Conferences are a minefield of migraine triggers

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I went to the Evolution meeting last week in Ottawa and had a great time. Everything I had to say about how great ESA meetings are applied there, too (if you replace “ecology” with “evolution”):

I love hearing about the latest research in my particular subfield, and I’m inspired by research seemingly unrelated to mine. I love meeting the scientists behind the research I admire. I love presenting and discussing my research with scientists who know about four million times more than me. I love all the dinners and coffee breaks spent geeking out about ecology and catching up with friends and colleagues.  Basically, ESA is more fun than Christmas.

Going to conferences is one of my favorite parts of being a scientist, and I’m thrilled that I’ve gotten to go to so many. Anything that happens at a conference that keeps me away from all the cool talks and fun conversations is sad, and getting a migraine at a conference most definitely throws a wrench in my exciting science-y plans. Unfortunately, there are a lot of migraine triggers associated with going to a conference. Below is a long list of those triggers and how I try to deal with them. If you have migraines or other health issues or are interested in the minutiae of living with a chronic illness, read on, otherwise you may want to skip to the end.

Flying

The first and biggest issue is travelling to the conference, which generally involves an airplane. About the time your ears start popping, I start getting a migraine. I very carefully plan the timing of my medication prior to the flight and make a detailed plan for my travel from door to door. I don’t want to have to figure out how the buses work in a new city when I’m so nauseated I can’t see straight. Even if my meds work perfectly and I don’t end up feeling like I’m going to die on a flight, it still takes me a bit of time to recover. If possible, I like to arrive the day before the conference starts – otherwise I’m likely to miss the first day entirely or still be experiencing migraine postdrome – spacey and emotional is not the mood you want to meet potential employers and collaborators in.

Eating

Food is the next big problem. I need to eat fresh, healthy food frequently (every 2-3 hours) and without much variation in timing day to day. While traveling or at the conference, the availability of such food can be quite limited and the timing of meals is dependent on things like the conference program or whether or not your dinner companions run into their science hero in the hallway on the way out of the conference center. Once you actually get to a restaurant, it’s usually swamped if it’s anywhere near the convention center and you can end up waiting a looooong time for food. My solution to this problem is to always have an excess of  good food stashed in my bag. It can be difficult or impossible to travel with all the food I need for a weeklong conference, so I seek out grocery stores and small markets with good prepared salads and sandwiches near the convention center and stock up. Having a hotel room with a fridge really helps, because then I can go shopping only once or twice. Almonds and apples stand up well in a conference tote bag. Naked juice is a lifesaver. Well packaged vegetarian sandwiches and salads make excellent small meals. This allows me to eat non-migraine inducing food on the schedule my migraines demand. I still eat out because that’s half of the fun/networking of a conference; I’m just doing it more explicitly for the people than the food.

Conferences and hotels often provide at least some food. Unfortunately, the timing or type of food usually means I can’t rely on it. Since you can’t be reimbursed for meals provided by the conference or hotel, this often adds significantly to my out-of-pocket expenses.

Sleeping & low energy

A lot of scientists have funny stories of staying in terrible and overcrowded accommodations to cut costs while attending conferences. I probably won’t. Adjusting the time I go to bed and wake up and/or the length of time I sleep is a sure way to give myself a migraine. I can definitely do an overcrowded room as long as I’ve got a semi-comfortable surface to sleep on – give me an eyemask, earplugs, and a benedryl, and I can sleep through a lot of rustling covers and late night showers. What’s more important is the temperature of the room. I cannot sleep when it’s hot and being hot can give me a migraine very quickly regardless of sleep issues. Since conference housing is often old dorms which can have inadequate or no air conditioning, usually I have to suck it up and pay extra for a hotel. I also have to make sure I’m not sharing a room with people who think 25C/77F is room temperature (I’m looking at you, Cameroonian friends).

I ignore new time zones as much as I can to make the smallest adjustments to my sleep schedule as possible. Sometimes this means I get up at 4am every day at the conference. If the time change is very large, I slowly shift my sleep schedule over the week before the conference.I try to take sleep into account when I schedule my flight to avoid disruptions to my sleep schedule; this can add a fair amount to travel costs.

Conference schedules are jam packed with presentations, meetings, entertainment, and schmoozing. It’s not unusual for large ones to have events booked solid from 7 am to 11 pm. I don’t think anyone could survive a week going to something every available minute of a conference and most people are exhausted even after skipping a lot of events. But I still attend far less than the average conference attendee. I don’t let the conference schedule interfere with the times I need to go to bed and wake up. I also have considerably less physical energy than the average 20 something and am a bit of an introvert as well. I can only take in 3 or 4 hours of talks each day. To avoid exhaustion and migraines, I make time to wander off somewhere cool and quiet every day, and I take a nap every afternoon.

New climate

The first requirement for grad schools I applied to was a climate where large and/or rapid swings in barometric pressure – my biggest uncontrollable migraine trigger – were rare. Conference organizers don’t  take my personal migraine triggers into account, and conferences are usually in places that have much larger pressure swings than is good for me. Unfortunately, there’s absolutely nothing I can do about this. Sometimes location combined with time of year means I just don’t go to a conference. Sometimes I cross my fingers and take a lot of drugs. (Usually that leads to a lot of time stuck in my hotel room feeling awful.)

Getting too hot or too cold can also give me a migraine. Getting too hot is definitely worse. It’s harder to avoid temperature extremes while traveling than while at home where I have more control over my environment and schedule (avoid going outside in the afternoon in the summer, for example). Layering, somewhat embarrassing products like the cool-tie, and avoiding the riskiest settings (e.g. midwestern conference field trips in August) are the best strategies I’ve come up with.

I also wear a big old lady hat and lots of sunscreen. Sunburns suck and, of course, can give me a migraine..

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Conferences are busy and tiring events for everyone who attends, but can be especially hard if you’ve got health problems. Things that would be minor inconveniences or discomforts for other people can lead to days of awful pain and vomiting for me. While I love conferences and get a lot out of going to them, migraines mean that I attend fewer sessions and meet fewer people. I worry that my colleagues and acquaintances think I’m wasting time/money or slacking off. But by discussing the sorts of things I detail above or by being inflexible about so many things, I feel like I’m coming off as whiny and weak. I’m still working on how to communicate the boundaries I live within without garnering annoyance or pity. Plus, a lot of my avoidance strategies make attending conferences more expensive, which is awkward to explain to my PI and even more awkward to explain to other grad students staying in terrible, un-airconditioned dorms.

While conferences are exciting and make me feel inspired about research, sometimes they also reinforce the ways being sick sucks. I cannot overemphasize how important it is for my motivation and confidence that I connect with successful scientists who also struggle with some kind of chronic illness. Early in my undergraduate science career, I found out that an ecology professor I really admired had some health issues. I probably wouldn’t have gone to grad school without her example and advice. And at the evolution meeting I met another graduate student with migraines who nipped some budding feelings of frustration, inadequacy, and isolation in the bud with some excellent migraine humor.

Comments

  1. Karina says:

    I’m glad that you’ve found ways to be able to attend conferences and that you’ll be at ESA!

  2. Ryan Kitko says:

    I just have to add a big “hell yeah” to everything you said here. I was at Botany 2012 in Columbus and missed the entire Tuesday session because of a migraine. I unexpectedly met up with some friends from my undergraduate school at the meeting and spent far too much time with them, thus messing with my sleep schedule and bam – migraine. Sometimes communicating the difficulties associated with this chronic condition to others, especially advisors or those on committees, can be frustrating. “It’s just a headache, right?”

    I’m glad you’ve found boundaries and what works for you. I suppose we all develop a certain shielding and know what to avoid in order to keep the pain away.

  3. Sam(antha) Davis says:

    Stumbled on your site while looking for tips/tricks to survive ESA next week in Minneapolis. If you’re planning to attend, maybe we can get together and commiserate about our migraines? It sounds like we suffer on similar levels, though I promise you, I’m in my mid twenties and I’m not full of boundless energy either. Thanks for the post!

    • sarcozona says:

      Unfortunately, my migraines ate so much of my spring that I can’t afford the time (and additional migraines) ESA would cost. So I won’t be going this year. But maybe next year? Good luck at ESA – I wish you many cool, dim rooms of quiet science conversation 🙂

  4. I’m not a chronic migraine sufferer, but nevertheless there are a couple of surefire migraine triggers that I have to be especially careful of while travelling.

    1. Wrong pillow.
    2. Painkillers not close – sometimes walking to the kitchen/up the stairs/to a store is the difference between a minor headache and throwing up for the rest of the day. At home I keep them in my bag, in my car, and beside my bed, but I often forget to put them beside my bed when travelling.
    3. Carrying water. This one got me in a lot of trouble while flying from the states back home to Australia. I actually was carrying water, but security took it off me before boarding, so my next access to water was not until the flight had taken off. Unfortunately, it was an extremely short flight and I was not able to get water from a flight attendant. They ended up having to wheelchair me off the plane and all the way to a hotel (at Atlanta, if you’re familiar with it) because we all agreed I couldn’t catch the ATL-LAX-Australia flight. They organised hotel and flight for me, though. I was so incredibly grateful!

    My main experience with disruptive illness and chronic pain came from a relatively innocuous little hernia that unfortunately arose during my fieldwork-intensive honours year in 2010. It ended up requiring 3 surgeries to fix, which meant I spent the best part of 3 years not able to do much more than walk short distances between chairs. This is obviously a game-changer for a field ecologist.

    Since I was in a constant state of switching between healing and avoiding exacerbating a potentially dangerous injury, painkillers weren’t going to be enough – i had to find exclusive desk work. I ended up approaching the resident spatial ecologist and learned how to code and model and have actually been employed (albeit on many short-term contracts) throughout the entire period. I never found an adequate way to go back to study, though…still working on that.

    In terms of pain management, it was exactly as you describe it – finding the box in which you can live comfortably/safely and sticking to it! Finding others going through similar situations was also key.

    The long term repercussion is that I don’t have a phd and am not competitive for scholarships for masters/phd compared to those who have been able to complete honours. Nevermind that i teach phd students and post docs how to analyse their data… doing a lot of it for them in the process. I also developed anxiety during the whole debacle, so have to put a lot of energy into managing that. And, while I may have recovered now, my leg isn’t the same as it used to be (I’m too young to be saying that, haha), so I have not yet tried to embark on fieldwork yet.

    On the plus side, I love my work, lots of people want to work with me, and I discovered a lot of new, fun hobbies. I’m considering spending a bit of time doing a coursework masters to boost the programming/GIS skills. The alternate research postgrad path would involve a 1 year grad dip of research methods, masters by research, then phd. Given that I’ve spent the last couple of years in research jobs I feel that certainly the grad dip is superfluous and my supervisor even thinks masters would be too, so I think I’d gain more from doing a coursework masters.

    Gosh…i’ll stop typing now, haha.

  5. JaneB says:

    Oh, this all sounds so familiar… especially the fear of sounding whiny. I have depression/GAD/stress-related health problems (I get ‘flu-like symptoms without the fever and/or laryngitis with depressing speed and ease under stress, or gastric issues, or migraines, and sometimes all three which is not fun when you still have to get home somehow). Oh, and I also have a chronic lower back problem which tends to kick in after sitting in cramped conditions or carrying a case or bag, and can make climbing stairs very very slow.

    And I’m the PI/Supervisor! Travelling to conferences with the rest of the group can be tricky because I just don’t have the energy they do, I’m picky about travel times, plan very carefully, often need to take the lift rather than the stairs or go hide out in a quiet corner for ten minutes to get control of my anxiety in a crowded airport or need to stop frequently if we’re driving somewhere. I go to fewer conferences, I am really picky about what I attend at the ones I do go to, I protect my alone time and sleep fiercely… I pack a lot of ‘good foods’ – fortunately cereal bars, nuts and dried fruit all work for me and survive in the bag – obsess about drinking enough water and often skip out of the big plenaries to take a top up nap! It’s hard, but it’s possible, and although my health has gotten more complicated my science is still getting better!

  6. Frankie says:

    Thank you so much for your comments. I returned yesterday from a conference where I had to (was privileged to have been chosen to) present a workshop about my dissertation topic. While in the midst of a chronic fatigue flare up, I strategized about all the triggers and about coping mechanisms. Out of three days, I made the first plenary session, my own workshop and three meals. For the first time since starting my PhD (knowing that I have Fibromyalgia Syndrome), I was content that I could give the limited energy that I had; that I could have three meaningful conversations (instead of thirty) and that I managed to get home without collapsing (although I had to order a wheelchair so that I could make it to my gate in one of the largest airports in the US).
    For five years I managed to keep up with my cohort; but that is no longer an option. Now I’m going to use some of your advice so that I can make the dissertation writing process work for me. My advisors are already very cooperative, but you have made me realize that I need to set up my world more proactively. Thank you!

  1. […] Puts my Evolution 2012 hangover in perspective. If you thought conferences were exhausting and stressful, try attending one with migraines. […]

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