I am afflicted with a malady known as cluster headaches. These are hard to predict, although a shift in barometric pressure tends to set them off, or bright glaring lights, and alcohol will frequently trigger them too. I can personally verify they hurt worse than many other medical conditions including gallstones, migraines and broken bones. Yes, I get migraines too, but they’re different and don’t involve the imaginary-ice-pick-stabbing-my-eyeball-from-behind type presentation.
As the cartoon mentions, O2 helps, if I should happen to have an onset when I’m sitting next to a tank of oxygen, which hardly ever happens. I get a bad reaction to serotonin agonists like Sumatriptan and I’m a little leery of ergot too, but I have noticed that I can kill a cluster headache with simple over-the-counter meds like Tylenol and fifteen minutes of sitting somewhere quiet. If I let it go for more than about fifteen minutes, there’s a good chance I’ll be afflicted with headaches on and off for several days.
Obtaining meds and quiet aren’t a problem if I’m at home, or at work, or on vacation. It can become a big problem in big noisy congested cities like the one where I live, where you can’t just pull over to the roadside for a couple minutes without it turning into a complex business transaction.
According to Wikipedia, “People with CH may dread facing another headache and adjust their physical or social activities around a possible future occurrence.” That’s what I did. Somewhere in my mid-twenties I figured out how to make driving optional, because I was getting far, far too many clusters (technically one (1) cluster is far too many, so “far, far” = anything over one).
So I’m one of the small minority of Americans that doesn’t routinely drive. I live close to work, in a city with great public transportation, where my commute consists of spending 20 minutes reading books on my phone. I get my groceries delivered. If I’m going somewhere beyond walking distance, I’ll get a taxi or a rideshare. I used to belong to a car share community until I realized I wasn’t actually using the cars enough to make it worthwhile, and now I just rent cars occasionally when I feel the need – or when I’m on vacation.
I’m an adequate driver that can drive a stick and/or parallel park on busy streets, and occasionally I really enjoy being behind the wheel. I also occasionally enjoy the feeling of having an alcohol buzz – but alcohol sometimes brings on the clusters, so I only drink when I have no plans for the following day. I’ll note that having headaches that prevent me from both drinking and driving is probably less optimal than having headaches that force me to choose, but I’m just grateful I’ve been able to spend the last couple of decades avoiding weekly clusters, like I’d get back when I was commuting by car.
Someday soon, we’ll have driverless cars, which means I’ll be able to lead a suburban lifestyle again if I so choose, but in a lot of ways I’m glad I opted out. The car-free lifestyle is a lot more peaceful and aesthetic. My commutes are shorter, and more entertaining since I can read or watch videos or look at webpages or text or whatever, as opposed to staring at the same old advertising signs, in a car-scale landscape. (I’m more about the pedestrian-scale landscape, such as in blocks built before 1900.)
There are a lot of us car-free people in the US. People who are visually impaired, or who have seizure disorder, or whose chronic pain is controlled by large amounts of narcotics. Some of us don’t drive for legal reasons rather than medical ones. It can be tough navigating contemporary America without driving.
My clusters didn’t start until I moved to the mainland. I’ve never really experienced a cluster in Hawai’i, where the air has overwhelming amounts of oxygen thanks to all those green plants and ocean breezes. Maybe it’s a climate adaptation thing.