Tramper-migraineur Hazel Phillips ponders how to deal with losing her vision from aura while in the wilderness.
The first time I ever got a migraine with aura I was 26m deep, scuba diving on the HMNZS Canterbury wreck in Deep Water Cove, Northland. Sparkles took over one side of my vision, like one of those kaleidoscope toys you had as a kid, and I realised I couldn’t see properly. I also couldn’t think, and I wouldn’t have been able to get words out, either – not that that was an option while breathing from a tank.
I thought it might be the bends and I signalled to my dive buddy to ascend to the surface. The visual blockage took about 20 minutes to fully pass. And then the headache started. A wise soul on board the boat advised me it was a migraine with aura, and I alternated between vomiting and taking way too many painkillers.
I was 37, and although I’d had headaches all my life, I’d never experienced this sickening brand of violent roller coaster.
My doctor prescribed triptan drugs that can be taken without water, and I carried these around for some months before I needed to use them. I was zig-zagging up to Sunrise Hut in the Ruahine Range when I realised I couldn’t quite read one of the signs. Everything swam in front of me, so I dropped my pack, put one of the drugs on my tongue and lay down in the middle of the track to wait it out. Again, I couldn’t speak properly (I tried, out of curiosity, attempting to talk to myself while lying on the track – and only gibberish came out) and I wondered how I was going to explain the situation to a passing walker. Mercifully, there was no one and, after half an hour, I was able to pick up my pack, utter a few sentences that actually made sense and slowly get to the hut.
Over the five years since I’ve been afflicted with migraines, I’ve become something of an expert in determining and avoiding triggers. Chocolate, cheese, alcohol and coffee are basically the Four Horsemen of the Apocalypse in migraine theory (there goes your weekend!). Bright sunlight and dehydration are deathly, and both usually come hand in hand with days out in the wilderness. And then there’s stress, which has accompanied every migraine attack I’ve ever had.
Migraines do tend to visit when I’m in a wilderness setting. I’ve lost my vision a couple of times while climbing on Mt Ruapehu, a few times diving, and many times tramping. The combination of harsh sunshine, very white snow contrasted with a blue sky, and physical exertion is just a migraine looking for somewhere to happen.
My migraine app (Migraine Buddy) tells me it’s been 95 blissful days since my last attack. That was just after arriving at Ball Hut in Aoraki/Mt Cook National Park. There must be something about the relief or comedown you experience when reaching a hut that tells your brain: now would be a great time to start having an aura. I dropped my pack and headed straight to the longdrop and realised I couldn’t fully see the bolt on the door. Returning to the hut, I told my endlessly patient tramping buddy what was happening, swallowed drugs, took off all my clothes without caring for modesty, got into my sleeping bag and began drinking as much water as I could tolerate while shielding my eyes from sunlight. Perhaps it was the unspoken stress of tramping with someone new, or the dehydrated exertion of the barely cut new track that avoids the extreme Husky Flat washout. I will forever remember with fondness the generous shelter Ball Hut extended to me that day, offering its cool quiet, its calm red alpine exterior and its soothing green mattresses.
There is hope, though, for the tramper-migraineur. Not only have I learned how to minimise the triggers, I’ve also learned how to handle the effects better. In the early days, the inability to see and speak would stress me out, which only made things worse. Now I know that it’ll pass, and I’ll be able to get up off the ground and continue – which is, perhaps, an excellent metaphor for the trauma of life in a wider sense.
Writer Joan Didion, in a 1968 essay, said she had come to regard her migraine more as a friend than a lodger. ‘Now that I am wise in its ways, I no longer fight it. When the pain recedes, everything goes with it – the migraine has acted as a circuit breaker, and the fuses have emerged intact. There is a pleasant convalescent euphoria. I open the windows and feel the air, eat gratefully, sleep well. I notice the particular nature of a flower in a glass on the stair landing. I count my blessings.’
There’s a commonality there with the circuit-breaking action of tramping. Feel the air, eat your dehy, smell the flowers. Perhaps pain has something to teach us all.