Podcast #43-Chapter Four- Not My Mother’s Menopause

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I mentioned a couple things at the start of this week’s podcast. First and foremost, Anna landed her first real-world job! She starts only a few days after graduating in May! We are overjoyed for her and couldn’t be prouder.

I’d also like to ask that you all surround my beautiful friend Kristen and her family (our soul family) with love and light. They are going through a tough time right now, so please keep them all in your prayers and loving thoughts.

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The topic of today’s chapter is chronic pain and migraines that I had during my perimenopause. Takeaways from this chapter include the following two recommendations: have your hormone levels tested and get yourself whatever type of serotonin you can get your hands on during perimenopause (and menopause).

I also want to introduce you to NAMS, The North American Menopause Society. I meant to share that in the first podcast post of my book reading. You do not need to be a member to use this website. This is where you may find Menopause Practitioners, which I mentioned in Chapters 1 and 2.

North American Menopause Society (NAMS) – Focused on Providing Physicians, Practitioners & Women Menopause Information, Help & Treatment Insights

Here are some sources that can provide you with further information:

13 Scientifically Backed Ways To Increase Serotonin Naturally

Serotonin: The natural mood booster – Harvard Health

And this is the migraine treatment center that I mentioned:

Diamond Headache Clinic – World leading headache care.

Patients come from all around the world. So, if you suffer from migraines and do not live near Chicago or Milwaukee, they will help you regardless of where you live.

As always, the complete text of the chapter may be found at the top of the blog under the Menopause menu, or by clicking here.

Thank you to everyone who has taken the time to listen, read, or leave comments. Your encouragement means the world to me.

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Chapter 4

Beneath the Ice Packs

The shower water battered my skin like hailstones.  

“Perhaps if I run cold water over my head, I’ll be able to get rid of it all,” I convinced myself. 

I’m in so much pain so often that I can’t recall where I begin and where pain ends.

Is this pain a life lesson? Is it my fault that I’m suffering? 

My youngest daughter recently asked me, “Do you need a migraine today, mommy?” She refers to migraines as if they were a much-needed hug or a chocolate chip cookie.  

She’s so little, so unaffected. My oldest daughter, on the other hand, is not unaffected. She is a teenager, and she’s aware of everything that’s going on with her mother. 

THIS ISN’T FAIR! I want to yell. I HATE THIS! I wish to scream. WHY AM I GOING THROUGH THIS? I want to holler. IF IT TAKES TEN YEARS OFF OF MY LIFE TO MAKE THE PAIN GO AWAY, I DON’T CARE! I want to howl. 

Instead, I burst into tears. Until my entire body begins to quiver, heave, and quake.

I’m sobbing uncontrollably, snot streaming down my face, and the water from the shower lapping on my back. I’m so engrossed in my emotional rapture that I’m not aware of how loud I’m being until my 15-year-old daughter storms into the bathroom and opens the shower curtains. 

“Mom! What’s wrong??” she yells. 

I wipe my eyes and try to hide my tears. I feel like she’s caught me doing something shameful.  

“I’m so sorry,” is all I can say to her through sobs. She approaches me and hugs my naked, wet body, which causes me to cry even harder.  

She, too, starts crying.   

“Don’t worry, mama. It’s okay,” she says. 

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During my adolescence and early twenties, I was quite lucky in that I seldom experienced migraines associated with my monthly periods. My first migraine attack occurred when I was in my mid-thirties. When I was 36 years old, I began using migraine medicine for the first time. I began seeing a neurologist when I was 37 years old. When the MRIs came out clean, it was assumed that hormones were the source of the problem.

My migraines became an issue during perimenopause. 

A major issue.

An issue from which I’m still recovering. 

They began interfering with my daily life. I started canceling plans in order to avoid being too far away from home. I became afraid and obsessive over details such as which foods could trigger a migraine attack. I’d wake up fearful that my entire day would be ruined by pain. My migraines became like another member of our family, as if they were a permanent resident living in our home. As a result, I grew increasingly bitter, restless, depressed, and resentful. Migraines had seized control of me and every action I made. My life no longer belonged to me. 

My neurologist’s annual battery of tests always came back normal, which never made me feel better. I wanted something tangible to explain why I was in such excruciating pain. I would actually prefer a test that revealed a brain tumor so that it would make sense. At the time, I was so desperate for pain relief and an answer that I couldn’t see why that reasoning didn’t make sense, because perimenopause did not feel like a sufficient explanation. That seems fabricated, like I opted to have a playdate to avoid doing responsible adult things.

During my five years of perimenopause: 

-I was prescribed 11 different migraine preventives, ranging from anticonvulsants to beta blockers, calcium channel blockers to injectables, antidepressants to blood pressure medications. 

-I altered my diet and experimented with yoga and targeted exercises. 

-I went through intensive physical therapy. Twice. 

-I experimented with essential oils and sought ‌a well-known local acupuncturist. The oils were beneficial (I don’t sell them), but the acupuncture was not. 

-I followed every suggestion made by my doctors, specialists, physicians assistants, and nurses. I took my medications exactly as recommended, and I never missed a dose.

Still, my headaches persisted.

By the spring of 2020, I was averaging three manageable migraines per week, two tension headaches thrown in for good measure and one knock-me-down migraine every month. The knock-me-down migraines would last up to fourteen hours and none of my pain relievers would touch them. I was using cannabis at the time, and even that wasn’t helping, but I hadn’t gotten to the point where I needed to go to the emergency room for pain relief. 

For years, I read in migraine support group feeds about people who had to go to the emergency room to receive pain relief. They would share stories of being treated as if they were a drug addict in desperate need of a fix. Some of those migraine sufferers visited the emergency room on a monthly basis for pain relief. Hearing their tales helped me feel less alone, but also better about my own suffering. At the very least, I would convince myself, I could manage my pain.

That is until May 2020.

On a Sunday evening, the migraine began. I spent the entire night writhing in pain—so much pain, in fact, that I was in and out of consciousness at various points. I had a difficult time getting to the bathroom and ended up falling off the toilet early the next morning. That’s when I called for my husband and asked him to take me to the hospital emergency department.

My primary concern the entire time I was there was that I wouldn’t be able to get rid of the pain. I continued telling them I was still in pain. “Can’t you give me more?” I asked. They stated they had reached a point where they would have to admit me to the hospital in order to provide me with more. This was at the start of the pandemic, when no one wanted to be inside a hospital. They finally got rid of my pain after six hours of IV fluids and pain medications. 

But the real battle came when I returned home. In my mind, the pain threshold I had never wanted to cross was no longer there. I had no idea when perimenopause would end. My anxiety was telling me that my migraines, like perimenopause, would be a permanent part of my life. This emergency room visit was confirmation of that. Because of this mindset, I ended up experiencing 25 consecutive days of pain after the emergency room visit.

On the evening of day 26, I took all of my pain relievers and some cannabis edibles before going to bed. My judgment was impaired by neuroticism, pandemic fatigue, and utter mental exhaustion. That night was filled with sleep disruptions, strange dreams, and fear. My heart was racing, my ears were ringing, and I was violently shaking. I eventually fell asleep around four in the morning. 

The next day, as my husband was getting ready for work, I clung to his shirt. During the pandemic, he’d been working long hours in a front line position. He keeps this family financially afloat, but I desperately wanted him at home at that moment. I asked him to risk his job and stay home, which was unusual for me. 

I was tired of wrangling with doctors and pain medications. I needed help, and I needed others to recognize that I couldn’t do it alone anymore. I’d been putting on a show for almost five years, pretending I had everything under control. I could run a household, care for the children, do the things, be the one person to all the people, and keep my pain to a respectable level. Occasionally, the pain would inconvenience others. To be clear, it was always an inconvenience to me. But when it got out of hand, I couldn’t take it any longer.  

I’d become numb to the prospect of hope as a result of my near-constant pain. Ironically, I’d become numb to everything except physical pain. I’d wake up every day terrified to be optimistic for fear of being rewarded with a headache later, as if the Universe was listening and would punish me for my optimism. I was frightened of being in pain, and I had no idea how to stop myself from hurting. By the fifth year of my perimenopause, I almost didn’t want to live any longer. 

I was just done. 

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Many years ago, I learned about a specialized headache clinic in Chicago. I never considered calling since I didn’t believe I’d be a good fit. Perhaps I assumed it wouldn’t be covered by insurance. I also didn’t think I needed special migraine treatment. Yes, I realize how absurd that sounds. I suppose I didn’t want to admit to myself how severe my pain levels had become. I didn’t want to accept how addicted I’d become to my pain relievers. It would’ve required me to acknowledge failure or some kind of weakness during a phase of great vulnerability. 

My headache specialist is patient and understanding. He assures me that I will have as much time as I need throughout my appointment. At one point, he looks me in the eyes and pauses typing into his computer to listen to what I’m saying. I’m not sure why this gesture makes me cry, but it does. He offers me a tissue and tells me to continue when I’m ready. His intent to focus on me and see me in this vulnerable condition feels genuine. 

After hearing me, he begins questioning me about my personal history, migraine and neurological history, and perimenopause. We go through my whole hormonal history, and he informs me that there is a reason why my migraines are getting worse. My body was losing estrogen, and if his calculations were true and based on what I’d told him about my medical history, my body doesn’t deal well with low estrogen levels.

My hormonal headaches always occurred at the end of my menstrual cycle, when my estrogen levels were at their lowest. The closer I got to the end of perimenopause, the less estrogen I had in my body. The less estrogen I had in my system, the worse my migraines were. 

But that wasn’t the only issue; he felt I also had low serotonin levels as a result of my low estrogen levels. Serotonin is the good shit; it helps us feel good and creates a feeling of well-being. One of the functions of estrogen is to increase serotonin and the number of serotonin receptors in your brain. When you lose estrogen, you lose that connection with serotonin. For me, it was creating a cycle of sadness, depression, pain, repeat.

He said that women in perimenopause are overlooked and misunderstood. For the first time in five years, I felt like a person rather than a statistic or a number on a chart.  

I cried a lot throughout this appointment. I also felt heard and seen during this appointment. For a long time, I held shame in my pain, as if not handling it made me a horrible mother, wife, or daughter. I felt I had to be able to manage my suffering. When I was in perimenopause, I had no control over my discomfort, my emotions, or anything else happening within my body. Having a doctor validate my anguish by explaining why I was experiencing what I was experiencing felt very affirming.

A few weeks after meeting my new migraine specialist, I was struck down with a horrible migraine. My worst migraine to date, even worse than the migraine that brought me to the emergency room. However, because I now have a migraine specialist, he is able to give me stronger medicine over the phone to my pharmacy, something my neurologist was unable to do. That’s the part I recall. That, and the physical discomfort. 

I was in such excruciating pain that I was chanting things as if I were in a pain-induced coma. Every time I come in and out of consciousness, I can see my husband’s stressed-out face. I can hear my daughter’s apprehensive words asking him if I’ll be okay. It was the last time I had a terrible migraine. I can now laugh about it, but it was as if my migraine was saying goodbye to me with one final dose of migraine fuckery.  

My pain was caused mostly by a lack of estrogen and serotonin, but this was not the only cause. I believe that those two factors, together with years of negative thought processes, toxic behaviors on my part, and a horrible internal voice, all contributed to the severity of my migraines. It took many months of therapy, soul searching, and antidepressants to reach that conclusion. It wasn’t until I found a headache specialist and started taking the right medications that I was able to see it clearly.  

Migraines forced me to miss so many important days; soccer games, horse shows, college drop-offs, and school concerts. I won’t be able to relive those experiences. All those years spent beneath the ice packs, thinking about those lost moments and lamenting how much I was missing, have helped me appreciate all the times when I felt fine outside of the ice packs. Those are the kinds of moments I never take for granted. I don’t think I will ever.

Despite the fact that my headaches are far less frequent these days, I continue to see my headache specialist every six months. Because I have faith in him, he has become my primary care physician. He noticed me when I was the most invisible. When you discover a doctor like that, you must hold on tight to them. If I could give you some advice, it would be to have your hormone levels checked regularly; serotonin in any form will be your best friend during perimenopause, and if you are experiencing pain, don’t suffer in silence. 

I miss the girl who didn’t have to scribble little m’s and h’s on her calendar to keep track of every migraine and headache day for the doctors. I long for the day when I won’t have to lug around a mini-drugstore in my purse. I also hope that one day I will be able to overcome my fear of pain. That I will be able to quit taking my preventive medications and enjoy my life without restriction. For the time being, my pain is being managed, but I am still at its mercy, my fear too fresh. Will there ever be a day when I don’t have to scribble little m’s and h’s?

Only time will tell.