| First, tend to your migraine and then enjoy your
vacation
By Denise Dube, Globe Correspondent, 6/6/2004 According to the International Headache Society, one out of every 20 American women suffers regular migraines. These aren't just headaches, but the kind of searing head pain that can cause loss of sight, put you in bed for days, cause you to cancel events and work projects, and even make it impossible to make a simple pot of coffee. Migraines, more common in women than men, are a vascular headache caused by chemical changes in the brain. Those changes constrict the arteries that supply blood, causing severe pain, stomach upset, and a host of other symptoms. One would think that traveling would be out of the question for someone who suffers migraines. I like to travel, however, so knowing that a migraine can strike at any time, and usually has some sort of cycle or trigger, I prepare for travel jaunts in ways that will, I hope, prevent interrupting a trip. No one likes to sit on a tour bus beside a fellow passenger wearing a bright blue ice pack and moaning every time the bus hits a pothole. Tour directors, trying to show you every side street and seashore, aren't likely to want to pull over while you heave on the side of a historic road somewhere. Last year, on a trip to Montepellier, France, I was on a plane in which each seat had a screen for movies, video games, television shows, all free with the mere push of a button. It was a luxury experience -- for anyone without a crying baby or a migraine. My babies are grown. Instead, I had the migraine. So, I wore a dapper ice contraption that the stewardess and I fashioned out of a plastic bag and one of those eye masks with the elastic ear bands. We stuck it on my head somehow. I took my regular medication and spent the eight-hour journey in agony. Fortunately, my friends did not take pictures. I'll never know if the other passengers did.I felt better a few hours after we landed and within 24 hours, with medication and the support of my friends, I was able to enjoy the remainder of the trip. A few months ago, I was scheduled for a seven-day writing assignment in Ireland. I wanted to follow that with a week in Italy. I was worried. Two weeks is a long time for someone who suffers with regular migraines. It was a sure bet that I could not go 14 days without an attack. My neurologist, Carolyn Bernstein, director of the headache clinic at Cambridge Health Alliance in Cambridge, worked with me before the trip to ensure that, if I did have a migraine, I would have a plan. ''Everybody who has migraines should have a rescue medication," Bernstein said, referring to the preparations that can help alleviate attacks. Migraine sufferers should ''meet with their headache specialist before they go and have medications that they know are going to be effective," she said. They ''must also be really tuned in to triggers, such as time change, food, and weather," which also can cause migraines. Bernstein, who is also a Harvard Medical School neurology instructor and medical director of Medical Specialties at Cambridge Health Alliance, said that advice goes for anyone who suffers migraines, even if they never travel. ''They should use that drug when they are in severe shape, but they should absolutely have something that will take the pain away even if they know it will make them feel sleepy or tired," she said. Once a migraine strikes, there are other solutions to accompany the medication. ''It's really important to drink a lot of fluid, to use ice, to acknowledge you might miss something exciting," Bernstein said. ''But it may be better to go to bed and sleep the migraine off and then enjoy the rest of the vacation." Most attacks last less than 24 hours. Still, Bernstein suggests having a migraine care plan signed by your doctor before you leave in case the headache is unusual or unrelenting and a doctor or hospital visit is necessary. The migraine care plan will let the doctor know you suffer from regular attacks, and the health care provider can react accordingly. I have learned, as have her other patients, that if you get migraines and you like to travel, it's best to be prepared. Denise Dube is a freelance writer in Lexington. This story ran on page M10 of the Boston Globe on 6/6/2004. © Copyright 2003 Globe Newspaper Company.
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