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Is That a Light I See?

Cartoon sketch of a young person in a striped t-shirt, glasses, and shorts standing on an outstretched hand. Illustration by Earle Levenstein.

Close—I mean, buddies, real tight, no way we'd break it up—since I was a kid, I'm still impressed by the seemingly endless number of ways in which migraine, says, "Hi there, pal; it's me again!" with a spike in the groin here, wave of nausea there; a spasm of dread, a brain lurch, a kick in the gut; terrifying night; spinning bedroom. Usual raucous greeting.

Always masked, disguised as someone else, something else.

Most of the time I know who it is: it's the usual bag of tricks. Rarely—I mean nobody can know everything, plus, I take no chances—I visit my physician, let him tell me it's nothing.

In fact, diagnosis can be a real challenge. Migraine doesn't show up in the blood, in bodily fluids, in imaging, with fever, in none of the usual tests.

Example: Personal experience.

Years ago, my symptoms said stroke; my internist diagnosed it as stroke. An MRI was taken for confirmation, but with a negative result. There was great puzzlement, a consulting neurologist review, identification of my experience as a déjà vu, migraine, and lengthy study of my physical and emotional history providing confirmation and certainty.

Not infrequently, I have to laugh—weird but true—when some odd symptom, out of left field, so obviously trying not to be migraine that it couldn't be a migraine invention, turns out to be—a migraine invention. A Gotcha! experience. What imagination; what an incredible variety of perfect imitations.

Where does all this invention, chaos, confusion, come from? How? Why?

The migraine story is fascinating and complex and goes back hundreds of years, maybe as far back as recorded history; producing many books, judgments, opinions, claims, advice. All over the lot.

For years, my bible has been Migraine, by the late Oliver Sacks, the Sherlock Holmes of neurology and author of a number of other books examining the brain in all its complexity, each book as engaging as a mystery novel: encyclopedic and heavily resourced.

Migraine—published in 1970, with added material in 1992—is incredibly detailed and thoroughly researched, including a number of centuries-old descriptions of the very same iterations we suffer today.

No breakthroughs; no miracles.

As a matter of fact, his preface to the 1992 edition includes this disclaimer: "A patient who has read Migraine will not be cured, but at least he will know what he has…"

Generally, he says, nothing has changed in 2,000 years.

Certainly, nothing that eliminates—cures—migraine, in every part of the body, inside and out.

On the other hand, I thought it was ridiculous when my wife signed me on to the Biofeedback program at Columbia Presbyterian's Psychiatric Center for Stress and Pain-Related Disorders back in the early 1980's.

Thirteen weeks of listening to an audio-taped relaxation exercise while being connected to a stress-monitoring device.

Result? I haven't had a migraine headache in forty years.

Now, why did Biofeedback work for me and not for everyone, as I understand from comments on Facebook?

My strong belief—I'll pursue and elaborate upon that conversation next week—is that for me, awash in emotional issues since I was born, the treatment was tailor-made: establishing an atmosphere of calm, focus, removal of external distractions and in combination with psychotherapy, broadening the exploration, allowing me—encouraging me—to address my basic, lifelong, persistent, recurrent, instigator of migraine.

Unexpressed emotional turmoil.

My chance to be me. (…more next week)

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