You’ve got deadlines. It’s got a baseball bat. It doesn’t care.
Now then, gentle reader. Come and stand in front of me. I imagine you’re here for a calming, informative ten minutes – a quick breather before the next challenge in your day. Ooh, you’ve got a big presentation later? Well, forget that now. Theresa May might’ve simultaneously coughed up a lung and delivered a party conference speech, but you see, I am not the common cold.
I’m going to hit you in the eye socket with a bat for 90 minutes. Wait there though, because I’m not finished. We’re going to meet like this eight more times over the next six days. You won’t know when I’m about to start, or when I’ll decide you’ve taken enough. I imagine 50% of my attacks will be in the middle of the night – don’t worry, I’ll wake you up before I get going. Chances of sleep after we’re done? Very slim.
On probably two occasions, the swing of my bat will be so forceful you’ll sit with your back to a wall, bashing the base of your skull against it just to relieve the pressure. Yes, loved ones may remark that you ought to be sectioned.
The thing is, I’m a cluster headache, not a migraine. Possibly the cruellest thing about me is that in most people’s eyes, I don’t bat in the same league as the mighty migraine. Headache is my last name, and headaches are for taking two of whatever’s in the staff cupboard and pressing on. Bad headaches are for ten minutes in a dark room with half a cup of tea and a 6pm deadline. Only migraines require proper drugs. Only migraines demand an understanding from employers or warrant time off.
Though little is known about me in the common vernacular, a simple YouTube search yields dozens of, ahem, hits. Men (who are four times more likely to suffer than women) writhe in agony on-screen, clutching their heads, begging for it to just end. One, no older than 25, says he begged his doctor to drill a hole in his skull, “to get whatever’s killing me out”.
Not since the NFL Super Bowl 1998 has there been substantial, celebrity-backed media coverage on clusters. Terrell Davis, star-player for the Denver Broncos, started as running back that night against the Green Bay Packers as usual. At the end of the first quarter, he felt the intense lights and swinging bat of an attack begin. Media coverage widely reported he’d been hooked due to a migraine, but when he returned fully recovered in the fourth, suspicions were piqued. “Migraines don’t come and go in a quarter!” an internet forum-goer wrote, as Davis ran back out. His miraculous return was instrumental to the Bronco’s win.
After the game, Davis spoke about his battle with clusters. They began when he was just seven-years-old. On Super Bowl night, lights flashed across one eye (often a feature of cluster headaches) and playing quickly became impossible. Luckily, the team doctor was ready with Davis’ prescribed nasal spray, a solution which narrows the brain’s blood vessels called dihydroergotamine mesylate. That, plus the fact that clusters are usually shorter-lived than migraines, meant he could return to play.
Sadly, US and international media outlets didn’t much care for the new name. Probably the term ‘migraine’ was still reported as it sounded worse and kept within tabloid word counts.
Healthcare professional website webmentorlibrary.com describes clusters as, “severe one-sided pain in the head.” The Leeds-based site explains, “Each attack develops suddenly, usually without warning. Typically, you feel the pain mainly in or around one eye… most commonly for 45-90 minutes. Attacks may occur from once every two days to eight times a day. Each cluster of attacks usually lasts for several weeks or months. In about one in 10 cases, attacks continue without any remission periods – a chronic cluster headache.”
It’s not known exactly why the hypothalamus (an almond-sized portion of the brain which controls body temperature and hunger, amongst other things) seems to go into overdrive during clusters. For entrepreneur Justin Granger however, it’s the simple sneeze.
“It was the day after the Ryder Cup, three years ago” he told Persist.
“Three days of drinking in Gleneagles, and I had a cold. I sneezed at the train station. I first thought it was the worst hangover I’d ever had, but it became agony. I had spots in front of my eyes and terrible pain between my left ear and temple. Later, at home with my daughter, I sneezed again. I collapsed. I couldn’t see or speak. At hospital they initially thought I’d had a stroke.”
Granger, now 35, finds this time of year particularly difficult. The change in seasons means colds are likely, and the whiplash-like forward motion of one strong sneeze could spark a cluster. He now takes prescribed tablets three times daily when mid-bout. These occur every few months. Two weeks ago, Granger had to leave a friend’s wedding when a cluster hit.
Victoria* (who asked not to be named. Her employers don’t know), a mature law student, is one of the estimated one in 4,000 women who suffer. Her first attack was four years ago, when she was 32.
“If you’d told me I had a terrible tumour behind my left eyeball that needed operating, I’d have believed you” she explained to Persist.
Before that first cluster, she too had a cold. Initially her GP diagnosed sinusitis. The following day though, Victoria found herself sobbing in A&E where, she says, she begged for anything to dull the pain.
“I refused to leave. I genuinely thought I was dying. I couldn’t see out of that eye.”
Today, Victoria always carries a plastic case containing two tablets of a drug called sumatriptan. She calls them “lifesavers. I never go anywhere without them. To be caught out would be unthinkable.”
When asking on social media for cluster headache sufferers to come forward for this piece, one brilliant writer commented, “Oh my God, I pity anyone with these. ‘Suicide headaches’ they call them. Awful. As a family of migraineurs, we thank our stars we don’t have these.”
And there’s the point – made succinctly by a non-sufferer. You may never know the misery of a cluster headache. But please, know of them. While humans aim to persist through illness, some are fighting battles we’re blissfully unaware of. Most likely they aren’t yelling about it, but somewhere, someone is preparing for the next time I approach holding my bat. They’re watching powerless as I throw my suitcase on the bed ready for another lengthy stay – their silent friend.