A Migraine PSA
A silent migraine is basically a migraine without the headache. Everyone has different migraine symptoms, but mine are always the same: a sort of motion-sickness-like nausea, oversensitivity to light, extreme oversensitivity to smell (it's a dead giveaway when I'm in a place I've visited many times and smell things I've never smelled before), and difficulty processing visual cues. I know that visual symptoms like flashing lights or jagged lines are common with migraines, and I don't get any of those. I can see fine, but I have trouble understanding what I see or responding appropriately to it, which means driving with a migraine takes 100% of my attention. On rare occasions, I've also gotten tingling in my extremities, particularly the toes on my left foot.
Migraines are really, really weird.
Maybe 15 or 20% of the time I get these symptoms, they're followed by a severe headache, of the moany-groany, can't-do-anything, please-kill-me-now variety. The rest of the time, the nausea just gets progressively worse until I can't do anything but lie on my back. Fortunately, I seem to have found a formula that forestalls or stops these serious symptoms most of the time. For a silent migraine, three Tylenol (aspirin works better, but I can't take it) and a glass of water, followed by a small dose of caffeine and at least an hour of quiet "down time" seems to work. For a migraine with headache, Tylenol and water, followed by a nap or at least a couple of hours of lying down in a dark room, and finally a hot shower and another glass of water. I have no idea why the shower helps, but it really does. Also, this may be just superstition, but I never touch alcohol until I'm sure that the migraine is completely gone.
Finally, I'm fortunate that one of the drugs I take occasionally for my stomach, metoclopramide, is also used to treat migraine-related nausea. This drug can, rarely, have nasty side effects, especially in large dosages, so I'm not recommending that you Go Ask Your Doctor necessarily, but it might be something to consider if you have severe nausea with migraines. (I haven't had any side effects from the tiny dosage I take.)
Finally, I would like to complain about how annoying it is that no one knows what causes migraines, or even what they are, physiologically speaking. It's obnoxious to have to treat a disorder by trial and error, without having any idea why certain things work and others don't. If anyone knows anyone who does research on migraines, let me know so I can give that person moral support and brownies.