When I talk about migraine disease and the effects the attacks have on me and my day-to-day life, I tend to focus on only two of the four phases of migraine: the aura and the “attack” phases. This is likely because the aura phase can be one of the most disabling stages for me, personally, and the attack phase is the most understood by those around me. The outer two stages, however, shouldn’t be disregarded, especially at times of chronic attacks.
When I’m chronic, my migraines attacks bleed into one another. Sometimes, I can’t tell if I’m in postdrome or prodrome, until after one becomes the other and I’m experiencing a new aura. But I’m working to get better at it.
There’s a part of me that believes that knowing the exact moment the postdrome switches to a new prodrome will enable me to take actions that may curtail the severity and length of the new attack. Unfortunately, so many of the symptoms of the two phases are the same, especially fatigue and cognitive dysfunction. It’s hard to tweeze them apart unless I’ve had a good day or two in between.
Right now, for instance, I am struggling to work. I woke up exhausted, stiff, and sore, and I’m having trouble concentrating. I’m irritable, and my right hand and tongue have the feeling they get in the time before the tingling and weakness actually start. My right temple and right eye also are offering a harbinger: a nice burning sensation that’s more cautionary than painful.
I’m quite obviously in prodrome, and, for me, that means I’m going to be in aura soon. My prodromes never last very long. But I really only know this because I haven’t had an attack for the past 36 hours, which means I’ve had time for the postdrome from my last attack to wind down. If this had happened yesterday, I may be thinking it was still part of the last attack.
At times like this, when I’m very chronic, and the attacks come nearly every day, I am reminded again of just how disabling the buffer zones of migraine can be. This is when I should be able to work, I think. To catch up on all the things I let fall to the side while I couldn’t see well and felt dizzy, weak, nauseous, and in pain. And yet, I still can’t function at top form.
I’m still struggling to keep up. The fatigue, brain fog, confusion, and overall slowed comprehension of the outer stages make everything take twice as long as it would otherwise (and use up twice as many spoons). I’m learning the buffer zones, while providing a nice reprieve from the pain, nausea, and sensitivities of the other stages, are nothing to be ignored.
How do you manage the prodrome and postdrome stages of your attacks? Can you easily distinguish them or do they seem to bleed together? Please let me know in the comments below.
(Photo courtesy of Migraine Buddy: http://www.migrainebuddy.com/migrainesymptoms-the-stages-of-a-migraine/)