The above image was done using stable diffusion using the prompt 'the pain scale.'
I got my first migraine at age 16 and began experiencing frequent debilitating headaches in my early twenties. After years of trying I succeeded in consistently preventing migraines, at which point I was left with just cluster headaches. When I first realized what was going on, I didn't want to believe it.
Migraines I could handle. Yes, they were awful and sometimes incapacitating. But they ran in my family. My mom had a serious case. If migraines were a known quantity, cluster headaches were something much darker. They were a life-destroying curse that almost no one had even heard of.
I remember the exact moment that I admitted to myself that I had cluster headaches. Looking at myself in the mirror in a bathroom in Brooklyn, coming off of an attack, I just knew that either I had a brain tumor or it was cluster headaches. From that point, it was 7 years until I was able to get in front of a neurologist.
This neurologist worked in a famous headache care clinic and had a strong reputation. She ordered scans that ruled out a tumor, but in every other way she sucked. When all was said and done, she diagnosed me with trigeminal pain and acted like I was faking or exaggerating my illness for attention. I didn't actually receive a cluster headache diagnosis from a neurologist until 2020, 13 years after the point where I knew what was going on.
Years ago when I was poor and uninsured, one of my teeth broke, then abscessed and ruptured. My neck and face swelled up. I became feverish. In this state, I went to the discount dental clinic and was told that the waiting list was full and no appointment would be available for months. So I begged and was visibly in such disrepair that they agreed to do an immediate emergency extraction.
That ordeal was very painful, on par with the time I tore a tricep. And yet, at its worst, it was only about a 5 on the 1-10 pain scale that I use to describe the cluster headaches I experience. At level 3, most people would call in sick to work. At level 4, they'd seek urgent medical attention. At 6 and above, they might call an ambulance if they could use a phone in the midst such extreme discomfort.
In my lifetime I've experienced thousands of attacks at level 6 and above, each one lasting 45 minutes to 3 hours. I've had a handful of 10s, hundreds of 8s and 9s, and too many of the rest to count. They come in clusters and when I'm not in a headache cycle I'm perfectly fine. The cycle I'm in now has so far included a couple of 8s, which were ungodly.
Imagine a massive steel spike descending to Earth from space. The point comes down from the sky like some kind of celestial hydraulic press and pushes itself through one side of your head. You're pinned there, fatally impaled from above by an impossibly large object, as if you're an unlucky bug and a child with a pin is ruining your day.
That's how one of the 8s felt. The other one involved more stabbing sensations and less crushing force. Both lasted about 90 minutes. Recovering from attacks of this intensity is a whole thing. Beyond bodily care, the trauma needs to be processed and the experience needs to be integrated. I always try to do this part quickly but inevitably it takes time.
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