I have never experienced this before during activity, though I have suffered from migraines in the past. Typically, when I get a migraine, I get an aura in the morning, then have a headache the rest of the day and need to sleep it off. This Saturday though, was a first in a few ways.
I ran an Olympic tri, and during the bike (about 15 miles in) I started to have an aura, indicating that a migraine was on its way. This has never happened to me during activity before. It was particularly distressing, because it happened on my left side, on an open bike course. The majority of my field of vision on my left side was blocked by the aura, making it dangerous to pass. After 10-15 minutes it went away, but I knew the other shoe was going to drop.
It finally did around mile 2 on the run, and my head was in a vice for the remainder of the race. Then, at mile 4, I got another aura - also a first getting multiple “waves” of migraine symptoms. I did finish (poorly), but it was a torturous race. I have not felt that poorly about a race in years.
What’s more concerning is that the “waves” of migraines didn’t stop there - I had another wave right after finishing, and 2 more on the hour ride home.
I’m 32 and healthy, but this is distressing. I keep wracking my brain trying to think of what could have contributed (limited sleep the night before, limited caffeine in the morning, higher stress with twin 3-month-olds, broken FD cable discovered as setting up transition = stress), but I didn’t feel anything different than I usually would on race morning.
Has anyone else experienced this during activity? The multiple “waves”? Trying not to freak out, and looking for any related experiences you might have.
My experience is that common triggers are stress, dehydration, and lack of sleep. All things you were dealing with. On the surface, seems somewhat explainable.
That said, I think the general rule about migraines is to be on the lookout for a consistent change in severity, duration, and/or frequency. So, if this wave experience is a one-off, chalk it up to bad luck, but if your migraine pattern changes, go see your doc.
For the record, I’m not a doctor and not dispensing medical advice, just sharing my own anecdotal experience.
I take a beta blocker every day to prevent them and when one gets through I take Zolmitriptan. Might be worth having something like Zolmitriptan with you when you race, take it straight away at any sign of a migraine.
I usually have migraines once every 1-2 months and the auras usually comes in the morning hours. I have had the auras start during long bike rides, and that’s why I carry around my migraine medication everywhere with me to take after the aura ends. It really helps prevent the migraine and at worse I only feel some slight pressure in my head. Obviously would recommend you first go and get checked out by your doctor, this is only my experience!
I had migraines frequently as a teenager, they went away until my late 20s/early 30s, which I was told is normal.
No, I don’t have a regular medication for migraines. I have other neurological conditions, but get migraines only once every 6 months or so, so I haven’t sought medical attention for them. This incident has caused me to reevaluate that stance.
I take generic over-the-counter remedies when I have an aura, but I get them so infrequently that I don’t carry it with me. Might change after this weekend.
I’ll keep an eye on things and see how it goes. Excellent if this is a one-off, but if I get anything else happening in the next couple of months I’ll likely see a neurologist to get evaluated.
No, I don’t have a regular medication for migraines. I have other neurological conditions, but get migraines only once every 6 months or so, so I haven’t sought medical attention for them. This incident has caused me to reevaluate that stance.
I take generic over-the-counter remedies when I have an aura, but I get them so infrequently that I don’t carry it with me. Might change after this weekend.
I’ll keep an eye on things and see how it goes. Excellent if this is a one-off, but if I get anything else happening in the next couple of months I’ll likely see a neurologist to get evaluated.
I’d definitely recommend seeing a neurologist and having medication always on hand even if you just suffer occasionally. I suffered for years because my migraines are atypical and I wasn’t convinced they were truly migraines. Once the neurologist told me they were and gave me meds it was life changing.
This happened to me recently (70.3 Des Moines in June) - second time it’s happened in a race.
I also get an aura on the left side (can’t keep my eye open) and also get tingling in my extremities.
Few things I’d recommend for management:
know & try to mitigate your triggers (for me it’s stress and weather. One of those can be managed by good race prep, the other is out of my control).
have an exit plan. For me, if it happens during a race, my other half and I have an agreement that I should DNF and live to see another day if it happens pre-race, on the swim, or on the bike. If it happens on the run, it’s my discretion. My symptoms are ones where it can get dangerous on a bike and the physical stress prolongs the migraine for an extended period of time. Having a plan / decision ahead of time helps with the guilt of the DNF and honestly takes a lot of ambiguity out of the day.
keep a migraine med in your transition bag.
assess your med set up and go to a neuro. Highly recommend nurtec (if it’s covered by your insurance). Works as a preventative medication and an abortive medication. Works almost instantly too and has minimal symptoms (nausea for about 20 minutes).
Sorry you’re going through this. It’s really brutal. Hope this helps.
I’ve had this, too. I’m like you in that when I get migraines, it starts with auras, then proceeds to the severe headache. In normal life, I immediately take sumatriptan / Imitrex and head to bed; Excedrin Migraine seems to work decently in a pinch, too.
It’s happened to me in a couple races (3 years apart and also auras on the bike) and I’m with you that’s it’s scary as hell. One time I DNFd, the other one I carried on when the auras stopped but probably shouldn’t have. Neither were good races. I tried to find common links --both were colder water races (<60 degrees), both were during times of fairly high personal stress. Was yours in cold water?
I started to just take 2 Excedrin Migraines before my races as a preventative measure, although I don’t know if there’s actually medical backing for that A little pre-race caffeine is never a bad thing, paracetamol has been shown to help with heat management, and I’m not too worried about the low level of aspirin/ NSAID, so this feels like a safe enough substance to take pre-race.
I’m similar in that these happen rarely enough that I’ve never really dug too deep and haven’t seen a neurologist in decades since I was first diagnosed as a teenager (when a migraine mimicked a stroke, as they sometimes do for me, and scared the crap out of my parents).
Good luck, hope this experience remains rare for you, and if you do get any answers, please share.
No, I don’t have a regular medication for migraines. I have other neurological conditions, but get migraines only once every 6 months or so, so I haven’t sought medical attention for them. This incident has caused me to reevaluate that stance.
I take generic over-the-counter remedies when I have an aura, but I get them so infrequently that I don’t carry it with me. Might change after this weekend.
I’ll keep an eye on things and see how it goes. Excellent if this is a one-off, but if I get anything else happening in the next couple of months I’ll likely see a neurologist to get evaluated.
There are several severances. Mine (already since 45 years) seem to be as yours: I only get it a couple (2? or 4?) times a year. It starts with an aura (40 minutes of sight problems, makes it hard to read because letters are partly invisible) mostly followed by a dull headache. Next day I often feel rough, no sports (one time I had it the day before an IM: should not have influenced the IM positively).
To come back on your question: once I had it during a training jog but the aura just went away after 30-40 minutes as always. However, I also experienced that neglecting the aura can cause it to stay or to come back: what I generally do is lay down with closed eyes until the aura is over.
I’m lucky that mines are not so severe and I also do not need medication because if that.
This seems really helpful. If it isn’t a common occurrence something like sleep/stress/diet all make sense. Did you eat/hydrate enough the night before the race? The morning of? During? What was the weather like for the race? Maybe you just needed some nutrition.
This seems really helpful. If it isn’t a common occurrence something like sleep/stress/diet all make sense. Did you eat/hydrate enough the night before the race? The morning of? During? What was the weather like for the race? Maybe you just needed some nutrition.
Yeah it is interesting to try to find out the triggers.
With me I did not find out anything: they seem to come randomly (although the one 1 day before an IM could have been stress).
My wife though has clear triggers: she always got migraine after a (running) race and after a heavy (running) training. She started taking water with her during training and since then the migraine stayed away.
She did a HM a week ago where she took water with her, and also she did not give absolutely 100% of effort, and did not get a migraine afterwards.