'Will not a migraine very close to our vision blot out the glory of the world, and leave only a margin by which we see the blot?' – Middlemarch by George Eliot

When I was lying in bed last night, in pain, I was thinking about my 'normal' migraines – or what I've grown used for the last 18 months on Topomax. I think migraines have three components: physical, mental and emotional. Usually mine are more mental and emotional: I get dizzy and confused, unable to put a sentence together, inordinately tired and sometimes I get spots or lines in my vision (that's the mental side); and I get depressed, fatalistic and weepy (the emotional). This time it's been mostly physical – lots of head pain, muscle tension and nausea with a little bit of tiredness and confusion.

Since I'm delusional and too analytical for my own good, I began wondering which component I preferred, or was least bad. If I have to get migraines, which symptoms do I want? Stupid, I know. My answer was: none! I want none. Whichever set of symptoms is dominant at the time of questioning, that would be my least preferred, whatever I wasn't experiencing too much I would say wasn't too bad and I could handle. (I.E. for this migraine, I think the emotional stuff's easiest to deal with, then the mental and physical is the most all-consuming of the symptoms. But that's not usually true for me.) This near-sighted version of each migraine is another symptom, I know that. Every migraine I have is the worst one, and never-ending, while I'm in it.

Migraine, migraine, go away, come again some other day. – Childhood chant

I'm ready for this migraine to move on. It's day three. I'm getting to the point where I'm not completely hazy so I'm starting to feel frustrated at the hinderance to my life. Day one I coped: I took various medications; I went to work and ignored it; I didn't tell anyone. Day two I wallowed: I called in sick; I cried in bed; I saw my chiropractor/acupuncture duo; I clung to my husband. Day three has only just begun so I don't know how it will pan out yet. Maybe I'll go back to ignoring it so I can enjoy the weekend with my husband. Maybe I'll get so sick of the pain I'll take all the drugs I can think of, at once, and pass on the bed with the hope of waking up clear again. Maybe I'll guzzle gatorade, have sex, meditate and do any other at-home, alternative remedy I've ever heard of.

'I shall take the heart… for brains do not make one happy.' – The Wonderful Wizard of Oz by L Frank Baum

I am almost off the Topomax – down to a half pill per day. But I am having doubts about whether I can cope without it. That makes me sound like an addict, which gives me another reason for not wanting to be on daily pharmaceuticals. The self-doubting voice in my head is picking up on every 'off' moment and headache. It's asking me if I'm feeling like this now, how will I feel when I'm fully off the medication. And the most telling moment came this morning. When I was about to cut my pill in half, I caught myself thinking: it would just be easier to take the whole thing, one pill is still better than the two I was on before, and I would probably feel better over time with the help of Topomax.

I didn't really expect to have to deal with mind games as well as potential migraine symptoms when I went off the medication. I don't remember this sort of thing, or not to this degree, when I went of daily beta-blockers or other chronic migraine medications. Perhaps I've just blocked it out and moved on. I'm hoping it's helpful to record these mental struggles here so that in the future I (and others?) are wary of the wider implications of these medications. Also if I read, in black and white, things like this morning's inner dialogue, hopefully will give me the motivation to continue toward alternatives to pharmaceuticals.

'The chief proof of man's real greatness lies in his perception of his own migraines.' - The Sign of the Four by Sir Arthur Conan Doyle

I've had my New Year's resolutions for about two weeks now and I feel like I should confess how I'm doing to hopefully push myself to do better. Usually when I'm trying to start a new habit I bribe myself with money that I can use on fun, off-budget purchases. I haven't set up anything like that this time, which might be why I'm having mixed results. I am drinking more water, at least a litre and usually the 1.5L that I'm aiming for. I am in the process of weaning off Topomax and have been taking a pill that has things like feverfew, valerian and butterbur daily. I have meditated a few times, but not three times a week. I usually feel good when I meditate (or do yoga), but I often find other, more 'productive' things to do when I first wake up or in the few extra minutes before I leave for work. Finally, other than the herbal pills (and my normal restricted diet and monthly chiro/acupuncture) I haven't tried any new remedies for migraines. It's partly because I want to stabilise on the non-pharmaceuticals first, partly because I haven't had many migraines in the last few weeks. I have been trying to record my migraines, but am discovering that it's often hard to know what to write down: which of the many variables from the past 24 hours contributed to this migraine? is this a migraine or just heatstroke? when does one migraine end and the next begin? I guess like everything it's a work-in-progress.

'Of course there must be lots of Magic in the world… Perhaps the beginning is just to say nice things are going to happen until you make them happen.' – The Secret Garden by Frances Hodgson Burnett

Findings were released this week about the effectiveness of placebo pills and patient's expectations in relation to migraine pain relief. (One of many articles can be read here.) I find it interesting but not surprising that our brain 'trick' us into feeling better than medicine alone. Given that this week I'm going to start weaning off Topomax, I'm wondering if I can convince my brain that it doesn't need to give me migraines in the process. Even if I can't do that, it would be nice to convince myself that feverfew and lavender are an effective substitute. Fingers crossed.

'Those who gave thee a body, furnished it with migraine; but He who gave thee Soul, armed thee with resolution. Employ it, and thou art wise; be wise and thou art happy.' – Akhenaton

I'm going to do something this year that I haven't done before: make migraine New Year Resolutions (and no others). This is with the hope that it will help me continue to get a handle on my chronic migraines, but also improve my quality of life.

As it stands right now, I've been on Topomax daily for about fifteen months and been sick on and off for about fifteen months. My migraines have been pretty manageable, which is good, but I have been losing weight and struggling under constant minor illnesses. I don't know if the two are related, but anti-epileptic medicines are pretty heavy-duty and hopefully my resolutions will help with overall health, not just migraine-maintenance.

My resolutions are:
1) Drink more water – 1.5L is what the calculations seem to say I should be drinking.
2) Replace Topomax with herbal migraine prophylactics such as feverfew and lavender – the caveat on this one is that my quality of life needs to be the test. If these herbals don't sufficiently control the migraines, then I'll re-evaluate.
3) Do more meditation/yoga – aim for three times per week (or more).
4) Try a variety of anti-migraine alternatives throughout the year and record the results – approach them open-mindedly, try at least six this year.