Black blobs and bright squiggles bounce into view, blurring the tree-lined trail in front of me. This isn’t the ethereal sight of early morning light filtering through the forest that inspires photographers, poets, and painters. This is the stuff of my nightmares. The orbs are visual auras (not to be confused with the spiritual term of the same spelling)—the kind that typically precede a migraine or seizure. They’re the Oh Sh*t Alarm System that tells me I’ve got minutes or maybe seconds to prepare for an impending neurological storm.
I have a rare condition called hemiplegic migraine. The unpredictable and debilitating symptoms mimic a stroke and can include these visual auras as well as sensory auras (numbness and tingling), motor auras (partial temporary paralysis), and aphasia (the inability to comprehend or speak). That’s in addition to the actual migraine pain, piercing electrical pulses through the brain, hypersensitivity to light and sound, and subsequent “migraine hangover.”
If I were at home and the unwelcome orbs appeared, I’d follow my personal migraine protocol: drink water and some kind of caffeine with sugar (coffee, tea, and/or dark chocolate), pop a prescribed amount of Aleve, consume some quick calories, lay down in the dark, and hopefully ride it out.
That’s the best case scenario. Other times, I lose the ability to comprehend and speak. The first time this happened about 10 years ago, I remember looking down at a magazine on the floor of my friend’s car, trying to read the words on the cover—a quick and silent self-administered test to reassure myself I was ok. I could see the words on the page but I couldn’t comprehend them. They may as well have been hieroglyphics or an abstract painting, totally illegible to me in that moment. I looked over to my friend in the driver’s seat, panicked and wanting to scream for help. But I could barely see him through the visual auras. I couldn’t put together even a simple sentence in my mind, let alone command my mouth to move. I was trapped inside my own mind.
When the symptoms of a hemiplegic migraine attack reach this level, they’re similar to a stroke. In fact, when they get this bad, I need to get to a hospital just to rule out that I’m not having a stroke. On the outside, I look confused and unresponsive. On the inside, it feels like my body and brain have been hijacked—my eyes are open but I can’t form complete thoughts, can’t verbalize what is happening, and can’t ask for help. I’m completely powerless.
The Anatomy of an Attack
Here on the tree-lined trail in the Zubia Forest of northern Jordan, I’m not sure how far away the nearest hospital is—I’m with a handful of hikers I hardly know, five days into a 44-day hike across the country—and I’m desperately hoping I don’t have to find out.