Tag Archives: migraine

Sir James Black

The man who transformed my life has just died.

I never met him. I had never considered him as an individual until I read his obituary in the Telegraph this morning. He is Sir James Black, and he invented the beta-blocker propranolol, 80mg of which I take daily.

He originally developed propranolol to treat high blood pressure, and as such it has saved thousands or tens of thousands of lives.  It is sometimes taken by performers to reduce stage-fright and it is a banned substance in the Olympics, in fact a South Korean marksman was stripped of his medals because he took it to reduce hand tremors.

I take it because it reduces the frequency and severity of my migraines; as I said, its effect on me has been life-transforming.

Migraine is an ancient condition. The word comes from the Greek hemi-cranium meaning half the head. This is an acknowledgement that migraines only affect one side of the head at a time.  There seem to be two current models for how migraines work, and consequently two models for treating them. The first assumes that it is a vascular disorder that, broadly speaking, there is too much blood in the head, and this is the model that beta-blockers work within. The second notes disturbances in the brain function, which is the model treated by triptans. Bizzarely, although triptans are effective in tackling the pain and nausea, they don’t tackle the disturbances, and can leave one with a spaced-out sense of dislocation. More of which in a moment.

Those of us who do suffer migraines get mightily irritated by those of you who get a headache and call it a migraine to feel important, cadge sympathy or bunk off work.  A migraine is not just a bad headache. If only it were. It is the complete inability to function.  Although I would not go as far as the World Health Organisation, who consider that severe migraine can be as disabling as quadriplegia, I am aware that if my future comprised nothing but unrelieved migraines I would be on the next plane to Switzerland, eyes closed and vomiting all the way.  I throw up until my stomach is empty, drink water and then throw up again. I then rinse, as it were, and repeat. Sounds and light are physical assaults. But the strangest aspect of migraines are what they do to your mind. I became most aware of this when I started taking triptans – I would sometimes be reduced to being a pain-free but quarrelsome zombie, distanced from what was going on, unable to think or talk coherently, bad-tempered and petulant. My husband described me as being a Ben-shaped hole when I was in that state.

So while the obituary writers talk about blood-pressure, I raise my glass of sparkling water to Sir James because he has relieved me of migraines which I used to experience every three weeks or so. It is a gift beyond compare.

Sir James Black’s Autobiographical notes for the Nobel Prize Committee

Informative and well illustrated Obit from The Times

Recent Advances in the Diagnosis and Treatment of Migraine – Peter J Goadsby – The BMJ (restricted access)

Migraines 4 – Headbanging

I can tell when one of them has scented me out and is tracking me. We are a prey species, however much men like to think of themselves as mighty hunters. Douglas Adams knew it when he defined “ely” (which is pronounced “eelee”) as “the first, tiniest inkling you get that something, somewhere has gone terribly wrong.” We can tell.

There’s a word he didn’t define though, for the first, tiniest inkling you get that a migraine has found you. That it has sniffed you out from the whole of the rest of migraine-suffering humanity. That it is hunting you down, waiting to stroke you and suffocate you. Waiting to turn you into pain, hallucinations and vomiting.

Then, like a victorian parent, the migraine will sit beside you on the bed smoothing your forehead and telling you kindly that it is for your own good. It is because you have been doing to much, driving too far, working too late. If you won’t take a rest, it says with benign sanctimony, then I will make you take a rest. You know you need a rest. You know you need me.

Triptanes help. If triptanes were not proof of the efficacy of science, they’d be proof of the beneficence of a god. But the only real defence, and the only real cure, is sleep.

I bargain with my migraines. “Look”, I say. “I’ll take this little tablet today, but tomorrow I’ll spend the whole day in bed. I know you are right,” I say slyly, “I do need to rest. But I am busy today. Spare me today. Please”.

Sometimes it works.

Migraines 3

You wouldn’t think lying in bed sleeping would be this exhausting.

I am not sure if it is the migraine itself, or if it is the triptane, which I took too late to be effective.

Either way, I have spent the last 36 hours dreaming great long complicated convoluted dreams, mostly about work. I guess it is a good sign that they are mostly about work, since it suggests that the rest of my ducks are in satisfactory rows. It’s odd when one dreams in Visiothough.

I wonder if Microsoft could sue me for running an unlicensed copy in my head?