PATIENT PROFILE: EMILY (12)
Emily began getting migraines, and frequently, when she was six years old. As a young child, there are fewer preventative and rescue meds available than for adults, because little testing has been done with these medications for children under 12 years old. So, Emily was limited to over-the-counter medications, which were all fairly ineffective as rescue meds for her.
Emily's migraines would come on rapid and usually severely. She craved soaking in the tub as a means to get some comfort, though soaking provided little actual relief. She would soak for a while, then go back to bed and lie down, then, get up and soak in a warm bath, again. Ultimately, her migraines would not go away until she had thrown up at least once.
Since her migraines often start in the afternoon, she was able to keep her absences from school within allowable standards, until 5th grade, when the frequency and duration of her migraines increased. Around that time, her migraines began lasting for up to 3 days, still unable to take any prescription rescue meds and with other-the-counter medications being of limited success.
Now 12, Emily has just reached the age in which she can begin taking other medications. However, Emily's doctor and parents are hesitant to place her on a regimen of preventative medications. Migraine is most often a lifelong condition. So, while some medicines are effective treating and preventing migraine for some patients, they may also have long-term side effects. For anyone starting a long-term, potentially lifelong, regimen of daily medications, there is reason to pause. That is especially true for children, whose bodies and brains are still developing rapidly.
Migraine is a near constant companion for Emily. In terms of frequency, she is chronic, which is technically defined as 15 or more headaches per month, or 8 per month associated with migraine. Emily has 2-4 migraine days per week, and that fluctuates throughout the year.
Chronic migraine is a condition that affects every aspect of a patient's life: socialization, emotional development, career decisions, life decisions, your daily mood, your personality, time planning, and so on. For Emily, she no longer participates in sports. She prefers to stay at home more than most people. She will cut short vacation stays with extended family, so she can sleep better in her own bed. While she may enjoy an outing or a short trip, even a college football game, she is not a big fan of travelling. Going to a summer camp longer than about 1 week is out of the question. And, even with that, she has only chosen to go to a Math and Science Camp, in which most of the activities are in indoor, air conditioned classrooms. When she is going to a week-long camp or travelling with friends, or anytime she absolutely needs to NOT have a migraine, she takes Ibuprofen and anti-histamines as a preventative, which has worked well for her, but would not be a regimen advisable for her to continue every day, starting at such a young age.
Despite missing a fair amount of school days, Emily does well in school, and she has some especially strong skills in areas that they will never measure in school. She is a good artist, and likes to draw her favorite animals, especially Green Cheek Conures and Puppies. Though she no longer plays sports, she is physically very strong. She is extremely effective at arguing, especially fast thinking on her feet. Her parents joke that though she is only 12 years old, she challenges any nonsense. Her older brothers will one day be working for her.
No doubt, long-term, migraine will likely continue to influence Emily's decisions. Her parents encourage her to aspire to anything she wants to do. But, they also recognize that chronic migraine will cause people to steer toward certain career aspirations and away from others. As you can see, for the most part, Emily is a normal 12 year old girl. If you saw her out in public, you may never realize that she is in a continuous battle with a disabling illness.