Monday, 1 April 2019



My mother-in-law, the Missus, twirled her lacquered index finger in a circular motion near her right ear. She leaned her coiffed hair in closer to the spun beehive that her mother sported. Their backs were to me but I could see their sarcasm.

They accused me of being crazy.

I crunched on the couch a few feet away from the kitchen island where they conferred. I pressed my thumbs into my temples and massaged my scalp. I wanted to cry but crying would hurt. 

Every flicker of light and every smidgeon of sound exacerbated the agonizing pulsating pressure infecting my eyes and invading my mind. A hammer pounded on my skull and drove spikes through my eyes in rhythm to my every heartbeat. I needed aspirin or Tylenol but I was too nauseated and humiliated to ask for help.

I’ve had migraines since I was born. It took a migraine-induced stroke for the reason to be diagnosed. Until then, I went through a gamut of medical specialists with their differing theories on the cause of my migraines and their varied regimens of therapy.

Fluctuations in blood flow to the brain cause the symptoms a migraine brings. These fluctuations don’t initiate the pain but they may contribute to it. For example, high blood pressure can cause pain in the brain, but the pain of a migraine may cause high blood pressure. For that reason, beta-blockers and calcium channel blockers are often prescribed. These drugs lower blood pressure. I’ve been on several different varieties. I’m on Norvasc now. It keeps my blood pressure from climbing to panic levels when I’m having a migraine. 


Serotonin is a chemical in the nervous system associated with regulation of mood, appetite, and sleep. Serotonin is necessary for nerve cells to communicate with each other. It is also a trigger that contracts and narrows blood vessels throughout both the body and the brain.

Serotonin plays a role in both migraines and depression. Thinking there may be too little serotonin in my brain, I was given Zoloft and Prozac. These are serotonin reuptake inhibitors (anti-depressants). I wasn’t depressed until I took them. My migraines raged on. I stopped taking the meds. Depression is a mental health disorder. Migraines are not. 

Serotonin levels affect both men and women but women suffer from migraines three times more than men. Fluctuating estrogen levels play a role.

Contractions in the brain’s blood vessels may occur when serotonin and estrogen levels rise and fall. These contractions lead to throbbing pain. This knowledge led to the development of the triptin class of migraine drugs. Triptins dilate the cerebral vessels and increase the flow of blood in the brain. I take one of them – sumatriptin. It helps cut the agony of a migraine.

Migralepsy is a word that comes from putting together migraine and epilepsy. It was once believed that migraines were caused by seizure activity when in truth, they are not related. I was given high doses of Tegretol and Topamax – anti-seizure meds. They made feel dizzy and loopy but did nothing for my migraines. I stopped taking the meds.

I was given injections of fentanyl and steroids into the base of my skull. These procedures required me to be put under anesthesia. The third time I received the injections, I had an allergic reaction to fentanyl. I stopped breathing and had to be revived with three doses of Narcan. I never consented for more.
Migraines are murder. They disrupt the planned activities of my day and suck the joy out of my life. Migraines don’t outwardly mark me as being disabled the way a crutch or scars on the skin would. My migraines are invisible to everyone but me.

Nothing I do or avoid eating or drinking prevents migraines from waking me in the middle of the night with nauseating, head banging, excruciating pain. These migraines feel like my brain is oozing out of my skull through my nose, eyes, and ears. I live in fear there’s a migraine waiting to happen that I won’t survive.

On average, I have three to four migraines a week. To soften the hammer in my head, I take rounds of Imitrex, Migraine Excedrine, Norvasc, and ibuprofen. I’m amazed my liver isn’t dead. After one particular miserable episode, I ended up in another emergency room with a migraine-induced stroke. I was given a standard migraine cocktail. It consisted of an IV bolus and injections of Benadryl, Compazine, and Toradol. The cocktail did nothing for me except make me dizzy.

An electroencephalogram (EEG) was followed by a magnetic resonance imaging (MRI) of my brain. An electrocardiogram (EKG) of my heart preceded an echocardiogram (ECG) and a bubble ECG, plus a transthoracic echocardiogram (TTE).

The cardiologist who did these procedures found a small hole in my heart. I had partial patent foramen ovale (PPFO). The heritage of this hole is to allow small blood clots to travel to and create havoc in my brain. He believed these miniscule blood clots caused my migraines. He put me on a diuretic, Hydrochlorothiazide (HCTZ) and a daily regimen of aspirin (ASA). The goal was to break up the blood clots before they could do any damage and to reduce the pre-load, the pressure, to my heart.

My migraines raged on while I ended up with a permanent side effect of the HCTZ – dry eyes. I stopped taking HCTZ and had an invasive procedure to repair my eyes.

Current research has moved more towards the prevention of migraines. There is a new class of drugs called biogenics. I’m seeing a neurologist next month. I hope he prescribes this drug. It would be wonderful to sleep through the night without the fear of waking up with another migraine.

Although chronic migraine sufferers may eventually experience PTSD, migraines are not a psychological disorder. Migraines are a neurological debilitating disease. There is no shame in having either.

It’s difficult to give forgiveness to someone who had a habit of scoffing at me while I was in the middle of a migraine. There may be some small amount of justice in where she might now live.

For more stories on living with migraines that are murder: 

True Crime Memoir – Survivor: As Long As I Breathe
is dedicated to:
survivors of emotional, physical, spiritual, or sexual abuse,
those who have had to bury a murdered child,
former members of a religious cult based on misogyny,
children born with Cornelia de Lange Syndrome,
and anyone who was falsely accused of a crime.


Joyce A Lefler is a true crime survivor and the author of
From Miracle to Murder: Justice For Adam.
She is a facilitator for Parents of Murdered Children,
a bereavement counselor, registered nurse,
and an advocate against abuse.

Connect with her:
Advocacy project: