38: Migraine Isn’t a Pain Problem. It’s a Brain Problem, with Neurologist Dr. Carol Foster
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If you’ve ever been told to power through a headache, lie down in a dark room, or “just relax,” this one’s for you. It’s also for the busy, overcommitted people holding everything together.
One of us landed in the ER with a thunderclap headache. The other grew up watching a grandmother lose three days at a time to migraine in a dark room. So we sat down with Dr. Foster, a headache neurologist with nearly 40 years in practice, to ask the questions we wish someone had answered sooner.
She explains what’s happening in the brain during a migraine and why triggers pile up and threaten to overflow the river. She also explains why hormones matter at every stage of life, and why the hardest prescription might be the simplest: do less. There’s also a bedtime tip that involves podcasts. You’re welcome.
What to listen for:
It’s a brain problem, not a character flaw. Dr. Foster describes migraine as an adrenaline surge in the autonomic nervous system, a kind of electrical storm that spreads across the brain. It isn’t about being “too sensitive” or not handling stress well enough.
Lower the river. Stress, skipped meals, dehydration, low blood sugar, certain foods, screens, travel, and hormone shifts all add up. The goal is to keep the water level low enough that one rainy day (a sick kid, a big deadline) doesn’t flood you. Her simple baseline is protein, carbs, and water in the first hour of the day, then every three hours. Her words: treat your brain like a baby.
Timing matters. She calls treating migraine “a time thing, not a pain thing.” She explains why waiting it out can backfire, and why even an occasional migraine deserves a plan, because the brain learns patterns. This isn’t individual medical advice, so take the discussion to your own doctor.
Hormones are part of the story. We talk about the estrogen drop around a period, perimenopause, and beyond. We also cover less obvious forms, like abdominal migraine in kids and migraine-related vertigo. We’d never heard of these before.
Doing less is part of the treatment. In her words, “If you do not take this time, migraine will take it.” That means getting comfortable saying no, because “no” is a complete sentence. Her bonus tip is to go dark for 60 minutes before sleep and listen instead of look.
About our guest:
A West Virginia native, Carol A. Foster, M.D., is a 1985 graduate of Marshall University School of Medicine. A migraine sufferer herself, Dr. Foster chose neurology as a specialty and completed neurology residency at the Barrow Neurological Institute in Arizona in 1989. Her time spent at the BNI also included a headache clerkship at the Princess Margaret Migraine Clinic in London. Later that year, Dr. Foster began practicing in Phoenix, Arizona, and established the Valley Neurological Headache and Research Center. By 1990, Dr. Foster had established her practice as a private clinic dedicated to treating and researching headache disorders. She now practices in Denver, Colorado.
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