Could not get up today . . .

March 21, 2023

Migraine life

I had every ingredient for a migraine yesterday (not enough sleep, faster run, full work day) and yep, by 6 pm my head was pounding.

Currently I get 3-4 migraines/month. Luckily, the prescription medication I use works each time; the only side effects are some nausea (though not sure if that’s the med or the migraine) + fatigue. It is always harder to wake up the morning after a migraine — med or not — and today was no exception.

I still hate these migraines and wish they would leave me alone but I guess this is the steady state I have reached. (I do think my hormonal birth control could be related but I don’t have other good options right now and also, I do not want PMDD back in my life so . . . here we are).

(Things I’ve tried: Magnesium, Migrelief supplements, electrolytes, increased hydration. None have worked and some have had intolerable side effects. Not saying they wouldn’t work for others, but just in case anyone was about to suggest them!)

my actual headache log in Apple Notes ugh

Some more positive things:

I wanted to mention this month’s Patreon session — the topic is Tough Parenting Moments, and let’s just say I did NOT have any trouble brainstorming a list! Laura and I will be going through different scenarios and there will be group input on what has worked (plus a lot of group commiseration, I’m sure – as we realize certain struggles are so common). It’s this Thursday at 12 pm Eastern and it’s definitely not to late to join our group.

(As an aside, in addition to our monthly live sessions, we’ve had a lot of action/fun participation in our message board style threads — it would be a great social media alternative for anyone looking for something more finite and personal than the vast FB/IG/tiktok landscapes).

Check it out here: BOBW

One more positive thing:

Since I’m not feeling so positive today, I’ll leave you with this lovely interview posted by Elisabeth!! This was really fun to do 🙂 Thank you Elisabeth for including me!!!


  • Reply Elisabeth March 21, 2023 at 8:41 am

    Ugh. So sorry you continue to struggle with migraines, Sarah. I had 6-months of on again/off again migraines when my oldest was a toddler and until that point I did not realize how utterly debilitating a true migraine (not the same as a headache…I did not realize until I started getting migraines!) really is – I would get nauseous and literally could not focus on anything other than the pain. I’m shuddering just remembering those migraines over a decade later (in my case Tylenol with codeine was the only thing that helped with the pain – it took me months to figure this out; eventually I went to a chiropractor which led to dramatic and almost immediate improvements, but I realize mileage varies with results from alternative treatments like this).

    I’m so glad the prescription meds help when you need them to, but here’s hoping things level off moving forward and your migraines go away completely. It’s hard to focus and work and enjoy life when battling an incredibly intrusive form of pain.

    And thanks so much for doing the “interview” on my blog!!

    • Reply Gwinne March 21, 2023 at 6:14 pm

      My.migraines are caused by any things but alignment/ neck muscle tightness are at the top…

      I hope you can figure it out! Mine are down to 1 / month after PT for neck issie

  • Reply J. March 21, 2023 at 9:28 am

    Zofran helps A LOT with the nausea (for pediatric migraine it’s sometimes the only Rx needed). And the tiredness may be the postdrome of the migraine, not a med side effect. You’re a champ at tracking so you probably have data on meal patterns, hydration, etc. which can help identify other contributing triggers. The key thing I’ve found is to take the rescue meds right away—don’t fall into the pattern of “maybe it will go away” because it probably won’t; you’re just postponing relief, not the migraine.

  • Reply Christina March 21, 2023 at 10:54 am

    Long time fellow migraineur here – digital hugs to you!
    If you’re getting more than 3 attacks a month, consider more detailed logging for symptoms, quality of life impacts, severity, which medication taken (especially avoiding overuse of triptans etc. An app can help cue you to write this level of detail down, and then export reports to your doctor as needed (I use “migraine buddy” which is free).
    Having such details helped me get a referral to a great neurologist, and then succeeding in my battles with insurers.

  • Reply Joanna March 21, 2023 at 11:17 am

    I feel like you’ve probably explored this (esp being an MD!) but I was getting occasional ocular migraines on the pill and they went away when I switched to an IUD at my Gyn’s recommendation. In case it helps!

  • Reply Sophie March 21, 2023 at 12:29 pm

    Oh no! As a previous monthly migraine sufferer (caused by hormonal birth control), 3-4 a month sounds awful. If you think at least some is caused by the pill, could you try going on antidepressants for a fortnight a month for the PMDD (I remember from your BOBW ep that was the alternative option). I’m on an SSRI for anxiety and it works beautifully with zero side effects. Just a thought. Anyway hang in there, and I hope they ease off soon.

  • Reply Rebecca March 21, 2023 at 2:12 pm

    Hello! I’m sure you have already considered esp being a physician, but I cannot take hormonal birth control anymore because of a blood clotting disorder found during TTC. Since we are done having kids, my husband got a vasectomy. Funny enough, since I’ve been off BCP, my PMDD has actually gone away. I used to take an antidepressant on certain days of my cycle, then later on I had to switch to a different one daily, but I am off of them now and don’t really have symptoms anymore.I actually feel better off all hormones- Pills and pregnancy haha- This may not be related to your personal situation but wanted to tell you just in case! 🙂

  • Reply Omdg March 21, 2023 at 4:27 pm

    No advice, just sympathy. I get ocular migraines about twice per year. They have not been affected by birth control variety (or no birth control), but taking 800 mg ibuprofen gets rid of my symptoms reliably. My triggers are… being outside? Going for a walk? Idk. So I always try to have ibuprofen nearby because it’s hard to see through the shiny shimmery lines. Maybe your symptoms will get better when you go through menopause? That would be something to look forward to!

  • Reply Caitlin March 21, 2023 at 9:37 pm

    You should consider the newer infusions. They are really effective and minimal side effects!

    • Reply Sarah Hart-Unger March 22, 2023 at 6:21 am

      I think the medication I take is in the same family – calcitonin gene-related peptide receptor antagonists (CGRPs). I think some of the infusions just have a longer half life . . . I fear taking something that would be in my system every day though if the frequency increases any further I would consider.

  • Reply coco March 21, 2023 at 10:22 pm

    so sorry to hear that migraine is still in your life. do you think running can cause/worsen migraine? I’ve never heard of that. but looking at your notes, many times it came with running days?

    • Reply Sarah Hart-Unger March 22, 2023 at 6:22 am

      exertion is a known migraine trigger. mine almost always show up on harder run days.

  • Reply Vanessa March 22, 2023 at 2:37 am

    I’m so sorry about the migraines! I’ve been trying to figure out how to deal with PMDD, but I’m really happy with fertility awareness (the Marquette method) as a non-hormonal bc. I just had an appointment with my gyn and I think bioidentical progesterone might be an option for the PMDD. I’m sure you’ve considered these options, but wanted to throw it out there.

    • Reply Sarah Hart-Unger March 22, 2023 at 6:23 am

      I’m definitely interested in exploring other options! Not really into the idea of taking OCPs forever anyway esp since I am over 40 AND have migraines occasionally with aura . . . not ideal.

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