James Lucas writes:

Subject: Painless Migraine?

I have suffered what eventually was diagnosed as migraine headaches since I was a child. My parents called them sick headaches because I would throw-up near the end of the episode. Finally, sometime between 1963 and 1965, when I was 27-28 years old, an army physician using Cafergot as a diagnostic tool, diagnosed my headaches as migraines. Cafergot has worked to relieve the problem ever since.

In 1969, the visual aspects started with a blind spot in the central area of my vision. An ophthalmologist diagnosed this as my migraine symptoms changing, The aura continued to be present, though it would change slightly with each series of headaches. In between each series there could be months without any headaches. Later, the blind spot went away and visual field disturbances, blinking or vibrating lines around the peripheral area of each eye, were present. Pain could be avoided through relaxation techniques, cafergot, and/or sleep. Only on one occasion did I ever wake up with a migraine--that scared me to death, because sleep had always been part of the sign of the end of the migraine. Over the years, as I learned to control the migraines when the aura first started, pain seldom was an issue.

Two unusual events have occurred recently. I am a 72 years old, twice divorced, now happily married, Caucasian male, with six children by my first marriage. The first change was on June 1, 2009. I had spent the day preparing for a dinner party at our house for 26 family members. The dinner went well. Most, if not all, of the guests were still present, when sitting on a couch in our family room, I attempted to raise my left hand. I could not raise my left hand. I tried to speak. I could not speak. I thought, "Jim you are probably having a TIA or a stroke." To confirm this I raised my right hand. Since that worked, I thought, "Well that confirms it. It is a TIA or a stroke." I did not feel any fear, just addressed it in my normal problem solving manner. I used my raised right hand to get the attention of a relative sitting on another couch across from me, motioning him to come over. He then sat beside me. I kept trying to speak and after a while, I could hear myself making what can best be described as drunken noises, too slurred for anyone to understand. I noted that my hearing seemed to be fine but my speech center was not functioning properly. I thought, "Try just using one syllable words." Then, when my son come over, I said, "Nine-----one-----one." I noted that these one syllable words seemed to me to be clear and I repeated them several times. Finally my son said, "You want an ambulance," went to another room and called 911. I could feel myself coming out of whatever had been going on. The paramedics arrived and did their diagnostic stuff. Someone asked how long I had been observed in this altered state. The response from someone else, was "About 15 minutes."

I insisted on being taken to St. Joseph's Hospital Emergency Room, which includes world-renowned Barrows Neurological Center, and where on a previous occasion, I had seen a Dr. Flaster, a stroke specialist. The ambulance crew did not like this, nor the fact that I did not want an IV, but at my insistence relented and took me to St. Joe's. Enroute, the slurred speech started again and the paramedic said something like, "I don't care whether you like it or not, I am starting the IV now," and she did so. When we arrived at St. Joe's Emergency Room we find that alas, Dr. Flaster was no longer at St. Joe's nor Barrows Neurological Center. The doctor that saw me kept me overnight, ran a bunch of tests, did an MRI, and diagnosed the problem as a "painless migraine." Note, there had been no recognized aura experience, with this event.

The second unusual event occurred, the day before yesterday. I was doing carpentry work on our back patio, and then the peripheral field visual disturbances, earlier described, started, without any aura. I made an unusual decision. I decided to keep on doing what I was doing. A short time later they went away, with no other symptoms. That, event termination without intervention, had never happened before.

What does all this mean? I do not know. Could it relate to the doctor and personal trainer supervised exercise program that I started three months ago? Could it relate to the fact that I took myself off all those medications that I had been on about three months ago? Does anyone out there have any ideas?

Generally about three weeks after I stopped all those medications, I started feeling much better, so I am thinking that that was a good decision, though, I cannot be totally sure. When I saw my primary care physician this week, she was upset that I had stopped the medications without consulting her. My thoughts had been “All the doctors that I had seen for the last two or so years kept remarking that I was taking a lot of medications.” My response had always been, “You doctors prescribed them all.”