Ah, the view from my beach chair last week.  Oh how I miss that little thatched roof gazebo on the water.  I disappeared last week to this beautiful place and left all my worries behind. I spent seven days without a computer, phone service or children.  You would have thought it would have been more of a shock to my system than it was.  I adapted quite nicely to absolutely no responsibilities.  When your biggest stress is what to eat for breakfast, you know you have it good.

Stress reduction is key to overall health status.  At least most normal medical personnel will give you such advice.  The first neurologist I saw as a result of my migraines basically poo-pooed my stress stating that "women in war-torn countries may suffer from stress...not women in suburban Tulsa". 

When under acute stress our bodies release cortisol and adrenaline, hormones that help when stress is acute so that we can either fight or flee the stressful encounter.  However, when our bodies experience chronic stress everyday during our normal routines i.e. bad employers, chronic pain, child-rearing, driving in traffic, and the list goes on.  This chronic exposure to hormones over time damages blood vessels due to inflammation.  There are numerous studies available chronicling the benefits of vacation on heart disease.  I would argue the benefits of decreasing the inflammation of blood vessels goes beyond just heart disease and extends to a variety of disease states--migraine being one of them.  A study by Gretchen Tietjen out of the University of Toledo found that a third of study participants with migraines had blood vessel damage, which was five times higher than the control group.  The verdict is still out on the exact cause of migraines, but most helpful medications for migraines reduce vessel inflammation.

Remembering that traveling itself can be and issue for the migrainuer, proper planning is a must.  Adequate sleep and hydration are vital the days prior to a tropical destination.  Unless of course your lucky enough to be in driving distance from such a location.  That first travel day is always kind of a struggle for me...probably due to sleep alterations (if it's an early flight), barometric pressure changes, and yes-- stress (and not the stress endured by women of war-torn countries, but  stress endured by women with migraines who have their passport and flight ticket taken from them by a Spanish-only speaking security worker and told they were randomly selected for an extra security screening).

But once I am beach side listening to the sounds of the ocean the stress seems to disappear.  For seven days my worries become which bathing suit to wear to the beach, which book I should read, whether to swim in the ocean or the pool, or whether or not "Frank the Iguana" will be there to greet me when I head home from the beach.  Everyone should be lucky enough to endure the above listed stresses for at least one week a year.

"Frank The Iguana"

Asian food can be difficult for the migrainuer due to fact the soy sauces, teriyaki sauces, onions, etc. can be triggers.  So, here is a yummy dish that can be served without a headache.

Here are the ingredients:
Ginger Quinoa:
1 cup quinoa
3 tbs grated ginger
2 cups of vegetable broth

Shrimp and Veggies:
3 tbs Sesame Oil
1 bag of preservative free shrimp (To avoid a headache: NO sodium tripolyphosphate or sulfites! Check your label and with your store to make sure what you are eating is without preservative.)
1/2 cup grated carrots
1 head of broccoli
10 green onions (remember migrainuers can eat these leeks and shallots, but not onion)
3 cloves garlic

I poured out 2 cups of vegetable broth

and prepared the ginger by cutting off a piece and removing the skin.

I grated the ginger into the vegetable broth.

In a medium saucepan, I combined the ginger broth with 1 cup of Quinoa on high heat to bring to a boil.

Once boiling, I covered and let simmer until broth was gone (about 15 minutes).

While the ginger quinoa is cooking you can start prepping your shrimp (pulling the tails off) and veggies (cutting and cleaning). 

I prepped the green onion and broccoli.

Now, I get out the secret ingredient, Pure Sesame Oil.

I coated the bottom of the wok in Sesame Oil and turned on low heat.

I added the shrimp first and then my prepped veggies.

If you were wondering where the carrots came from...they were purchased prepped:)

Once all ingredients were added, I stirred them together coating them in the sesame oil and then covered the wok, leaving it on low heat.

Wow, I almost forgot the garlic!

I chopped 3 cloves of garlic and added to the wok.

It takes about 15 minutes on low heat to completely cook the shrimp.

The quinoa should look like this when fully cooked.

Ahh, and the shrimp is cooked!

Yummy stir fry shrimp without soy, teriyaki, or any other migraine inducing product!

Q:  Is it wrong to eat about 30 shrimp in a 24 hour period?
A:  Depends on the shrimp.

I did it...and I paid for it with a nice little headache.  Don't feel too sorry for me.  I went to bed with ice wrapped around my head and woke up feeling great.  Since I have eliminated almost every possible trigger with my "Migraine Plan", it is rare that I have these annoyingly painful experiences.  You might be wondering why anyone would eat 30 shrimp in 24 hour period.  So, let me explain:  I prepared a shrimp dish for dinner Wednesday evening and not wanting to be wasteful, I consumed it for lunch and dinner on Thursday.  Perplexed about the cause of my headache, because I truly felt like had my plan down to a science, I put on my detective hat. It doesn't take a great detective to discover 30 shrimp as an outlier in my routine.  It is unusual for me to eat this many shrimp.  I may split a shrimp appetizer with Bryan on occasion yielding a 3 shrimp intake, but I would guestimate my usual maximum is probably closer to 8 shrimp in a 24 hour period.

With my detective hat on, I started researching shrimp.  At first I thought my problem with eating 30 shrimp might be related to sulfites.  After further research, I learned about a little something called sodium tripolyphosphate.  Unfortunately, the bag of frozen shrimp I bought on Wednesday included Raw Shrimp, Salt, and Sodium Tripolyphosphate.  Please excuse the  quality of the  ingredients photo containing sodium tripolyphosphate.  This food detective is suspicious this little ingredient might be where her headache trigger lies.

Let me tell you what I learned about sodium tripolyphosphate:

1.  It is produced on a large scale and used in many domestic and industrial products including detergents.
2.  There are problems with eutrophication due to it's widespread use.
3.  It is also known as STPP and is a preservative for seafood and meats.
4.  It is used as an emulsifier and to retain moisture.
5.  It  substantially increases the sale weight of seafood (they can charge me more for less shrimp).
6.  Other uses include: leather tanning, flame retardants, rubber manufacturing, and antifreeze (visualize me consuming 30 antifreeze pellets).
7.  The FDA lists this product as "generally regarded as safe" (generally, they don't count on people eating 30 sodium tripolyphosphate laden shrimp in a 24 hour period).

My research included a visit to a local Wholefoods and visiting with their fishmonger, Brian.  He assured me I could be safe eating 30 of their shrimp in a 24 hour period.  Whole Food's standards prohibit use of antibiotics, added growth hormones, added preservatives like sulfites and phosphates, genetically-modified seafood, and animal by-products in feed. They contract with fish farms that adhere to their standards.  I ventured into their frozen foods to check out the ingredients on their frozen shrimp.

I just never thought I would have to check the ingredients label of shrimp.  I assumed it was just frozen shrimp.  I check my meat labels for nitrites and nitrates, hormones, and antibiotics and now I will be making sure my shrimp is just shrimp and nothing else.  Another headache lesson learned--avoid sodium tripolyphosphate.

Busy lifestyles require some prepackaged snacks.  I am on the road in my car some for work. It is difficult to find migraine-friendly snack options suitable for this migrainuer in roadside gas stations, especially in Nowhereville, OK.  I always try to leave my house with something stashed away so that I won't starve to death due to my somewhat self-imposed dietary restrictions.  If I do find myself unprepared with a rumbling belly in Nowhereville, I pull into the one and only gas station convenience-mart for miles around and  I come out with a bag of good old potato chips.

Yes, I eat potato chips when the listed ingredients are: "Potatoes, Vegetable Oil, and Salt.  No Preservatives" (or something very similar).  No faux-cheesy, MSG contaminated food flavorings for me, just salt and oil please.  Very rarely in these stores a bag of Kettle brand potato chips will appear with "salt and vinegar" or "salt and pepper" flavoring (my true favorites).   Although, I am sure that this bag of potato chips might give me some sort of  cardiac derived health issues over time, it will not be causing a headache today.  And it is very important as I enter my vehicle homebound from Nowhereville that I don't have a headache today.

I just finished my first women's USTA match of the year!   I am so excited to start a tennis season without migraines.  When my migraines became chronic, I was in the midst of competitive tennis season.  A number of factors coincide during a tennis match to create the perfect migraine storm. 

1. Heat: Here in Oklahoma, it is not unheard of to be playing a match in over 100 degree weather.  To combat this I try to make sure that I am adequately hydrated and seek shade whenever it's possible.

2. Blinding Light: During these 100 degree days, even with the best pair of UV shades available, there is no avoiding staring directly into the sun during a match.  When I toss my ball up for a serve the sun is there.  When my opponent annoyingly, but wisely lobs me, the sun is there.  I wear my shades and hat or visor and hope for the best.

 3. Dehydration: While deliberately blinding myself in this "just for fun" game of tennis, the heat and activity drain me of all my water reserve.  Like I said making sure I drink plenty of water the day before and day of a match is important.

4. Stress: If heat, the bright and blinding light of the sun, and dehydration weren't enough to trigger a migraine I can add competitive stress to the list of triggers.  Don't forget about stress caused by anger and frustration.  If you think an adult won't cheat you at a "fun" game of tennis you are wrong. When I am not playing up to my usual aptitude the anger isn't directed towards my opponent it is directed towards myself.  I try to remember that tennis is  my entertainment and recreation, not to be stressed and worried about.

After rereading those triggers, I am starting to wonder why anyone would play adult competitive tennis.  I never completely gave up tennis through my bout with chronic migraines, but I did sit myself out of many a match when I was in pain or knew I couldn't handle the heat.  During those days I popped quite a few drugs (triptans and anti-inflammatories) to get through my tennis match and that day.  It's hard to combat the heat, but making sure I am adequately hydrated prematch is a must.  I good pair of shades and a hat or visor helps some when playing in the sun. 

The migraine experts will tell you that regular exercise can lower your migraine threshold.  However, it can be somewhat of a catch 22 since it's also a trigger.  Adherence to my migraine plan has resulted not only in being almost  migraine-free for a year, but now I can start my competitive tennis season without the anxiety and anticipation of a headache.  I have listed a bunch of bad things I associate with tennis and obviously there must be an upside to the sport or I wouldn't be playing it.  Here are some good things about tennis...

1.  It builds cardiovascular fitness, strength, agility, flexibility, and coordination.
2.  According to Dr. Ralph Paffenbarger, playing tennis for 3 hours per week at a moderately vigorous intensity will cut your risk of death in half from any cause.
3. Competitive tennis burns more calories than aerobics or cycling, according to studies in caloric expenditures (and my polar watch).   I don't even realize how hard I am working because it is more like a game than exercise to me. 
4. Scientists at the University of Illinois found tennis requires alertness and tactical thinking which can generate new connections between nerves in the brain and promote a lifetime of continuing brain development (I knew tennis players were smart people).
5. It's a lifelong sport. I hope to be hitting the little yellow ball well into my senior years.
6. It's a social sport.  My closest friends have been found on the tennis court.  Just look at all these pretty people!

Chicken, spinach, artichokes, and red bell peppers  make me forget this pasta dish is missing red sauce and cheese.   Here is what I used to make this gluten-free/migraine-free pasta:

Gluten-free Penne
Chicken Breasts (3)
Salt and Pepper
Olive Oil
Garlic (4 cloves)
Chicken Broth (2 Cups)
Spinach
Red Bell Pepper (2)
Artichoke Hearts (a can of quartered hearts)

I started by chopping the chicken into bite-sized pieces.

I started boiling the water for the penne.

Then I tossed the chicken in my wok (I am using the wok due to it's ability to hold all the yummy ingredients I am going to combine) with a little olive oil and salt and pepper on high heat.

I spread the chicken out into one layer, so they weren't bunched up on top of each other.

I let the chicken cook about half way through, getting nice and brown on one side before I flipped the pieces over.

My water is now boiling...so, I add my gluten-free penne.

I toss my two red bell peppers into the oven to broil for 5 minutes on each side.

My little chicken bites are cooked and brown and I removed them from the wok.

I chopped up the garlic and toss it into the wok.

I turned down the wok to medium heat and added the garlic and the chicken broth.

I am going to let this cook down while I drain the pasta and chop my bell peppers.

I pull the crispy looking red bell peppers out of the oven and let them cool down a bit.

I strain the gluten-free penne.

I highly recommend al dente pasta.  It is really easy to overcook gluten-free pasta and it will make a difference if it's overcooked.

This pasta took about 6 minutes to cook once the water was boiling.

When the red bell pepper is cool enough to handle, I remove the stem and seeds and chopped it into pieces.

Now we can add some spinach.

Yep, I said we.  I didn't shrink and start wearing "Hello Kitty" shirts.  That is my kitchen gnome, Kate.  She is fully aware of the heat coming from the wok and realizes the potential risks of being a kitchen gnome.

She added about half of the container of spinach to our broth.

We added the red bell pepper.

We added the artichokes and the chicken.

and then my little kitchen gnome made me nervous tossing it all together.


Then we all ate without a headache.

** I added some crushed red pepper and salt to my personal dish.  I like the heat and...well, I like salt too.

Who doesn't like a good laugh?

The process of consistently dealing with pain can cause one to lose your sense of humor and put you in a pretty dark place.  At some point I took a personal inventory of how much fun and laughter was in my life.  I looked at what I was reading.  I looked at what I was watching on television.  I looked at who I was spending my time with and what I spent my time doing.  I realized that I wasn't capitalizing on fun and laughter like I should.  The books I read were about migraines.  I was watching horrific news stories and crime dramas on television.  My conversations with friends would inevitably turn into discussions about my health simply because they were kind enough to ask about it.  A lot of my down time was spent dwelling on how to cure my migraines, figuring out how to work and cope with migraines, how to manage children while in the midst of a migraine, etc.  I had quit playing tennis and doing activities I loved because of migraines. 

I think in life you become what your surround yourself with and what you do.  Fortunately, we get to choose these things.  I made a deliberate choice to have more fun and change what I was reading, watching on TV, doing and talking about.  I tried to bring laughter back into my life.  

My crazy little laughter plan has some scientific research to back it:

A study conducted at the University of Oxford proved that laughter can increase pain thresholds.  The benefits are not just emotional.   They believe the physical act of laughing exhausts the abdominal muscles causing a release of endorphins which lessens painful experiences.  So, I guess for more benefit, laugh louder and longer?

According to The Mayo Clinic the benefits of laughter are both short term and long term:
1. Stimulation of heart, lungs and muscles by oxygen-rich air while laughing increases endorphins in the brain.
2.  Feelings of relaxation caused by the activation and release of the stress response.
3.  Stress symptom relief caused by an increase circulation and muscle relaxation.
4.  Boosting the immune system with neuropeptides released to  fight stress and illness.
5.  Natural painkillers released to break the pain-spasm cycle in common muscle disorders.
6.  Increasing coping skills and building connections with other people.

Generally laughing and doing fun things makes me feel better.  I don't really need scientist and the Mayo Clinic to convince me to do more fun things.  However, I think our thoughts and behaviors are a reflection of how we feel. When we don't feel good we can create a habit of negative thoughts and feelings.  So, in the spirit of April Fools Day, I recommend we all have a little more fun and laughter.  Happy April Fools Day!