Alexandria Constantinova Szeman

@alexandria-constantinova-szeman | contributor
Survivor of childhood sexual assault and Munchausen by Proxy (MBP) abuse. Author of several award-winning books.

5 Things Restaurants Can Do to Eliminate Migraine Triggers

I love going out to restaurants. It’s a real treat not having to cook an entire meal myself or enjoying dishes that are too complicated or time-consuming to make at home. Every once in a while, I like having someone wait on me, even if I’m only having a cup of tea or coffee with a fresh muffin while I read a book. No matter how much I may love dining out, however, there are many times when visiting a restaurant has triggered a migraine. Though I avoid known triggers and call potential ones to a manager’s attention, it’s sometimes too late: the migraine has already started. I don’t want restaurants to become sterile, uninviting places, but I do wish all restaurant owners, managers and employees knew some of the most common triggers of migraines so these triggers could be eliminated. Their customers would then feel safer enjoying that meal away from home. Control the Temperature Temperature control is very important for most people who get migraines since extreme variations and quick changes can trigger those pounding, one-sided headaches. For some of us, heat is a trigger, so, no thank you, we don’t want to sit at that table with the full sun shining on it. If there are blinds or shades, please put them down even if our table is not right next to the windows. For many of us, that cold air blowing down from the air-conditioning unit will trigger a migraine. We’re not trying to be difficult when we ask to be moved to a different spot. We just want to enjoy our meal without getting stabbed in the head by the icepick-pain that is our migraine. Moderate temperatures probably work best for all customers, but it’s imperative for those who get migraines. Please keep the restaurant at a more moderate temperature, neither stifling hot nor freezing cold. Eliminate Flickering Lights Whether it’s from those romantic candles on each table, from that television hanging in the corner above the bar or from a failing fluorescent bulb in a ceiling fixture, flickering lights can cause debilitating headaches in almost all of us diagnosed with migraines. If I ask to be seated someplace where I can’t see the flashing lights of sporting events or commercials, I’m trying to take care of myself, not annoy you. I can blow out a candle on the table to keep its flame from triggering a migraine, but I can’t fix that flickering fluorescent light on the ceiling, and moving to another table doesn’t always keep that blinking light from my peripheral view, and that, too, can trigger a migraine. Please check all the ceiling lights before opening each day, and replace any bulbs that are humming or flickering. Don’t light candles on individual tables unless the patrons request it or agree to it when they’re seated. We, too, may love romantic lighting, but nothing kills romance faster than the excruciating pain of a migraine. Please be aware that flickering lights are triggers, and eliminate them whenever possible. Turn Down the Noise I’ve only walked into a sports bar/restaurant once, and I immediately left because there were big-screen televisions everywhere, each turned to a different sporting event, all with their sound blaring. When popular restaurants have the sound on the bar’s television turned completely off (sometimes with closed-captioning on for patrons who want to watch television while dining out), I’m very grateful. But that loud music pumping through the restaurant’s speakers can cause just as many headaches for those of us who get migraines, and not because we don’t like whatever music you happen to be playing. If you have live musicians and we ask if their microphones could be turned down, we’re not trying to insult your musicians. We just want to eat our meal without having a migraine triggered by the noise. When patrons talk even louder to be able to hear each other over the already loud television or music, the migraine triggers are compounded. Keep ambient noise to a lower level so everyone can enjoy their dining experience, not just those of us who have migraines. Avoid Strong Odors Of course, anyone may encounter unfamiliar smells at a restaurant, especially if it serves ethnic food or dishes with which patrons may not be familiar. Those kinds of smells don’t usually trigger a migraine for me, but that chlorine bleach or Lysol with which you cleaned your restrooms almost instantly causes a migraine. Cleaning product odors can trigger fierce headaches for countless migraineurs. I realize you have a large volume of traffic in your restaurant and that you want to keep your patrons safe from germs and contagious illnesses, but there are plenty of natural products free of such triggering odors, products that also disinfect and keep germs at bay. If you are prohibited from switching to more natural, less offensive-smelling disinfectants for some reason, you might clean your bathrooms a few hours before opening and avoid cleaning them with strong-smelling products while diners are present in the restaurant to keep those powerful odors from triggering a migraine in the middle of a patron’s meal. List All Food Ingredients and Additives There are many food ingredients, natural and manufactured, that can trigger migraines. Those artificial sweeteners in your restaurant’s diet sodas and desserts may be fine for most patrons, but they cause migraines for some of us. Food allergies can trigger migraines — or worse, anaphylactic shock (a life-threatening allergic reaction). As someone allergic to bees, I can’t have honey, raw or cooked, but honey is rarely listed as an allergen in restaurant foods. MSG is a known migraine trigger, and restaurants that specialize in oriental foods are not the only ones that use it. MSG could be in the packaged gravy mix your cook uses for the homemade meatloaf, in the seasoned salt he sprinkles on the fish or meat, or in the bouillon cubes he tosses into the soup to make it taste richer. Other ingredients, like soy or yeast extract, can also trigger migraines even if the patron is not actually sensitive to MSG. Some restaurants have their wait-staff memorize the ingredients in each dish; other restaurants have all ingredients hanging in the kitchen so the list can be consulted if patrons have questions. The wait-staff needs to be informed about such food and beverage triggers, and then trained to be diligent and knowledgeable when serving patrons. Even better, having every ingredient in every dish listed and available to patrons on request will protect all your patrons with food allergies, not just your customers with migraines who might be triggered by a dish’s ingredients. Any initial expense of printing all the ingredients would soon be recouped by loyal patrons who know they can eat your restaurant’s meals without fear of having a migraine triggered. Though I don’t go out to eat regularly, I appreciate having a safe environment when I do go out to a restaurant. If the manager monitors the ambient noise level, is aware of climate control and watches for any flashing or flickering lights, they can protect customers from being inadvertently exposed to migraine triggers. Additionally, I scrupulously avoid known food triggers, so when the wait-staff, cook or manager can readily provide me with the complete ingredient list of any dish I order, they’re helping me take care of my own health and inspiring customer loyalty. We want to hear your story. Become a Mighty contributor here . Stock Photo © by Sidelnikov @ 123RF

Why I Struggled Wearing a Medical ID Bracelet

“You’re getting a migraine, aren’t you?” said my physician last year during one of my regular visits. “If you were pulled over, a policeman would think you were drunk or on drugs. If you were taken to a hospital, they would think you were having a stroke. Time for you to get a medical ID bracelet.” I was so shocked that I just sat there staring at him, and not just because he’d said I sounded impaired. I was first diagnosed with migraines at age 5 and have suffered from the throbbing head pain, vision changes, vomiting, and sensitivity to light, sounds, and smells all my life, as have many of the women in my family. When I was 9, a doctor realized that I was having seizures when I had a migraine, though he did not give my headaches a different name. In my mid-30s, a migraine specialist determined that I struggle with not only from complex-complicated migraines but also from familial hemiplegic migraines, which are rare. Hemiplegic migraines mimic strokes by causing temporary paralysis or numbness on one side of the body, loss of balance or coordination, and confusion or an inability to understand speech. Hemiplegic migraines can also cause speech difficulties such as slurring, dysphasia (words get mixed up or switched around in sentences), or aphasia (an inability to speak). Most frightening, this type of migraine can cause changes in consciousness including seizures or coma. No one in my family who has experienced migraines ever carried anything other than pain medication, and though migraines with aura significantly increase the risk for stroke, no one in my family ever wore a medical alert. Now, however, medical ID bracelets are being recommended for people diagnosed with hemiplegic migraines since so few physicians are familiar with the symptoms. Once I got over my initial shock at my doctor’s suggestion that I wear a medical ID bracelet, I welcomed the idea of the bracelet, if only because I thought I would feel safer wearing a medal with “hemiplegic migraines, aphasia and seizures” inscribed under my name and emergency contact numbers. To my surprise, I was terribly depressed upon receiving the bracelet. For months, I was so depressed that I found myself constantly “forgetting” to put the medical alert bracelet on. Because my doctor insisted I wear it, I had to figure out why the medical ID bracelet depressed me. This is what I came up with. 1. My medical condition was no longer private. Many people describe migraines as an “invisible illness” because the pain can’t be seen, and I suppose I felt more comfortable having a condition that most people didn’t know about. With the medical ID bracelet, instead of my life partner and close friends being the only ones who know I have migraines, everyone who sees me now knows something’s wrong with me. I’m wearing a bracelet that says so. Even though the bracelet is for my safety, it felt like an intrusion into my privacy. 2. I felt like a failure. I take care of myself by getting plenty of sleep, avoiding dietary and situational triggers, and by walking, doing yoga, and meditating almost every day. I’ve tried every anti-depressant and anti-seizure medication on the market to get my migraines under control, but wearing a medical bracelet listing my condition made me feel as if I hadn’t done enough. The bracelet didn’t change the frequency or severity of my migraines, but it made me feel I have somehow failed to prevent them. 3. I felt like my migraines were my fault. Migraines are neurological conditions, and researchers are still investigating whether all types of migraines may be inherited. Both sporadic (not inherited) and familial (inherited) hemiplegic migraines definitely involve genetic defects or mutations that upset neurochemicals in the brain, causing the symptoms of the aura and the pain of a migraine. Despite knowing all that on a conscious level, having to wear the medical ID bracelet made it somehow seem as if the migraines were my fault, which I had never felt before. 4. I felt like I was wearing a sign for my illness on my forehead. I readily admit that I’ve had to make a lot of lifestyle changes and adjustments because of my migraines. I can’t go to concerts or movie theaters because the high volume triggers a migraine. I avoid grocery aisles with humming or flickering fluorescent lights that can instantly cause both a severe migraine and its associated seizures. I use only unscented lotions, soaps, or shampoos, nor can I be around anyone who’s wearing perfume because it causes migraines. I have to know every ingredient of every dish I eat to avoid food triggers like artificial sweeteners or additives such as MSG. Those things can cause migraines, and hemiplegic migraines can cause seizures which can lead to coma. I’ve been called “neurotic” by more than one person in my life, including doctors who dismissed my symptoms as “all in my head” when they didn’t know anything about hemiplegic migraines. I guess I never minded being considered “neurotic” because I knew that I was taking care of myself. Though I’m unable to work when I have a migraine, I never considered myself to have a chronic illness let alone a disability. Wearing the medical ID bracelet made me feel like I was chronically ill as well as disabled. To my surprise, my life partner was very pleased when I got the ID bracelet. He admitted, for the first time in almost 25 years together, that he has always been concerned about my having a migraine-induced seizure. He worried that he would be unable to adequately explain hemiplegic migraines to medical personnel. The instructors in my T’ai Chi and Kundalini Yoga classes looked so relieved when I showed them the bracelet that I felt quite guilty for not having gotten it sooner. When I went to a new dentist and then to an oral surgeon to have a dying tooth extracted, both doctors immediately asked about the medical alert and were then pleased to know that my medical condition, which neither had ever heard of before, was clearly indicated on the bracelet. One day when I went to the grocery last month, I actually forgot to put my bracelet on. After I realized that I’d left it at home, I became anxious that I might experience an aura and have difficulty speaking while I was among strangers. That was when I understood that my initial depression over wearing the medical ID bracelet had completely disappeared. After wearing my medical ID bracelet for almost a year, I can honestly say that I am happy to have it. I wear it every day, even at home, and have it on 24-hours a day when I have a migraine in case of seizure. I feel only safety wearing the medical alert bracelet now, and I encourage anyone who has a severe, chronic, or rare medical condition to wear one. We want to hear your story. Become a Mighty contributor here .