Transcript - Is Trigger Stacking Real When It Comes to Migraines
Leslie: Today I'm talking to Mary, who runs our awesome Facebook community about a recent article on migraine.com that talks about trigger stacking. How are you, Mary?
Mari: I'm doing good. How's that going over in the Chicago area?
Leslie: Very nice. We're having some beautiful mid seventies weather, low humidity, so very nice. How about you?
Mari: I'm doing good. I'm a little sore, I'm not gonna lie. I went to the Amusement park a couple days ago, and I'm like, how does it take it out of you. You know, like I have bruises on my legs and arms from banging against the stupid rides and, but it was so much fun. It was worth every bruise. So tell me about this article.
Mari: I know when we were ready to jump on it, we were talking about trigger stacking and I have never heard that term before. So tell me what this is.
Leslie: So this is an article on migraine.com. It's an article written by Tom Picerno, and the title of the article is How Trigger Stacking Affects My Migraines. So then you think “Well what are triggers? Anything that affects my migraines, if it's trigger stacking, I want to know about it.” This is obviously what a migraine sufferer is going to think when they hear that title.
Leslie: And so what is trigger stacking? This was not something that I had heard either. I think this is a term that the author sort of coined. I have never heard anyone refer to trigger stacking. I think they're trying to put out sort of a new term to the migraine community with this article.
Mari: It sounds scary and emotionally triggering, I guess, in a way. So it would be like something would really catch your attention and want to make you know more for sure.
Leslie: Right. The article describes, even though the term “trigger stacking” is an unknown term to anyone that I talk to about migraines. What he is describing as trigger stacking is a phenomenon that is going to be very well known to any migraine sufferers. So basically what he is calling trigger stacking is the phenomenon that we experience of being exposed to multiple triggers, or what I call stressors that sort of pile up throughout the day and then, oops, now I have a migraine.
Leslie: This is the phenomenon where we wake up feeling pretty good, then we spend too much time in the sun, miss lunch, get in a fight with our husband, and then, whoops, I've had too many stressors or too many triggers and now I have a migraine.
Mari: And don't forget the Doritos at lunch. Right?
Leslie: And the Doritos for you, the Fritos for me, right.
Mari: Exactly.
Leslie: To those of you that are new to the podcast, we're referring to a podcast that we did a few weeks ago. I'll reference it in the notes. This is where I talked about eating a whole bag of Fritos and getting a horrible migraine. Like I say, this is a phenomenon that chronic migraine sufferers are well aware of and they devote a lot of their daily time and energy to avoid.
Leslie: It's like when we have chronic migraines, we kind of want to wrap ourselves in bubble wrap so that we are not getting exposed to these stressors or these triggers, right? Because we can feel this phenomenon that he's calling trigger stacking. Uh oh. You know, the sunlight bounced off the hood of a car and now I'm getting an aura.
Leslie: Oh no, that was the last straw. That was all I could take.
Mari: And I'm picturing like the mental obstacle course of when you have to crawl under this and over that and jump this and jump that. A mental obstacle course of winning all of the triggers.
Leslie: Right, right. Can I do this? Can I sit out in the sun for 10 minutes? Can I sit out in the sun for 12 minutes? You know, all of this and that you go through in your mind. He describes all of the different triggers or what I call stressors, you might call stimuli, that people with chronic migraines can be sensitive to. Such as, what we call stress, mental and emotional stress, sleep disruptions, sleeping too little, sleeping too late, hormone fluctuations, eating something or drinking something, changing the weather, not drinking enough water, getting a little dehydrated. This is a big one, light and sound, sound stimuli or excitement type stimuli.
Leslie: So he lists these common triggers or what I call stressors. He describes them as adding to the trigger pile and then stacking up, and then him experiencing a migraine.
Mari: Right, right.
Leslie: So all of this is very relatable to anybody with chronic migraines. You have occasional migraines, Mari, but have you experienced this?
Mari: I don't even know. I get them so infrequently. I'm not sure if I'm paying close enough attention to getting a trigger stack per say, but I definitely do relate to that light bouncing off the mirror in my car and hitting me in the retina wrong and then suddenly having an aura. I just don't know that I noticed the previous trigger stacks before that.
Leslie: For me, I've definitely been very aware of trying to live, trying to keep myself in a bubble wrapped state. I could definitely relate to feeling like, “Oh, yep, they're piling up. They're piling up. And then, whoops. Uh oh, this was the last one.”
Mari: I definitely relate to that uh-oh moment. We always talk about where you can't feel that it's there. You're almost to the migraine state, but you haven't quite gotten there yet and you're just like, uh-oh. Here it comes.
Leslie: Uh huh.
Mari: The worst part of it to me is when I’m at the grocery store and worried that I'm not going to be able to drive home because I'm not going to be able to see, uh-oh.
Leslie: Yeah, that's what I call the uh-oh moment. When we feel, uh-oh, something's not right here. We're going down.
Mari: I feel for people that have a pile of triggers though. Maybe it's just that I haven't been observant enough to notice it, but it usually only hits me when I'm at the uh-oh moment.
Leslie: This article is very accurate. It is very relatable from this perspective, but the author then proceeds to say the same thing that everybody else says. And that's where we come into what is false about this article. He is assuming. Because he says in the article, “I wake up every day with the amount of resiliency that I have,.” Hopefully, because we can't control all of these stressors. We can't control whether the light bounces off of the hood of the car and hits us wrong in the retina. We can't control the barometric pressure. We can't control if we go to the grocery store and somebody with a whole bottle of perfume walks by us.
Leslie: So in the article, he is like, “Well, I wake up with the resiliency to triggers that I have and hopefully I won't run into too much.”
Mari: Yeah. That sounds a lot like the spoon theory thing that we've talked about in the past where you only have so many spoons for the day.
Leslie: So this is the piece that's incorrect. We can increase our resilience to stressors. If we have chronic migraines, we've probably felt our resiliency to stressors decline over time. Whereas, when I was 25, I could have a beer, I could be out in the sun, I really had to have 20 triggers stack up before I got a migraine and now I'm 45.
Leslie: Now I know, if I do three of those things, I'm going to be down.
Mari: That's true in all areas of life.
Leslie: We could feel our resiliency to triggers or stressors decline as our health declines. So why wouldn't the inverse be true? As our health improves, our resiliency improves.
Mari: Hmm. That just really hit home to me because, I feel like we assume that our health declining and our resiliency declining is just a fact of life. But I've never been like, oh, well if that's true, then this is also true. I can increase my health/resiliency. I mean, obviously you can increase your health by losing weight or whatever like that, but I didn't think of it in this context.
Leslie: Again, in the author's perspective, he believes that he's just sort of like a victim. I hate to use the word victim because it's such a loaded term these days. Everybody's kind of using that term. But it fits in this situation. “Well, I wake up. I got what I got and I can't control anything else, so let's just hope for the best.”
Leslie: Right. It's like we don't have any agency in our lives. We don't have any control over our lives. It's a pretty bleak place to be.
Mari: Yeah, it's super passive. There is something to be said for saying, okay, the things I can control versus the things I can't. Like you said, you can't control walking past somebody in the grocery store with a pound of perfume on, but you can control how you take care of your body.
Leslie: Right. We do things that improve our health and therefore improve our resiliency. That is something we can do. And I just talked to a client this morning. I've been working with her for several months. When we started working together, she would get a raging migraine if she was in a restaurant and somebody a few tables over had too much perfume on.
Leslie: You can't control that at all. And so over the past two months, she's noticed a tremendous improvement in this. She has a late teenage brother who wears a lot of perfume. You know, maybe kind of like an Axe perfume. A lot of these young men, they kind of put on cologne heavily.
Mari: Yes, they haven’t learned the benefits of using it discretionarily.
Leslie: Exactly. Exactly. And so, we were kind of chuckling because she said, “Oh, I went home and my brother's home for the summer and he had himself doused in his cologne and I didn't get a migraine.”
Mari: Oh, nice.
Leslie: Right. So as we do the things that we need to do to improve our health, our resiliency to stressors is automatically going to improve because that's part of the definition of health.
Leslie: Then instead of just saying, “Well, let me hope for the best. Let me cut out everything that I have control over that's fun because I don't have control over the weather and the lady in the grocery store with the perfume. We gotta cut out everything that we have control over to account for uncontrollable stressors.”
Leslie: No, we want to improve our resiliency, improve our health, so that we can weather all of these stressors throughout the day. The ones that we have control over and the ones that we don't.
Mari: And we don't want to live our lives in a little box where we never leave the house. I mean, that's just, it's no way to live.
Leslie: It's no way to live.
Mari: Yeah, our listeners deserve better than that. Right?
Leslie: One hundred percent. Absolutely. Absolutely. He didn't talk about this in the article, but what inevitably happens, because when we start getting chronic migraines, we start becoming sensitive to the light and the odors and the barometric pressure, we are already falling out of a state of health. If we don't do anything to turn that ship around, we're going to continue to get further and further out of a state of health. So our resiliency to triggers or stressors is going to continue to decline. What happens to people is that when they're 25, they say, “Well, okay if I run into a little old lady in the grocery store with too much perfume on aouple times a year. Well, I'll just have to live with that.” But 20 years later they're sensitive to the weather. They're sensitive to even more odors. They're sensitive to noise. They're sensitive to light, they're sensitive to doing a presentation at work. They're sensitive to mental and emotional stress.
Leslie: Things don't improve. That ship is not going to turn around on its own. We've got to intervene and we've got to do the things that we need to do to get our health restored.
Mari: Right.
Leslie: He wrote this article from the standpoint of where he is right now and listed the things that he's sensitive to. But what about a year from now?What about five years from now? What about 10 years from now? He's going be more and more sensitive to more and more triggers. That stack is going to get higher and higher.
Mari: What you’re saying is it just traps people really. I can't go to work. I maybe said this before, but I don't know a lot of people that can afford to just stop going to work. That's a huge deal or missing out on time with family or friends or all of the things that make life worthwhile.
Mari: We shouldn't have to miss out on those things either.
Leslie: Absolutely.
Mari: Did this article go into any suggestions or was it just kind of like, good luck with that?
Leslie: The point of the article is to sort of illuminate this phenomenon. It's to articulate this phenomenon that we experience. So it's sort of like, let me put into words what the chronic migraine suffer experiences. But then again, the attitude, the underlying assumption is, well, there's nothing you can do about it, but at least I've put it into words.
Mari: Right. Well, there is something to be said for knowing that other people experience something similar that is less isolating and helps you feel not so on your own. But at the same time, that sounds like it leaves you in a very passive position where you can't do anything about it.
Leslie: Correct. I've personally experienced this. I used to get insanity level brain buster migraines if I was out in the sun too long. I definitely developed some PTSD from this. Uh-oh, I'm going to meet a friend for coffee at Starbucks. Is this the type of friend that's going to want to sit outside?
Leslie: Uh-oh yeah. She's the type of friend that's going to want to sit outside. Well, is there going to be shade? Is there going to be a table with an umbrella? I mean, I would go to the Starbucks 15 minutes early just to scope out the patio situation and make sure I got the spot right. I have to get the spot where my back's to the sun under the umbrella. I can't get there after her because what if she picks another spot. This is how I lived.
Mari: Right. That sounds like the obstacle course.
Leslie: Exactly. I have spent some time clearing this post-traumatic response. That's how bad these sun migraines were. I joined a tennis league this summer. I'm having a great time playing tennis and joined a little league.
Leslie: I'm on the D team, which is the lowest level.
Mari: That's a heck of a lot better than a lot of people. That’s awesome.
Leslie: Well, I'm trying to get to the C team, but we had our first match last Friday. Now, last Friday, the high here was 92.
Mari: Ouch.
Leslie: Here in Chicago, when we woke up the Friday before, it was 45 degrees outside. This is typical Chicago. You're going through 60 degree temperature fluctuations. So when I saw that it was going to be in the low nineties for this match, I was like, uh-oh. I had an uh-oh moment. By the time the mash started at 10, it was hot. It was very hot, and it gets pretty humid here too. I wouldn't say it's so humid that I can't get out there, but it was very, very hot and none of us are acclimated to this because it was 45 degrees a week before.
Mari: Right.
Leslie: So I was nervous.
Mari: Right.
Leslie: I was like, man, I really hope I don't get a migraine and I did not get a migraine.
Mari: That's awesome. It's because you have taken time and done the work to build your resiliency, I'm guessing.
Leslie: Yes. And so this was also an opportunity to do even more clearing of this post-traumatic response that I developed from these brain busting migraines that I get from being out in the sun too long. The whole weekend I was just like beaming because I was like, wow. I was out there like that and unacclimated to the heat in the sun and the worst thing was my feet got tired after two hours at tennis shoes.
Mari: That's something to be celebrated for sure.
Leslie: I cannot tell you how thrilled I was the entire weekend.
Mari: I've never been more grateful for anything. Right.
Leslie: Exactly. I'll take that. But there was a time in my life where I was avoiding bicycling. I was avoiding being outside, going on a boat tour. Oh gosh. I don't know how hot it is going to be. Am I going to be in the sun on the boat? You know, all of these things. We can't live our lives like this.
Leslie: We can't bubble wrap ourselves. You can't wear a huge sun hat while you're running around on a tennis court.
Mari: That would look pretty silly.
Leslie: So the answer here is to identify what is preventing our body from returning to a state of health, and then taking action on those blockers or deficiencies or missing pieces, and getting this ship turned around.
Leslie: When we do that, our resiliency to triggers or stressors is going to improve. I see this over and over again. I've experienced it personally. Don't let the migraine industry tell you otherwise. You are not broken or defective. Your brain doesn't hate you. You're not doomed genetically. I have migraines and headaches on both sides of my family.
Leslie: I am not doomed to living a life of chronic migraines.
Mari: It does seem like there's quite a bit of messaging out there. I mean, not just this one article, but in general where they say accept your fate, don't, you can't do anything about it. Here's a pill that will hopefully help you. Right. There's just a tone to the messaging, which is very… the only word I can think of is unhopeful.
Mari: That's not the best word, but it's what I have.
Leslie: The author says, how do I manage less controllable triggers like the sunlight. He says there are other things that can be used to help manage triggers beyond my control. I can wear my hat and sunglasses to lighten the weight of a trigger like bright sunlight, noise protection can dampen irritating noises or other unfriendly ambient sounds. Medication can be a big counterbalance. This is where we're taking the triptan before we're going on the boat tour. Nothing in the article talks about how he can improve his resiliency to all of these triggers. Frankly for me, if I were reading this back in the state where I was as sensitive as I was and as horrible as I would get if I were out in the sun too long, if you told me to put a hat and sunglasses on, this is like somebody saying, have you drank enough water today?
Mari: Oh my.
Leslie: Well, wear a hat and sunglasses.
Leslie: It's like, are you kidding me?
Mari: Yes. I've never thought of that before. Thank you. Yeah.
Leslie: Right. Oh yeah. Okay. Thanks. Sunglasses. Yeah. Again, don't let the migraine industry tell you these types of things because they're not true. I didn't even play the match with sunglasses last Friday.
Mari: Oh wow.
Leslie: Yes. That's how much my resiliency has improved.
Mari: I can't go out in the sun without sunglasses because I can't see anything, so I'm impressed.
Leslie: Well, right, yeah. I used to be the person that would go outside and if I didn’t have sunglasses, I had to turn around. But again, if we have enough resiliency, we can go outside and our eyes are going to adjust. Our irises are going to constrict and we're going adjust to the light, but we're not going be thrown by it because we have the resiliency to weather that.
Leslie: So I wanna talk about the website, migraine.com.
Mari: Okay.
Leslie: So migraine.com, it's a very well known migraine website. They were able to purchase that URL right when the internet was born. They were able to snap up migraine.com
Mari: Back in the .com days. Yeah.
Leslie: Exactly. They have a Facebook page with over 200,000 followers and I believe they have an affiliated migraine Facebook group as well.
Mari: Okay.
Leslie: It's pretty well known. This is pretty well known within the migraine community. When you hear there's migraine.com, Mary, what would you assume? What type of organization would you assume that this is?
Mari: First of all, I would think that they know everything and all things that there is ever to know about having migraines, like a super trusted source.
Leslie: Mm-hmm.
Mari: You know, kind of the tip top experts. That would be my first assumption.
Leslie: Yeah, I kind of assumed that it was like a nonprofit organization, philanthropic type organization.
Mari: Right. And probably affiliated with researchers would be another thing I would guess.
Leslie: Yeah. Maybe the National Institute of Health, something like that. So when you go on the migraine.com website, you see that they are owned by a company called Health Union, LLC. So I looked them up. Health Union, you can go to their website, healthunion.com. They are a for-profit company that has purchased the URLs for a wide variety of chronic health conditions.
Leslie: So they own alzheimersdisease.net, chronichives.com, chronicdryeye.net, endometriosis.net, inflammatoryboweldisease.net, irritablebowelsyndrome.net, llupus.net. They own all of these domains on the internet.
Mari: Interesting. That begs the question of what is their purpose? What are they trying to accomplish? Because certainly they can't be experts in every one of those fields.
Leslie: Correct. So when you go on their website, they have a little FAQ page.
Mari: I'm actually there because I’ve got to see what you're talking about.
Leslie: When you look at their FAQs, there's a question, “How does Health Union make money?” This is from their website, “Health Union enables companies to connect, interact, and engage with our patient communities.” So Health Union allows other companies to engage with the people who suffer from these conditions.
Leslie: How does that engagement occur? Through paid relationships for media. They are paying Health Union to promote what these companies are selling.
Mari: Well, and there's a big paragraph about that, just through advertising and access to surveys and just all kinds of things, clinical trial announcements. There's a lot there. Yeah.
Leslie: What companies are going to want to do that?
Mari: Do you want me to tell you or is that a spoiler?
Leslie: What comes to mind?
Mari: The pharmaceutical companies?
Leslie: Correct the pharmaceutical companies. So you're not going to have an article on migraine.com that talks about… I used to have daily head pain and I used to be susceptible to odors and noise and sunlight, and I'm not anymore because I restored my health. You're not going to have that kind of article on migraine.com because if you had that kind of article on migraine.com, the pharmaceutical companies would pull their funding.
Mari: Ouch. Like I don't know that Here comes another question. Who does this benefit?
Leslie: Exactly. It benefits the pharmaceutical company. I feel for the gentleman that wrote this article because I totally relate to what he's saying, I have been there. But there was a little voice in my head when my migraines went chronic that when my doctor gave me that prescription for Tryptans, there was this little voice in my head that said, no, this is not the answer.
Mari: Right.
Leslie: You know, I couldn't articulate it in this way when I was 24, 25, but I knew I didn't have a sumatriptan deficiency. I knew that there was something out of alignment. I knew that there was something wrong and that's why my body was generating these symptoms. Not wrong in the sense that I was defective or broken, but there was something wrong in the sense that I could fix if I just had the right guidance, I would be able to solve this problem.
Leslie: And me following that inner knowing is what saved my life because I have no doubt that had I started to take those triptans at the age of 24, 25, I would've gotten that relief that the triptans provide at the beginning, but eventually they would've stopped working and then I would've had to get on all of these other things.
Leslie: I would have to start going down that road and 25 years later, I would be potentially bedridden.
Mari: And I think so many people do have that instinct that something is wrong and if I can find the source of what is wrong, I can fix it. Then when you start jumping through the medical hoops like we've talked about before, it's easy to get lost in this shuffle and not find a source of the problem and just cover it up with meds.
Mari: It's so easy to get sucked into that system because that's really all we know. We've talked about that before too. We only know western medicine culture really in our communities.
Leslie: Right. If you are listening and you have that same inner knowing that I had, reach out and let's see if I can help. In order to restore our health, there are three things that we have to do, and I call these the Three Principals. I try to talk about these on every podcast. I have several free trainings on my website.
Leslie: We will link to them in this podcast, but if we are not feeling well, if our body is generating symptoms like migraines, it's because there are blockers or deficiencies or missing pieces within these three principles that are required to restore and maintain our health.
Mari: Mm-hmm.
Leslie: The first principle is we have to get the nutrients that our cells need to every cell in the body.
Leslie: That does not mean we need to eat a special diet. Our cells run on nutrients and if they don't have the nutrients that they need to do their work, we are not going to feel well. Number two, we have to clear metabolic waste material and other toxins from the body. That doesn't mean doing a cleanse. This is not a weekend warrior cleanse.
Leslie: Then the third principle is we have to restore our resiliency and vitality. This article here is within this third principle. What I have been able to accomplish over the years is to restore my resiliency and vitality to the extent that I could do this tennis match in the hot sun in early June when nobody's used to the heat, without getting sick. If you're not feeling well and you're getting chronic migraines, you have blockers or deficiencies or you’re missing pieces within these three principles. The question is, what are yours? That's what we need to determine. Once you know what it is, then you can take the action to fill in those missing pieces, and when we do that, our body responds.
Mari: What you're getting at is that it's different for everyone too. So it's not a one size fits all. My blockers are not the same as your blockers.
Leslie: Correct. These three principles are universal, but the individual blockers or deficiencies, those are unique. This is why people, if they go into the natural medicine route, people will put a hodgepodge of things together and sometimes they'll hit on something that might be filling in a deficiency or removing a blocker. Then they'll say, “Well, you know, I did this.” Then somebody else does it but that didn't do anything for them. This is because your body is only going to respond if you’re actually filling in a deficiency or a blocker or a missing piece.
Mari: Right. So with your program, you can't just say all people A plus B, equal C, and we'll fix it. It's very customized to the actual individual.
Leslie: Right. If people are using a protocol, that is a one size fits all thing, like the typical migraine protocol that uses supplements is coq 10, magnesium and b2.
Mari: Right. And that should work for everyone, if it works.
Leslie: Right. Someone may say now I'm taking nutrients and that would fill in the blocker in the first principle because if I take nutrient supplements, that will put nutrients to my cells. Can you digest the pills? Do you actually need magnesium? And that's just the first principle. We're not even talking about the second or third with that type of an approach. But, if you're doing a protocol, then that is like… okay, everybody with migraines, this is the miracle migraine cure. Or, everybody with migraines, you need to do A, B, and C. You need to do this protocol.
That's not a good approach because you're not identifying where your blockers are missing pieces and you're not specifically working on those things.
Mari: Right.
Leslie: Two things that I really want to get across from when I read this article. Number one, you are not broken, you're not defective, you're not doomed to this. Every human being has been created with an innate ability to heal and restore themselves to health. Every living thing on the planet has that ability. Why would we be any different?
Leslie: Number two, the information that you are getting about your migraines is probably funded by the pharmaceutical industry.
Mari: I was gonna say it sounds so hopeful. And then you did number two. So the first one sounds very hopeful. The second one, not as much.
Leslie: Well, what does the pharmaceutical industry want you to think?
Mari: They want you to think that the only way that you can get better is by buying their products. Really?
Leslie: Exactly. The more doomed and defective you feel, the better customer they have.
Mari: So true.
Leslie: I don't want anybody.. I know a lot of people are going to say, but I need these meds to function. I'm not telling you to discontinue your medication. I'm not telling you that only bad people take medicine. That's not the message here.
Leslie: If you need to take medicine, take medicine. But at the same time, let's get this ship turned around so that you feel better. You can get off this medicine, you can live your life and you can do whatever it is that you want to do.
Mari: That sounds amazing to me.
Leslie: Well, thank you, Mari. I guess I'll step off my soapbox. I got a little passionate there.
Mari: Yeah, no, we love it. Because that just shows us why you do what you do and how important it is.
Leslie: Yeah, it is why I do what I do because there's no doubt in my mind that more than likely I'd probably be disabled if I had taken those meds.
Mari: Yeah. That's scary.
Leslie: It's very scary and I work with clients that have become disabled. I feel for them tremendously. I don't take anything for granted.
Mari: I hear you. I'm right there with you because I know I get migraines so I can relate to a lot of this, but I also know that I don't get them on the same level of suffering as many, many, many of our friends. I don't take that for granted either, and I don't take it lightly.
Leslie: Well, wonderful, Mari. Thank you for joining me.
Mari: No problem. It was a good chat. We'll see you guys all later.
