Strength Behind the Scenes: A Conversation with Lilly Singh

Summary

The Head Start: Embracing the Journey
Episode: Strength Behind the Scenes: A Conversation with Lilly Singh
Host: Nora McInerney
Guest: Lilly Singh
Release Date: June 17, 2025

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1. Introduction to the Episode and Guest

In this heartfelt episode of The Head Start: Embracing the Journey, host Nora McInerney welcomes the multifaceted entertainer Lilly Singh. Known for her roles as a comedian, actress, author, singer, YouTuber, and activist, Lilly shares her personal journey of navigating a high-profile career while managing chronic migraine. The episode sets the stage for an open and honest conversation about the challenges and triumphs faced by those living with this invisible disease.

2. Lilly Singh’s Experience Living with Chronic Migraine

Lilly opens up about the relentless nature of chronic migraines and how they intersect with her demanding career. She recounts a particularly challenging day on the set of Muppets Mayhem, where a severe migraine attack disrupted her performance amidst the intricate and high-energy environment.

“...when you have a migraine attack and you're already kind of like, I'm not 100. I had to be like, okay, but I can't fall off the set and have to walk here.”
— Lilly Singh [08:50]

This vivid portrayal underscores the immense pressure she faces to maintain her public persona while grappling with intense physical discomfort.

3. Coping Strategies and Communication

Lilly emphasizes the importance of effective communication in managing her condition. She shares how she has learned to articulate her needs clearly to her team and loved ones, a skill she attributes to her mother’s guidance.

“I've gotten really good at being like, hey, just to let you know, I'm getting a migraine attack. And this is probably how I'm gonna react.”
— Lilly Singh [09:15]

Her ability to communicate openly has fostered better understanding and support, reducing the personal strain of her condition.

4. Mythbusters Segment – Dr. Christopher Ryan Debunks Migraine Myths

Dr. Christopher Ryan joins Nora for the popular Mythbusters segment, where he addresses common misconceptions about chronic migraines:

1. Myth: Migraine is just a headache.
   Busted: Chronic migraine is a complex neurological disease with symptoms including nausea, light and sound sensitivity, and cognitive difficulties.

   “Chronic migraine is associated with more than just head pain. It's often associated with nausea... visual disturbances...”
   — Dr. Christopher Ryan [13:00]

2. Myth: Caffeine is the cause of my migraine attack.
   Busted: While excessive caffeine can trigger migraines, abrupt cessation in regular consumers can also prompt attacks. Awareness of caffeine sources is crucial.

   “Too much caffeine can certainly trigger migraine attacks. But if we are regular caffeine consumers, unfortunately, stopping that caffeine can also trigger migraine attacks.”
   — Dr. Christopher Ryan [13:41]

3. Myth: There are no preventive treatments available for chronic migraine.
   Busted: Preventive treatments, including medications like Botox, exist to reduce the frequency and intensity of migraine attacks.

   “There are preventative treatments that are built to keep the headache from showing up in the first place.”
   — Dr. Christopher Ryan [14:20]

4. Myth: Chronic migraine only affects women.
   Busted: While more prevalent in women, chronic migraine also significantly affects men.

   “More than half a million men experience chronic migraine in the United States today.”
   — Dr. Christopher Ryan [14:59]

5. Myth: I just have to get through a migraine attack alone.
   Busted: Support systems, including medical professionals, advocates, and the migraine community, are available to help individuals during attacks.

   “There are millions of people living with migraine attacks who absolutely are here to help you through this.”
   — Dr. Christopher Ryan [15:37]

Dr. Ryan's insights not only debunk myths but also highlight the importance of understanding and support for those battling chronic migraines.

5. The Story of Lilly Singh’s Diagnosis

Lilly recounts the pivotal moment of her chronic migraine diagnosis during a bachelorette party. Surrounded by friends who are medical professionals, she realized that her recurring headaches were more than just ordinary headaches.

“In 2022... I felt a little tug happening on the left side of my head on my neck... they were like, I think that's you're describing chronic migraine.”
— Lilly Singh [18:03]

This recognition was a turning point, leading her to seek professional help and adopt strategies that have significantly improved her quality of life.

6. Balancing Career and Chronic Migraine

Navigating a demanding career while managing chronic migraines requires strategic planning and support. Lilly shares how she prioritizes her well-being without compromising her professional ambitions.

“I vividly remember having a lot of migraine attacks during that time. Because there's no way you can sleep the appropriate amount... this schedule, I'm all for putting in the work... but it has to be made in a way that brings out the best in everyone.”
— Lilly Singh [25:00]

She emphasizes the necessity of maintaining a structured routine and having a supportive team to accommodate her health needs.

7. Advice for the Chronic Migraine Community

Towards the end of the episode, Lilly offers valuable advice to listeners dealing with chronic migraines:

1. Advocate for Yourself:

   “Even just being comfortable with making your needs clear and being open to receiving people meeting your needs just like you would help meet their needs is really, really important.”
   — Lilly Singh [26:31]

2. Establish a Morning Routine:

   “Having a structured morning routine... really commit to it.”
   — Lilly Singh [26:42]

These strategies highlight the importance of self-care and effective communication in managing chronic migraine.

8. Conclusion and Final Thoughts

Nora McInerney wraps up the episode by reiterating the significance of self-advocacy and community support. She praises Lilly for her resilience and positivity, leaving listeners with a sense of hope and empowerment.

“When you advocate for yourself... you are also making space for the people around you to be able to acknowledge and honor their own.”
— Nora McInerney [29:57]

The episode concludes with a reminder of the upcoming final episode and expressions of gratitude to listeners, reinforcing the podcast’s mission to build a supportive community for those affected by chronic migraine.

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Key Takeaways:

• Open Communication: Clearly expressing needs and symptoms is crucial for receiving appropriate support.

• Structured Routine: Establishing daily habits can significantly alleviate migraine symptoms and improve overall well-being.

• Myth Busting: Understanding the true nature of chronic migraines dispels misconceptions and fosters a more supportive environment.

• Self-Advocacy: Advocating for oneself not only benefits the individual but also empowers others in their support network.

Notable Quotes:

• “Chronic migraine is associated with more than just head pain. It's often associated with nausea... visual disturbances...”
  — Dr. Christopher Ryan [13:00]

• “I have made my social algorithms such that I only get served funny dog videos now, and my feed is just full of hilarious dogs.”
  — Lilly Singh [05:15]

• “And now you don't have to say to a woman you barely know at a bachelor party, would you mind pulling out your elbow?”
  — Lilly Singh [19:58]

This episode offers a profound and uplifting exploration of living with chronic migraine, blending personal anecdotes with expert insights to provide a comprehensive understanding of the condition.

Transcript

[Lilly Singh]

Ruby.

[Nora McInerney]

Life sometimes has a way of blindsiding you with a feeling of being overwhelmed at the worst possible time. That's why you have your self care, your coping strategies. That's why you have us. I'm Nora McInerney and this is the Head Start Embracing the Journey, a podcast where we'll be taking all those things you usually save for your friend group out into the open so we can all find a bit of optimism. For those battling chronic migraine. These conversations are going to be even more helpful and relatable, so definitely stick around. This show is brought to you in partnership with AbbVie. So first let's hear some important safety information and stay tuned to the end of the podcast for more Foreign.

[Dr. Christopher Ryan]

Botoxin A is a prescription medicine that is injected into muscles and used to prevent headaches in adults with chronic migraine who have 15 or more days each month with headache lasting four or more hours each day in people 18 years and older. It is not known whether Botox is safe and effective to prevent headaches in patients with migraine who have 14 or fewer headache days each month or or episodic migraine. Important Safety Information Botox may cause serious side effects that can be life threatening. Get medical help right away if you have any of these problems Anytime hours to weeks after injection of Botox, problems swallowing, speaking or breathing due to weakening of associated muscles can be severe and result in loss of life. You are at the highest risk if these problems are pre existing before injection. Swallowing problems may last for several months. Spread of Toxin Effects the effect of Botulinum toxin may affect areas away from the injection site and cause serious symptoms including loss of strength, an all over muscle weakness, double vision, blurred vision, drooping eyelids, hoarseness or change or loss of voice, trouble saying words clearly, loss of bladder control, trouble breathing and trouble swallowing. Please stay tuned for additional important safety information within this podcast. Today's guest, Lilly Singh, is an actual Botox patient who was on prescribed therapy when she shared her story. Changes in therapy status may have occurred since that time Lily was compensated for sharing her story.

[Nora McInerney]

If there's one thing I've learned from hosting a podcast about chronic migraine, it's that chronic migraine does not care about your plans. It does not care about your deadlines or your agenda for the day. It doesn't care if you're on a movie set surrounded by Muppets, which might only be an example that today's guest can relate to. Lilly Singh is the definition of doing it all. She's a comedian and an actress and an author and a singer and a YouTuber and an activist. And honestly, I could keep going, but I think you get the idea. This is a woman with a lot on her shoulders and her resume. She's living the dream, and she is doing it with chronic migraine, which means that the dream can be a little less dreamy sometimes, like pushing through a migraine attack while filming, because the role calls for joy and goofiness in front of a camera, a crew, plenty of lights, Even though the migraine attack calls for a nice dark room and an ice pack over her eyes. Living with chronic migraine means that sometimes we have to keep showing up, even when it feels nearly impossible. That's one reason why I'm so excited to share this conversation with Lily. She's full of life and energy and joy, and she knows what it's like to have chronic migraine try to steal the show. But before we meet Lily, let's check in with Dr. Ryan. Let's welcome back our buddy, Dr. Christopher Rine, who I'm seeing in real life for the first time.

[Dr. Christopher Ryan]

Yeah. Nora. Hi.

[Nora McInerney]

It's so cool.

[Dr. Christopher Ryan]

Wonderful to meet you and see you at the same time. Right. I think Lily is a great sort of guest to have for this because her story is one that I think leans into sort of the core notion of what the Head Start is, and that's to go get help. And I think she does a really good job of expressing where she was, how she worked through that, and then certainly, you know, how she's come out on the other end and still living her life in the presence of chronic migraine, but still living your life.

[Nora McInerney]

Yeah.

[Dr. Christopher Ryan]

And that's really. That's really the goal. That's what we want.

[Nora McInerney]

Lily, welcome to the show. Welcome to the Head Start. Embracing the Journey, season three.

[Lilly Singh]

I am pumped to be here. Thanks for having me.

[Nora McInerney]

Lily, you are a professional funny person.

[Lilly Singh]

Wow. Thank you.

[Nora McInerney]

But what makes you laugh? Like, what has made you laugh lately?

[Lilly Singh]

I mean, a wide range of things, to be honest. And this is going to reveal how unhinged I am, possibly as a person. I have made my social algorithms such that I only get served funny dog videos now, and my feed is just full of hilarious dogs. And nothing will make me laugh, cry more than just funny animal content, you know?

[Nora McInerney]

Yeah, I love that. Have you gotten into the videos where, like, a hamster is given a small meal at, like, a picnic table?

[Lilly Singh]

Absolutely, Nora.

[Nora McInerney]

Absolutely.

[Lilly Singh]

But what a time we live in where that. You could say that and I'd be like, yes. I actually have the merch.

[Nora McInerney]

I do. I. So you are a person who entertains for a living, who brings other people joy. And there is this parallel between that kind of role, that, like, performance role, and stories we've heard from so many people in the chronic migraine community, which is sometimes you just have to put on the mask and push through it totally. And sometimes that's harder than other times. Can you tell us about a time when a migrant attack hits and you just cannot mask it any longer?

[Lilly Singh]

It's a great question, because there's quite a few examples. Honestly, there's quite a few examples. Um, I guess the one that comes to mind is a few years ago, I had the absolute joy of being on this show called the Muppets Mayhem. And it's exactly what you think.

[Nora McInerney]

It's.

[Lilly Singh]

All of my. Most of my co stars were Muppets.

[Nora McInerney]

Yeah.

[Lilly Singh]

So every day I would go into work and it was really cool because we'd be on these stages that were actually six feet in the air. So I'd be on a stage so that, you know, puppeteer can put their hand up. And all this to say, it's a very intricate setting, it's very fun. Every day you get to play, you're talking to co stars that are Muppets, and it's lovely. But I do remember that there was one day and I remember there was this big scene and I had a migraine attack. And I remember I was so uncomfortable and I would try to mask, and I'd be really used to masking it, but just this day, it was just. I could not do it. And the tough thing about being on a set, I mean, migraine attacks are difficult regardless of where you are, but being on a set makes it particularly hard because there's so many lights, there's so many sounds, smells. Yes. And I'm in hair and makeup. Right. So when you're in hair and makeup, like, I can't lie down, I can't put an ice pack directly on my skin. So I remember, like, having an ice pack strategically kind of touching my head. And I vividly have this memory of everyone having fun and me just in the corner being like, I have so much discomfort. And I think the thing that bothered me the most is someone who's so passionate about quality and being prepared. When I watched the show back, I could tell in my performance exactly when I was having a migraine attack, I was like, I can see it. I can see it on my face. Which kills me because I always want.

[Nora McInerney]

To do my best yeah, but. And your best, even in that circumstance, is probably better than so many others. But it doesn't matter because you are judging yourself.

[Lilly Singh]

But it's also difficult because, like, you know what? Who absolutely cannot relate to a migraine attack? A Muppet.

[Nora McInerney]

A Muppet.

[Lilly Singh]

A Muppet. A Muppet can.

[Nora McInerney]

They really are limited in their absence.

[Lilly Singh]

Empathy in a lot of ways. Don't get me wrong. They have a lot of real emotions, but not sure if they understand the discomfort of a migraine.

[Nora McInerney]

No, but also what you're describing is so much pressure, too, to be the number one human on the call sheet.

[Lilly Singh]

Number one human, yeah.

[Nora McInerney]

To be in most of the scenes and then to also have, you know, something that you physically can't control come and interrupt something that, you know, you were getting into this. You're on a set, there's a lot of people.

[Lilly Singh]

And the only reason I brought up the complication and the uniqueness of the stage is because there's not much room for error.

[Nora McInerney]

Yeah.

[Lilly Singh]

Because there is a possibility to fall off the set.

[Nora McInerney]

Don't do that.

[Lilly Singh]

Right. So when you have a migraine attack and you're already kind of like, I'm not 100. I had to be like, okay, but I can't fall off the set and have to walk here. So there was just a lot to deal with.

[Nora McInerney]

Yeah, it is a lot. How do you manage that without being completely overwhelmed?

[Lilly Singh]

Well, most of the things in my life go through the filter of, how can I prevent myself from having a migraine attack. One thing is I've gotten way better at communicating. I think for a while in my life, I was very like, no one's gonna get this. Like, there's no point in me talking about this. But I've gotten really good at being like, hey, just to let you know, I'm getting a migraine attack. And this is probably how I'm gonna react. And so it's not personal. It's. Cause I think people can take it a little personally because you become someone that's like, you're breathing so loud. You're doing everything so loud right now. I need you to bring it down here. Right. And so I've gotten better at just communicating that. Like, hey, I'm super sensitive right now, and that's been really helpful.

[Nora McInerney]

Was that hard for you to learn?

[Lilly Singh]

It was because I think I actually learned this from my mom. You know, my mom travels with me. I lived with my parents for a long time. And my mom would describe. Sometimes she would say, lily gets in a mood. Lily gets In a mood every once in a while. And more often than not, that mood she's talking about is a migraine attack.

[Nora McInerney]

It's such a mom way to put it.

[Lilly Singh]

And it is what. I'm a little, like, snappier, and my patience is a little less, and I'm a little, like, short. And so, especially with my mom, our relationship has really improved. Once I just explained to her, like, this is what this feels like. This is the struggle. This is the discomfort. It's nothing to do with you. It's nothing to do with the setting. It's just, this is what I'm going through. And now I feel like that's really helped. But she can hold space for that.

[Nora McInerney]

Yeah. It's not a mood, but it is affecting my mood.

[Lilly Singh]

Correct.

[Nora McInerney]

What are your triggers?

[Lilly Singh]

I can always feel when I'm gonna get a migraine attack. It's always gonna start on my left side of my head and kind of coming up from behind my ear and my neck. I've gotten so used to, like, understanding, oh, my mus feels a certain way. And this is probably going to make my head start. And so I, like, literally, here's the things. My night table has, like a gua sha, Like a metal gouache. Game changer. I always have cold. A cold ice pack in this mini fridge that's literally by my bed.

[Nora McInerney]

Brilliant.

[Lilly Singh]

So that I don't have to go super far, I stretch. I have a regimented stretching routine every morning that I do.

[Nora McInerney]

Good posture, too.

[Lilly Singh]

Thank you. Lot of water. Whatever. I can do. Even. Even because I get my hair and makeup done a lot, I have to. It's a full negotiation with my hairstylist about how high that ponytail is going.

[Nora McInerney]

Also and how tight.

[Lilly Singh]

Exactly.

[Nora McInerney]

Yeah.

[Lilly Singh]

Correct.

[Nora McInerney]

And now you can do that. But do you think you always could have, or do you think building your career, because that's such a touchy thing, too, is having, you know, a very real, unpredictable physical limitation and balancing that with ambition and drive and, like, wanting to do things.

[Lilly Singh]

Absolutely. I actually didn't know I had chronic mind for a really long time in my life. So when I started YouTube in 2010 and I started to build my career, I was just like, I get headaches a lot, and I just have to deal with them, and I don't know how to deal with them. But now I do things that really help me manage. I'm in a place where my migraine attacks are much more manageable. But previously, when they weren't, it did take me a while to get to a Place to be like, oh, I have to, like, call my team and be like, I need to reschedule this meeting.

[Nora McInerney]

Yeah.

[Lilly Singh]

Cause for years I would just be like, I just gotta do it. Like, this is not a good enough reason.

[Nora McInerney]

It's.

[Lilly Singh]

How do I explain this? But I'm very good now at being like, no, this is like a real thing. I am so uncomfortable. I'm not gonna be able to focus. This needs to be rescheduled.

[Nora McInerney]

And that is self care, too. Okay. It's not all bubble baths and, you know, salad.

[Lilly Singh]

It's like holding space, holding grace.

[Nora McInerney]

Yes. Okay, Dr. Ryan, we're going to switch things up a bit. We did this last season, but are you ready to play a game of Mythbusters?

[Dr. Christopher Ryan]

I'm so ready, Nora. This was one of my favorite episodes we did last time. And so, yeah, let's do it. Let's bust some myths.

[Nora McInerney]

Myth number one. And look, it's hard for me to say this because I know better, but there are listeners who might not know better. Migraine is just a headache, so that.

[Dr. Christopher Ryan]

Is very much not true. You're exactly right, Nora. It's absolutely a myth. Chronic migraine is a neurological disease. Chronic migraine is associated with more than just head pain. It's often associated with nausea. You've got the light sensitivity, you've got the sound sensitivity, maybe even sensitive to odors. There's difficulty in concentration, thinking clearly, even speaking. Sometimes people living with chronic migraine can even have visual disturbances. They can have numbness. There's that language impairment risk. Rarely. In some cases, they can even have weakness associated with it. So it's an all encompassing experience, and it's definitely not just a headache.

[Nora McInerney]

All right, myth officially busted. And on to myth number two. Caffeine is the cause of my migraine attack.

[Dr. Christopher Ryan]

So caffeine is unique. I really like that you asked this question. Too much caffeine can certainly trigger migraine attacks. But if we are regular caffeine consumers, unfortunately, stopping that caffeine can also trigger migraine attacks. So the moral to the story here is to remember that tea, soda, sports drinks, pre workout drinks, some people forget that. And obviously coffee, all can have caffeine. And so we just want to watch labels and see what we're consuming. We want to look at the amounts of caffeine that are in each one of these drinks so we know exactly what we're taking into our bodies.

[Nora McInerney]

Okay. Myth number three. There are no preventive treatments available for chronic migraine.

[Dr. Christopher Ryan]

We are on a roll, Nora. It's absolutely not true. So there are two main types of treatments that we've talked about throughout the podcast, and we've talked about acute treatments which can effectively reduce the pain associated with the migraine attack, the other symptoms associated with the migraine attack, and the disability associated with the migraine attacks. And there are preventative treatments that are built to keep the headache from showing up in the first place. A goal of that preventative therapy is to reduce the frequency and intensity of those migra attacks. There may be preventative options available for you, so talk with your doctor about those options.

[Nora McInerney]

You're three for three. Let's bring it up to myth number four. Chronic migraine only affects women.

[Dr. Christopher Ryan]

Nora. It breaks my heart because I think sometimes people do feel like this is true, but let's bust this myth right now. That is absolutely incorrect. More than half a million men experience chronic migraine in the United States today. Technically, migraine attacks tend to present more in women, and so it is a problem that's women deal with, but men do, too. Here's the statistic. Migraine is three times more common in women than men. But migraine can affect people of all sexes and all genders.

[Nora McInerney]

Okay, so our final myth. Let's see if you can bust it. Here we go. I just have to get through a migraine attack alone.

[Dr. Christopher Ryan]

First of all, the myth is completely untrue. But I cannot tell you how much I hear this, and it is a tremendous bummer to have a patient come in the room and express this kind of energy that they're going to be alone. There are hundreds of doctors out there. There are thousands of advocates. There are millions of people living with migraine attacks who absolutely are here to help you through this. So even if it's offering a simple, yeah, man, that stinks. Me, too. That kind of energy, that kind of attitude around it. They definitely know what you're going through, and you're not doing it alone.

[Nora McInerney]

Amazing job, Dr. Ryan. Five out of five, 100%. Your trophy is in the mail. Now let's get back to our conversation with Lily.

[Dr. Christopher Ryan]

Chronic migraine is 15 or more headache days a month, each lasting four hours or more.

[Botox Advertisement]

Botox. Onobotulinum toxin a prevents headaches in adults with chronic migraine. It's not for adults with migraine. With 14 or fewer headache days a month. It prevents, on average, eight to nine headache days a month versus six to seven for placebo.

Prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection, causing serious symptoms. Alert your doctor right away as difficulty Swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk. Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, asthma symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions including als, Lou Gehrig's disease, myasthenia gravis or Lambert Eaton syndrome, and medications including botulinum toxins as these may increase the risk of serious side effects.

[Dr. Christopher Ryan]

Ask your doctor and visit botoxchronicmigraine.com or call 1-800-44-BOTOX to learn more.

[Nora McInerney]

Lily, you have this beautiful story where before you were diagnosed, you're on a bachelorette trip.

[Lilly Singh]

Yes.

[Nora McInerney]

And a bunch of women just jump in to help diagnose you. And that is, that is being a girl's a girl. So tell us that story.

[Lilly Singh]

It's one of my favorite stories. Okay. So I'm just gonna keep it 100 for many, many years. I was like, I just get headaches. And I attributed it to like, anything. I was like, it's probably because my hair is really long and heavy. It's probably because I haven't drank enough water. Maybe I didn't get enough sleep. There was always a reason. There was always a reason why I had a headache. And then in 2022, I think it was, I was at a bachelorette party and it was fabulous. It was my close friend's bachelorette party. It was like 10 girls. Now my friend, she is a cardio. She's really smart. All of her friends were also doctors. So we were at this bachelorette party and there was one evening where the sun was setting. We were like in the water on a beach. And I felt a little tug happening on the left side of my head on my neck. And I went up to one of her friends and I said, ah, claim I got a headache. And I said, can you take your elbow? And she's like, what are you talking about? And I was like, I just need you to like, really, really apply pressure to this point. And she's like, what's going on? And I was like, well, I just get like headaches every once in a while. And then slowly they all start gathering around me. And we're in our bikinis in the middle of the water and they're like, well, tell us what happens. I'm like, well, I get really sensitive to light and sound really bothers me and I feel nauseous though. I don't throw up, but I feel really nauseous. And sometimes I don't go away for a few days, and it's really debilitating. And they're like, I think that's a migraine attack. And I was like, no, no, no, no, no, no, no, no, no. And the reason is, growing up, I did have a friend that had migraine attacks, but hers looked very different. She would explain, like an aura, a light she would see, and I didn't. So I was like, well, that's what a migraine attack is, so this can't be it. And then my life changed when one of the girls at the bachelorette party was like, I think that's you're describing chronic migraine. So I went back to la, I went back home, and I researched and I went for my consultation, and it has changed my life.

[Nora McInerney]

And now you don't have to say to a woman you barely know at a bachelor art party, would you mind pulling out your elbow?

[Lilly Singh]

I don't even remember the last time I asked someone to stab my shoulder or my neck. Yeah, yeah.

[Nora McInerney]

So, Dr. Ryan, I have a specific topic for this episode. Lily brings up a really good point. Chronic migraine has a bunch of varying symptoms. So people can see someone else living with chronic migraine with different symptoms from what they're experiencing and then think that they don't have chronic migraine. How do you talk to patients about their unique experiences and get them to realize what could actually be at play?

[Dr. Christopher Ryan]

Nora, it's the most important conversation in the room. I think one of the things that I try to share with patients right away is that their story is the thing that matters the most. It's not what Dr. Ryan thinks we're gonna do next. It's not the medication, education. All those things are really critical. But the single most important thing is that individual experience. So that's where you start. You gotta get to know the person sitting across the T from you. You can't do a cookie cutter, one size fits all approach. And then on top of just identifying their symptoms, you're right that chronic migraine looks different for everyone. You might not have the same symptoms as your friend living with chronic migraine. And that's why it's really important to track your symptoms and to be open to talking to your doctor about them, whether you think they're minimal or not.

[Nora McInerney]

So a common thread with people who have chronic migraine or experience migraine attacks is missing out, like, being sort of pulled out of their lives. Do you have moments like that that you think of when you think of chronic migraine. Like things that you missed out on that you wish you wouldn't have or, you know, just. Yeah. Life moments.

[Lilly Singh]

Totally, totally. Like, again, I could pull up my scroll. I probably have a bunch. But one that comes to mind not to, that's obsessed with her mom. But I am. I love you, mom. I love you so much. You're my queen. I take an annual trip to India every year because I support some schools that are on the ground there. And so my whole team goes and my mother comes with me every year. And this is a really exciting trip. We get to go all across India. My mom doesn't get to go back often. So it's a really, really special trip. And because of just the flight, the travel, everything prime for me. Landing with a migraine. Yeah. So we were in the airport, really exciting trip. We were leaving, I think Bombay, heading to Delhi. And. And I was like, the discomfort is kicking in. And my whole team were in the lounge and they were having fun. And I was like, a little snappy at my mom and it bothered me. She got like. I could see that she got a little like, oh, this is like supposed to be a nice, lovely trip. And Lily's like, a little snappy with me. And of course I explained to her and she understood it. But when I tell you it bothered me for like a full month after, I kid you not that I had to journal about it because I was like, this once a year trip, there's a special moment that we were so excited to travel. Like, I could not fully just be in that space. It was just her face.

[Nora McInerney]

Yeah.

[Lilly Singh]

It really bothered me.

[Dr. Christopher Ryan]

My queen.

[Lilly Singh]

I'm sorry. I love you so much.

[Nora McInerney]

Yeah, I get it. And also, it's like, yeah, that is like the perfect recipe too. Like, long travel day, uncomfortable travel day. Like, you're changing climates, hemispheres also.

[Lilly Singh]

Listen, I'm all for, like, holding space for each other and accommodating to people when I need, but there is something that I'm slightly uncomfortable with when I don't love the idea of people. I love having to so accommodate as often as they had to.

[Nora McInerney]

Yeah.

[Lilly Singh]

And I'm happy now. They don't have to. But people love each other and they accommodate. But I'm like, I don't love that. Like, I have to be like, be quiet. Turn this off. Do you know what I mean? I don't love that space.

[Nora McInerney]

Yeah. I interviewed my sister. I was like, we've never actually talked about your chronic Migraine. I wonder if we should do that for the first time in public on a podcast. But, I mean, she said something really similar, too, which is like, you know, of course your mom understands, right? Like, your mom has been there your entire life.

[Lilly Singh]

Right.

[Nora McInerney]

You know, she knows it's no longer just like, Lily's in a mood. She gets it. And also all the grace that you would give somebody else. It's just there is something hard about being like, but they're giving me so much. Even though if it was them, you'd.

[Lilly Singh]

Be like, take it.

[Nora McInerney]

It's okay. We're going back to your work. You are so successful, but you bounced between all of these, like, different genres, which is so cool. Right. That is such a hard thing to do. And, I don't know, all success. In my limited experience being moderately successful, I do think, like, everything has, like, some amount of sacrifice to it. Right. Like, you're sacrificing your time or privacy. You're stretching yourself to your. Right. There's just, like, some. You have. You have to pay in some way. How do you make decisions on new projects? Like, what are things you will and will not budge on or sacrifice? And how do you add chronic migraine into that equation, too?

[Lilly Singh]

Totally. Well, some of them have to do with chronic migraine, and some of them don't. One is when you shoot, you shoot for a long time. Sometimes you shoot for 12, 14 hours a day. You're with these people for a long, long time. And I have learned that no amount of money or accolade is worth you going home to be like, oh, I really did not have fun. So the people, the vibes are very, very important to me. The schedule is also really important. And that kind of does align with chronic migraine, because when I did, for example, the late night show, I did 96 episodes in three months. I vividly remember having a lot of migraine attacks during that time. Because there's no way you can sleep the appropriate amount. No, there's no way you can have exercise. An exercise. Exact stretch, exact water. So this schedule, I'm all for putting in the work and putting in the hustle, but it has to be made in a way that brings out the best in everyone.

[Nora McInerney]

Yeah.

[Lilly Singh]

You know, like I said, I have a very regimented stretching morning routine. I have to be able to do that before I do something.

[Dr. Christopher Ryan]

Yeah, I love the space to do.

[Lilly Singh]

That, and I have the time to do that. So that's a big part of my decision making as well. And because my team is really used to how to help me if I'm having a migraine attack. I need to make sure that there's access for the people who are on my side to be there and present as well.

[Nora McInerney]

Yeah.

[Lilly Singh]

You know, cause my assistant, I love her, I would not survive without her. But I mean for other people, like even my mom, like the people that just really know how to deal with.

[Nora McInerney]

Those situations, you need those people too. Like you need the people who know you. But I think it's also so valuable that like, you know yourself and you know what you're not gonna not do. So we like to close our episodes with our guests sharing a message.

[Dr. Christopher Ryan]

Okay.

[Nora McInerney]

For the chronic migraine community, is there anything that you wanna leave our listeners with? Any piece of encour or inspiration or a third thing?

[Lilly Singh]

Even just being comfortable with making your needs clear and being open to receiving people meeting your needs just like you would help meet their needs is really, really important. And the second thing I'll just say honestly, is something that has really changed my life is having a structured morning routine. And if you don't have one, don't convince yourself you need to have a two hour morning routine. Mine is very simple. I journal, I stretch, I drink tea. And it has, has truly changed my life. Like my body feels so much better with my regimented stretching. My mind feels so much better because of my journaling. So just whatever small routine works for you, really commit to it.

[Nora McInerney]

I think that's smart. That's beautiful. No one said that. Oh, really?

[Lilly Singh]

Well, you've been an absolute joy.

[Nora McInerney]

Well, Lilly Singh, thank you for joining us today. You've been both a joy and exceptionally funny. So thank you. All right, Dr. Ryan, knowing that it can take so long for people to receive a diagnosis for chronic migraine and the importance of finding a headache specialist, what are some of the things to keep in mind to help people describe their experience to their doctor so their doctor better understands their headaches and their migraine attacks? Could you maybe make it into a list for people to check off easily?

[Dr. Christopher Ryan]

Nora, I love this question so much. It's really important that we get this right.

[Botox Advertisement]

Right.

[Dr. Christopher Ryan]

So once we finally go and sit down with the provider. Right. It's important that we've prepared for that discussion and don't leave out any details. First, you want to be really explicit about everything that you're experiencing. There can be a lot of stigma and insecurity around discussing whether or not you're nauseous. The light's bothering me that there are foods that you can't tolerate There are things that you can't do or things that are impacting relationships. It's important that you bring all of that up. We want to be really clear. We don't want to minimize any of those experiences. Second, we want to be really specific about the number of days, particularly in a month, that you're experiencing symptoms of any kind. It's even better if you could keep a really specific headache diary to share with that provider when you show up. That would be the very best thing that you can do. We want to let our doctor or our app know if we're experiencing light or sound sensitivity with those headaches. Want to pay attention to things like nausea, like we've talked about already, even if that's not vomiting. One of my favorite things about patients is, I'll ask, you know, you know, are you nauseous? And the first thing out of their mouth is, I never throw up. But really what we're talking about here is nausea, not necessarily just vomiting. Third, I would make sure to be very clear and extend a bit of trust to your doctor. It's okay to be a little bit more vulnerable. The key takeaway here is to simply be really, really crystal clear. You know what's going on with your life, you know what's going on with your symptoms. We need to make sure that we really, really demonstrate that to the provider sitting across from you. And we recognize everything that migraine attacks are doing in your life. They need to hear it from you first so they can provide that diagnosis and then move forward with discussing treatment options. Lastly, and I think this shouldn't be forgotten, we want to make sure that we mention medications that we're currently taking, that we've taken in the past, you know, even supplements, over the counter medicines. All of that counts. Things like that are really critical for your provider to hear about.

[Nora McInerney]

Dr. Ryan, thank you so much. You are the best. I always love when we get to talk and catch up, and I feel like I always learned something from you. Thank you again to Lily Singh. What a lovely person. There's so much that I love about the conversation that I got to have with Lilly Singh. But one thing that I hope you take away from this episode is something I took away from this episode, which is that it is okay to advocate for yourself. It is okay to ask for what you need, need from the people around you. And I also know that's hard to do. That's hard to do even if you aren't, you know, starring in a TV show or a movie, even if you don't have, you know, hundreds of people counting on you. I know that everybody listening to this podcast has somebody who counts on them, has a whole lot of responsibilities on your shoulders and nobody wants to be the person who is dropping the ball or letting someone down. But I truly believe that the people who are around us want to be as supportive as they can, and they can't do that without good information. So when you advocate for yourself, when you tell people your limits, when you honor your own limits, you are also making space for the people around you to be able to acknowledge and honor their own. And I think that is the kind of world that we all want to live in. So thank you again to Lily Senior for bringing the laughs, for bringing the light, for bringing her wonderful, amazing energy to this conversation. It is always an honor to make these episodes. It is always an honor to be adjacent to the chronic migraine community. You are all incredible people doing incredible things in this world and I hope you feel that, especially after today's episode. Next week is our final episode episode. I'm Nora McInerney. This is the Head Start Embracing the Journey. I truly hope this has helped you find a bit of comfort and maybe a smile. Maybe. See you next episode and stay tuned for more important safety information. The Head Start Embracing the Journey is hosted by myself, Nora McInerney, executive produced by Yvonne Sheehan. Our Head of Post Production is James Foster, our researcher is Sierra K. Kaiser and our writer is John Irwin. The show is mixed by Michael Hardman, original music by Soundcat Productions and Artlist.

[Dr. Christopher Ryan]

Important safety information continued There has not been a confirmed serious case of spread of toxin effect away from the injection site when Botox has been used at the recommended dose to treat chronic migraine. Migraine Botox may cause loss of strength or general muscle weakness, vision problems or dizziness within hours to weeks of receiving Botox. If this happens, do not drive a car, operate machinery or do other dangerous activities. Do not receive Botox if you are allergic to any of the ingredients in Botox. See Medication guide for ingredients. Had an allergic reaction to any other Botulinum toxin product such as Myobloc right Rimabotulinum toxin B Dysport Abobobotulinum toxin A Zeomin Incubotulinum toxin A Jeuveau Daxify Daxibotulinum toxin A Lanm or Latibo Ledibotulinum toxin awlbg this may not be a complete list of all botulinum toxin products. Have a skin infection at the planned injection site. The dosage Use of Botox is not the same as or comparable to another botulinum toxin product. Serious and or immediate allergic reactions have been reported including itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint. Get medical help right away if you experience symptoms. Further injection of Botox should be discontinued. Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton Syndrome as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of Botox. Tell your doctor about all your medical conditions including if you have or have had bleeding problems, have plans to have surgery, had surgery on your face, have weakness of forehead muscles, trouble raising your eyebrows, drooping eyelids and any other abnormal facial change, are pregnant or plan to become pregnant. It is not known if Botox can harm your unborn baby, are breastfeeding or planned to it is not known if Botox passes into breast milk. Tell your doctor about all the medicines you take, including prescription and over the counter medicines, vitamins and herbal supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Tell your doctor if you received any other botulinum toxin product in the last four months. Have received injections of botulinum toxin such as Myobloc, Dysport, Xeomin, Jeuveau, Daxify or Letibo in the past. This may not be a complete list of all botulinum toxin products. Tell your doctor exactly which product you received have recently received an antibiotic by injection, take muscle relaxants, take an allergy or cold medicine, take a sleep medicine, take aspirin like products or blood thinner. Other side effects of Botox include dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, eye problems such as double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids and dry eyes, drooping eyebrows and upper respiratory tract infection from for more information, refer to the Medication Guide or talk with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov MedWatch or call 1-800-FDA-1088. Please see Botox full product information including boxed warning and Medication Guide by clicking the link provided in the podcast description or by visiting www.rxabvie.com PDF botoxpi.PDF if you are having difficulty paying for your medicine, AbbVie may be able to help, visit abbvie.com patient access support to learn more. Botox is a trademark of Allergan Inc. An Abbvie company. All other trademarks are the property of their respective owners. What is chronic migraine?

[Botox Advertisement]

It's 15 or more headache days a month, each lasting four hours or more. Botox Onobotulinum toxinae prevents headaches in adults with chronic migraine. It's not approved for adults with migraine who have 14 or fewer headache days a month. Ask your doctor about Botox Botox is.

A prescription medicine injected by your doctor. Effects of Botox may spread hours to weeks after injection, causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk.

[Lilly Singh]

Risk.

[Botox Advertisement]

Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, welts, asthma symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions including als, Lou Gehrig's disease, Myasthenia gravis or Lambert Eton syndrome and medications including Botulinum toxins as these may increase the risk of serious side effects.

[Dr. Christopher Ryan]

Talk to your doctor and visit botoxchronicmigraine.com or click call 1-800-44-BOTOX to learn more.

[Lilly Singh]

This is an I Heart Podcast.