I just completed two weekends of tennis tournaments without a migraine!  I realize not every migrainuer plays tennis.  Whether you want to run, bike, hike a mountain, or do whatever form of activity you love, avoiding a migraine means you must properly prepare.

Before beginning my migraine plan I spent tournament weekends overusing triptans and caffeine in an attempt to just make it through the weekend.  Then I would spend days trying to recover from the weekend in a dark room with ice wrapped around my head.  I am now able to make it through my tournament weekend through proper preparation.

The difficulty playing in tennis tournaments (and many other sports or activities) for the migrainuer lies in the high temperatures (1), the change in activity level (2), and possible dehydration (3).  All three of these factors are physical stressors and require proper preparation in order to overcome them.

1.  High Temperatures:  The weather in Oklahoma did not reach 100 degrees until a week before the tournaments began.  Although the beautiful 80 degree weather up until now provided many comfortable days of tennis it did not give me the opportunity to acclimate to the 100 degree weather I encountered for the tournaments.  Another important temperature fact about tennis is that you add 10-15 degrees to the temperature when playing on hard court surfaces (which I did this past weekend).  Since I spend most my days in a well shaded air-conditioned room, preparing for the tournament means I needed to start acclimating to a sunny 110 degree environment.  Most of the time as a migrainuer I avoid heat and exercise because it is a migraine trigger.  However tournament officials don't appear to care about my migraine brain so at least one of my match times will be in the middle of the day and at peak heat.  Since no one has invented a weather machine yet, I must acclimate to this hot environment.  The experts say that it takes about 7-14 days to acclimate to temperature changes.  My acclimation plan started with adding a walk into my routine at the hottest possible time (around 5 p.m.).  I gradually increased the length of my walks in the heat in order to slowly acclimate and avoid an exertion level that would trigger a migraine.

2.  Change in Activity Level:  Any change for a migrainuer can be a trigger.  Stressing our bodies to do something that they aren't accustomed to whether it is staying awake too long or skipping meals can put us over the edge.  Tennis tournaments mean an unpredictable amount of activity.  A highly competitive third set match could possibly mean I am on the court for over two hours.  Since we play two matches a day, I may be playing four hours of tennis a day.  Trust me when I say that I never play four hours of tennis a day.  What I can do is make sure my body is well-conditioned.  I get on my treadmill or bike whenever I can squeeze in an extra 45 minutes of cardio in order to prepare my body physically.  Only one Saturday before the tournaments began was I able to play tennis twice in one day.

3.  Possible Dehydration:  Properly hydrating is extremely important for exercising in the heat.  Headaches are a main symptom of heat exhaustion.  Heat exhaustion is brought on by high temperatures, humidity and overexertion.  Body water is what keeps us cool.  If you allow your body to dehydrate you can't sweat enough to keep from overheating.  I start hydrating the week before the tournament.  My goal is to never be thirsty and to pee clear.  The day of the tournament I wake up drinking water.  I drink two full 16 oz. waters before I get to the courts.  The Sport Medical Advisory Committee recommends you drink another 8 to 16 oz. of water 15 minutes prior to your event.  They also recommend drinking 4 to 8
oz. of fluid every 15 to 20 minutes during your event.  I drink as much as possible at every change over.  Their recommendation for after events is to drink 16 to 20 oz. of water for every pound lost before the next competition (I will not be weighing myself at the courts). I plan to drink as much water as possible and seek shade  (if I can find some) between and during matches.  The recommendation regarding sports drinks is that they may provide additional benefits with "prolonged continuous or intermittent activity of greater than 45 minutes, continuous or repeated exertion, and in warm-to-hot and humid conditions".  The problem with sports drinks for the migrainuer is that the ingredients are many times migraine triggers.  The idea behind sports drinks is to give an athlete both carbohydrate along with electrolyte replacement during the event.  This migrainuer  will stock some cherry juice in my cooler to sip on if I need some carbohydrate and carry a salty snack for sodium replacement.

Happy Hot Exercising--I hope my experience will help better prepare another migrainuer for exercising in the heat.

Whew!  Safe here in Tulsa after a tornado originated very close to my home and touched down near friends last night in Broken Arrow.  This weather is scary and exhausting.

Last week was a rough one for those of us living in Oklahoma.   Depending on where in Oklahoma you were life was a little more fragile but emotions and grief  were high no matter where you were.  We all know the risk that comes with living in this part of the country.  However, we also become a little numb to the warnings after years of getting in our closets.   The tornado drills at schools start at a very young age.  We are trained early to file ourselves into the hallways away from the windows, to get as close to the center of the structure as possible and then to curl up into a little ball and place our hands over our heads and then wait.  We are instructed to locate the safest room in the house.  In my case that room has typically been a closet.  Even though we follow the safety protocols that have been drilled into us since elementary school most of us do so expecting to come out of the closet at the end of the storm to learn the tornado passed through without insult or injury to anyone.  The Moore Tornado last week put all of this training into perspective as well as stripped away the numbness that had built up over the years and left most of us raw and exposed to the emotions that lay in the wake of the devastation. 

So, whether it was tears of sadness and pain from losing precious lives or whether it was tears of amazement in awe of the generosity and miraculous resolve of the human spirit, tears were shed.  As if the barometric pressure changes weren't enough for the migrainuers living in Oklahoma the past few weeks the outburst of tears and strong emotions were a  problem as well.  The knowledge that a good hard cry will most likely precipitate a migraine attack prevents me from allowing myself a good hard cry.  When I feel the tears begin to swell I quickly distract my brain and gather my emotions to become this stoic little robot the migraines have created.  My heart is extremely heavy on the inside but in no way shape or form can I allow myself to relax and let the tears turn into an uncontrolled cry.

Why would crying cause a migraine? 
I believe, along with several scientist that it is worth looking further into for some answers.  There is not much in the literature on crying being a precipitating factor for migraines.  In an attempt to examine the role of crying as a trigger these scientists enrolled 163 migrainuers in their study.  Crying was identified as a trigger by 55% of participants.   In this study the only other triggers listed greater than crying were stress, anxiety, and menstrual periods.  These scientists concluded that since the physiology of crying is not well documented or understood, but it seems to be a migraine trigger, crying warrants further research.

Here are some of my hypotheses with regards to why crying may trigger migraines:
1.  Intense emotions start the process.  This stressful state may be enough on its own to be a trigger. 
2.  Physiologically there is an increase in pulse and respirations, muscles in the head, face, and neck become tense.  This tension may irritate the trigeminal nerve which is linked to migraines. 
3.  The tears themselves may contribute to water loss and hence have a dehydrating effect.  
4.  Crying causes facial and sinus congestion which is a trigger for many a migrainuer.

Typically, I like to present solutions on this blog.  I am not sure we can always stave off a good cry and maybe you could try hydrating if you can't hold back the tears.  So, my solution to my tears and tornados is contributing to the rebuilding of the areas devastated by last weeks storms.   If you haven't already contributed here are some links that might be helpful:
1.  Lifechurch.tv has ways to help either through donations or volunteer on their site
2.  Donate to the United Way Oklahoma Tornado Relief
3.  Volunteer Opportunities on OKStrong
4.  Donate to OKStrong
5.  Also, participating Starbucks will be taking donations this week for OKStrong in exchange for a free cup of coffee!

Prayers to all those that have suffered as a result of this storm.  If you can handle some tears my friend Lisa lost her brother last week in Moore and the rescue worker who found his body was her angel through this tragedy.  Here is a link to their story: http://newsok.com/article/3833849.
 

Snow, ice, and thunderstorms all in the last few days...drastic changes in weather use to make me brace myself for an impending headache.  However, as the months pass without incident (migraine) my confidence is growing in my Migraine Plan.  Here in the past week we went from sunny and 60 to a beautiful snowfall to freezing rain to thunderstorms.  Here I sit migraine-free (can I have a hallelujah please).  Part of the construction of my Migraine Plan follows the rule of controlling the things I can, because I can't control things I can't control.  Seems simple enough, and believe me in the state of chronic migraine I felt that I had no control and that this migrainous state had taken control of my body.  I feel that by eliminating enough of my controllable triggers (diet and medications) and by maintaining consistency in my sleeping, exercising, eating, and hydrating I am able to keep my body from tripping itself into a migraine.
 
There is a lot of information out there about weather changes and migraines...and still some varying thoughts on exact causes.  It's thought that possibly the changes in barometric pressure trigger barometric receptors in our bodies to cause changes in our blood vessels (dilation and or constriction).  So far in this paragraph I have used the word "changes" three times (now four).  What I know about migraineurs is that our bodies are extremely sensitive to changes (five).  My body doesn't like change in my sleep pattern, change in my blood sugar,  change in my hydration level, or change in my hormones.  I can attempt to control my sleep, blood sugar, and hydration.  Hormones along with the weather are a little more difficult to control. 

Many offer remedies for weather-related headaches like:
taking a triptan when you know that the weather is about to change (I quit taking these as part of my plan)
increasing your daily preventive medication (I don't take a daily preventive medication)
buying a humidifier and opening windows (an attempt to have control over air pressure and humidity)

I will let you all know when I figure out how to control the weather, but until then I will eat my gluten-free oatmeal with blueberries and help my children build snowmen when it snows:)

This is delicious by the way...
Just some steel cut oats, brown sugar, blueberries and a little milk for me.