Anatomy of a Migraine

I used to get migraines a few times per month, but that tempo has greatly decreased over the past few years. On Sunday, I had the first since June 2013.

Migraines are not the same as regular headaches. Because people often don't understand why people can't just "walk them off", here is a behind-the-scenes look into my own as a PSA.

• Root Causes: Unconfirmed. Often related to changes in weather / air pressure, and sometimes related to computer usage or very bright, burning lights or camera flashes. Mine have never been food-related.


• Phase I (Minute 0 - 10): Miniscule visual artifacts invade my vision like "eye floaters" on steroids. Where I can fling eye floaters around through quick eye movements, migraine artifacts stay in one place, perpetually blocking my sight with pulsating white noise, like one of those disposable cameras that inserts penises into your pictures. The best course of action at this point is to shut everything down -- cancel whatever I'm doing and retreat to a dark bedroom with eyes closed, and hope to fall asleep before the next phase progresses.


• Phase II (Minute 10 - 50): Visual artifacts increase in a positive feedback loop -- my eyes try to compensate for the original artifacts and the eye strain generates more artifacts in other parts of the eye. The white noise crescendoes by example, like a trumpet section following a lead trumpeter who's playing too loudly, until my vision is 100% affected. The faster I can get into a situation where I can close my eyes and be in the dark, the farther from 100% I can stay, which is important in the next phase.


• Phase III (Minute 50 - 60): To equate migraines with World of Warcraft concepts, Phase II is the rogue's Sinister Strike action, gradually building up to the Eviscerate finishing move of Phase III. The amount of stacked visual artifacts I have accrued in Phase II translates into direct damage to one focused area of my brain, usually in the left-central or right-central lobes. All visual artifacts vanish, and my vision becomes almost too clear. The headache portion of the timeline starts now, and the pain is front-and-center, interfering with all mental and physical activities. It's as if my brain pain is talking too loudly, like an advertisement at the gas station pump. If I try to do anything during this time, I will likely throw up or fall over.


• Phase IV (Hour 1 - 4): It can take up to four hours for the primary pain to subside to a level where I can resume normal operations. If I was able to mitigate Phase II / III successfully by napping, I will hopefully just be waking up towards the end of this phase. The bulk of this phase is spent in bed, doing nothing.


• Phase V (Hour 5 - 48): Although the primary pain has subsided, there will still be an aftermath ghost pain for over a day following the event. I can still do normal activities, but it will hurt if I cough or move my head too quickly.