It approaches with subtle but clear symptoms, though the onset and ultimate presentation are unique for each sufferer. When you realize what's coming, you're as overcome with dread as with the pain itself. You know what you're in for. You know how long they can last and whether or not you respond to any of the available medications or treatments out there. You know how truly awful you'll very definitely feel and that no one who's never experienced a migraine can truly understand. Mine start with a mild heartburn accompanied by a feeling that I'm more motion-sick than ever before. The nausea churns my stomach, my head feels heavy and sick. It's not a migraine yet, but it will be. My shoulder blades seem to seize, held hostage by the muscles surrounding them being ever more tightly winched. Imagine a boat captain, knowing a storm is coming, desperately lashing his ship to every cleat on the wharf as tightly as possible, hoping to prevent the ship from budging even an inch. As my lower trapezius muscles cede all flexibility, their northern counterparts which line my cervical vertebrae become equally rigid. It is as though these muscles are a slab of hardening cement, though one whose expected smoothness is pocked by knots of spasm.

At this point, the migraine has moved in, full of presumption and a mean intent to stay despite its being wholly unwelcome. I never throw up but remain nauseous throughout, and the headache itself, capped in a vise-like sheath, cycles between tympanic throbbing and what feels like electrical shocks and currents coursing through my brain.

I become photosensitive as well as highly intolerant of loud noises. Dark rooms, sleep, complete quiet, peppermint oil spread liberally over my neck and upper back...these are the only things that help with any regularity; what relief they do provide is rarely a panacea to restored well-being. You can imagine this really meshes well with being a mom of two young and extremely active boys. If I catch the migraine early enough, massage and/or light exercise can sometimes keep the pain at bay but it's rare to both catch and be able to deal with the beast before it's too late. If I get a multi-day migraine (not the least bit uncommon), I usually go for a glass of cold white wine around night 3, both because I'm then in such a bad mood and because it's been known to help in the past, I think because it relieves some of the tension I've at that point very surely amassed.

I'm one of the unlucky ones who've never responded to the medicines on the market. Imitrex injections and the triptan family did less for me than a bad placebo, and the one thing that did help, Vioxx, well...you may recall what happened there. Too, mine map incredibly accurately with hormonal fluctuations; while that's helpful to know and can, in some respects be planned for, it sucks to expect these so regularly.

I woke up with one this morning and soldiered well through the 1st grade field trip today. But I will tell you that the long, loud bus ride back to school was a challenge. I'm flat on the couch right now, nauseous and throbby but grateful that Jack stays for chess after school on Wednesdays and that because of the field trip my mother-in-law picked up Oliver and is bringing him home later. What a reprieve!