How This Husband-Wife Team Navigates Migraine

Sarah McDaniel Dyer and her husband, Thomas, met on move-in day during their freshman year of college in 2003. They were friends for a couple of years before Sarah walked into the college’s student medical center with extreme pain: “I was like, ‘I feel like someone’s trying to take my eyes out with an ice cream scoop.’ And they said, ‘Welcome to migraine.’”

The effects of her migraine attacks would sometimes make Sarah miss class—something everyone, including Thomas, knew was not normal for her. She’d talk to Thomas about her migraine attacks and her doctor appointments. So when Sarah and Thomas finally started dating, he was already well aware of Sarah’s migraine. 

From the early days of their relationship to today, as a married couple with a 2-year-old, migraine has been a constant presence in their lives. Over the years, Thomas has been a supportive, understanding partner for Sarah when migraine hits—something she is grateful for. 

The couple sat down for a conversation about how migraine has impacted them through the different stages of their relationship.

When they were friends, if Sarah wasn’t hanging out with Thomas, he sometimes thought she was ghosting him. It was actually that she couldn’t hang out because of her migraine symptoms.

Sarah’s migraines start with head pressure that makes her feel like she’s deep underwater. As the migraine continues, she becomes sensitive to light and sound. Sometimes she has nausea and vomiting. These migraine attacks usually last 6–24 hours.

As Thomas got more familiar with Sarah and the effects of her migraine, he realized how migraine may affect their time together—especially once they started dating.

How did migraine affect the early days of your relationship?

Sarah: There were definitely times when we had plans and I’d have a migraine, and it would be, “We don’t have plans now because I can’t go anywhere.” I remember it would be the worst if we were out doing something, and then I would feel it come on, and then suddenly, we’d be trying to get home before it hit.

Thomas, as someone who wasn’t experiencing migraine symptoms, how did you feel when plans had to change?

Thomas: The upshot is that Sarah is not the first person I’ve been in a relationship with who had migraine. My first girlfriend back in high school had it as well, so I already had a little bit of training in very quickly codeswitching into caretaker mode.

But they had very different requirements. With my first girlfriend, I had to be there with ice water and a washcloth, cover her eyes, and things like that. Sarah does not want that kind of treatment. So I think that may have been an issue where I probably tried to do too much when I first started dating Sarah.

Sarah: Well, you wanted to be helping, and I was like, “I want you to go away.”

Thomas: There’s definitely a nurse-like mentality that I was already prepped to get into, and there’s still some amount of that. But mostly what you need is to make sure that the environment has been reduced to as much of a cave-like atmosphere as possible, and just keep the distractions low. 

How do you communicate to each other when Sarah feels an attack coming on?

Thomas: It’s not like you blow a little trumpet—that would be a terrible idea—and go, I have a migraine coming on. It’s just you’ll turn to me and go, “Could you give me Tylenol?” And that’s kind of just the indication. I’ve also gotten texts from you.

Sarah: Yeah, because sometimes just hearing my own voice will hurt. So usually when I’m at that point, I’ll just start texting him everything.

From when you were dating through now, has the way you communicate about migraine developed over the years?

Thomas: I probably have fewer follow-up questions.

Sarah: Yeah.

Thomas: I think before, when you would say you’re feeling a headache coming on or something like that, I was like, “How bad is it? Do you need me to do this? Do you need me to do this? Do you need me to do this?” And now when [you get a migraine attack], I’ve realized I’ve fallen into such an automated process I don’t even know I’m handling anymore. It’s just, “Oh, this is happening, so I’m just doing this routine.”

Sarah: Yeah now I feel like I just have to go, “Hey, I have migraine coming.” And you’re like, “OK, taking the baby. Gonna go.”

Having their daughter Penny has changed things for Sarah and Thomas—both in terms of what is needed when a migraine happens and how often the migraines happen. Sarah used to have a migraine a few times a year. They’ve become more frequent since the baby—as often as two a month.

How has having Penny changed things for both of you in the context of migraine?

Sarah: Before [we had Penny], if I had a migraine during the week, I could just take a sick day, and it’s fine. And now, we both have to take a sick day sometimes, because I have to be home incapacitated, and he’s going to stay home and watch her.

People with a chronic condition might have some sense of guilt. Sarah, have you experienced any moments like that?

Sarah: Not from him, but on his birthday this year, I got a migraine, and I felt horrible being like, “Happy birthday, wake up and take the baby.” And he was totally cool; he didn’t make me feel bad at all. It was just me feeling bad that I felt like it messed everything up.

Thomas, has being with someone with migraine ever been a challenge for you over the years?

Thomas: Obviously, I have a deep-seated, budding resentment that’s been growing year over year until it eventually comes to a head.

Sarah and Thomas both laugh at this. They approach the situation with humor.

Thomas: We work very well together, but we also parallel play a lot. In close proximity to each other, we don’t need each other to keep ourselves entertained or busy. And there are certainly enough other rooms that I can run off and hide in if she needs a larger amount of space that she wants quieter. And I probably both consciously and subconsciously adapted to that.

I’m a person who [has] hobbies in sound, music, and things like that—the only way it could be worse [for migraine] is if I also had a hobby in strobe lights. There are speakers in various rooms of the apartment, and I know how to make sure everything is isolated from each other. I’ve taken that level of protection that even if she needs areas of the apartment quiet, I don’t have to change my activities; I just do it in a different zone. 

Being aware of the noise level when working with his sounds is one way Thomas helps during a migraine. There are other things he does to help. Because certain foods can trigger or worsen migraine, Thomas is prepared to switch meals if needed. He picks up pain medicine from the store. He likes sunlight in the morning but uses an alarm clock that simulates a sunrise since the couple uses blackout curtains to prevent the real sun from coming in.  

How else do you help Sarah during a migraine?

Thomas: It’s just a matter of making sure any sound that might be happening is limited, reducing the number of screens to the bare minimum, keeping things dark, giving you a face mask for when you need it.

Thomas, when Sarah’s having a migraine attack, how do you feel for her?

Thomas: I mean, I feel bad. All I can do is make her environment as comfortable as possible. That is not necessarily enough for me to feel like I’m doing a good job, in that I can’t reach some sort of cool psychic hand in there and just stop it. On a serious note, I know it’s not a problem I can fix. And I feel bad that it’s not a problem I can fix. But it’s been a problem I can’t fix for half my life now, so at a certain point, that just kind of recedes into a background murmur. I feel bad for you, and that’s kind of the most apt description. 

Sarah, how has having Thomas as your partner benefited you as someone with migraine?

Sarah: It’s great to know that I can go take care of myself, and he can handle everything else and I don’t have to hold his hand every time and be like, “No, take the baby, go do this with the baby.” He just takes over, and it’s great.

What would be your advice to other couples who have someone in the relationship with migraine?

Sarah: Communicate what you want at the different stages of migraine, like what you know you can do or what you know you’re going to need in advance so you have that game plan before it happens. And then, just understand you don’t have control in this situation. Sometimes you’re going to really want to do a thing, and you just can’t. It sucks, it really sucks.