Fisher Meets Status Migrainosus

June 9, 2020

Well I had a really good run! Fisher didn’t have to cope with one of my excessively lengthy migraines until he was 11 months old. Thank goodness for that. That maturity really helped make things easier. I had a migraine from May 5th – June 6th 2020 which is why you haven’t heard from us in awhile.

If you’re not familiar with migraine here’s a quick rundown:

  • Migraines are more than just headaches, they’re more like neurological attacks with 3-4 phases. The period leading up to an attack is known as the prodrome, then some people (but not all) experience an aura which immediately precedes the headache phase followed by a postdrome period after the pain ends. To learn more go here.
  • Symptoms have a large spectrum, the core of which are throbbing head pain, sensitivity to light and sound, and nausea. I experience vestibular type symptoms where I lose my balance and varying degrees of aphasia meaning I switch words, struggle to find the right words, mix up sentences, and say one thing when I’m trying to say another without realizing it. This is not an exhaustive list of possible experiences.
  • Migraine sufferers tend to be women but men suffer too. It is estimated that 14% of the world population experiences migraine with 2% of the world population meeting the definition of chronic migraine. Migraine is ranked as the 7th most disabling disease in the world. Reference here.
  • Migraine is poorly researched and understood despite it’s prevalence but recent advances like CGRP antibody drugs have brought hope to many. Unfortunately seem to be having some sort of negative response to them but they work for so many!

Technically what I had going on this past month is known as Status Migrainosus, a migraine lasting longer than 72 hours. I broke my previous record of 28 days straight, not a fun record to beat. In the times before COVID-19 I could have gone to the ER or even been admitted to break it but this wasn’t an option because of the pandemic. So I had to just hang in there and wait for it to stop.

Living with an adolescent GSD while essentially rendered non functional for a month was not on my bucket list. Luckily I knew this would happen eventually so Fisher was prepared for a long string of quiet days. It’s critical to plan these things if you’re training a service dog and have disabilities that can lead to unpredictable amounts of down time.

Here’s what we’ve been practicing since he was a puppy:

  • Quiet personal play sitting in one spot. His favorite is rolling onto his side to bat at my hands with his paws, a little like patty cake.
  • Solo yard time. We’ve been working on solo trips into the yard for activities since he was young. Sometimes I just can’t sit outside with him with a migraine. His favorite yard activities included using the grass as a giant snuffle mat and running around carrying the large yard toys like his Jolly soccer ball.
  • Transferred walking skills. Fisher has learned to generalize his walking skills to my significant other so they can have peaceful walks when it’s impossible for me to do so.
  • Extensive reward history for calm behavior in the house. See the Settle and Relax unit in The German Shepherd Dog Network.
  • Practice at using food enrichment to make eating an event. He uses various kibble dispensing dogs toys and frozen stuffable toys.
  • Training sessions where I am lying down or sitting on the floor. Dogs do not generalize well and most of us primarily train from a standing position. Mental stimulation is doubly important when you put an energetic dog through a period of reduced physical exercise so I made sure he could train even if I can’t get up due to pain or dizziness.
  • Quiet Enrichment activities that don’t require a lot of movement on my part. You can get ideas here.

I also used some of my own modifications in order to fulfill some of his exercise or mental needs on days with lower pain. Whenever we talk about owner trained service dogs I like to remind myself that this dog did not choose this life I have planned for him. He didn’t ask for an owner who can essentially get stuck in bed for 30 days at a time. Knowing this I do my best to meet him halfway because that’s what a partnership is all about. Too often we look at a service dog or service dog in training and only consider what they can do for us, and not what we can do for them.

Migraine Survival Tricks For Raising a Service Dog in Training:

  • I use a baseball cap and sunglasses so that I can go outside and walk him or sit in the yard and play.
  • Icy hot maximum strength is a great option for knocking the pain down a couple of levels to get through a physical activity.
  • When I can’t go outside due to temperatures that aggravate my migraine we go down to the carpeted area of my basement so he can chase a ball.
  • In order to keep him satisfied and engaged we work on new behaviors that he has never tried before. I am patient as he struggles a bit due to my sluggish mechanics due to my pain.

My first service dog was not trained in migraine tasks, though my goal is to work toward some for Fisher. I was lucky enough to get to do some scent work with saliva samples taken at my migraine onset when he was under 8 weeks old. There have been subtle signs that this stuck. He regularly sniffs the top of my head, left eye (starting pain location of 90% of my migraines), and mouth with insistent behavior during an attack. Now whether or not I can train a scent based migraine alert is very much an experiment. I’m currently diving through some scientific papers on migraine, CGRP, and saliva sample collection and storage to try and get a better understanding of how to design a training protocol that would help me determine if there’s a reliable scent for him to hit on. The ultimate goal would be an alert of an attack BEFORE pain starts because it’s critical to treat a migraine as soon as possible to better your chances of breaking an attack.

Here’s my migraine task wish list for Fisher:

  • Scent based migraine alert if possible.
  • Fetch a drink
  • Fetch a medication bag
  • Go get help
  • Counterbalance while walking, this one will wait until his growth plates are closed.
  • Turn off the lights

Now that Fisher is one day away from his first birthday and showing a solid SD appropriate temperament I am beginning to start thinking about his task training. When I feel more confident about my scent based migraine alert experiment I’ll be sure and make a post or posts explaining the rational, sample taking, and training.

Right at this moment, I’m plotting his first birthday celebration and basking in the joy that is being pain free!

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