Thank you B for the insight you shared. Ask why do you have a headache. It often represents a “psychological block to action that is needed to make oneself feel safer/acknowledged/present . . . So ask what were you about to do? Pause. Diaphragmatic breathing . . . the answer may appear if you are open to listening.

Until Premenopause, I’d never had a migraine. Seldom had pain of any sort. What I did suffer from, was chronic, unmitigating, snot-factory-standard sinusitis. I developed migraines that made me realize what some of my patients have had to endure.

I blamed hormones and sinusitis and anything else I could imagine until I faced the true problem.

Below an article published in The Medical Post written by yours truly

In medical school, I was taught about the link between stress and disease and pre-menopause forced me to realize that anxiety is a vicious inflammatory disorder.

     From pre-teen years I battled bouts of sinusitis that lasted up to six weeks without the use of antibiotics. These attacks followed me from South Africa to rural central British Columbia, and, until my early forties, conformed to the usual pattern, a quarterly irritation easily remedied with medication.

     Five years after landing on Canadian soil, I awoke one morning with a wicked headache and was quickly reacquainted with the previous day’s supper, followed by lunch. By day two my husband was prodding me to go to the ER, but he is not a doctor, and I knew better. This too shall pass, as did every drop of liquid that spent less than five minutes in my oppositional stomach. Seventy-two hours later, I was left with only the usual sinus congestion.

     The blip in my health became more of a kick in the derrière when, a few days after the incident, my laboratory results revealed I was in third stage renal failure. My kidney filtration rate remained abnormal despite careful nurturing. Bouts of sinusitis increased in frequency to one every six to eight weeks.

     My GP referred me to an immunologist who, after garnering a healthy load of red juice, diagnosed an immune disorder. I contributed a sizable chunk to Canadian medical spending with immunotherapy, which unfortunately failed to make a substantial difference.

     When the immunotherapy failed, I consulted an ENT surgeon who performed endoscopic nasal surgery, widening my maxillary sinus openings. Within a year, another severe attack drove me to Kamloops, five hours from Quesnel, and I underwent inferior meatal drainage. Both times the CT scans confirmed air fluid levels. The procedures relieved my symptoms, but only temporarily.

     Without antibiotics, my attacks raged on for six weeks at a time and, as I was in solo practice, without a locum doctor, I relied upon antibiotics to avoid missing work, powering through headaches and nausea. Also, horror of horrors, my perfect sleep pattern had changed. I counted myself lucky if I managed four hours sleep a night and no longer bounded out of bed in the morning with a song in my heart.

     At the age of forty-six, a few years into pre-menopause, I’d become desperate. I reached for any information that could help me solve a problem that was becoming embarrassing. Wearing a surgical mask while managing patients was cumbersome. I felt guilty consuming antibiotics while hypocritically preaching the dastardly drugs should be avoided.

         Mindfulness kept cropping up in magazines, at conferences, on the internet and in journal articles. A presenter at a winter conference suggested an addiction to extreme sports could be a symptom of anxiety. I scoffed. The only person anxious when I hit the hills to snowboard, or the water to wakeboard, was my husband. He was a nervous wreck when I played ice hockey, which I had to give up after a concussion, a dislocated shoulder and, the final crack in the ice, a fractured radius. Trying to walk without tripping over my own two feet is about as extreme as I get these days.

     Realization finally set in when a psychiatrist announced in her opening statement at a medical conference, that anxiety is an inflammatory disorder. My defences stripped down, I finally accepted that stress was the reason for my migraines and that anxiety was causing the inflammation in my sinus cavities. The treacherous dominance of estrogen over progesterone had compromised the fragile grip I’d had on my health.

     I gave the troglodyte occupying the space in my brain a stern warning. Time for change. My patient husband showered me with Taoist and Buddhist literature he’d studied eons ago. Who knew? It seems the ancient philosophers may have been onto something. I began to practice paced abdominal breathing with my pre-menopausal paunch, giving my Vagus nerve the stimulation it requires. 

     I had been spending between eighty and ninety hours a week on work, around fifty sleeping, or trying to sleep, which left precious little for family life. Restructuring my work schedule proved to be challenging. The health authority was less than charmed when I resigned from the emergency department, but fortunately I had the support of the majority of physicians.

     As my health improved, so did my interest in things outside of medicine. Our house has become my sanctuary, no longer pointing a finger in my direction when I neglect her. The reincarnation of dust poses no problem, as I remove my glasses the minute I enter the house, giving me true peace and more time to write.

     I have become mindfully anxious. When I “think” or “worry” about something, the little Buddha in my head greets the thoughts of the future graciously, accepts them as anxious thoughts, and kicks them out the door, no time for tea. I pay attention when I become overexcited. Happy stress can be as inflammatory as bad stress. It appears that our minds can’t tell the difference between stress of any kind, physical or emotional.    

     An unexpected bonus has been improvement in patient care. Despite slowing down, I noticed I was operating more effectively. After tentatively sharing some of my stories with a few patients, it became apparent that there are patients who appreciate knowing their physician understands their pain. Mindfulness has lowered my anxiety and improved my ability to approach patients with understanding and tolerance.

     Each day, when I wake, I take a few moments to breathe mindfully, and remind myself that there is much I have no control over. When my sinuses flare up, the post nasal drip tickling the back of my throat, I pay attention. When tinnitus sets in, I answer the ringing in my head and invariably it disappears. I am now post-menopausal and it has been four years since my last course of antibiotics. Thank you pre-menopause for giving me the incentive to live mindfully.