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How to Minister With Migraine: what I've learned over the course of 50 years.

Smalkowski, Frances

doi: 10.1097/01.NNN.0000405025.48414.fc
Departments: Speak Up

One woman's story of finding spiritual understanding in her 50-year struggle with hormonal migraines.

Frances Smalkowski is a director of pastoral care in a long-term care facility where she has worked for 25 years. She has self-published a chapbook of poetry, Panning For Gold. In 2010, she celebrated her golden jubilee as a Sister of the Holy Family of Nazareth.



This is my milestone year: I'm turning 65 (the new 45, I'm told) and it is with God's help, the necessary medication, and a good deal of self-understanding that I have been able to make it this far. For more than 50 years I have been living with hormonal migraines.

I wish I could say that I have befriended the one-sided blinding headache, nausea and vomiting, double vision, loss of feeling in my face and hands, and auras. Instead, I have come to at least recognize and accept this familiar, lingering visitor.

I wasn't officially diagnosed until years after the migraines started, but I noticed a clear association between them and my menstrual cycle—specifically, I experienced an increase in migraines premenstrually and mid-cycle. Even today, the same regularity of timing persists, though with less severity now that menopause is behind me. (My current gynecologist says they are not hormonal anymore but “cyclical.”)

What have I learned about coping with migraine? As a sister of the Holy Family of Nazareth, most of my work has been in nursing, counseling, and teaching. I have learned to be extra careful when dispensing medication, because of the double vision. Also, I need to be aware of my sensitivity to certain sounds, lights, and odors—even conversation topics. Because of this sensitivity—and the impulsivity that sometimes accompanies it—I try to think before I speak or act, and I've learned to say, “I'm sorry.”

During my 15 years of sharing an office with a male codirector, I learned to tell him that my being quiet on a specific day had nothing to do with our working relationship.

In my work in pastoral care, I try to do planning and scheduling on my migraine days. Though I still visit residents, I know it is more difficult for me to listen, focus, and remember as clearly when I'm having a migraine. I have become fairly adept at adjusting while engaged in my ministry.

Staying active and taking an over-the-counter medication that contains both a pain reliever and a diuretic helps me keep “walking through the tunnel” of a migraine knowing I will get to the other side. Sometimes that walk can last for days.

My spirituality supports me too. I ask that the pain I am enduring helps lessen someone else's. In other words, I try to make the unrelieved pain into a kind of prayer. This assists me in finding meaning in an aspect of my life over which I have no control.

Trying to get adequate nighttime sleep is crucial, and I make every effort to make this happen. Also, as time has passed, I have paid closer attention to taking medication as soon as I feel a migraine starting. Previously, I used to wait too long before taking the needed pills. I have also learned to reduce stress and (almost) eliminate low blood sugar headaches by avoiding long periods of time without eating.

Reflecting on my family's history, I discovered that I had a maternal aunt who was regularly bedridden with hormonal migraines. I also discovered a male cousin who had severe cluster headaches. I was grateful when I learned that neither of my two nieces is a migraineur.

It is a blessing that there have been so many gains made in migraine treatment. With other migraineurs, I pray for further breakthroughs.

©2011 American Academy of Neurology