Dealing With Headaches

A recent study in The Cohrane Library published in the Land of Oz (Australia, of course) concludes that oxygen therapy may significantly help those suffering from cluster headaches or migraines. 210 human guinea pigs volunteered to participate in nine small studies around Oz in order to compare treatments. Cluster headeadche patients, in partuicular, did much better than placebos after 15 minutes of breathing in an oxygen chamber.

Normobaric and Hyperbaric Therapy

There are two kinds of oxygen therapies. Sadly, just breathing in and out like usual doesn’t count. Anyway, normobaric oxygen therapy refers to breathing pure oxygen from an oxygen tank. Buy hyperbaric oxygen therapy (the one considered so promising) involves going in a chamber and breathing pure oxygen. Why the chamber? The chamber is put under pressure.

No, I have no idea what this means, either.

Which Leads Us To The Problem

Finding an oxygen chamber is just about as hard as trying to comprehend oxygen therapy. Critics of the Oz study point out that the migraine or cluster headache might even be over before the patient can begin snorting the pure oxygen. Also, oxygen tanks are highly flammable (not that this hasn’t stopped us from driving cars). However, this could be a first step in finding a far more practical solution.

Meanwhile, keep on taking your usual medicine.

I can’t remember if I ever mentioned this experimental abortive drug for migraines on this blog before now. That’s what enough migraines and blog posts will do to you over time, make your memory a little wacky.

Anyway, the drug in development that is getting a lot of promising buzz is called (wait for it) calcitonin gene-related peptide. Mercifully, it’s usually known as CGRP for sanity’s sake. This is a neropeptide (a little chemical ding-hooey in the brain that helps gets things done in the body) activated by a protein called RAMP1. (Let’s not go into what RAMP1 is short for.) It seems these two brain chemicals are great mates — if one gets excited, so does the other. The theory is that these two could be responsible for migraine pain and possibly for the pain of cluster headaches.

You Can’t Get It Yet

CGRP for migraines and cluster headaches is still in the clinical trial stage. Giant Pharma company Merck currently has a hold of it and calling it MK-0974. Although also known as CGRP in some media publications, MK-0974 actually BLOCKS CGRP from getting excited. It is currently thought that MK-0974 will have less side effects than current drugs like triptans.

MK-0974 is currently in the Clinical Trial Stage III phase and not looking for any more human guinea-pigs. The experimental drug is currently just be checked for migraines. Presumably, if they get the OK to market it for migraines, then they can do the whole clinical trial merry-go-round again for cluster headaches. This means Merck gets to hold on to the patent for another decade or so before it would be required to go generic.

Practical Upshot

Where there’s life, there’s hope. There is something waiting in the wings in a lab somewhere. In the meantime, work with your doctor to help tame your pain. That’s pretty much what most of the rest of the posts on this blog is about.

Nope this helps….whoops! That’s a typo!!! HOPE this helps. (Arrghhh)

Woot. A French team of scientists have announced something that may help clear up the mystery as to why we get migraines. A part of the brain called the hypothalamus gets very active when a person is suffering a migraine. This is leading the researchers to believe that migraines do not have one cause, but that a chain reaction has to occur, of which the hypothalamus seems to play a big role.

The Details

The study was done at France’s Ranqueil Hospital. The goal was to capture what the brain goes through when a migraine attack happens naturally, NOT induced. In order to see what the brain was up to, Positron Emission Topography (PET)was used. PET is yet another scanning machine, but you don’t have to be in that little tunnel like with other scanning machines. PET shows what areas of the brain are currently active during specific times.

They hoped to study migraines without aura, as they are the most frequent types of migraines. They got their wish. Seven migraineurs volunteered to have their heads examined. When they felt a migraine coming on, they went to the hopsital without taking any medications or therapies. Their brains would get PET scanned within three hours to get an accurrate scan.

Why not just induce a migraine? They hypothalamus does not get busy then, and the hypothalamus has long been a brain organ of interest in the cause of migraines. It had been suspected that the brain reacts differenetly when a migraine is induced than when one just comes from out of the blue. And they were right.

Hypothalamus activity was previously caught before cluster headaches (which are different from migraines). According to Professor Peter Goadsby of the institute of Nuerology at University College London:

The area [of the hypothalamus] reported as activated in migraine is about 10mm more anterior than the cluster headache area.

What Does This Mean?

It’s a tad bit difficult to cure anything if you don’t know it’s cause. Although the cause of migraines is still unknown, at least this latest study helps show how to better focus future studies. In other words, the haystack that our needle is in has just suddenly got a lot smaller.

Hey, I just noticed on the little blurb about this site (which I didn’t write — it just materialized one day!) that I’m suppossed to be posting about support sites every now and then. I guess you noticed that I haven’t really done too many posts about Headache and/or Migraine Support Sites…as in, this is the first post on the subject.

When I talk about support groups here, I am NOT talking about 12 step programs for addicts. That’s a different animal. If you are an addict, go to the 12 step progams and KEEP GOING.

I’m Not Against Support Groups, But…

You need to be a certain type to benefit from any kind of support group, whether it’s in the real world or online. If you are prone to get obsessed about anything, then you need to be careful. Also, if you have problems saying “No,” you need to be DOUBLY cafeful, or soon you’ll have the responsibilities of the support group dropped in your lap before you know it. Now that will be a MAJOR source of headaches, both literal and metaphorical.

The best way to deal with support groups for physical ailments is to go only a few times, take the literature home with you, read the literature often and then not go to the group again for at least a year.

My current main support group is composed of my relatives who also get a variety of head pains. For me, that’s the best kind of support group.

The Pros

Support groups let you know that you are not alone. They also can make you feel better knowing that you don’t have it as bad as other people. They also are an ever changing resource of tips and tricks for coping with headaches and migraines. And, it’s always nice to talk to people who know and can sympathise what you are going through.

You can find Headache and Migraine Support Groups in your local paper, in the phone book, or go online and enter “headache support group” into your favorite search engine. For example, if you have cluster headaches, then you can find resources, sympathy and some good laughs from Cluster Headaches Worldwide Support Group.

Basically, if you can think of any medical condition, there’s a support group online out there somewhere.

The Cons

Sometimes, support group meetings (whether online or in real life), start to turn into contests or “Who Has The Worst Pain.” Although it is a great source of stress releif to complain, there should be limits on it. Hearing new symtpms that sound frightening can plant some nasty suggestions in your subconscious and suddenly you are experiencing new symptoms, too. You always need to take these meetings in perspective.

Keep your personal space. Don’t make yourself the only means of finacial or emotional support for the other members of your group. Although it sounds selfish, you need to follow this for yor own survival — YOUR HEALTH MATTERS MOST. Don’t be afraid to tell any other member to bugger off and leave you alone.

And if you are on an online support group, it’s much better for computer’s security if you stay away from peer to peer networks and ANY kind of file sharing. Any peer to peer network just does not have the security of one admin on a regular internet site that can filter out spyware or other kinds of malware. Not that you need to be paranoid about this, just keep it in mind.

Hope this helps.

I once asked someone who had cluster headaches how they differed from migraines. My none-too-amused companion replied, “Cluster headaches suck big time.” Years later, I thought I better find a more thorough if less eloquent difenition of cluster headaches.

What Are They

Cluster headaches are extremely painful series of headaches that are akin to torture. They tend to rise and fall in intensity, so when you think it’s over, it’s not. They often concentrate on one side of the head. An attack usually lasts from 15 minutes to three hours. They tend to come at the same time every day over a period of time (usually from 2-12 weeks), then go away for an undetermined length of time (this is called remission). Any onlooker will probably panic seeing you in such pain. You may display very dramatic actions such as pounding your head against the floor in order to ease the pain. Many cluster headache victims prefer to be alone when the clusters come. But, believe it or not, despite their intensity, cluster headaches are not lethal.

What Causes Them

Quite frankly, no one knows. Lucky you. The current theory is that some chemicals like tobacco or alchohol might, which freaks out the trigeminal nerve. Here’s a direct quote from this site:

Biochemical, hormonal, and vascular changes induce cluster headaches, but why these changes occur remains unclear. Episodic cluster headaches seem to be linked to changes in day length, possibly signaling a connection to the so-called biological clock.

In other words, “Your guess is as good as mine, dude”.

Who Gets Them

Cluster headache victims tend to be in their 20s-40s. Very, very rarely, they start when you are in your 80s. They are more men that get them than women (I guess because the women have the migraine market cornered). They can affect any race. So far, there does not seem to be firm evidence to show a genetic cause, but cluster headaches can sometimes run in families. Some throerise that a combonation of factors have to come together to produce cluster headaches. They are one of the rarest kinds of headaches.

What Other Names Are Cluster Headaches Called

They are often called suicide headaches, as you wish you were dead when you have them. WebMD.com estimates that cluster headaches are 100 times more painful than migraines (and that’s saying something!)

Cluster headaches are sometimes called “Night headaches” or “nightmare headaches” becuase they usually strike one or two hours after you go to bed. They often receeed in the daylight.

What Can Be Done

You have to go to the doctor if you have cluster headaches. There are a lot of medications available to ease or even prevent attacks. They usually come in injectable and nasal spray form. You may have to take a comination of medicines. If you can discover a trigger, such as alcholic drinks, avoid them.

The periods of remission are not fully understood. They differ in length from person to person. Sometimes the cluster headache period goes away by themselves.

Only 10 to 15% of cluster headache sufferers are chronic, where there are NO periods of remission. Chronic cluster headache sufferers can also get benefits from modern medicines, and even from inhaling from oxygen machines. There are also anesthetics available on perscription, usually in nasal sprays.

Although there is no cure, there are two experimental surgical procedures. However, surgery is a last resort. The first surgery involves cutting or burning away part of the trimeminal nerve, the other is focusing a beam of radiation onto your head (no cutting is involved). As you might expect, the second procedure is far more controversial than the former.

You might benefit from talking to someone, whether a therapist of a support group. There are many online support groups, including Cluster Headaches Worldwide Support Group.

So, what’s worse — cluster headaches or heart problems? That’s a tough call, but hopefully those on the new cluster headache drug verapamil will ever have to find out. A British study has reported in August 2007 that verapamil can negatively affect your heart. But this did not hurt the hearts of all people on verapmil. It is therefore highly recommended for verapamil users to have periodic EKG (electrocardiagrams) checks of their hearts to be sure that that everything is tickety-boo.

Study Summary

This study was reported in the August 14, 2007 issue of Neurology, an English journal specifically for neurologists and neurosugeons. The report was written by the respected Dr. Peter Goadsby, who works in nuerology on both sides of the Altantic. He has had many cluster headache patients, mostly men.

The study participants were made up of 217 men and 152 women, making 369 in all. All of them suffered from cluster headaches (also called suicide headaches). They were all given verapmil, starting at 140mg a day and increased until the headaches went away or they developed an irregular heartbeat. However, only 108 had regular EKGs done. Twenty had irregular EKGs done, while 80 had no EKGs at all. This is not highly suprising, even though the excuses given ranged from “I forgot” to “My docotor thought too many EKGs were unnecessary”. The study did not mention who paid for the EKGs. Most of the study’s finding centered on the 180 who had regular EKGs. They found that:

21 patients (19 per cent) had arrhythmias (irregular heart beat).
13 patients (12 per cent) had first degree heart block at 240 to 960 mg a day, with one patient needing to have a permanent pacemaker fitted.
4 patients had junctional rhythm.
1 patients had second degree heart block.
4 patients had right bundle heart block.
Bradycardia (heart rate below 60 beats per minute) occurred in 39 (36 per cent) patients, but verapamil was stopped in only 4 patients

He concluded that verapamil was still a relatively new drug and patients on it needed to be closely monitored for any signs of irregular heartbeat. Docotrs needed to be informed about the possible side effects, as the drug is so new that they might not be aware of it. He also noted that the pain of cluster headaches is so excruciating that patients may be tempted to stay on verapmil even if their hearts fail an EKG test.

Hopefully, new studies can be done to back up these findings, as it is going to be very hard for any cluster headache sufferer who finds relief from verapamil not to be discouraged, but empowered to take more action to assure they can help both their hearts and their heads.

Choose the best answer for the following four questions.

1. How would you describe the pain?
a) Pressing or tightening, mild to moderate
b) Throbbing
c) Radiating pain

2. Where is your pain located?
a) Both sides of the head
b) One-sided
c) Behind one eye or it’s region

3. What are your headache’s triggers?
a) Anxiety or depression
b) Diet, stress, environment, perfumes, medications and/or hormone changes (seems to be everything!)
c) Alcohol and/or smoking, but only when I am regularly getting them, which is often in the spring or fall

4. What other symptoms do you have?
a) Sleep changes, guilt, weight loss, dizziness, poor concentration, chronic tiredness and nausea
b) Nausea, light and sound sensitivity
c) My eyelid sometimes droops and my sinus on the affected side is congested

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