The Morning Migraine Audit

An excerpt from my upcoming book Sick Of Being Sick

I roll over and stretch. I am a stomach sleeper and my neck has paid the price over the years.

Within the first thirty seconds of being awake, the audit begins.

How much does my head hurt this morning? Is there a twinge over my right eye? Is it blurry? It’s not headache pain, it’s an almost indescribable, unique to me code that my body starts to whisper. The sensation connects my ear and eye together and as my eye moves around in my head it’s like a string being pulled, tightening and then knotting up, creating tension where there shouldn’t be any.

Breathe in, deep from your toes, at least six seconds, hold it, hold on to it, push oxygen to your brain, let it feed your senses, let it wake up your nerves and nourish them. Push it out slow and deliberate, keep pushing all the stale air out of your head, the air is not gone until you have no breath left. Repeat twice more. It is not what you think it is.

Am I nauseous? A specific kind of nausea, not the food poisoning kind, a little closer to being on a boat, because when I roll to my back I’m triggered, which also means my balance will be in question. The nausea tells me that the ocean inside my inner ear and cerebellum, where balance is regulated, is sloshing around, waves slamming side to side, pulling those strings that connect my ears and eyes and wreaking havoc. This sends up a flare to my stomach that something is off. Typically it’s not bad enough to vomit but instead just annoying enough to linger for days.

Why am I nauseous? Did I eat something bad? No. Is there any other possibility that could be causing this sudden feeling of nausea? Maybe. What could it be?

If the nausea is absent and the eye and ear are quiet, it’s probably just pressure from my neck. But neck pressure doesn’t clear me either. Top of the head pressure is typically cured with a cup of morning coffee, but neck pain is another story so I have to be mindful. Am I grabbing at my neck, trying to rub away a stiff, rock-like feeling, a knot that has no pressure point and will not simply be massaged away?

Tilt your head back and crack your neck, it will clear the pain. I must have done something during my workout. I also lifted the corner of the couch yesterday. Yes, that must be why it hurts.

My right thigh tingles and aches deep inside the bone, sometimes combined with muscle twitches that bubble up and down my leg. And by the way, that is not a sign of a migraine. Nope, no one on earth gets that, so I can rule it out. Right? Except wait, it happens almost every time.

Along with my thigh, my right arm feels sleepy, weak and uncomfortable, as though I slept on it funny, so I shake it gently, opening and closing my fist.

Damn it. I am opening and closing my hand. That is not good. 

I refuse to let this be my story today. I am safe in my body and my energy ends at my skin. 

I say this because it helps. If it is anxiety induced then I can soothe my body by reassuring it that I am safe and I don’t have to be sick today. But these days it’s something else, because the anxiety induced ones are few and far between. I know how to manage them now and I know myself and my body so much more intimately. But I still get so annoyed.

The other biggest signs for me are what I like to call blender head, tin foil teeth and light blocking. I use these terms because that’s how it feels. Calling blender head a cognitive fog doesn’t give you the graphic description of what I am actually experiencing inside my body. It’s literally like someone turns a blender on inside my brain and my thoughts are jumbled but moving at high speed. It’s maddening and disorienting to say the least.

Tin foil teeth is exactly what it sounds like, the sensation of tin foil in my mouth. No other way to describe it and I suspect there is a part of you cringing at the thought of it right now. If that is the case, you understand exactly why I use that description.

Light blocking is the kind of aura I experience. It’s not lightning or a dark spot in my vision, though I have had that too. Instead, when I close my eyes I can actually see the entire scene I was just looking at projected behind them. For example, if you are looking at a lamp and the rest of the room is dim by contrast, when you close your eyes you will probably notice the light behind them. For me that experience is on an entirely different level. It is so distracting that I blink constantly just trying to make it go away. But it’s not only there when my eyes are closed. When I open them, the shape of that lamp trails with me, layered over anything else in my field of vision, so I end up seeing shadows and light imprinted over everything I look at. Are you feeling just a little panicked at the thought of existing that way? Trust me, I understand, because that is exactly how I feel. These days it is more of an annoyance, especially when it lingers for days, but it can still be deeply disorienting.

No light blocking. No blender head. Teeth feel fine. I might be okay this morning.

I have been doing this evaluation every single morning for most of my adult life, well before I even realized what I was doing or why. Most migraines that hit, even now, I still try to deny, because I am so sick of being sick. But beyond simply hating to be ill, I deny it because during all of these physical shifts happening in my body, my mind is beginning to fail. The fog rolling in is probably the most debilitating part of my personal experience.

It is a slowing or slurring of my words, an inability to find them or a tendency to put them in the wrong order entirely. It affects my motor function too, so forget spelling my own name. My thinking is slow, nonlinear, unclear. I cannot decide if I want to eat, which I do not, but I can’t arrive at that conclusion on my own. And I can’t decide if I need to take medication, which I do, but because I’m still in denial I convince myself I can wait it out. I do not want to sit down, and yet my foot starts to turn upward on its own and suddenly sitting feels more reasonable.

Then I sit and I stare. Seriously, I stare. Having arguments inside my head because I am almost frozen in place. The irony is that while my words and my outward function have slowed to almost nothing, inside my head everything is moving at a terrifying speed. The blender is on high now. But from the outside I can barely focus or move.

It is difficult to describe, but it feels something like this. We all have thoughts, but if you pay attention, thoughts are more like concepts, not fully formed sentences. When this is happening to me, every single word rushes to the surface as fast as it can, all at once. And the particularly disorienting part is that when I close my eyes I get flashes of faces, like someone flipping through a picture book at full speed. I can’t make the faces out, they are just there and gone, there and gone, in fast forward. The same way my word-thoughts are moving. So I try to keep my eyes open until that passes, because the faces can make me even more dizzy. Instead I stare at the layers of shadow and light imprinted across my vision and listen to my brain.

But on this morning I pass the audit. I move out of bed, grab a sweater and put my hair up.

My dog Lily and I make our way downstairs, her paws tapping down the wood steps, reminding me she needs her nails trimmed again. She freezes on the steps if I double back for something and keeps moving only once my feet hit the step again. She is my shadow and I love her for it.

It’s around 7am. A glass of water. A probiotic. An Americano and the couch with Lily by my side. Outside when the weather cooperates, but that is just geography. This is about the quiet, the space and the air around me.

The probiotic is as essential as coffee for preventing my headaches. It delivers good bacteria to a stomach lining in constant need of remedy. Skipping it for a week will set me back a month. Why? Because I used NSAIDs. A lot. Before I understood what was truly wrong with me, and while resisting doctors because I never got real answers from them anyway, I used NSAIDs every day, three and four times a day, not understanding rebound headaches, stomach lining deterioration or the risk of bleeding. It was what I did to survive. 

Didn’t everyone need ibuprofen after one glass of wine? Was it not normal to get a headache so severe you felt like your ears would pop off when it rained? Or to feel, every time you were in the heat, a pressure so heavy in your head that you couldn’t hold it up, as though your spine were weakening and your head might simply fall off? No? Just me? Alright then.

Lily and I sit together and meditate for about 45 minutes. Some mornings I open my eyes and she is sitting directly in front of me, staring in the exact same direction I am. I can feel her stillness as deeply as my own. She is so much like me in that way. She loves deeply but does not want to be smothered. She needs her space but wants to know you are there. She loves to sit outside and soak in the sun, but not for too long, because she gets hot and has to move to the shade.

I laugh thinking about the neighbors watching us every morning, moving from the sun to the shade and back again like we have somewhere to be and nowhere to go.

Meditation is genuinely restorative for me. I need a great deal of alone time, something I have come to understand is not a preference but a necessity, pivotal to keeping not only my migraines managed but my nervous system regulated. In the beginning it was about being hyper mindful of my breath, seeing colors and feeling floaty. Over time I have come to understand it never has to look a certain way. Every day is different, but the constant is the stillness and the quiet. It feeds every part of me and gives me new life each morning.

After meditation, I grab some mixed nuts and fruit and hit play on my workout playlist, which energizes me almost instantly. Yoga and weights first, then thirty minutes on the treadmill. It is a full morning but worth every minute of it. It took a decade to get back to exercise and I didn't realize how much I had missed that adrenaline at the end of a workout. I try to talk myself out of it over coffee every single morning, but I rarely give in anymore, because the workouts are about more than fitness. They keep blood and oxygen flowing to my brain, and I have found they also reduce my hot flashes now that I am 50 and navigating early menopause. More on that later.

This is what healing looks like for me. Not the absence of symptoms. Not a clean bill of health from a neurologist. This careful, practiced, body literate morning is where it has landed for me. But the beginning, that is where the real story is.

I used to tell every doctor I saw that I live at a 4 on the pain scale. Anything above that and I might start to mention it. Below that, I had simply learned to function inside it.

It’s frustrating to look back and realize that not one of those doctors was ever curious enough to ask why. Why was I living in baseline pain? What was my body trying to tell me? Instead I was dismissed, or handed a prescription, several prescriptions if we are being honest, and told in a matter of fact way, once I finally had an actual diagnosis, that I would be on medication for the rest of my life, as if that were simply the terms of my existence and I should go ahead and accept them.

I did not accept them.

That is where my story lives. Not in a quiet morning with Lily, an Americano and a meditation cushion. It lives well before the peace and even before some of the physical pain. My story begins with a little girl who was taught that survival was how you lived, and that in order to survive you must hold everyone else's energy, everyone else's emotions, and carry it all so they didn’t have to.

It goes back further than you might expect. And I am going to take you there slowly, because I want you to understand not just what I do or what I know, but why this is my purpose and how my story might help you find your peaceful morning too.

Amanda Richardson, BCDFN, CFNC is a Board Certified Doctor of Functional Nutrition, researcher, and publisher of Migraine Unread. She lives with hemiplegic migraine and has made it her mission to connect the dots that conventional medicine never thought to connect. Her upcoming book Sick of Being Sick is set to be released early 2027. Work with Amanda at AmandaRichardson.co.