why CHOCOLATE is just fine, and other incredibly useful things I learned from Dr. Christine Lay

A few weeks ago I went to the Women’s College Hospital Headache Centre to hear a lecture by the centre’s director, Dr. Christine Lay. I found myself in a room with mostly women, my age and older, wearing name tags and eating dry mini-carrots in awkward silence. I wondered if they were migraineurs like me, or if the lecture was for medical professionals and I had been let in by accident. I only had to hear the first words out of Dr. Lay’s mouth to know I was not an impostor. Her welcoming, compassionate, and matter-of-fact tone inspired the group’s confidence as she dove into some fast-paced myth-busting and plain-language explanations of the disabling beast that is chronic migraine.

Here is my interpretation of, and reaction to some of the incredibly helpful things she said:

On the migraine brain:

It is inherited. It is a lifelong disorder. There is no cure, but there are many management tools out there, some of which are brand-spanking new. Chronic migraine is one of the most disabling, misunderstood, and mis-diagnosed disorders around.

I already knew this, but man, it was nice to hear it from an authority on the subject. In order to go about my life without feeling majorly disappointed every other day, it has been freeing, and critical, to understand that there is no point in trying to fix myself, or hope that anyone else will fix me. I am not broken. I have a hyper-sensitive brain that is helpful for smelling the compost from the other side of the house, and really unhelpful in the pain department. Learning to cope is realisitc. Wishing for a miracle is not.

Why migraine can be so disabling:

Having a “hyper-sensitive brain” is a full time job. So for many (like me), even when we’re feeling pretty good, the threat of the next attack is always there, and it affects how we move through the world 24/7.

Also, a single migraine attack might mean severe pain for anywhere from a few hours to a few days, but the prodrome and postdrome symptoms mean things like fatigue, confusion, and depression make the time in between attacks pretty crappy too. Basically, two attacks in a week can mean a migraineur has been in a fog all week. Other people experience this! I’m not crazy! Phew!

Dr. Lay did this fantastic job of explaining how the migraine pain takes hold of the brain. I can’t do that explanation justice, but what stood out to me was that once the pain signals make their way to the brain stem and create a chemical pain soup, things that are normally not painful become painful. Regular old touch, smell, sight, and hearing hurt. The brain can’t filter stimuli, so everything intensifies. Yup. That thing that happens when my bra turns into a boa constrictor? It even has a name! Cutaneous allodynia! Not crazy.

She also busted the theory about swelling/constricting blood vessels (vasodilation). Apparently this doesn’t have to happen for a migraine to be in session, and certainly is not a cause or trigger.

Management tools:

I sort of had these figured out already, but it was helpful to have them all laid out at once. She basically said to…

-eat tons of protein, especially first thing in the morning, and often to keep blood-sugar as even as possible

-avoid alcohol, caffeine, sugary things

-maintain a regular sleep schedule (no napping! bummer)

-beware of preservatives and dyes and other synthetic stuff

-stay hydrated

-watch out for pain meds and triptans.. most of them will actually make you feel worse via medication-overuse pain if you take them too often (like, more than twice a week or even less)

-practice some sort of mindfulness activity regularly (she referenced a study that showed meditation can actually physically change the brain and calm hyper-activity. Pretty cool.)

Someone asked her about the low-tyramine headache diet –that one that I’ve been on for almost a year making me the most annoying house guest and pickiest grown-woman eater on the planet– and GUESS WHAT SHE SAID? She said there is some scientific evidence for it… seritonin in the gut…etc… but that it hasn’t made a difference for her patients. She said sure, watch out for patterns, and avoid super aged cheeses and meats, but mostly, focus on getting a good variety of additive-free nutrition.

HELLO avocado, I’ve missed you. What’s that, banana? You’d like to get in my smoothie? Be my guest. Trail mix? Don’t mind if I do!

THEN GUESS WHAT SHE SAID??? She said that chocolate is not a migraine trigger, but rather a tricky correlation because the hormone fluxes that can trigger migraine can also trigger chocolate cravings. (WEB MD says this too.)

Got that? Rich, dark, pure, sweet heavenly chocolate IS NOT A MIGRAINE TRIGGER.

So then obviously I ran home and did this: Image

Sort of.

Anyway, I’ve been eating tyramine-filled foods and dark chocolate galore for a couple of weeks now, and there has been no change in the intensity or frequency of my attacks. Amazing!

She went on to list a whole slew of drugs and therapies out there including everything from Botox to new space-age electro-stimulating headgear. This list gave me hope.

With an anecdote about treating a young patient who was ready to throw in the towel and sign up for long term disability, her final message was this:

Don’t give up or the migraine wins.

She said it twice. This made me cry in public. Again. Damn.

My first appointment with a neurologist at the clinic is next week. On that day, they will start to work with me to find a more effective treatment plan with the goal of reducing my pain by at least 50%. I am so, so grateful for people like Dr. Lay, who are working like mad to study and treat conditions that are complicated, frustrating, invisible, and from a Western medicine perspective, just not sexy. And I can’t wait for next spring when I go to hear the same lecture just so I get to sit in a room full of people who feel exactly the same way.

(Image source unknown/not filtered by licence)

6 comments

  1. Amazing post! I’m SO happy for you that you received an injection of hope as well as an injection of chocolate!

  2. lynnesherman · · Reply

    Excellent post! I’ve been eating chocolate for years without triggering a migraine – I just thought I was lucky! My migraines are much more affected by weather changes rather than by food. I use medication as a last resort, after I’ve tried food, fresh air and exercise (when possible!), and meditation. But so many times nothing works, the migraine knocks me down, and I stop fighting the inevitable. I used to get so angry when a migraine kept me from doing things, but of course that just made it worse. Now I just lay quietly with a cold cloth on my eyes, and think of the Queen! 🙂
    Best of luck with the neurologist!

    1. Anonymous · · Reply

      Hahahaha!! Think of the Queen… Haven’t tried that yet.

  3. […] might not move me the same way as my past endeavours, but will move me nonetheless. It means eating chocolate every god damned […]

  4. […] CHOCOLATE. DON’T FORGET CHOCOLATE. […]

  5. […] Just the other day, we picked up a chocolate turkey while in Napa.  We didn’t go for the $250 super large life sized chocolate turkey, just a small cute one.  Still, this small, expensive chocolate turkey to bring to my parents house on Thanksgiving seemed fun.  And I have to say I may eat it all.  I may resort to yelling ‘Mine’ and running away with it, because an article was shared with me last week that said chocolate is not a migraine trigger.  It’s an article written by a professional, and I’m going with it!!!  See the article here:  https://migrainebrainstorm.com/2014/04/22/why-chocolate-is-just-fine-and-other-incredibly-useful-thin…. […]

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