let it simmer for awhile — I don’t bother to time it. Eventually, I take my tomato knife out and dice four juicy, perfectly ripe tomatoes. When I feel especially motivated, I tear piles of fresh herbs from their stems: rosemary, thyme, parsley. This time, though, I let bunches of dried herbs steep in the broth for a long time before I started cooking.

It’s 86 degrees Fahrenheit, but I don’t care. My Whatever-Vegetables-I-Have-In-The-Fridge-Soup requires no thought, no planning, is easy to prepare, impossible to mess up, will last for several days, and is delicious and healthy. This is my favorite thing to cook. Sometimes I add beans, but this time I simply forgot.

local, organic vegetables from a CSA

A selection of vegetables, fruit, and herbs from this week’s produce box (beets, swiss chard, red onion, cabbages, peaches, dill, cilantro, tomatoes). Photo by Kelly Lynn Thomas.

For someone with a constant headache, the routine of picking up a box of veggies at the same time and place every single week is comforting. The food we get from Kretschmann is a higher quality and fresher than what we get from the store. Fresher foods have less tyramine, a compound that develops as foods decay and that can trigger migraines for some people.

My husband and I sat down in the living room with our big bowls of fresh soup and a fan blowing our way to keep us cool while we watched the first season finale of Buffy the Vampire Slayer, which I had finally convinced him to watch with me. We ate slowly while Buffy fought ugly-faced, toothy undead. I can’t speak for him, but I was content.

There are subscription-based programs like this, called Community Supported Agriculture or CSAs, all over the country. To learn more about them or find one in your area, visit www.LocalHarvest.org/csa. I’m not getting paid to talk about CSAs; I simply think they’re a great way to help the environment, the local economy, my body, and my migraines.

What do you do to make cooking and food preparation easier?

Miss Migraine: Emergency room averse

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine (and other crap).

Saturday I had to go to the emergency room. I’m fine now, but I experienced a sudden and extreme pain in my lower right abdomen that was anything but normal. In this situation you’d think my biggest concern would be OH GODDESS AM I GOING TO DIE THIS FUCKING HURTS, but no. My biggest fear was that they’d tell me there was nothing wrong and I was “exaggerating” my pain or something like that.

I knew something was wrong. The pain started out like a bad menstrual cramp but quickly escalated to “I cannot stand up straight my insides are on fire what is happening.” The pain was definitely in my right ovary, and I thought perhaps a cyst had burst (nope–endometriosis, but I was right about the ovary part). Probably something you should go see a doctor about, right?

But so many times I’ve seen a doctor, or gone to the ER with a severe migraine that’s lasted five days, and they’ve said “Oh, it’s just stress, here are some muscle relaxers/Vicodin.” (Muscle relaxers and narcotics, by the way, don’t help migraines. At all.).

Or I’ve gone and said, “Hey, you can look this up on your fancy computer because we live in the future and all my medical records are digital, but my migraine specialist said I should go to the ER if X happens, and X has happened, and she’d like me to get an MRI,” only to be told “Whatever, it’s just stress, but we’ll do a CT scan just to be sure!” Real helpful, doc.

Once, before I was diagnosed with chronic migraine, an ER doctor pressed so hard into the back of my neck I started crying. I went in because I’d had a headache for a month straight, and none of my regular doctors had any ideas. Urgent care wasn’t a thing yet. He was trying to “prove” I had a tension headache and just needed to “relax.” Nevermind that neck pain and soreness is often a symptom of migraine, AND ALSO he pressed so hard it would have hurt even if I didn’t have a migraine!

ER doctors, especially male ER doctors, have a history of dismissing my pain and not listening to what I say about my own body. So, you can understand why I was hesitant to go to the ER despite the awful stabby pain in my right ovary.

Thankfully, and to the credit of the staff at UPMC Shadyside, the doctors who treated me listened, were kind, and even *gasp* got me a diagnosis. So, bad news–I have endometriosis. But good news–my ER experience didn’t lead me to murder anyone! The next step is to follow up with my lady parts doctor. In the meantime, I’m still in some pain, but no where near the level I was on Saturday.

Onward, I guess?