Tuesday, April 18, 2006

A duel: Chronic Tension Vs. Migraine

I have chronic tension-type headaches.

That isn't my naming choice, but the clinical descriptor greater neurological minds than mine have given my plight.

And no, they aren't migraines.

People with tension-type headaches don't get a lot of sympathy. Not even when their headaches are chronic: meaning Every Single Day. You see, I don't suffer, clinically at least, from the glamourous varietal the world knows as Migraine.

Tell someone you have tension-type headaches and they think you have a stress (tension) problem. (It actually refers to muscle "tension" but that's too much information).

No one is familiar with "tension-type" headache. But I can't feel too bad; I imagine cluster headache sufferers have it worse. Cluster whuh?

You try to decribe tension-type headache by saying "well, when you (generic non-headache suffering person) get a headache, it's probably a tension headache." So, hey, it doesn't sound so bad!

But this brief description underestimates what I and many others experience. You see, on my pain scale, I can experience headache ranging from about a 2 to an 8 (out of 10) over the course of a day, with an 8 being disabling pain that makes me need to go to bed (aka about the same as a bad migraine), and a 2 being perfectly bearable but clear-and-present pain. My levels fluctuate during the day. Some days are worse than others. But a "run-of-the-mill" headache , like in my example, would score about a 2 or a 3 on my scale. Meaning if you (regular joe) have a "headache", I probably have worse than that most of the time.

What difference does it make if I prove to you how much pain I have? Does it help if I compare it? We all know it's impossible to describe our pain. But giving examples helps because it lets me translate my daily experience into something a stranger can fathom. Which will help me convey how I experience the world. But describing my headaches as what the average guy gets doesn't tell half the story. And I have given up seeking comfort from strangers. Most people simply don't care.

My headaches can be mild, or they can be as severe as "migraine". And I sometimes say that. But, ethically, I never say "I have migraines" because (a) clinically I don't and (b) I don't want to jinx myself.

But if I say "they're not migraines" people automatically assume I'm not disabled by them, that they aren't "that bad", etc. It would be so much easier if I could just say "I have migraines", because people can relate to (or are aware of) the level of pain and disability associated with this condition. My headaches debilitate me, disable me, and kick my joie de vivre out of the house. They make it very hard to work, to function normally, and to participate in a fullsome life. They disrupt my thinking, reduce my intellect and destroy my interest in much of anything. My bloody head hurts, all the frigging time. Is that enough?

But saying "I have migraines" is usually met with "oh, you poor dear" and some much-needed sympathy. Ahh, wouldst be easier to suffer the migraine, methinks.

Now to change my tune:

Migraine sufferers don't have the market cornered on compassion either. They usually get trumped by someone's cousin/sister/mother/friend. Say in mixed company "I have migraines" and you'll be met by a chorus of "oh, my sister has migraines" or "my daughter has migraines", thereby dismissing your own sorry story. Many times in having a conversation about my headaches, I've just gotten started when I hear a 20-minute litany of stories about so-and-so's migraine problem. They soon forget what I was saying.

Maybe I'm just looking for praise or compassion or something. An acknowledgement, maybe, of the crap I put up with every day. I look normal, and since I don't wear a scowl on my face every day, I guess I seem healthy-enough to an untrained bystander. So, no one I work with, for example, even bothers to ask about my headaches. They could care less. But when I think about it, do I care about their high blood pressure or diabetes? Yes, but not enough to ask. Maybe I think it isn't my business. But likely, I just don't think of it.

It makes me realize: we're most interested in our own stories.

My boyfriend is the only one who asks how I am. Every day. And I so appreciate the acknowledgement he gives me. And my Mom asks too, but she's far away and it slips her mind sometimes, because she doesn't see the effects. But sometimes you want someone else to care, someone to take an interest. Someone to ask questions. No one does. Except for other headache people who just want to pump you for information (just kidding my lovelies).

So I'm tired of Migraine People getting all the sympathy. Ok, not really, but it just seems easier to have a label people can understand. P.S. This is an invitation for migraineurs to write and tell me "no, it isn't any easier, princess, so stuff it!"

A Migraine Example: on Sunday, David and I went for Easter dinner at his brother's house. His brother and his brother's lovely wife (LW) hosted us and David's Mom for a wonderful dinner. I experience headaches Every Single Day and yet no one asks me, ever, about my headaches. Not their fault, right? No one thinks of it (not even my own family). But arriving at the door, we were informed that "LW is getting a migraine and is upstairs resting". Now I don't want to downplay LW's headache. I bet it was a bitch. But LW was met with a lot of sympathy and clucking from all parties when she joined the party later on. She was encouraged to "go and rest" and fussed over, and so on. During the meal, my own headache was probably about a 7. And had been all day. I'd taken two muscle relaxants before going over there, and about two dozen Ibuprofen. I wanted to say (in a teeny voice) "I have a headache too"!

But it didn't matter. I was upstaged by A Migraine. Her first since August. Poor Thing.

Now I don't mean to be callous. I wouldn't trade my headaches in for anyone's migraines. But it's just an example of how chronic daily headache takes a back seat to people with Emergency Headaches who rarely have them and Make a Big Production. And we take a back seat to migraine too. But you can't really fault people. As humans, we are most interested in our own problems, which you can tell from any conversation where we try to out-do each other and not really listen.

And I'd probably be bitching non-stop if my wrist started aching every day, but plenty of people live in silence with arthritis. Or asthma, or MS, or back pain, or rheumatism, or sciatica, or....a zillion other ailments that people don't get praised for tolerating like the noble souls that they are.

But the truth is, not getting acknowledged once in a while can hurt. It's a tiring journey, bearing the load every day, and sometimes a little credit would be nice. A kind inquiry as to our health would be nice. Then we could be Trooper-of-the -Year and say "I'm doing fine" instead of whining, like I am now, pleading for attention.

But the more I write, the more I realize how many people there are in the world who suffer in silence. Or are caregivers to those who do. You're all saints in my book.

So that's my vent. I hope the Migraine People don't hate me. This blog was meant to be funny, with a little kernal of the truth inside the hard shell. I wouldn't trade my headaches in for anything (except maybe relief), because at least I know my demon. But sometimes, it could be easier. Or maybe just different. Or maybe this is as good as it gets and I should be thankful for being so well that no one notices.


  1. I can imagine how difficult it is to explain just how painful the condition is to someone who doesn't understand the distinction. I can also imagine how hard it would be to be in that situation with LW getting sympathy for an episodic migraine when you're sitting there in pain as well, and nobody says a word about it. That would just plain suck. Sometimes people are just oblivious to each others' needs :(

  2. I used to have chronic migraines (I was having at least 2 a week plus the headaches) and you certainly haven't offended me ;)

    But you are exactly right--I think the majority of people who get *a* migraine or *a* headache now and then just don't get it. And the media sure does minimize our pain as well.

    Have a headache? Take an excedrin. Have a migraine? Imitrex will fix it!

    But it's not that simple for us--or anyone with an "invisible illness" (and I have 2 others besides CDH).

    For what it's worth, I care about your pain. (((Hugs)))

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