In the Netherlands, 33% of women and 13% of men have migraines at some point in their lives. The fact that migraines are three times more common in women than in men is probably because female hormones play a role, according to the Brain Foundation. Anneke Pruijssers (43) has a hormonal migraine and can set the clock to it every month when she has another migraine attack.
The first migraine symptoms appeared when Anneke was about eighteen. “I noticed that I was getting headaches more often than usual and that my headaches were getting worse, lasting longer and that regular painkillers didn’t help.” When she went to the doctor with her complaints, it became clear that it was a migraine. “The doctor prescribed medication. Fortunately, these helped somewhat, but despite this I suffered from a monthly migraine attack, which could last for three days.”
‘I found out that my migraines are hormonal’
It was striking that when Anneke was pregnant, she did not suffer from anything and the migraine disappeared like snow in the sun. “I’ve been pregnant three times and felt really good during those periods. As soon as the hormones were out of my body, everything started all over again and the attacks came back in full force.” She decided to keep a headache diary and realized that she had attacks every time in the same week of the month. “I found out this way that my migraines are hormonal and related to my monthly cycle.”
No light, sound or movements
“It starts with a nagging feeling that gets worse and worse,” Anneke describes her complaints. “Without medication, I can no longer tolerate light, sound or movements and I lie in bed or on the couch for three days, waiting for the weather to pass. Fortunately, the course of an attack has become much less severe since I started taking medication. If I now feel an attack coming on, I immediately take my medication. The sooner I get there, the better it works and the shorter and milder the attack is. Usually it stays with an attack of a day.”
Within fifteen minutes after Anneke has taken her medication, she already feels the effect. “It starts with tingling in my neck, a sign that it’s working and pulling up to my head. Then I just feel the headache go away.” However, she can sometimes suffer from side effects and she has a numb feeling in her head. “It just feels like I have a cotton ball in my head, but everything better than the pain of a migraine attack.”
Limits
Migraine has had a significant impact on Anneke’s life over the years. “Especially when the children were small, I encountered many limitations. A day in bed during a migraine attack was out of the question, because I had to be there for the children. Luckily I was on medication; otherwise it would not have been possible.” Unfortunately, Anneke has suffered more from hormone fluctuations in recent years, which has had an impact on her migraine. She suspects this is because she is heading towards menopause. “This has made my symptoms worse. Sometimes it goes well for months, but there are also months when I have to call in sick at work because I can’t do anything anymore because of the pain.”
If Anneke is in a bad period and has to stay home for several days in a row because of a migraine attack, she can feel very gloomy and exhausted. “That’s upsetting me; during an attack I don’t even look like the person I am when I don’t have a headache. In order to give in as little as possible, I consciously dress, do my hair and make up. As much as I want to get on with my life, I can’t help but endure these migraines and hope it’s over soon.” However, she is not rebellious. “I always keep in mind that there are people who have it much harder than me. I can get on with my life once the attack is over, they often don’t.”
Botox treatment for migraines
Three years ago, Anneke suddenly had three attacks a month and was referred to a neurologist at the headache clinic. There she received botox treatment for migraines. “It should relax the muscles in the painful area. At first it seemed to relieve the pain a bit, but this didn’t work enough either.” To get rid of the pain, Anneke took various nutritional supplements and followed every nutritional advice. “Because my migraines are hormonal, you can’t solve this by, for example, leaving coffee or alcohol. Of course I use these types of products in moderation now that I know that it can affect migraines, but it doesn’t have much effect.” Because she hopes that a solution will be found for migraine patients in the future, Anneke regularly participates in studies of the LUMC.
poser
Anneke has sometimes been afraid that people would find her a poser. “Before I got migraines myself, I always thought you could solve this by taking some paracetamol. In the beginning – and still – I was very strict with myself and afraid that people wouldn’t understand if I couldn’t keep an appointment or had to call in sick again at work.” However, the opposite turns out to be true; her family, friends and colleagues fully understand and sympathize with her.
“I now realize that I am the one who cannot accept that my life is on pause for a few days every month because of migraine. I just want to be able to do my job and not have to call in sick every time. I stand in front of a SO class, with children with serious behavioral problems and find it very difficult that I can offer them less structure. I also find it annoying to my colleagues that I am absent so often or that I am not completely fit for my work.”
‘I just want to be able to do my job’
When making appointments, Anneke must always take into account the week that she can expect an attack. “Every month there is a cross in my diary; in that week I can get migraines. If I do make an appointment in that week, I often say that it could not take place because of migraine. It is also possible that the attack is mild and I can meet or work.”
For some time now, Anneke has been taking anti-epileptic drugs for people with epilepsy on a daily basis. “As a result, my brain receives fewer stimuli. In the beginning it seemed to have an effect, but last month my migraine attack was back to normal. That’s so disappointing, it really makes you wonder what I’m still taking all this medication for. But when I look back on all those years that I have had migraines, I have to conclude that I am doing better in some periods thanks to the medication. Of course I would like to get rid of it completely, but I suspect that I have to go through the transition first.”