Losing my career to a chronic illness is one of the most devastating experiences I have faced. Old coworkers told me, “You’re so lucky,” in reference to me quitting, not even understanding what I was going through. I felt worthless. I lay on the couch, barely ate anything, and watched TV when I could. This state of depression can easily become a cycle if you let it. You can sit there and feel sorry for yourself, cry, and hate everyone. Or you can make a conscious decision that you will do anything and everything in your power to change it.
I decided I was too young to give up. So, I began to research everything I could on types of migraine, vestibular migraine, supplements, medications, mindfulness, and how that could all benefit me in some way. Eventually this led me to discover a book called Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain, by Dr. David Buchholz.
I nearly didn’t order it because of the title. After all, I didn’t have “headaches.” But I was happy I took a chance, and I highly recommend you read the book to gain a better understanding of the mechanism and spectrum of migraine. There’s not a lot of information out there on vestibular migraine specifically, and this was the first time I even saw it mentioned in a book about migraine. Although the symptoms of vestibular migraine are different from what most people associate with migraine, the treatment plan is quite similar. In fact, there are many ways migraine can manifest itself in the body—from stomach pain to sinus symptoms. It’s a sneaky illness that often makes it difficult to diagnose. And many doctors only receive four hours of education on migraine in school, hardly making them experts. Yet this illness plagues millions of people, especially women.
The book is divided into three parts: “Avoiding the ‘Quick Fix,’” “Reducing Your Triggers,” and “Raising Your Threshold.” The idea is to reduce the dependency on triptan drugs or “quick fixes” like Excedrin, which can actually lead to more pain or dizziness days through what is called a “rebound cycle.” If you’re stuck in a rebound cycle, no preventative measures will work. You must effectively break that rebound cycle to have any chance at success with alternate treatments. (Heal Your Headache is a little out of date when it comes to rebound information. Recent research presented from the Migraine World Summit says that even over-the-counter meds like simple analgesics—NSAIDs, acetaminophen, ibuprofen—taken more than fifteen days a month for more than three months can cause rebound. For triptans, the risk of rebound occurs when used ten days a month. Even caffeine at more than 200 milligrams a day can increase rebound symptoms.) For those with vestibular migraine, triptans aren’t incredibly effective, so this may not be an issue you have to worry about.
The second part of the book covers triggers. Migraine triggers can literally be anything and are highly individual. Some find that weather, stress, and dehydration spike their symptoms, whereas others have major sensitivities to food, scents, or hormonal changes. The idea is to reduce the triggers that you do have control over, so you can better handle the ones you don’t have control over. The most avoidable migraine triggers are dehydration, food, stress (to some extent), exercise, and rebound. No, this does not give you an excuse to stop exercising! You just might need to modify your routine until you can build up your tolerance by raising your migraine threshold—the third part of the book.
The idea is to raise your overall migraine threshold through preventive measures. Medications, supplements, mindfulness, activity, and a migraine diet are all great ways to do this. In fact, they work best when combined as a multimodal approach. While you may not see the benefit of any one thing, all these efforts work together to raise the threshold that it takes to have a migraine attack. For example, perhaps you previously used to get a migraine attack after one stressful day, but with these treatments it would take three stressful days to finally reach that threshold.
There was no easy way to “fix” myself. I had to focus on diligently taking my supplements, trusting that the medications I was trying were working in ways I just couldn’t see, and I had to take this migraine diet seriously, even when it seemed crazy. Trust is key in this process. You’re putting so much effort into healing and blindly hoping it works out. I promised myself I would give this process a few months and re-evaluate if it was the correct path.
The diet that Dr. Buchholz recommends is a low- tyramine elimination diet, where you exclude certain ingredients that are likely to trigger migraine symptoms for a period of time in order to calm down the excited neurons in the brain. (I’ll explain more about this later.) Since the diet was also recommended for migraine prevention by Johns Hopkins, I decided it was worth a try. About two or three months in though, I was fed up. I had not seen a huge decrease in my dizzy days and the diet took so much effort to get used to. I greatly missed avocados and almond milk. That evening, I decided to try a little yogurt sauce with my lamb. Previously I had eaten yogurt almost every day for breakfast but had eliminated it when I began the Heal Your Headache diet. I distinctly remember sitting at the dining table and having everything start to move around me. I was having a violent vertigo attack similar to the one I had the night I went to the ER. Was yogurt really a trigger?! I couldn’t believe it. Here was something I used to eat daily, but I never noticed a spike in symptoms like I had just felt. It was enough of a push to keep me going.
After that, I stayed on the diet faithfully for another four months before my symptoms subsided enough that I felt confident to reintroduce foods. In that time, I had weaned off a short-term, low dose of Ativan, which my doctor had prescribed to help settle my brain, and only took a half milligram of Valium as a rescue medication for horrible attack days, or when traveling on long car rides and flights.
The hardest part of the diet for me was the first month. I had my list of “no” foods printed out and saved to my phone, but the sneaky names for MSG (a big trigger for migraine) were tough! I never realized how many additives are in foods that I once thought were additive free. Food producers are even putting triggers like carrageenan into organic creams and milk. The diet taught me that although something is marketed as “organic” or “healthy,” you still need to check the label for potential triggers. I always tell people not to count their first month because you will mess up a few times before you really get it down.
Another difficult aspect for me was the recipes. The few out there weren’t very good in my opinion. I wanted comfort foods and felt deprived eating kale and bland chicken all the time. When you’re tired and sick, all you want is for someone else to tell you what to do. You don’t want to spend the time reading through ingredients and matching up what you can and can’t have. Grocery shopping can be a giant trigger by itself, then you sit there and read every ingredient because nearly everything has additives… trust me, I know it’s a beating. The thing that kept me going was knowing that if I could get through cooking a delicious and migraine-compliant meal, I could be proud of myself for that day. It was something that I made and that my family loved. Even if nothing else during that day went right with my job or doctor’s appointments, everything felt right when I sat down at the dinner table with my husband. Having my family say, “Oh! This is so good!” left me with a proud feeling that I hadn’t had in so long. Cooking brought the spark back to my life that my migraine disorder had once snuffed out.
Three years later, I feel as though I’m in remission or extremely close to it. Most of my days I feel 100 percent normal, and I haven’t had a bad attack in months. There are a few times that the dizzies make their appearance—often after a very long day of travel, a very intense workout, or when I have a messed-up sleep schedule. It typically only lasts a moment or two, never a full day. Unlike how it used to be where I would be stuck in bed for days with a bad attack, I can carry on with my life.
When I was first diagnosed, I never imagined that I could survive a fourteen-hour plane ride or get on a boat for a snorkel trip ever again. These are all goals I’ve been able to successfully accomplish with the right diet, supplements, medication, and therapy. Once you discover that perfect combination of treatments, you too can get your life back.