If It Isn't One Thing, It's Another

Patient Expert

A few weeks ago, I boarded a plane and headed out to sunny California for a wine tasting mini-break in Napa to celebrate a good friend's forthcoming wedding. I'd been working some long hours and was happy for the opportunity to get away for a few days to relax, but I was worried that between my late hours and the stress of traveling, my rheumatoid arthritis might spy an opportunity to creep up and ruin a perfectly good vacation. I made sure I drank plenty of water, dosed myself with vitamin C and slept on the plane to try to keep my immune system in check. I took a nap that afternoon when I felt my energy starting to give out, but after a solid night's sleep, I felt like I was in good shape as we were on our way to our first wine tasting the following day.

Ever wary, I still made sure I balanced out my imbibing with plenty of water, spent some quality time in the Jacuzzi before bed, and again got lots of sleep to keep my reserves up and my RA at bay. The next day went much the same: wine, sunshine, good food and lots of laughing, with a healthy dose of hot tub and hydration in the evening. When I awoke on the fourth morning ready for another day of vineyards and cabernets, I felt like I was safely in the clear and that my RA was going to behave.

Phew And then I felt it: a niggling little ache in my left temple, like a small nail was slowly being prodded into my brain. The tell-tale sign that one is on its way is this very slight aching on the left side of my head, and as much as I wanted to ignore it, I could tell it was there, even if it was faint. Along with rheumatoid arthritis, I am also a migraine sufferer. While I've gotten migraines ever since I was in college, they have increased in frequency since my diagnosis of RA. For many, migraines can also be an unwanted side effect of some medications for RA, such as Humira (any others?), which means that on top of dealing with an autoimmune disease, we also have to monitor our bodies for signs of a migraine.

When mine began to multiply post-diagnosis, my rheumatologist sent me to see a neurologist, who gave me a medication to take at the first sign that a migraine was on its way. As we drove past the foggy vineyards- the sun had been exchanged for clouds and rain - I debated whether or not to take my migraine meds. Taking them would mean no alcohol, and considering that I was on a trip whose explicit purpose was to taste wine, and it was the last day, I really hated to have to miss out. On the other hand, not taking them would mean that my migraine would most likely grow from a tiny, nagging little pain to a full-blown, knife-wielding, nausea-inducing maniac of a head ache within a few hours. As I have so oft asked in my articles, what is a (wine-loving) gal to do?

Unfortunately, this is where my last shreds of denial regarding my health kicked in and convinced me that maybe I wasn't really getting a migraine. Maybe, just maybe, this was 'just' a headache that I could ward off by tossing back a few NSAID's (even though this NEVER works). But that is what I did. I put my migraine meds away and pretended that it was just a regular, normal-person headache that would subside quickly and leave me to enjoy the rest of my day pain-free. Needless to say, it didn't work. The migraine continued to fester until it felt like the entire left side of my brain was a cesspool of stabbing aches and pains and my stomach felt queasy and gross.

Luckily, it wasn't sunny outside, so there wasn't any light for my eyes to shy away from since my migraines often cause my eyes to become extra sensitive to lights, especially bright ones. I managed to stumble through most of the wine tastings and even rallied slightly during a late lunch at one of my favorite Napa bistros, which is impressive since my migraines are sometimes bad enough to chase me into bed with a pillow over my head until they recede. This one wasn't that severe, but there was no denying that I was in pain and feeling kind of miserable.

At this point, you may not have very much sympathy for me, which would be understandable given that I knew this migraine was coming on and decided against taking my medications anyway for the sake of some vino. In fact, you might be thinking I'm pretty dumb, all things considered, but I promise you, it's not that I'm stupid. It's just that sometimes, I like to believe that I'm not really a sick chick. Every day, I swallow a gag-inducing number of pills. I stick a needle into my leg twice a week and have to fit in numerous doctor appointments and trips to the pharmacy, all the while monitoring my energy level, assessing the amount of pain and stiffness in my joints, and running a constant risk-benefit analysis for every decision I make. All of this is primarily associated with the management of my rheumatoid arthritis, so given that I had been careful on this trip to give myself the best chance of feeling good and enjoying myself as far as my RA was concerned, I just couldn't bear to think that yet another health issue was going to get in my way when I felt that warning signal of a migraine pop up.

Even though I knew in my heart that I was getting a migraine, I wanted desperately to believe that since my RA was behaving, a migraine wasn't going to spring up and ruin all my precautions and planning. Unfortunately for me, that's not the way life typically works out. I paid the price for my denial, lecturing myself on the consequences of stubborn delusions as I fell into bed that night exhausted and still wishing my head would detach from the rest of my body and give me some peace. The next day, the migraine was mostly gone, but the remnants meant that I was fussy and worn down, just in time to board another plane cross country and head back to work the next day. You can be sure that next time, I'll take the meds- denial be damned!

Sara is the author of the blog, The Single Gal's Guide to Rheumatoid Arthritis.