Running With Migraines!!!

#379 - It's tough enough to run with the demands of our busy lives. Add migraines into the mix and well, you could have many missed training runs and even races! Millions of Americans suffer from migraines, and many of those are runners. This week, I take a detailed look at migraines and how we can if not avoid them all together, reduce their effects so they don't hurt our running careers. 

Fit, Healthy & Happy Podcast
Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...

Listen on: Apple Podcasts   Spotify

Transcript

[Ad] Fit, Healthy & Happy Podcast

(Cont.) Running With Migraines!!!

SPEAKER_00 0:03

I was born and raised in the West. When I think of the western United States, I think of majestic mountain ranges, never-ending coastlines. And I think of the people with spirits strong as the rivers and hearts as fiery as the desert sun, thriving in a land that's not always hospitable. Hidden West is about the history, people, and places that make the West so fascinating. Won't you join me as I share some of their stories on YouTube starting this January? Welcome to Martha Runs the World, a podcast with a new take on running, fitness, and all things health oriented. I'm Martha Hughes, your host, and each week I present a new topic that is of interest to all runners. Hi, and welcome to episode 379 of Martha Runs the World. Thank you so much for joining me. I appreciate it each and every week. Approximately 40 million people in the U.S. suffer from migraines. Migraines are a disabling neurological disease affecting about 12 to 15% of the population. That's a giant number. It's more common in women than in men. Women have 18% and men 6%, and it affects one in four American households. And you can bet many of these households have runners who are affected. That's why I thought it would be important to talk about migraines and runners or running with migraines in this episode. Migraines are one of the most underdiagnosed diseases, and it is suggested that up to 50% of sufferers are not accurately diagnosed or receive a formal diagnosis. And I know this personally, and I'll tell you that in just a second. What exactly is a migraine? A migraine is a headache that can cause intense throbbing pain or a pulsing feeling, usually on one side of the head. It often happens with nausea, vomiting, or extreme sensitivity to light and sound. It can also include vertigo and feelings of lightheadedness. Migraine attacks can last for hours to days, and the pain can be so bad that it interferes with your daily activities. For some people, a warning symptom known as an aura occurs before or with the migraine. An aura can include visual changes such as flashes of light or blind spots. The aura can also cause tingling on one side of the face or in an arm or leg and trouble speaking. Medicines can help prevent some migraines and make them less painful. Combining medicines with self-help remedies and lifestyle changes also might help. I suffer from what's called MAV, which is migraine associ Ah sorry, I just hit the mic. I suffer from what's called MAV, which is also called migraine associated vertigo. I take meds daily so I don't get them. But when I get vertigo, it's horrible. It will have me laying perfectly still in one position for hours because if I move at all, I'm gonna get sick. It's just that bad. The meds that I take and eating better and taking care of myself ensures that I don't suffer. And I rarely get vertigo at all anymore. I might get a vertigo attack every couple years, which I find which I call a success, considering that I was getting them almost every day when I first discovered that I was getting them. It was horrible. Each migraine sufferer has different triggers. Some of mine, and I don't know all of mine, but some of mine happen to be dehydration, coffee, or caffeine, chocolate, humidity, and a few others I don't even know. Coffee and chocolate are two of my favorite things in the world, and I haven't given them up. I have cut way back. And as long as I just have like one cup of coffee a day, I'm okay. If I have more, it gets to be a problem. I also have to make sure that I'm always well hydrated because the dehydration is a factor, especially when I start running a lot. If I get into the big miles and I'm not hydrated properly, that's a problem. Especially if it's humid. Oh, humidity. I it's like, no, I am not living in Florida. No, can't do it. And this is where running and migraines meet. I'm gonna go over a few basics about migraines and talk more specifically about running with migraines. Migraines can affect children and teenagers as well as adults. A migraine can progress through four stages that have different symptoms. Pro drome, aura attack, and post-drome. Not everyone who has migraines goes through all stages. You may only get one of them. You may only get the migraine itself. Pro drome. One or two days before a migraine, you might notice subtle changes that warn us of an upg upcoming migraine, and those may include constipation, mood changes from depression to elation, food cravings, neck stiffness, increased urination, fluid retention, frequent yawning. Don't feel bad if you don't get any of those. I don't get any of that. These are just things you could be experiencing. And maybe they're so subtle you haven't noticed. I'll be more mindful if I actually do get these changes and haven't paid attention. Maybe I do, maybe it's just something that I just haven't um that I haven't noticed. They could be very subtle. Aura. And aura might occur before or during migraines for some people. I don't get them at all. Auras are reversible symptoms of the nervous system. They're usually visual but can include other disturbances. Each symptom usually begins gradually and builds up over several minutes, up to 60 minutes. Example Here are some examples of migraine auras. Visual changes such as seeing shapes, bright spots, or flashes of light. Vision loss, a feeling of pins and needles in an arm or leg. Weakness or numbness in the face or on one side of the body, trouble speaking. I remember there was a video of a newscaster or reporter who was out on the field, and she started mumbling or not being able to speak right when she was talking, and everyone thought she was having a stroke, but no, she was having a migraine attack, and they figured that out afterwards when they did a bunch of medical tests on her and everything like that. She that was migraines. Migraines can mimic other diseases, and I'll talk about that as well in a little bit a little bit later. The next stage is the attack itself. A migraine usually lasts 4 to 72 hours if it's not treated. How often migraines occur varies from person to person. Migraines might occur rarely or strikes several times a month. During a migraine, you might have pain that's usually on one side of your head, although it can occur on both sides. Pain throbs or pulses. Sensitivity to light, sound, and sometimes smell and touch. Nausea and vomiting. Post-strome is the last stage. After a migraine attack, you may feel drained, confused, and worn out for up to a day. Some people report feeling elated. Sudden head movement might briefly bring on the pain again. So when you get out of one, you want to be careful and just ease out of it. Don't just jump up and try to live your life normally. Migraines are often not diagnosed or treated. If you regularly have symptoms of migraines, keep a record of your attack and how you treated them. Then make an appointment with your health care professional to discuss headaches. Now it might take a while to see someone, but go see your primary care if you have one. If you don't have one, try to get one. And then if your primary care can't help you, then that's the time to go see a neurologist. If you have a history of headaches, see your primary care if the pattern changes or your headaches suddenly feel different. And that is the time to seek out a neurologist, which you'll probably need a referral from from your primary care. It's a maze, I tell you, it really is. See your healthcare professional right away or go to the ER, the emergency room, if you have any of the following symptoms. And these could be caused by a more serious issue. An abrupt, very bad headache like a thunderclap, headache with a fever, stiff neck, confusion, seizures, double vision, or numbness or weakness in any part of the body. Now these could be a sign of a stroke, so it might not just be a migraine. Headache after a head injury. That's concussion. You must go to the ER seriously. People don't take concussions as seriously as they need to. Go to the ER. I don't care if you even if you didn't even have symptoms, go to the ER to get it checked out. We only have one brain. You can't get your brain replaced. Please take care of it. A chronic headache that is worse after a coughing exertion, straining, or sudden movement. New headache pain after age 50. When I first was diagnosed 14 years ago, I found great relief at the headache clinic at University of San Francisco Medical Hospital. UCSF was superb back then, but it's gone way downhill now. It took me six months to get an appointment, and I was basically brushed off. The doctor was terrible. She did it, she did me a huge disservice. So I went to so after being like it wasn't a big deal to them. They didn't see a problem. They didn't even think I had MAV. And I I was really upset with them. They thought that I had uh that my stiff neck was causing my vertigo. And how could my stiff neck cause uh vertigo when it when my vertigo was triggered by all kinds of things? Didn't make any sense, and I I just gave up trying to explain to them what was going on. She wasn't listening, she just wanted me off the line. So I talked to Sutter Health, who has CPMC here in town, and the neurologist was much more accommodating. She was much more she was much more open. She listened to what I was saying, she respected me as a patient. I no longer recommend the headache clinic here at UCSF. I don't know what it's like at other medical hosp other university medical hospitals. I don't know what they're like, so I I don't know if it's good or bad. But I would say don't go to the UCSF headache clinic. They're terrible. It used to be great, used to be a really, really good clinic, but not anymore. Now, into running, let's get into the running part. While moderate, consistent running lowers migraine frequency, once you get into the longer runs or the high exertion, it can cause migraines. High intensity exertion, overheating, and dehydration can trigger exercise-induced migraines. Management involves careful hydration, gradual warm-ups, monitoring intensity, and identifying personal triggers. Many times this can be stopped or reduced by making sure that you are properly hydrated and that your electrolytes are balanced. These are two things that are really, really important. This is why I, if you have migraines, please don't run fasted. Don't run fasted at all. This is not a good thing for us migraine sufferers to run fasted. Many times this can be stopped or reduced by making sure that you are properly hydrated and that your electrolytes are balanced and that you are well, that you have good nutrition in your system. Drink lots of fluids and taking a good electrolyte mix. This helps so much and it's made a huge difference to me. Running as a migraine trigger. Now, this is when running you think might running is the trigger. It might not be running, it might be dehydration, exertion and heat, intense running, especially hot weather, can cause primary exercise headaches or trigger a migraine attack. Dehydration and fuel, lack of water, or improper nutrition before or during long runs is a common trigger. Now that's this is where your proper nutrition and proper fueling during your runs is really important. As I said, I do not think the migraine sufferers should run fasted. I just think you're playing with fire there. Dehydration, of course, is terrible for migraine sufferers. Please make sure that you are properly hydrated and properly fueled for your runs, even short runs. It's really important. Physical triggers also include high heart rate, neck strain, or sun exposure, sensory overload can initiate pain, can initiate pain as well as humidity. For me, humidity is a big one. When we have that, ooh, that icky humidity out there, or it rains, that's another one. When it rains, I know that I have to be extra careful. And that's why I'm not living in Seattle or Miami. It's like, nope, nope, not doing that. I'm moving to a high desert next year, so yeah. That's more my style. Some people find exercise to be a migraine trigger, as I said. If you get migraine attacks after exercise, it may put you off exercising, but don't let it. Don't let it put you off running. Because if you get if you get a migraine attack during your running, you can solve what's causing it during your run. It doesn't mean you shouldn't be running. Now, sometimes physical activity, even just simple movements, can make migraine symptoms worse. If you have frequent migraine attacks, this may make it difficult to find a time when you feel able to exercise. Vestibular migraine is a type of migraine where you also get symptoms like severe dizziness and vertigo. This may make exercise particularly d difficult. And I remember before I was diagnosed with MAV, I would be out on a run and halfway through I would get vertigo on my run. Oh, I would have to. I remember being on being in the park and getting it and having to lay on a park bench for like an hour before it went away. It was horrible. I couldn't even move. I had to just lay there. I remember someone coming up to me saying, Are you okay? And I said, Yeah, I'm fine. I'm just having a migraine attack. And there was nothing anyone could do. I mean, I just had to wait for it to like go away. I couldn't move. So, but they they understood. It was very nice of them to ask, though. That was terrible. There can be other factors besides your migraine that limit your ability to exercise, too. This these may include other health conditions or disability, time pressures and lack of motivation and all that stuff. So just just be aware that it might not just be your migraine. There may be other things going on going on and maybe you don't know about. I would suggest talk to your healthcare professional. If running seems like it's a trigger for your migraines, you may start to fear doing any type of running at all. To overcome this, it's important to build up what you do gradually. Do shorter runs. If you usually run five miles, run three miles and see how that feels. Or walk more and during your runs. Just start a little bit. I mean, I know it isn't ideal, but it's better than not running at all, I think. What do you do if you get a migraine while you're running? Well, stop running, of course. Um, it can be helpful to keep an emergency or rescue migraine kit with you if you are at home, like on a treadmill. This may include any acute medicines that you take that might stop the migraine, a snack and a drink. Make sure you have details of people you can contact to give you right home if you need it. But I would suggest just drinking a ton of water, liquid right there, or maybe electrolyte mix with your water. Just start drinking it, just chugging it down. Personally, that helps. If I start getting that light head that leads to vertigo, if I just start drinking the water, just chugging it down, sometimes I can stop it. Sometimes. No, it doesn't always work, but sometimes. If you develop a headache or migraine for the first time after a run, it's important to get this checked with your doctor. Now, exercise tips for migraines. Pace yourself. Start with gentle exercise such as walking and build up with exercise intensity and duration gradually. Just do it slower. Gradually build it up. Plan ahead. Set a regular routine so that you can ensure that running is built into your lifestyle along with regular meals and regular bedtimes. If you feel unable to do your usual type of running due to symptoms like head or neck pain, consider trying other forms of exercise instead. I know that's not ideal. I'm sorry. Make sure that you have eaten enough before running to avoid drops in your blood sugar level. This is extremely important for migraine sufferers. Fasting is not good for our running. It really is not. Fasting is not good for migraine sufferers. Keep your fluid intake up by drinking before, during, and after running. This will help to replace fluid loss through sweating and avoid dehydration, which can trigger or worsen migraines. Drinking water can be enough, but you also may find that you need electrolyte mix mixed in with that water. These can contain sugar and electrolytes that replace those lost in your running. If at any stage you feel uncomfortable, stop. You may have not been able to exercise because of other factors. These may include a change in sleep pattern, what you've eaten or what you have not eaten, how much you have had to drink, whether or hormonal changes, for example. All that stuff enters into it. And see your doctor if there is any change or anything unusual, that if your headache is changed at all, if something's going on that's not the usual thing. And it's really super important to be your own best medical advocate. If you're not finding the advice that you need or the help that you need, you need to really work hard to find it. You are the only person that can find it for you. No one else can do it. You need to do it. Migraines mimic other diseases. Migraines like mine, MAV, migraine associated vertigo, mimics meniere's disease, which is when you get vertigo from your ears. But I'm not losing my hearing. And usually, migraines, usually, um, and usually meniers, you lose your hearing in your ears, in your inner inner ears. And I'm not doing that, so I know it's not meniers, but it does mimic it. And migraines, as I talked about the reporter earlier, it can mimic strokes, it can mimic all kinds of things. So just make sure that you're getting the right advice and that you're getting the right diagnosis. This is really important, even if it takes a while. It took me two years to get my diagnosis correctly. Two years. Make sure that you continue to battle for yourself and your health. It's really important. Now, on the positive end, running can help migraines. Now, how can running uh how can you run for migraine prevention? Reduced frequency, regular aerobic exercise, including running or Walking is shown to decrease the frequency, intensity, and duration of migraine attacks. That's great news, I think. Jeez, that truck was loud. Sorry about that. Consistency is key. Gradual, regular exercise helps build tolerance, whereas sporadic, high intensity bursts are more likely to cause issues. So be consistent with your exercise. Hydration, electrolytes, ensure adequate hydration and replace electrolytes, particularly on long runs, is happening. Make sure and do that, and you should you'll be better off. Pacing and intensity. Avoid sudden high-intensity sprints. Slow down if you feel a potential headache or walk. So you can avoid the intervals, the sprinting intervals right now. Just do your long run and go slow. Warm-ups, properly warm up muscles to reduce strain. Environmental adjustments. Run in cooler parts of the day, wear sunglasses, hats, and consider managing not pushing through the pain and avoid the humidity if at all possible. Supplementation, magnesium, especially magnesium glycinate, may help prevent attacks. I haven't tried this. If you have tried this and it works, let me know because I may start doing this. How exercise can help migraines. Exercise doesn't have to mean running a marathon or lifting weights, but we like running marathons. So yes, that's what we do. It can be anything when you're physically active. Studies have shown that regular exercise reduces the frequency of migraine attacks, reduces the duration of migraine attacks, reduces how severe migraine attacks are. So I would say it can be exercise like running can be beneficial. Just follow some certain rules and take care of yourself while you're out there running and you should be okay. Remember, you are your own best medical advocate. So stick up for yourself. And if you're not finding the help you need, go find it. I know it will take a while. It took me a long time. So just keep at it and work really hard to find the best uh medical professionals that you can. It doesn't get easier, I know that, but it's worth it. Your brain is worth it, your health is worth it, I think. And your running is worth it. This is all about running, right? It's all about keeping us on the road running. I'm sorry for my scratchy voice this morning. I don't know what's going on. It's allergies. I know it is, it's all allergies. Anyway, so that is it for today. And I hope that if you're suffering from migraines, I hope you can you can find a way to deal with it. Um we can't get rid of them, unfortunately, and there's no cure, but we can alter our lifestyle to more healthy, and we can't take meds to make them not be quite as bad. And that's better than nothing, right? Okay, well that is it, and thank you so much for joining me. I appreciate it. I always do, and until next week, let's tie up our shoelaces and go for a run.