Making Friends with Migraines

Illustration: Clayton Junior

Making Friends with Migraines

Nicole Freshée on what gets her through the most heinous of headaches.

The first time I had a migraine, my mom thought I was on drugs. Twelve years old, I called her from a restaurant pay phone and, slurring badly, said I was seeing spots. I spent the rest of the day vomiting and swearing that I hadn't smoked pot.

Since then I've become all too familiar with that woozy, dizzy feeling, which is called an aura. Its cascade of symptoms—tingly hands, the inability to say my own name, distorted vision (I'll look at a clock and see only half its face)—is just the beginning. What follows is ia stabbing headache so painful, it's difficult to stand or speak.

While my migraines descend only every few months, they tend to strike at the worst times: I've had to flee dates, skip a college final, plunge a syringe of meds into my stomach while driving on the expressway. When I got married, my biggest fear wasn't committing to my husband—it was being brain pained on my wedding day.

And so when I discovered I was pregnant last year, elation quickly turned to anxiety. The hormonal changes of pregnancy can trigger migraines, and I knew I wouldn't be able to pop anything stronger than Tylenol. Luckily, I went nine months without a headache—my longest-ever streak—but postpartum, I was slammed with several. With my husband at work and my breasts my daughter's sole source of food, I had to ditch my usual remedy of hiding in bed and summon the resolve to care for my baby.

I'd always believed in the mind-body connection, but this was the first time I'd considered it in the context of my own life: If I decided that I wouldn't let my migraines interfere with caring for my daughter and focused all my energy on making them go away, could it actually work?

One night about four weeks after Maya was born, I was trying to scarf down dinner before she started crying for her next meal. I had a forkful of salad halfway to my mouth when the aura hit. Instead of panicking, I went into the den, flipped off the lights, lay on the couch and talked to my headache. "You will go away," I said, closing my eyes and breathing deeply. "You will not affect Maya's well-being." I repeated the mantra for a few minutes. I didn't know whether doing so would keep the migraine at bay, but I knew it would at least help me stay calm and confident that I'd be able to fulfill my motherly duties regardless of how painful things became.

Unbelievably, it worked. While my headaches haven't magically disappeared, the mantra usually prevents them from progressing beyond blurry vision. There's no puking or searing pain, and—most important—my hands are steady enough for me to do what I need to do.

Making Friends with Your Immune System

Illustration: Clayton Junior

Making Friends with Your Immune System

A journey into Meredith Bryan's disaster of an immune system.

By February, my self-pity was thicker than the mucus clogging my sinuses. Sniffling my way through my fifth week of mutant upper respiratory infection, I was draining three neti pots per day before collapsing into bed slathered in eucalyptus oil. A few times I whispered nasally to my husband, "I'm dying."

Where was my immune system? Never tenacious—there's a picture of me at 12, clutching a box of tissues amid smiling relatives—it seemed to have abandoned me entirely. Did I sleep too little, eat too much cheese? But if so, how did my husband, who eats pizza at midnight and says he'll sleep when he's dead, elude our toddler's germs while I caught colds, the flu and rotavirus? (According to my doctor, I'm not even immune to chicken pox—for whatever reason, having it as a child didn't take care of it.) There's something almost Victorian about my constitution. I am a pale, sickly woman.

In March, I decided to figure out how to make my white blood cells show up for work. But when I called John Swartzberg, MD, infectious-disease specialist and clinical professor emeritus at the UC Berkeley School of Public Health, he was skeptical that I have a bum system. "Kids are germ bags," he said. "You're immune to every respiratory disease you've had, but there are hundreds." Okay, sure...but how to explain my spouse's robust health? Harvard Medical School immunologist Michael Starnbach, PhD, predicted that if he put cameras in my house, he'd see "differences" between my husband's behavior and my own. "Wash your hands more," he said.

If Western medicine thought nothing was wrong with me (except poor hygiene—hmph!), alternative medicine disagreed. Maurice Beer, MD, a Manhattan internist certified in holistic medicine, said illness results from disharmony in one's life and environment—"microbes, allergens, toxins, stress, trauma, nutritional deficiency"—and predicted that I may have "a multiplicity of these in play." Stephanie Propper, a Chinese medicine practitioner in Brooklyn, asked about my digestion, allergies and use of antibiotics, then concluded that several "organ systems"—the kidneys, spleen, liver and lungs—were "out of balance." She suggested I take an herbal kidney tonic and probiotic; nix gluten, sugar and dairy since "a lot of our immune system is in our digestive tract"; and try acupuncture for stress. (Swartzberg agreed that "stress appears to have a blunting effect on immune response.")

This plan was compelling. Here were things I could do. I'd become resigned to illness; perhaps my immuno-defeatism served as a sort of antiplacebo, ensuring that I caught every virus in the tristate area. When I suggested as much to Beer, he brought up "self-efficacy": our belief in our ability to control aspects of our lives, which affects the effort we put in and therefore the outcome. "People with little self-efficacy are much more likely to stay sick," he said (giving new meaning to the term head cold). It was true that I'd stopped trying to stay healthy. When my kid sniffled, I no longer popped a zinc; instead I panicked about deadlines I'd miss thanks to this new plague. Getting sick had itself become my biggest worry. If stress exacerbates illness, I'd been doing a great job of keeping myself miserable.

Chronic victim complex was not the diagnosis I'd hoped for. But most experts I spoke with agreed that there is much we just don't know about immunity: the role of intestinal microflora, for one. It was still possible that something was wrong with me. Propper had said I have lazy kidneys.

But as I told friends about my winter of wheezing, several said they'd been sick all winter, too. One had even—I can't lie, this made me jealous—gotten her doctor to administer vitamins intravenously. Maybe the story I'd told myself about my epic suffering was just that: a story. Maybe I don't get sick more than others. Maybe I'm just wussier about it. Maybe I need to wash my hands after exiting the filthy subway, before eating a muffin.

If our bodies are unknowable, our selves are, in large part, the ones we choose. I decided to make myself the hero of this tale. I will pop that zinc. I will lather up. I will rejoin the battle against illness, and I will, I imagine, feel better. And I will talk to you later—because if you'll excuse me, I'm going to bed early.

Making Friends with Doctors

Illustration: Clayton Junior

Making Friends with Doctors

When it comes to Lea Goldman's health, there's one thing she won't do: settle.

Our eyes lock. The connection is unmistakable. Just five minutes ago we exchanged introductions, and now I'm slipping off my clothes as he takes stock of my body. There are no distractions, no interruptions, just the two of us. He sweeps my hair to the side, leans in while pressing the small of my back and says softly, Breathe for me. Yes, that's it.

Welcome to my fantasy doctor's appointment. And for years, it was just that: a fantasy. Between the interminable waits and the drive-through consults, a visit to the doctor felt like the blind dates I'd endured as a singleton: I'd be desperate to capture his attention while he clearly had somewhere else to be. I used to play the fool, sticking with the same doctors no matter how many times they treated me with hurried indifference. Can you blame me? Switching is such a pain—trolling for referrals, waiting weeks for the appointment, filling out endless forms. And worst of all, transferring medical records, which feels like asking your ex to give back your Van Halen concert tee.

I'd resigned myself to unsatisfying relationships until the day my GP kept me waiting an hour and a half for a checkup, then spent all of 12 minutes with me. I deserved better. So I ditched all my doctors—the gyno who used to want to know how long I'd been in a relationship because "if he hasn't asked you yet, he's not going to"; the Ferragamos-and-fur derm who was cruel to her staff ("I'm pretty sure I've told you not to do that, what, a hundred times already?"); the waka-waka cardiologist who cracked jokes while we talked about my high risk for heart disease.

I went on the hunt for spectacular doctors I could settle down with. I was unapologetic about my prerequisites: must take my insurance and treat me like the center of the medical universe for a solid 20 minutes; must have a pleasant disposition—no socially stunted physicians for me. Bonus points for practices that made appointments online and shared test results via email. The search hasn't been easy. But I've spent hours comparing broadband packages, colorists, brunch spots—why shouldn't I invest as much in my own health?

My husband joked about that Seinfeld episode in which Elaine is designated a "difficult" patient and gets blacklisted by other doctors: He said the secret society of New York doctors would to do the same to me, and I'd never be able to book an appointment again. But I think my high standards have transformed me into a model patient, well prepped with my medical history and specific questions so I can make the most of my visits.

So far, my vetting process is paying off. After road-testing three ob-gyns, I managed to find the most incredible guy. He waves to me from his exam room when he sees me in the office and always recalls details from my last visit ("Good, you're not wearing those crazy heels anymore"). In my ninth month of pregnancy, I got once-in-a-lifetime work opportunity that would require me to spend a night in D.C. He warned me about the risks of traveling, but when he saw how much the trip meant to me, he helped map out a route to the nearest hospital and gave met he name of an obstetrician friend to call in case I delivered there. That's when I knew: He's the one.

Making Friends with Hypochondria

Illustration: Clayton Junior

Making Friends with Hypochondria

The Internet need not be the death of you, says Noelle Howey.

For years, whenever I experienced the mildest twinge of discomfort, I consulted Dr. Google. I'd always been a diligent student, and the glut of information was irresistible. Unfortunately, I was also a worrier, and every search turned up the same result: My days were numbered. If I had belly bloat, I never blamed the five-bean kale soup; I typed "bloated stomach" into Google (a.k.a. and prepared for the end.

The turmoil wreaked havoc on my diet. (When every evening meal could be your Last Supper, you might as well eat the entire pound cake.) It also destroyed my sleep. (Did you know insomnia can be a sign of Parkinson's? You're welcome.) But when I ran to the doctor, she'd inevitably inform me that the weird red dots on my chest were just a heat rash, and the random pain in my hip was just a random pain in my hip.

After many of these near-death experiences, I realized I had one genuine ailment: hypochondria. My GP gently suggested that cherry-picked factoids (gleaned by searching for " headache + tumor") weren't doing me, or my insurance deductible, any favors. She had a point. But since I couldn't bring myself to abandon my "homework," I decided to do some real research. I needed comprehensive medical information, delivered without a scintilla of sensationalism.

So over the course of a year, I read the entire Merck Manual. This may seem a tad obsessive to anyone who didn't spend her childhood reading The World Almanac for fun. And yes, it is 1,824 pages— but it was the ultimate antidote. The Merck Manual of Medical Information felt as trustworthy as sensible Doc Baker from Little House on the Prairie. Its entries explain the anatomy, causes, symptoms and treatment protocols for just about any condition you can think of.

During these months I spent poring (and dozing) over those dense pages. I learned that the body has only a limited number of ways to let you know something's wrong—pain, nausea, a twinge, a spasm—but the signs show up in many complex combinations, depending on the condition and even the individual. An aching back could mean fibromyalgia, or shingles, or a strained muscle. And it was these findings that finally led to my medical breakthrough: It makes little sense to fret about one isolated symptom, so I needed to take a chill pill.

I'm so grateful I conquered my hypochondria before I turned 40 a couple of years ago and weird aches and pains became a near-daily experience. Now I go to the doctor when something hurts for a while or hurts a lot; otherwise, I try to let it go. By the way, do you have any idea how many medical conditions can be caused by stress? Do yourself a favor: Don't look it up.

Making Friends with Your Diet

Illustration: Clayton Junior

Making Friends with Your Diet

Not feeling well? Here's why Jancee Dunn says you may want to head to the kitchen first.

Before you take another pill to fall asleep, fight allergies or quell tummy troubles, ask yourself, Was it something I ate? "Most people don't consider their symptoms," says Kelly Dorfman, a Maryland-based nutritionist. "But you'd be amazed at how often ailments are caused by what you eat—or don't eat." Dorfman, a kind of nutritional detective, teams up with doctors to solve medical problems through diet and supplements when all other options have been exhausted. These three cases from her files prove that we really are what we eat.

Case 1
Problem: Rashy Skin
Rebecca, 42

Rebecca was plagued by rough, dry bumps on the backs of her arms, which made her look like a plucked chicken. A dermatologist diagnosed her ailment as the common condition keratosis pilaris and prescribed a series of creams and ointments, to no avail. Rebecca consulted Dorfman, who, after ruling out allergies, grilled Rebecca about her diet, sleep habits and medications. Upon further research, something clicked. Was Rebecca constipated, by chance? Did she find she was rarely thirsty? Yes and yes. Dorfman began to suspect that Rebecca had a deficiency of essential fatty acids (EFAs). "If you deprive humans of essential fatty acids such as omega-3s and omega-6s, their epidermis gets scaly," Dorfman explains. "If you're eating well, the fats are incorporated into the epidermis to make the skin smooth." Rebecca's new EFA-rich diet included one serving a day of leafy green vegetables drizzled with olive oil, another serving of walnuts or ground flaxseed and at least two servings of fish per week. Two months later, Rebecca's skin was bump-free.

Case 2
Problem: Persistent Lyme Disease
Tanya, 34

By the time Tanya saw Dorfman, she'd tried several antibiotics; none had worked. Were antibiotic-resistant bacteria to blame? Possibly. But Dorfman had a hunch there might be a nutritional culprit. Dorfman peppered Tanya with questions, including whether she happened to be taking prenatal vitamins, which have high levels of iron. Tanya, a new mom, said she was. "When bacteria are grown in a Petri dish and the right antibiotic is added, the bacteria die," says Dorfman. "But if iron is also added, the bacteria may survive because most bacteria love iron. They need it to grow and thrive. Take away the iron, the bacteria can't easily multiply and the body has a better chance of fighting illness." Voilà: Tanya recovered.

Case 3
Problem: Severe Migraines
Lauren, 45

For 20 years, Lauren suffered regular skull-busting headaches. She tried countless medications, meditation, regular exercise—nothing helped. So Dorfman had er keep a food diary for a month and scrutinized it for headache triggers. Then she had Lauren eliminate foods with preservatives, such as tannins, which are found in chocolate; sulfites, added to many wines; and nitrites, ingredients in processed meat. Weeks passed, and the headaches persisted. Dorfman then consulted an old list of headache-provoking foods that mentioned common items like aged cheese and sauerkraut, as well as apples. Lauren didn't eat aged cheese or sauerkraut, but she did love apples. "She was eating at least one a day," says Dorfman. "I immediately had her give them up—and that was the end of two decades of headaches."

Making Friends with PMS

Illustration: Clayton Junior

Making Friends with PMS

Laura Kiniry on living with monstrous menses.

Every month for one week, an alien invades my body. This is no cute E.T.—it's a pissed-off beast that pounds its fists on my skull, punches outward against my breasts and kicks at my uterus in an attempt to break free.

I have premenstrual dysphoric disorder, or PMDD. (My mother did, too, but since the term didn't exist then, she was just "insane.") Some days my uterus feels like such a lead weight, I want to rip it out. Other times it cramps up so viciously that all I can do is cocoon myself in a blanket and mumble that it will be over soon. Losing my keys can, depending on the moment, make me scream obscenities or sob in desperation.

For a while I self-medicated. The wine I drank on my kitchen floor (the cool linoleum soothed me) calmed my nerves and curbed my pain. And since it worked so well, it seemed logical that I'd pour another glass, and another. Hours later, having blacked out, I'd awake in a panic: Why am I on the floor? What's happening to me?

I began to fear that I'd developed a problem, so with the help of a therapist I sought better ways to address the symptoms of PMDD, for which there is no guaranteed cure. These days, I opt to care for, rather than poison, myself when the alien touches down. Antidepressants help with the irritation and depression. I've also found it helpful to track my menstrual cycle with an app called Life and keep a journal of my symptoms. Knowing when to expect the fury and sadness helps me plan. On certain days of my cycle, I take a bath, watch The Mindy Project and nap. On others I avoid big decisions and personal interactions. (I don't want to be rash, and I really don't want to curse at my loved ones.)

And when the beast departs and I'm three weeks away from its return, I breathe easier—and take comfort in the knowledge that however brutal the next round may be, I can stand up to it.

Making Friends with Your Stomach

Illustration: Clayton Junior

Making Friends with Your Stomach

Jessica Migala asks, is your stomach trying to tell you something?

For the past few years I have dreaded dinner parties. One minute everything would be fine; ten guac-topped chips later, I'd feel six months pregnant. Or my heartburn would be so intense, I'd actually have to leave ("I'm tired, busy day tomorrow!"). My doctor told me it was just another attack of gastritis (an inflammation of the stomach lining), which I was diagnosed with eight years ago. "You might just have one of those stomachs," she said as she sent me home with a prescription for Prilosec.

My uncle died at 61 from esophageal cancer. After that, every pain, every episode of bloating had me on edge. I asked my doc whether I needed an ultrasound of my gallbladder, a breath test to check for bacteria that might mean ulcers or cancer, just one more endoscopy. When she kindly—but firmly—told me I probably didn't need them, it was time for a reality check. I'd been seeking high-tech interventions, but truthfully, I'd neglected some low-tech solutions. I knew that anything fried, cheesy, creamy or rich would set off my stomach, yet I ate that stuff anyway because I didn't want to feel deprived. If my friends were having bacon-wrapped dates and a few glasses of Pinot, why should I be punished with salad and water? Then when my digestive system paid the price, I was like a petulant child who whines, "Life's not fair!" I had a grown-up choice to make: potato skins or peace.

I decided to go back to the basics. I focused not only on what I ate (no more onions, fries, Sour Patch Kids), but also on how I ate, putting down my fork as soon as I felt full. I realized that though I'd been obsessed with my symptoms, I hadn't actually paid much attention to my body. Now I listened. And (surprise!) my stomach thanked me—by behaving itself. As in any healthy relationship, I learned the value of compromise. The things I'd given up on began to matter so much less than what I was gaining: a better quality of life. Now my stomach and I enjoy each other's company. We even look forward to dinner parties.