Half-way through Te Araroa with a brain condition: an appeal

I’ve made it through the North Island! If you have enjoyed reading about my adventures and tribulations so far, please consider donating to the Neurological Foundation at this link: https://discover.neurological.org.nz/fundraisers/fionaimlach/tramping-te-araroa-with-migraine.

The Neurological Foundation does lots of research and education about neurological conditions, and although they don’t have a dedicated resource for migraine research, the more we learn about the mysteries of how the brain works, or doesn’t, the greater the chance for new insights and therapies for all sorts of neurological conditions, including migraine. Advances are being made all the time. For example, until 2018, the official International Classification of Diseases noted only two types of chronic pain – nociceptive pain, due to direct stimulation of receptors that detect damage to the body, and neuropathic pain, due to damage to nerve tissue or pathways. But now a third category has been recognised, that of nociplastic pain, which is due the nervous system being overly sensitised or failing to inhibit pain sensations, in the absence of any obvious tissue damage. How migraine fits into these definitions is not entirely clear – more research is required!

I started on this journey wanting to know what would happen to my frequent, episodic-sometimes-bordering-on-chronic migraine condition if I stopped working in an office, at a computer most of the day, and spent my ‘working’ hours being active and outside in a more natural environment. Unfortunately, this change in lifestyle has not eliminated my migraines. They have been manageable and I’ve been able to keep walking despite their visitations, but they just as frequent and I am no closer to understanding why they occur or how to prevent them. I can’t really blame the office environment for their occurrence – this may be a positive, as I will probably be back in an office job once I finish this walk.

I’m grateful that the migraines haven’t been so debilitating that I’ve had to stop walking – that was my greatest fear. I’ve spent some days walking with a migraine, and the act of walking seems to distract from the migraine, perhaps because there are competing pains in the feet and legs, or because the brain is also occupied with moving and balancing the body, or because of endorphins stimulated by the exercise, or because you can focus on the sounds and sights and smells of the outdoors, and take your mind off the pain. It’s when I stop walking, especially in the silence and stillness of the night, that the migraines are most intense and disturbing. This is consistent with the advice of most pain specialists, who say that exercise is the best therapy for most pain conditions (excluding acute injuries) and that distraction is a good way to deal with pain, especially if you can detach yourself from the pain and stop yourself from reacting emotionally to it. So easy to say, so hard to stop the fear, dread, anxiety and despondency that comes with unrelenting or unpredictable pain.

The South Island part of the Te Araroa will provide more challenges – maybe some more revelations in this experiment of one. My conclusions so far are that migraine is a complex brain condition, that there is much more to be learnt about why migraine occurs and how to manage it and that there are no simple fixes. Not that walking the length of New Zealand is a simple fix for a migraine disorder – but it was worth a try.

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