Brigid O’Dea: My attempt to describe an acute migraine attack

“Hold on to that feeling.”

That’s what my friend recently advised, a few days following a severe migraine attack. “Remember the pain,” she said, “remember how angry you are about it.”

If you bump into me on the street, with my little tote bag and ambling gait, if you catch my flittering attention and stop to ask how I am doing, my response will be, to both you and me, unpredictable. The answer will largely depend on how I am feeling in that moment. And as anyone with a chronic illness will know, how one is doing fluctuates considerably from moment to moment.

But the truth is, if I’m out and about, buying my tomatoes in Tops In Pops, or my bread in Russell Street bakery, if I have the energy to walk from one end of Fairview Park to the next, I’m probably doing fine and that is what I will tell you.

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Much the same can be said of my writing. If I am well enough to write, the degree of pain and exhaustion are somewhat manageable. In that moment, I am connected to my work, and not to the despair of the days where working is beyond me.

So, I am taking my friend’s advice; I am holding on to the pain in an effort to share with you the physical experience of an acute migraine attack.

Language around migraine is changing. To enhance understanding of the condition, advocates are asking that we no longer see migraine as a once-off event but something you live with. A “migraine attack”, on the other hand, is the preferred term for the acute exacerbation of the condition as I outline below.

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Philip Larkin wrote: “The most difficult kind of poem to write is the expression of a sharp uncomplicated experience, the vivid emotion you can’t wind yourself into slowly but have to take a single shot at, hit or miss.”

A brief description of a migraine attack alludes me. The word that comes closest to the target is “gross”, which is entirely underwhelming, but appropriate in portraying a level of disgust; it is not enough for the migraine attack to “end”, I need to expel it from my body.

What I do know is that a migraine attack isn’t something you have, or get, it is something that happens to you. It takes you over. And when you are beneath an attack, migraine eclipses everything. In this way, the experience is uncomplicated.

For me, a migraine attack generally begins in one of two manners: either the attack will rise in a frantic energy that fizzes from my feet upwards, or it will descend, in a heavy exhaustion.

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In the former instance, the pain tends to be hot, alert and contracted. The pain is alive, and by god is it energetic. It is this type of pain that calls you to scream, to dig you nails into your thighs or bang your head against a wall. It is hyper and unruly and demands that you hear it.

In the latter instance, the pain is inert and stubborn. It doesn’t ask you to scream because it can’t. The pain drains you of life. Instead, it gurgles like a sea swell, tipping everything a little off balance. Even the legs become nauseous. During, and often following, an attack of this manner, my brain becomes humid. Everything on the inside is sticky and lethargic. It is like there is a damp cloth covering my brain that has become warm and stale but refuses to budge, compressing the breath out of everything below.

Sometimes this type of attack is accompanied by a tranquillising feeling of deliquescing, which I imagine could be pleasant, if it wasn’t for the pain.

But these descriptions fall short. They do not capture the vomiting, the lack of appetite, the thirst, yawning and congestion, the banging into bed-corners and smashing glasses, incoherent texts, whispering and tears of frustration. They don’t grasp that while sound, light and smell become physical antagonists, sensory deprivation only serves to make the pain louder.

Maria Popova writes: “The object of human communication is not the exchange of information but the exchange of understanding.”

This was my attempt to make understood the feeling of an acute migraine attack.

As regards, the anger. I’m not ready for that yet.

Should that unspool itself, my love, it will never end.