migraine

Migraines and men: Why I laughed when I was told to 'man up'

June 27, 2014 at 11:24 AM ET

Ian Sager poses for a portrait in New York, on June 25, 2014.
Lance Booth/TODAY
I've never felt any shame or trepidation about migraines, writes Ian Sager. How could I? The fear of the next storm leaves little room for that.

“Be a man!”

Lightning flashes across my eyes and my vision blurs. “Man up! Get back on the field!”

There’s a noticeable change in my body, and my cognitive abilities begin to slow. 

The voice barks again, this time bestowing me with a four-letter name no mother would give her child. 

The migraine is coming, there’s no doubt about it. It’s time to go. He can scream all he wants.

I saunter off the soccer field, desperately searching for my medicine.

The characters in this drama (and their propensity to speak like sailors) are unique, but the action will be familiar to the 36 million American men, women and children who suffer from migraines: When the storm comes, you batten down the hatches.

But illnesses do not operate in a vacuum, and because migraines impact roughly two to three times more women than men, I’ve found myself fighting on two fronts: against the agony itself, as well as those who cannot fathom a man not pushing through the pain of an illness that predominantly afflicts women. New research touches on the stigma migraine patients face, especially men who are more likely than women to miss an important event or report stress in their relationships. 

I’ve always laughed off the second concern. I've never felt any shame or trepidation. How could I? The fear of the next storm leaves little room for that. 

It could be worse, right?
I know I wasn't the first child to struggle with illness — and many face far bigger fights — but to be age 9 and know the fear of incapacitation, well, that wasn’t something I could easily wrap my brain around. My migraines, as well as their symptoms, grew as I did — and they terrified me.

At 9, I began losing feeling in my arms and face at the earliest signs of a migraine.

At 16, the symptoms increased, and my migraines included auras and loss of vision. Head-splitting headaches followed soon after. 

And by the time I was in college, nausea confined me to a bed — clearly not for the same reasons as the majority of my peers.

Most 9-year-olds fret about homework. Some daydream about the red-headed girl in the classroom next door. I wasn't like that. I sat at the edge of my chair, waiting for the symptoms — as if sensing them early could save me. But when they came, and they came like clockwork, I panicked. I cried and I got sick. I would leave class wondering what was happening to me. Again, many children suffer through illnesses far worse than mine, but no child should have to suffer the mental and physical torment that I did. 

By adulthood, my symptoms stabilized just enough to grant me a greater sense of freedom — and to ponder effective treatment. My routine of post-migraine pills, Advil, caffeine and hydration was wearing on me, and annoyingly becoming less effective. With my wedding on the horizon, and a recent string of four migraines in four days behind me, I said enough was enough. Not being able to read a book is one thing, but not being able to see my wife walk down the aisle because of the vision-altering auras was something I refused to let happen. I pursued a stronger course of treatment, one that allows me to lead a fairly normal life today.

I say fairly normal because I still battle through migraines — just far fewer than ever before. At my worst, around my 26th birthday, I was getting between five and 15 migraines a month. Now, I get one every two months. I'm very thankful for the fact that I found a doctor who specializes in migraines (who also had the patience of a saint). After some trial and error, he eventually found a daily, preventative medicine that worked. That, combined with a moment-of pill to stop any migraine I still get, has drastically changed the quality of my life. In addition, I made a a drastic change to my diet and exercise. I lost weight, whipped myself into good shape, and cut down on the foods that triggered my storms (anything that's salty, contains preservatives, even alcohol). That doesn't mean I avoid these items completely. One can only go for so long without a glass of wine. I just live my life in moderation now. It's a trade-off I'm more than happy to make. 

And most crucially, I didn't go through this transformation alone. Migraines run in my family, as they do with many. My mom gets them, just as her mother did. While I'm the first man in my family to get them, I always felt supported by those closest to me. Watching my mom struggle and find her own solutions — while incredibly painful to witness, especially as a child — is a big reason I'm healthier today. 

Which brings me back to the “man up” incident I referenced earlier. Although it was a passing moment during a high school soccer practice, it was not an isolated incident. My closest friends and family understood what I was suffering through, but to those who existed only in the periphery of my life (coaches, co-workers and roommates), I was someone who just disappeared from time to time. (Yes, I was often running away to get sick, other times looking for a quiet space). Many approached me with general inquisitiveness when I explained what I was dealing with. At the worst, I was openly scolded, labeled as someone to be regarded as a less-than. 

Every man at some point in his life is told to "man up." The phrase has become so common and devoid of meaning that our current secretary of state is even given a free pass to use it in interviews. Most American sporting events and films are just oozing man-up-ness. If being a man means we’re able to regularly find an extra gear of power and strength, somebody please tell me where it’s located. 

So it was with this as a backdrop that my colleague aimed insults at me, skewering me for not facing my migraine pain like he felt an man (or a teenage boy on the verge of adulthood) should: with dignity and quiet suffering. Really? I should just go ahead and drive, work and plow ahead with life when walking two feet is suddenly an Olympic feat? My manhood was never in question. 

The only thing in question was his conception of migraines and what it means to be a man. In my mind, seeking treatment, finding answers and relief is a sure sign of being a man. It allows me to be a better father and husband — and that's all my loved ones can ask for. 

As for my tormentor, I could only laugh at him (once I felt better of course). 

Ian Sager is an editorial manager of TODAY Digital.

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