Longtime horsewoman, trainer, riding instructor and saleswoman Andrea Jones has suffered migraines most ofher life. Since her early teens, Jones has been regularly struck down by the searing headache, blurred vision, slurred speech, dizziness, nausea and even fever that accompany her migraines.
But Jones, 33, just endured them, often with powerful narcotic drugs. She endured while building her business in Langley. She endured while recovering from at least one concussion and more falls than she can remember. And she endured through the non-stop stress of working with finicky animals and demanding clients.
“Between the horses, the shows, the costumes, the teenagers and the rich old ladies, there is a lot going on,” she said. “There is no time for anything else, not even time to take care of yourself.”
Now looking back, Jones agrees it’s no surprise her migraines got worse, even to the point where doctors suspected something much worse, such as a brain tumour.
“I had no idea what was wrong with me and I was so scared,” she said. “When all this was happening, my mom came and said to me: ‘Pack up your stuff, we are going home.’ ”
So about five years ago, Jones moved back to Vancouver Island and now lives in Saanich. She still works with horses and riders, but only a few days a week. She keeps fit and eats conscientiously. For those migraine attacks once or twice a month, she uses cold compresses and pressure, and takes no drugs.
She also makes time for her husband and two-year-old daughter.
Dr. Edward Atkins, a neuro-opthalmologist in Victoria and specialist in migraine treatment, said experiences like Jones’s are common, affecting about 20 per cent of the population and often running in families.
Atkins said migraines are not merely bad headaches. They are better described as inflammation events in the brain, usually resulting from sensitivity to specific stimuli or triggers.
These triggers can include sensitivity to light (often fluorescent or bright lights), noise, strong smells, missed sleep, poor nutrition or missed meals, dehydration, stress, even changes in weather.
“What happens is some trigger comes along and that starts the migraine process,” said Atkins. “This whole cascade of inflammatory events occurs in the brain once that process is initiated.
“It often culminates in nausea, dizziness and painful headaches that can last anywhere from six hours to three days. It then resolves itself and the key thing is a person goes back to normal between episodes.”
Most migraine patients get painful headaches. But not all get dizzy or nauseated or have vision problems. A few even get the dizziness or vision problems, but don’t get the headache. Symptoms vary from patient to patient.
“It has to do with where the migraine activity is happening in the brain,” Atkins said.
“In most cases, it develops into a painful headache associated with nausea.
“People tend to want to go into a dark room, cover their eyes and ride it out.”
But Atkins said knowledge of migraines and how to treat them has expanded, especially in the past 10 or 15 years, and most family doctors have a good idea how to help.
For example, a family of drugs called triptans, first developed in the 1990s, are a “gift” to many migraine patients, said Atkins.
But they are only effective if taken early in the onset of a migraine. Wait too long and the inflammatory process is well underway and it’s too late.
Non-prescription, anti-inflammatory painkillers, such as ibuprofen and Aspirin, are still used. But acetaminophen, lacking the same anti-inflammatory effect, is less effective.
Beta blockers, better known for treating the heart, have also proven useful, as have anti-depressants in small doses.
Atkins also said some good results have been achieved with Botox, injected into muscles of the head, neck and shoulders.
“It’s not clear how Botox works, but it obviously modulates the sensory inputs and does more than just relax muscles,” he said.
For those who don’t take Botox, an old-fashioned massage to the neck and shoulders can work.
“It turns out the head bone is connected to the neck bone, after all,” said Atkins.
Even dietary supplements, such as magnesium, a B-vitamin and antioxidants, have proven effective with some patients. An anti-migraine dietary supplement is available on the market.
Atkins said he has some patients who use triptans, but also take two or three supplements, and regularly receive neck massage, even opting for acupuncture. “For a complicated migraine patient who has multiple symptoms, you end up doing a combination of things,” he said.
Finding the right combination of treatments, medical and non-medical, is often just a matter of trial and error. But it can be exhausting for a patient and a physician.
Atkins said it’s a little ironic that migraines affect so many people, and cause such pain, despite a number of effective treatment options.
“The cost to society is huge and yet it is very treatable,” Atkins said. “The problem is that it is not easily treatable and it’s often not straightforward. Sometimes it can take a lot of trial and error.”
In Saanich, Jones has undergone her own trial and error based on her 20-year experience with migraines. When she was young, her mother and grandmother, who also suffered migraines, would apply pressure to the back of her head or over her eyes, sometimes with a cool cloth.
“My mom would squeeze the back of my head and sometimes put an ice pack over my eyes,” said Jones. “We’re Polish, so we would call it a ‘schmutz,’ a ‘cold schmutz.’ ”
Jones has put that “schmutz” home technology to work. She has designed and now sells the Icekap, a wearable cap she created with her own migraines in mind.
It’s a stretchy, nylon cap with tension straps to apply pressure to various spots on the head the way her mom would when she was young.
It also has pockets to take gel caps that can be frozen.
“It’s the only patient-designed product out there,” Jones said. “A lot of others are doctor-designed, but I’ve got 20 years of migraine experience I put to use.
“I guess my awful experience has had some positive effects because I’m helping people with the same problem.”