We may read articles in magazines and newspapers and think, "I can do that". Or in disagreement with an author wish to 'tell them how it is'. But to actually sit down and write - not so easy. But sometimes necessary.

As I read the article, I feel my temper rising and wonder, "Why haven't I written an article on migraines?" in order to remove blame from women for migraines that accost them. I liked a different one about the Convergence Hypothesis, stating there is a process with stages leading to the full blown migraine, all of which should be included in the diagnosis1. My symptoms in the "prodome phase"2 might involve grasping my neck, digging fingers into trigger points, a suddenly stuffy nose, or looking my environment as if it has shifted into slow motion, not me.

During the "early phase of the headache"3, my trigeminal nerve stops suppressing sensory input it should limit. I don't know where that nerve is, but it's failure makes me acutely aware of every other nerve in my body, not just the dull pain in my head. I feel unbalanced, fidgety, unable to focus on anything other than discomfort. If my shirt sleeves are uneven, my obsession becomes to feel pressure equally on both arms. Even at this level, the process has completely disrupted my world. I am often asked if I have a migraine, but I answer "No" or "Almost" or "I'm migraining" like it's a verb. The real answer is "Yes", because the process is more than it's final migraine phase, the "moderate to severe...one-sided throbbing or pulsating pain, light sensitivity", I'm gonna throw up, could you bring me a from which most diagnoses are made.

Part of my irritation with the other article is it was written by a fellow migraine sufferer, so she should know better. Using her craft to share with others things that are simply not true makes life so much more difficult for me. I thought that once it became common knowledge Freud was a crack addict and his "hysterical" female patients had been molested as children, the idea of blaming women's ailments on their "fragile mental state" would end. Yet a current study shows when men go to a doctor for pain they get a strong opioid, while women are more likely than men to be prescribed tranquilizers. Dr. Marianne Legato, head of the Women's Health Project at Columbia University's College of Physician and Surgeons notes that 20% of women have atypical symptoms (meaning different than men) when having heart attacks. "... these women will experience pain in the upper abdomen or back, feel nauseated, become short of breath, and sweat ... Such women are often sent out of the emergency room with a Valium for their hysteria ... and Tums for their indigestion." The actual problem, a heart attack, goes dangerously untreated.

While I think the mind-body connection is important, I feel this New Age Revolution has caused us to revert again to blaming the patient for her supposed inability to resolve her past issues, or get a grip on her wild emotions. If she would only learn to heal, forgive, express, make amends (all good practices), then her physical complaints would disappear (rarely true and possibly dangerous in postponing medical treatment.) Family members who suggest these philosophies profess them in the midst of chronic back pain and arthritic knees. They will not admit that emotional cleansing has not improved their pain, but they also see physicians, so no physical harm is done.

With a migraine diagnosis, I have to fight the insistence by others, both professional and non-professional that it's all in my head. They don't mean trigger points, inflamed muscles, changing blood vessel circumference, or the mouth full of so-called silver fillings that are actually 50% mercury. They are implying my problem is emotional. Yet I am one of the most emotionally stable, well-balanced people I know, and when pushed, my accusers have to agree. "Something must be buried deep inside", they say. I can see if someone is off-balance that they might want to dig into that stuff, but otherwise it seems counter productive. "But", they say "it's expressing itself through your body". I say it's genetics and toxins speaking loud and clear. I have a Masters of Social Work, and put great value on addressing psychological, relational and behavioral issues. Stress, emotional underlying issues, bad relationships, depression, negative thinking, and even lack of faith, can all exacerbate the migraines, but do not cause them.

Many suggest I simply avoid the triggers, the goal and the bane of every migraine sufferer. The endless search to find and avoid the cause, and therefore get relief, and regain a sense of control over our bodies and lives. It can become an obsession that places limitations on your world greater than the illness has already done. I know people who eat wheat bread and turkey, yet still have problems. I am not immune to this aspect of my illness, with charts and graphs to plot my symptoms against multiple interventions and avoidances. I have identified all kinds of triggers: some I avoid, when possible, some I limit, and others I simply indulge (chocolate). My triggers: MSG, smoke, car exhaust, perfume, chocolate, skipping meals, not drinking enough water, getting my period, bright sunlight, being too hot/too cold, turning my head, computer work, airplane seats, movie theater stadium-seats, or anyone chair too long, driving my car, exercising, lifting, carrying, holding the phone, pushing a shopping cart with messed up wheels, flickering flourescent lights and their buzzing, holding my camera with the zoom lens up to my eye, dancing, singing, and crying. The reality is, even if it were possible to avoid all my triggers, I would still get migraines.

I could make a list nearly as long of the interventions I try, filling my day, hoping one will work: stretching, darkness, heat, caffeine, ice, massage, chiropractic, Peppermint Schnapps (on my temples and neck, not in my mouth)... The same reality is that symptoms come and go as they please, responding randomly, giving me hope I can get rid of my pain if I just make the right choice. There are medications that help me maintain without which I would be worse. There is my miracle drug, Imitrix, which can actually stop a migraine about 60 % of the time, or least let me leave my bed. My next hope is showing promise: Botox injections, that were unexpectedly discovered to help migraines of sufferers who got cosmetic injections for crows feet and a wrinkly foreheads.

So what about this inciting article? Joan Didion, in her personal essay "The Bed" says she can handle the major stress of job demands without a hitch, but when it gets to little things at home - kids yelling, phone ringing, dirty clothes piling up - the tension overwhelms, sending her into a migraine episode. She could feel it building, feared it's approach, but once it was full blown with the bed and darkness wrapped around her, she welcomed it for what it is. "The pain comes and I concentrate only on that. Right there is the usefulness of migraine, there in that imposed yoga, the concentration on the pain...For when the pain recedes, ten or twelve hours later, everything goes with it, all the hidden resentments, all the vain anxieties. The migraine has acted as a circuit breaker..." Joan indicates only a migraine can force her to do what she is incapable of consciously choosing for herself: take a break, escape from it all, and recuperate.

The article angered me, because she was blaming herself, telling anyone who read it that if she could say "No", could do a relaxation exercise, learn how to manage her stress, she could be pain free, implying so could I and all the other migrainers out there. I guess what really agitates me is I have lost control over my life. That is finally what I must give into, and let it wrap itself around me. Perhaps I must accept my reality, and live life to the fullest in those tiny spurts of peace, to find my purpose. Not wasting gifts of time on fighting what I do not understand. As for the painful times, I must admit if I were to choose a soul mate, I would want exactly the kind of life partner my illness has proven to be: stronger and smarter than I, loyal and faithful, not fleeing the bed at dawn's first light, and willing to stick with me through thick and thin. (I have a feeling that someone else with migraines will read these words and get angry.) I reread the article that incited my anger, and perceive Joan Didion is not accepting the blame, but through the cathartic process of writing, searching for the sense of control migraines steal, and desperately needing to find goodness and purpose in her pain. That is a noble example for all of us to follow.

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