I need a routine to stay happy and productive, but migraines tend to throw my carefully planned days into disarray. This is ironic because routine is one of the best ways to prevent migraines. I wrote about a plan I made for sticking to routines that are constantly interrupted by migraine attacks. After a few months of trying hard to implement that plan, I have a few addenda.

But first a note on chronic migraine and routine:

Chronic migraine does not respond well to change. I need to eat similar amounts and types of food at the same times every day and wake up, nap, and go to sleep at the same times every day. It even helps to keep my energy levels similar day-to-day, doing higher energy things in the morning and lower energy things in the afternoon and evening. A very strict schedule is incredibly helpful for keeping migraine attacks under control and I have to prioritize routines around food, sleep, and exercise. Migraine attacks, however, interrupt the same routines that reduce migraines, leading to more migraines.

It turns out that staying home is the best way for me to keep up a routine that involves both relaxing and getting work done in the same day. It’s too easy for me to get a migraine when I go to my office because of the environment and difficulty maintaining the kind of routine I need there.¹ The downside to working from home is that I miss out on the really great culture in my lab and am missing out on career-building relationships. But that kind of disability-related isolation is a post for another day. This post is about migraines and routines.

The trick is to make my routines have just enough flexibility and slow, relaxed time in them that I can move back into my routines as soon as my migraine starts to abate. I also suit the intensity of my activities to how I’m feeling.

Another difficult balancing act is managing to do enough work and still do the things that keep me happy and healthy. The trick has been to spread the healthy, happy activities throughout the day and to break my work up into two or three chunks. This way, if I’m only well for part of a day I’m likely to get both work activities and personal activities in. I’ve been sick enough lately that I’m not doing enough work yet – I often have to nap or switch to easier tasks right now during my scheduled work time. But I’m hopeful that with a bit more time with this routine (and the good exercise, eating, and sleeping) that my ability to work will improve.

Here’s an example of how I might end up modifying my normal schedule (on the left) when I get a mild migraine.

Good day 6:00 Wake up and read the internet 6:30 Have breakfast, read some non-fiction (currently) 7:30 Study Russian 8:00 Work 9:00 Small snack and keep working 10:00 Exercise (push ups, squats, jumping jacks, crunches) 10:30 Shower, dress, and do some chores 11:30 Lunch 12:00 Work 2:00 Nap 2:30 Small snack and keep working 4:30 Dinner 5:30 Emails and planning 6:30 Read for work (textbooks, how-tos, papers) 7:30 Read for pleasure, watch a movie, hang out with roommate, or some other fun, quiet thing 9:00 Meditate and write in journal 9:30 Go to bed

Day with migraine starting at 8:30 6:00 Wake up and read the internet 6:30 Have breakfast, read some non-fiction 7:30 Study Russian 8:00 Work 8:30 Take meds and go to bed 11:30 Get up and eat some crackers 12:00 Listen to podcasts and sleep 2:00 Lunch (small snack) 2:30 Exercise (15 minutes slow yoga) 3:00 Shower and dress then sit and rest 3:30 Do some chores slowly, sitting down and resting often 4:30 Dinner 5:30 Emails 6:30 Read for work (textbooks, how-tos, papers) 7:30 Read for pleasure, watch a movie, hang out with roommate, or some other fun, quiet thing 9:00 Meditate and write in journal 9:30 Go to bed

My schedule and a little bit of strategizing go a long way in keeping many migraine days from being total losses. Even just doing my emails and a bit of reading for work keep me engaged in my project and moving forward, which leaves me relaxed enough to do the things I need to do to stay sane and healthy – reading for fun, writing in my journal, exercising.

I know a lot of the details of this post are specific to me, but hopefully some of the ways of thinking about routine will be helpful for some of you. Let me know if you have more ideas!

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1 The only way to make my office safe for me is to make it absolutely not ok for the 8 other people in there. There doesn’t seem to be a way for me to get my own office. The disability advisor assigned to me told me to work from home and seemed not to understand that interaction with colleagues is kind of essential for a career in science. I guess I’ll collaborate on twitter?