PATIENT PROFILE: ANDREW (17)
Andrew began having migraines when he was 6 years old. He is a chronic migraine patient, and has been since shortly after his initial onset of migraine. Andrew's migraines come on slowly throughout the day, and tend to crescendo after school and into early evening. In social environments, like being at school or playing with his baseball and football teammates, the adrenaline from the social interaction would often mask his migraine, resulting in a fast crash shortly after leaving school or sports practice.
Andrew is gifted, near the peak of human intelligence. He is easily among the top 100 in his home state, more likely somewhere in the top 20 or so. He spoke his first words extremely early, saying hi to a lady in a grocery store, when he was just 3 months old. He was conscientious, even as a baby, waiting for his parents to wake up, rather than waking them up in the middle of the night or early morning, even before he could walk. He carried a steady sense of right and wrong, standing up against other children who would seek to pick on a smaller child. He was the biggest kid in his class throughout elementary school. He is a very calm soul, mature beyond his years. He devours books and articles for hours every day, even during summer vacation. He has never been one to have a strong compulsion to compete, though he was a very good athlete growing up, and was even named to the All-Metro Football Team as an offensive lineman in the 8th Grade, an honor typically reserved for running backs, quarterbacks and defensive backs at that age.
From the age of 6 to 12, Andrew was unable to take any rescue or preventative medicines, other than over-the-counter medicines for children, which were not very effective as a rescue therapy. He craved soaking in a hot tub when he was migrainous, but his migraines would not go away, until after he had thrown up at least once. Now, he can take preventative drugs, but his compliance is very low. And, neither he, nor his parents, are anxious to start him on a lifelong regimen of drugs at such a young age.
Andrew's life decisions have clearly already been affected by migraine. Despite being a great football player, he stopped playing his Freshman year in high school, and has never returned. In middle school he was the top French Horn player, but the idea of long summer band practices, marching and playing on the football field, was not an attractive proposition for him, as a migraineur. So, he dropped music, as well. Andrew is now planning for college and his career, and migraine is one of the filters he uses to evaluate career options. Can I engage in this profession successfully as a chronic migraineur? Andrew's family took 3 years to orchestrate the family's relocation to the town where Andrew will likely attend college, so that they could be there to help support him and manage his migraine through college. It took that long for both his mother and father to align their employment options to facilitate the whole family's move.
When someone has migraine, we automatically know that at least one of their parents also had migraine. Often, the parents may not have realized that they have or had migraine. In Andrew's case, his father was diagnosed with migraine for the first time, when he was 33 years old, even though he had been contending with headaches, since he was a child. So, when Andrew began showing symptoms, his dad knew exactly what his son was dealing with. However, Andrew's mother also gets migraines, episodic, which may explain why Andrew had chronic migraine at such an early age. He got it, genetically, from both parents.