Dealing With Headaches

OK, calm down, all of you REM fans. This isn’t about a new song or anything. (However, “Daysleeper” from Up does accurately describe working the night shift as “colored headache grey”. Brilliant. I couldn’t resist adding that video, too.) I was parusing YouTube again, wondering about art based on migraine pain, aura and other physical and mental issues, when I came across this privately made video, which consists of a slideshow set to REM’s immortal “Losing My Religion”.

Is It Any Good?

I still haven’t decided whether I like this YouTube musical slideshow or not. I don’t know where the art is from or how many artists worked on it or even who the artists were, for that matter. All of that information is kindly left out of the YouTube video description. In one sense, I like that, because a detailed description can give you preconceived notions that can interfere with your enjoyment of a video.

Personally, I think “Daysleeper” sounds more like a migraine. So I have both up for your comparison. Then, of course, there’s “Everybody Hurts” and “It’s the End of the World As We Know It (and I feel fine).”

And remeber, REM is no stranger to head pain. Their drummer Bill Berry decided to leave the band after suffering from an aneuyrism on stage. I’m still amazed he survived — and so is he, apparently.

Warning: there are images in the slideshow which may be a wee bit disturbing. Well, it’s apparantly about migraines, so being disturned just goes naturally under thant subject heading.

Why Losing My Religion?

No explanation is given as to why the song “Losing My Religion” was chosen. The subject matter has nothing to do with migraines, although it does have a lot to do with suffering. The title is Southern American slang for “I’m breaking up with my significant other”. However, the song is vague enough to put your own interpetation on, so perhaps that’s why it was chosen.

Enjoy. Or not. I don’t mean to sound bossy.

It’s no surprise that often migrainers become extremely sensitive to sounds, light and sometimes tastes during migraine attacks. I had suspected that migrainers could get super sensitive to touch as well, because of my Mom’s unusual comment when she has a migraine that “My hair hurts.”

Well, Mom, You’re Not Alone

A recent study published in the April 22, 2008 issue of Nuerology found that migraineurs have yet another item to add onto their misery list. 16,573 people participated in the massive study, of which over 11,000 were diagnosed migraineurs, and nearly 1500 were “probable migrainerus” (ie — they hadn’t gone to the doctor yet, but display all the symptoms of migraines) and 3345 people just had “headaches”. About 68% of the lot had some skins owies when having a migraine or headache.

The practical upshot of all of this is that migrainerurs often find normal tasks like wearing jewelry, brushing their hair or rubbing your head as “excruciating”. The technical name for this sudden extreme skin sensitivity is allodynia. This was seen to happen to those not only with chronic head pains but also to those who fell into these categories:

• Women diagnosed with migraines
• Obese people diagnosed with migraines
• People diagnosed with the double whammy of migraines and depression

So?

One of the good points of this study is that it vindicates my Mom’s statement that when she had a migraine “her hair hurts”. We teased her about that when I was a kid, and do I feel guilty about that now. Perhaps migraineurs with skin sensitivity will be taken seriously now by both doctors and family members. As to treatment for this symptom, no recommendations were made other than:

“More importantly, this condition may be a risk factor for migraine progression, where individuals have migraines on more days than not. Identifying risk factors for progression is a very important public health priority. For example, it may be that individuals with allodynia should be more aggressively treated in order to prevent migraine progression, as well as to decrease this sensitivity on the skin.”

Obviously, more studies need to be done, both to determine relief for the symtom and to see if skin sensitivity is a reliable factor in determining whether migraine disease is getting worse in an individual.

Off to take some Excedrin.

It’s so experimental, it doesn’t have an official name yet. The company’s name is Neuralieve. I propose “Magnetic Doo-Hickey” as a name for their experimental device. It’s catchy, it’s descriptive and it’s hard to forget. Anyway, enough with the name-quibbling. What the heck is it?

It’s a Transcranial Magnetic Stimulation device. What does that mean? Basically, it’s a magnetic doo-hickey to help prevent migraines when you get an aura.

Now, the Details

Magnetic therapy for migraines and other afflictions like arthritis isn’t anything new. Pulse magnetic therapy basically sends electromagnetic waves over the area that’s hurting. Some people swear by it — others swear at it. The experimental device is strapped onto your head to send short bursts of magnetic energy through your skull and hopefully into your brain to soothe away the immanent pain to come.

It’s placed on the back of the head because that is where doctors think migraines start, based upon MRI scans of migraineurs with attacks in progress.

This is to be used only for migraine with auras (also known as classic migraines). So far, there’s no mention of trying to use it during the onset of a migraine attack.

Where Can I Get One?

It’s still in the clinical trial stage, so if all goes well, it’ll come on the market in about five years. If you are curious trying one out, your could look into participating in one of the many clinical trials currently being held.

Personally, I know it wouldn’t work for me because I become very clumsy when I get a migraine — (with or without auras). I’d wind up knowcking myself unconsious with the thing.

Hmmm — there’s a thought — we should have an experiemental device that knocks us out when we are about to get a migraine and then wakes up up 13 hours later.

Yesterday, we took an overview on the very painful affliction of ocular migraines. Although we don’t yet know what causes them or if they are seperate from migraines with aura, we do know thay they hurt a great deal. We also noted that the pain is nearly identical to a blood clot in the eye or a stroke, so if you are not sure what’s happening to you, call an ambulance.Today, we’ll try to take a look at treatments available.

It Is A Temporary Condition

The first time you get an ocular migraine, don’t be surprised if the doctor doesn’t give you any prescriptions or tests (other than checking for signs of a stroke or blood clot in the eye). If you have a history of headaches or migraines, than you may get a trial sized dose of whatever pain killer is in the office.

Ocular migraines tend (emphasis on TEND) to happen less often than “classic” migraine. The latter happens many times a month. Ocular migraines happen maybe once a month. (Note — this doesn’t happen to everyone I’ve talked to!) Some people even have a few episodes right in a row, and then not have any for months or even years. That they happen less often means a doctor is likely to not try to give you a lot of drugs for it, because the side effects (and the cost) might be worse than the ocular migraines.

Gimme Drugs!

When you get the strange visual symptoms or aura, you should immediately take any pain killer you can get (even an aspirin). I take Excedrin Migraine. Sometimes, this can help dampen the pain to come. If you can get into a dark room, lay down and do deep breathing, even a warm bath (or visulaizing you are in a warm bath) can help your body relax. If you practice mediatation, now would be a good time to practice some more.

If you get ocular migraines more than once a month, then the doctor usually tries to break out the drugs. Abortive migraine medicines like Topamax may be prescribed. You may also be prescribed Cafergot (a combination of caffeine and ergotamine artrate) or just plain old ergotamine. You may also be prescribed amitriptyline, which is usally classified as an anti-psychotic drug, but don’t panic. The doctor doesn’t think you’re psychotic.

There has been some sucess with injectable sumatriptan which usually is an abortive medicine, but can sometimes help diminish pain once the auras begin.

Will This Hurt My Vision?

In the long run, ocular migraines usually don’t seem to play a role in vision loss. There are a lot more things that will take their toll on your vision before ocular migraines will. Right before and even during an ocular migraine, you will normally see very abnormal things like zig-zag lights, double or triple vision and (what happened to me) seeing the world as though you are halfway underwater. There is even a sharp divinding line between perfectly clear and perfectly watery. It’s very disorienting, but a temporary thing.

Hope this helps.

In the early 1990’s, my doctor told me that ocular migraines were a myth. This was as I was having one. “How did you come to that conclusion?” He snorted, shaking his head at me as if he was trying to pity me, but really couldn’t care less about me.

“Your partner in this practice diagnosed me with ocular migraines a couple of months ago. Don’t you guys ever talk?”

Apparently not. So that shows you how much doctors know about migraines, when two doctors across the same hall in the same building have different points of view. I never went there again.

However, things are a little better in 2008. At least there is a general consensus now int he medical community that ocular migraines (also called eye migraines or ophalmoplegic migraines) are not a myth but (sadly) do exist.

What Are They?

Well, now we come to the fun part about ocular migraines. It is unknown what they are as opposed to other migraines or even how they are caused. There are many theories, however, including a weak nerve, palsy and constricting blood vessels. Now, recently the constricting blood vessels theory for any migraine pain has been challenged by new studies about serotonin levels. But, in the end, we just don’t know yet.

It is also unknown whether ocular migraines are seperate from other migraines or are a symtom of a migraine triggered by caffeine withdrawal (for instance). I’ve been putting off writing a post about ocular migraines for a long time because I could not find any general consensus as to what they are, let alone what causes them.

I have, however, had no problem finding a general consensus about the pain.

What Do They Feel Like?

Ah, here’s the fun part. If you have a sensitve stomach, then perhaps you should skip this part and we’ll see you tomorrow.

It feels like blood is dripping from out of your eyes.

Now, granted, I’ve never actually had blood drip from my eyes (knock on wood) but an ocular migraine is how I imagine what blood dripping from your eyes must feel like.

The pain is centered in your eyes, or just one eye. You often have other symptoms like dizziness, double vision and head pain, but the eye pain just becomes your entire world. It usually begins with an aura and ends with you vomiting in a dark bathroom (you hope it’s a bathroom, anyway). The first time you have one is a very frightening experience. It’s not as bad the next time, because you know that the pain will eventually end anywhere from twelve hours to two weeks. (Your attack might be less or more.)

When To Go To The Doctor

If you have never had any history of migraines or headaches and suddenly get felled by an ocular migraine, then you better go to a doctor. There is a fun condition called retinal artery thrombosis (a blood clot in your eye, basically) that also gives off the same symptoms and pain as an ocular migraine. Also, symptoms of funky vision and extreme head pain (literally blinding pain) and extremem nausea and dizziness may be the sign of a stroke.

If you know you have a history of ocular migraines or just plain old migraines, then you can usually assume it’s an ocular migraine. However, you really should go to the doctor just to rule out stroke.

Your doctor will probably recommend you see a nuerologist or eye doctor to rule out other problems. Other times, they’ll give you a prescription or cocktail of prescriptions to try and take it from there. We’ll look more about treatment tomorrow.

In this blog, I refer a lot to auras. They are “spots before your eyes” — flashes, squiggles, blurs and other visual hallucinations that often warns you that a whopper of a migraine is on its way. When you go get treatments, you will be asked if you get auras before your migraines. Some medications are being developed specfically for auras with migraines.

Auras before migraines don’t have to be strictly visual — some are audial and some people feel euphoric for absolutely no reason at all (why can’t I be one of those people?), but for the purposes of this article, we will just stick to visual auras.

But how about if you get auras and never get a migraine? This is a sign to contact your doctor right away.

“Ewww, Gross!” Warning

Signs that you have aura-like hallucinations like flashes, “floaters” (a bright glob or cobweb that doesn’t go away) or a series of bright little spots can be the sign of a detatched retina or other deeply gross eye damage. I don’t know about you, but I faint whenever someone begins putting on a contact lens, so just contemplating a torn retina for me makes me scream inside.

If you have a history of having auras before migraines, don’t blame yourself if you think you are just getting a migraine. However, if you have visual auras without migraines, then you need to see your doctor or your eye doctor. Prepare to spend a day at the hospital to get your head examined with scanning machines of one sort or another. If you ignore a sudden onslaught of auras without migraines, the damage to your retina will become so bad that you will loose your vision in that eye.

A blow to the head, such as a fall even a day ago can be the cause of the auras without migraines. Sometimes you will get auras without migraines due to getting older. In the latter case, the auras without migraines tend to come on gradually and can fade in and out of your perception.

Why Am I Banging On About This?

I guess this discussion about auras without migraines is a little off topic, but I have had a couple of my Mom’s girlfriends ask me about this phenomenon, so perhaps there might be more.

I have had a floater in my left eye for several years after I got punched in the face (I was in an abusive relationship which I left in 2004). I was ashamed to get my eye checked. Years later, I did get it checked out and, fortunately, there wasn’t any damage to my retina. I still see fairly well out of the eye and have seen the spot for so long I can ignore it (except for right now as I’m writing about it — but by bedtime tonight, I probably won’t notice it again).

Whatever your reason for checking about auras or for taking the time to read this post, I hope this helps.

No, you’re not the only one in the world who gets migraines. And migraine headaches are not a recent phenomenon. Although migraines are still very much of a mystery, there is solid evidence that many historical figures suffered with migraines. Here are just some of them who somehow got on with life despite migraines. Hopefully, their stories may be an inspriration to you.

Claude Monet

This amazing painter, who lived from 1840-1926 created works of startling brilliance and light, even when he was nearly blind at the end of his life. It is thought that some of his bright colors were inspired by auras. In Monet’s lifetime, migraines were thought to be a sign of insanity. His works are so admired, they are targeted for theft. In August of 2007, Cliffs Near Dieppe (1897) were stolen with two other painitngs in a brazen daylight robbery in France.

Elvis Presley

You might have heard of this guy. He had a lot of health related problems, and migraines were one of them. Perhaps that’s why he wore dark sunglasses a lot. One 1975 hospital stay was for examining his eyes becuase of pains and auras identical to that of migraines. By taking so much medication, he probably also suffered from rebound headaches. Sometimes he slurred his speech in a way that often happens to migraine sufferers.

Joan of Arc

If Monet kept quiet about his migraines in the 1800’s, then perhaps poor Joan (1412-1431) should have as well. Although now a cannonized Saint and considered a great hero, she was excecuted for witchcraft because she saw visions and heard voices. Visual and audio hallucinations are common with migraine sufferers. Tradition states that she also suffered severe pains in her head, which is another clue that she had migraines.

Terrell Davis

Terrell Davis of the Denver Broncos got a migraine…during the Super Bowl! However, he was able to return to the game, help- Denver win and become MVP. He was able to manage this migraine with Imitrex and through keeping a headache journal. More details of Terrel’s story is here.

Zeus

This was the Big God of the Greek Olympic panthenon, later known as Jupiter to the Romans. Greek Gods are especially known for mimicing human foilbles and illnesses. Zeus got one of His lovers, Metis, pregnant, which is a headache in and of itself. But Zues received a prophecy that the baby would one day kill him. So he swallowed the fetus.
Some time afterwards, he got the Mother of All Migraines. His head had to be split open and out jumped a fully grown (and fully armored) Athena.

Perhaps “auras” is a misleading name. When most people hear the word “auras”, they think of various halo-like colors around the head or body, maybe even the images from Kirlian photography. But if you have migraines, “auras” take on a whole new meaning.

What Are They?

Auras usually are a visual hallucination of some sort. This warns the migrane sufferer that a migraine is on the way. The most common auras are flashes or huge wiggly shining shapes. When I had my first aura, it looked as if the lower half of my left eyeball was under water. I had no idea what was going on, until my first migraine hit full force. Then, the aura was gone, but I had a lot more to worry about.

Some people don’t get shining shapes or the illusion that they are partially under water. Some people’s vision blacks out or clouds substantiably. Whatever form it takes, the migraine aura is impossible to ignore.

The aura itself usually isn’t painful — it’s just very strange and even disorienting. It can happen about ten to fifteen minutes before the migraine pain first collides into your consciousness. You can use the aura as a warning that a migraine is coming and can either take preventative medicine or dive for cover.

Very rarely, the aura isn’t visual. It manifests as a loud sudden ringing in the ears. It can also effect your sense of balance, making you very dizzy, even if you don;t have any ringing ears or hallucinations. Some people even have a sudden difficulty speaking or even experience partial facial paralysis (parasthesia).

Why Do Auras Happen?

Auras only happen to about 15% of migraine sufferers. And they do not occur for every migraine of your life. You can have auras before migraines for years, and then they’ll just suddenly stop. You could spend all of the migraines in your life completely aura-free.

It is not known for sure why auras happen. Although it is thought that the eyes are only sometimes effected by chemical changes in the brain going on that fires the brain into migraine pain, why it happens only some of the time is unclear.

One of the theories is that migraine auras are caused by slow wave elctrical impulses that creep across the brain, causing general mayhem in the senses. Then, after being barrages by these impulses, the brain areas then go through a long period of being unusually still. It is thought that the back of the brain controls our vision, so any electrical impulse waves going across the back of the brain will screw up your eyesight. Could the flashing or blurry hallucinations actually be of an electrical impulse? Who knows?

Hope this helps.

Women have it rough. Not only do they get more migraines than men, they can be at more risk of getting a stroke. A new study, which reconfirms a 2002 study, finds that women who have auras with their migraines are more susceptable to have a stroke — even more than women who have migraines without auras.

They also note that women who are especially vunerable to stroke don’t only have migraines with auras, but smoke and used oral contraceptives.

Here are some of the numbers, which studied about a thousand women in the United States with and without migraines:

Women with PMVA (that’s shorthand for Probable Migraine With Visible Aura) had a 50 per cent greater risk of ischemic stroke compared to the no migraine group.
The risk was highest among those with no history of high blood pressure (hypertension), diabetes or heart attack (myocardial infarction).
Women with PMVA who smoked and used oral contraceptives had a 7-fold increase in ischemic stroke risk compared to women with PMVA who did not smoke or use oral contraceptives.
Also, women who had their first PMVA attack in the preceding year had a 6.9 fold increase in ischemic stroke risk compared to women with no history of migraine.

Reading Auras

Auras are often seen before a migraine, but do not have to be present for a migraine to be diagnosed as a migraine. Often, you see flashes of various shapes or even small bright hallucinations a few minutes before the migraine pain kicks in.

For example, my first killer migraine happened when I was 24 and at my job. In my left eye, the weirdest thing began to happen. If looked as if the lower half of my left eye was under water, although the top half was completely fine. I polished my glasses to no end and even had other employees look to see if something was on or in my eyeball. They couldn’t see anything wrong.

And then about a half hour later the migraine hit. That funny underwater effect was an aura. My Mom, for example, used to see flashing C’s travel across her eyes before a migraine hit.

Usually, am aura happens before the pain. They can be a mixed blessing. Although you know a migraine is coming, if you have any medication around, take it immediately. You might cut the migraine off at the pass ort reduce the severity of an attack.

Back To The Stroke Warning

It does not seem to be clear why women with auras and migraines are more at risk of stroke than others. Perhaps smoking and oral contraceptives in combination make your body more vunerable.

This information is not meant to depress you. It is meant as a warning signal so you can take suitable precaustions that will not only make your heart healthier, but perhaps your overall body. First off, quit smoking. And use low-dose contraceptives…or have him get a vasectomy. And switch to more heart-friendly low-cholesterol diet.

If you have migraines with auras and haven’t had a check up in years, do try and get a check up — or at least keep your blood pressure monitored. Since you are more to a stroke, it is best to prevent one rather than recover from one.

Hope this helps.

If you’ve never had a migraine, it’s likely you’ll never truly appreciate just how painful and debilitating they can be. Headache patients often are asked to rate their pain on a scale of 1-10, with 1 being mild discomfort and 10 being the most intense pain you can imagine. For me at least, migraine is about a 12 — a couple orders of magnitude beyond anything you could imagine.

Here’s what it’s like:

Migraine is a primary neurological disorder involving the trigeminal nerve and muscles and blood vessels in the scalp. While the mechanism is not fully understood, experts believe serotonin levels in the brain play a key role. The most widely used medications for migraine prevention are intended to raise serotonin levels. Serotonin also has been linked to chronic depression and sleep disorders. Many chronic headache sufferers struggle with these conditions as well. I am one of them. I took a high dose of amitriptyline for several years that provided some relief from all of these conditions. The drug eventually quit working for me, which frequently happens.

Migraines vary in length, usually four to 72 hours, and frequency. Some people have one every few years. I have two to three a month. They usually last one to three days. Most people have “classic” symptoms. Nausea is common, as are hypersensitivity to sound or light. About 15 percent of migraine suffers experience aura, which includes a wide range of symptoms like seeing colored lights or numbness of the face that indicate a migraine is imminent.

There is no cure for migraine, but the majority of sufferers can be treated with varying degrees of success. About 10 percent of migraine sufferers do not respond to the most common treatments currently available.

migraine, serotonin, aura, amitriptyline