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While I suffer from migraine headaches, I recognize that mine are generally far less severe than many people’s, but that does not alleviate the pain or the unpredictability of my triggers.

Yesterday morning I had a quick follow-up visit with my dentist for her to check the sutures from last week’s minor surgery. Sitting in the office waiting to be called, I passed the time playing games on my phone when a mother and her little girl came in. The little girl, a strange child, was excited for “the doctor to look at her teeth,” and when told she had to wait, shrieked in frustration. Yes, from what I saw, it really looked like the little girl was upset because she had to wait to see the dentist and not from fear of the exam.

However, her single piercing shriek instantly ignited a migraine attack in my head. For me, this is one of the most difficult things to manage: when and if a migraine trigger will actually start an attack, warn that an attack may come, or leave me untouched as though I do not suffer from this condition.

There are times when the triggers, and they are nearly always audio triggers, start a process deep in my skull that I can feel and now recognize as a potential migraine. In those cases, I can flee the stimulus and often avoid the attack itself. Sadly, for me the triggers can be as mundane as the mere sound of someone eating. (I have never watched The Substancebecause I know that there are disgusting shots of people eating and talking as they eat, and the risk of a migraine is simply too great to ignore.)

Other times there is no warning that the trigger will ignite the attack, and from the very first moment of the trigger, the migraine starts. Pain exploding inside my skull, the sensation of pressure builds in my head, and a slowly growing dissociative detachment takes hold.

Yesterday I suffered for most of the workday with a minor to moderate migraine, moved slowly through my tasks, and had very little cognitive ability once I returned home to my sweetie-wife.

If these were more predictable, life would be more manageable, but as it is, I simply have to deal with the triggers and whatever they decide to do on a case-by-case basis.