When did you first start experiencing migraines?
I remember my first migraine like it was yesterday. I was seventeen years old and out with a couple of friends in New York City. All of the sudden I felt this shooting pain go from the front to the back of my head. I didn’t know what was happening, but I immediately became sensitive to any light and I was very nauseous. I went home right away and hoped that it was just a fluke. Unfortunately, that was just the first of many episodes I would have in the years to come.
How would you describe your migraines over the years?
By college, I would reliably get migraines a 2-3 times a week. Fortunately, my schedule was flexible enough that I was able to go to class and then rest or nap when I needed. Once I started working full-time, I was still getting very regular migraines but I was extra miserable and stressed because they were taking a toll on my new job. I felt very self-conscious about telling my boss that I had a migraine, so I would often go to work when I really should have been at home sleeping. On the occasions that I did have to call in sick for the day (or days), I felt enormous guilt and worry that they would think I was exaggerating or slacking off.
I sought out help from several doctors over the years. I saw several neurologists, acupuncturists, homeopathic doctors and physical therapists to try to find a solution. I tried so many medications – both abortive and preventative – but they didn’t really provide any long-term help (and some had some really nasty side-effects).
Finally by my late 20s, I had found that a mix of Excedrin Migraine right at the onset of a migraine along with a dose of Imitrex nasal spray could save me from my most miserable episodes.
What’s strange is that I thought of this phase as me having “control” over my migraines, which I realize in retrospect is totally crazy because I was still getting at least 6-8 migraines a month! This had just been my norm for so long that I didn’t know what a life without migraines was like. I considered myself lucky that I found a mix of medications that were keeping them somewhat under control.
What was the turning point in your migraine journey?
My Excedrin/Imitrex routine worked great…until it didn’t. The fun stopped for me very abruptly in August of 2014. Literally from one day to the next, the medication stopped working. Out of desperation I tried taking much higher doses but that didn’t work either. I had simply over-medicated myself for years and my body was no longer going to be responsive to the pain medication anymore. That begun a nearly 6-month long streak of non-stop episodes. I was either experiencing a migraine or recovering from one, with only brief respite in between. The only thing that could break the worst migraines was visits to the ER, but I certainly didn’t want that to be part of my long-term strategy.
I started seeing a new neurologist and we started testing a few different strategies, none of which ended well. I tried one medication that made me gain a ton of weight in a very short period of time. I then switched to another medication that made me start losing my hair! I knew at that point that I had to find a completely new way to get healthy without relying on heavy drugs.
How did you finally break the cycle of chronic migraines?
In my search for migraine answers, a physical therapist friend introduced me to a nutritionist. He said, “I know this is going to sound crazy, but whenever we have a client with some pain we can’t figure out, we assume it’s diet-related. You should just give it a shot.”
I considered myself a pretty healthy eater so I was skeptical. But I was so desperate at that point that I decided to work with her. I learned about how chronic inflammation, likely caused by a leaky gut, was at the core of my migraine misery. I committed to an elimination diet for 30 days and when my symptoms didn’t improve, she encouraged me go for another 30 days, which I did. By day 60, my migraines weren’t gone, but I was getting noticeably less intense episodes. I continued the diet another two weeks, and then, I swear, after 2.5 months total of being on the diet, my symptoms stopped. It was the closest thing to magic I had ever experienced.
What ended up being the things that you eliminated from your diet?
During the diet I ate a super strict paleo diet. I didn’t eat gluten, soy, dairy, grains or anything remotely processed. I cooked all my food, which consisted of good quality meats and organic veggies. I didn’t even go out to eat. I also did a lot to heal my gut, like drinking bone broth and taking probiotics. I also made sure to take a hard look at my lifestyle – my sleep, stress, and physical activity. I had to change a lot of things in my life to make sure I was giving myself the best chance to truly heal my migraines.
What impact did breaking free from chronic migraines have on your life?
Two big things: 1. I decided to run the New York City Marathon, and, 2. I decided to switch careers.
I’ll explain my marathon story first. A few years ago, I signed up for a local race to raise money for a great cause with a friend of mine. I immediately became addicted to running. However, the longer runs definitely took a heavy toll on my migraines. I always had daylong migraines after my longest runs. Once my migraines got much worse and I wasn’t able to treat them with any medication, I couldn’t tolerate any sort of exercise, especially running. I was devastated to give up my new hobby. So in my darkest migraine moments, I told myself that if I ever broke free of my chronic episodes, I would train and run for the New York City Marathon. The idea seemed crazy, considering I couldn’t even run for five minutes at the time. But it was enormously satisfying, when, just a few months later, I was able to train through the summer heat and run the marathon on a beautiful November day in New York City. It was one of my proudest accomplishments.
As I was undergoing my health transformation and training for this marathon, I reflected back on my many years of suffering and thought about the many things I had missed out on or pushed off because I was so sick. I was so thankful for my newfound health, as I felt that, for the first time in 14 years, I was able to live my life to my full potential. That made me think about all the people who were still undergoing a similar struggle and not able to live their life to the fullest. I ultimately decided to switch careers and become a certified Integrative Nutrition Health Coach and help migraine sufferers heal through food and lifestyle changes. As much as I hate that so many people are experiencing such extreme pain, it bring me great joy to help people address the core cause of their migraines versus just symptoms.
Are you completely migraine-free now?
No, I have had short episodes of migraines since that time during my first trimester of pregnancy and again a few months after my daughter was born. What was different about these episodes is that I was very much in tune with my body and I knew what modifications I had to make to my diet, sleep, etc. in order to get back on track. I feel very connected to my migraines now (as weird as that probably sounds) and I know they are my body’s alarm clock – the way my body tells me something is “off”. So I know I have to take the time to assess what’s wrong and make those modifications.
Caroline Misan Alvo is the founder of Alvo Wellness, an integrative nutrition health coaching practice that specializes in helping chronic migraine sufferers heal through food and lifestyle changes. When not passionately working with her migraine clients, she can be found running around Brooklyn, NY while trying to keep up with her husband, energetic pup, and adorable baby daughter.