Dealing With Headaches

This post is going to focus on caffeine withdrawal migraines, since I know them so intimately. Hopefully, it will have some bearings on your migraines, but if not, I apologize. There are days like today where I pop and Excedrin Migraine pill in order to avoid a migraine (Panadol Extra in the UK). Sometimes it works and sometimes it backfires.

As always, please don’t use this article in the place of your doctor’s advice.

The Pros

If you know that lack of caffeine triggers a migraine, then taking a pill loaded with caffeine when you can’t have a cup of tea or coffee can help head a migraine off at the pass. I had to rush and do errands this morning and only had time for one cup of tea. I didn’t know when I was coming home, so I took one Excedrin migraine before heading out. I do not have amigraine now (knock on wood).

The Cons

Lots of caffeine isn’t good for you. Some people can’t tolerate it at all. I’m embarrassed to be caffeine-dependent, but at least I’m down from three liters of Pepsi a day. Ideally, the best way to get rid of caffeine withdrawla migraines is to cut out caffeine from your life.

However, this requires an excrutiatingly painful cold turkey period that I am not strong enough to go through. So, I’ve gradually been cutting down on caffeine consumption instead.

In conclusion, I’d say that you really have to know your migraine’s triggers before you rely on taking Excedrin as a preventative. If you know that events A, B and C have always resulted in a migraine in the past and now you have to do evnts A, B and C, you better take some medicine. Otherwise, you should only take it after an aura or a migraine starts. You don’t want to get rid of one type of migraine only to develop rebound migraines.

Hope this helps.

I’m currently reading a book entitled Touching Peace: Practicing the Art of Mindful Living by Vietnamese Buddhist monk Thich Nhat Hanh. Although not a book devoted to pain management, he does give an original approach as to how you could deal with your pain.

Greet your pain and treat it with affection as you would a guest in your house. “If you embrace a minor pain with mindfullness, it will be transformed in a few minutes.” (p 30). In my case, the minor pain would be transformed into screaming agony, but I do see his point.

Anticipation and Panic

One of the things Buddhists talk about is mindfulness, which means living in the present moment instead of dwelling on the past or fearing the future. (I know there is a lot more to the concept of mindfullness than that, so to any Buddhists out there, please forgive me). It has long been known that meditation or at least being calm and relaxed can help your pain be less intense.

When you have chronic headaches or migraines, it’s not just the attacks that are fearsome. It’s the time between the attacks, when you are afraid when the next one is going to hit and how severe it’s going to be and how long will you be out of comission and will be able to pay the bills and OHMYGAWD! The fear starts small and then rolls on very quickly to a huge problem.

Being afraid of when the next attack hits puts you in a constant state of stress, which is not goog for healing or to maintain good health. So, your fear can make you more prone to having the very attack you fear. Not being in a constant state of dread can help you in managing your chronic headaches and migraines. It also makes life a lot more comfortable in between attacks.

What To Do

Thich Nhat Hanh gives some suggestions on how to greet your pain with mindfulness. He does not claim to be a doctor and still says you should see a doctor for pain. When you realize a headache or migraine is coming, still take your meds, but also welcome the visit of your pain and even the guest it brings along, Fear.

Say to it, “Hey, how are you? Take a load off. Some weather, huh?” or whatever you would say to a houseguest. Thich Nhat Hanh suggested, “Fear, my old friend, I recognize you.” He also says you should smile at your fear and pain, greeting them as clamly as you can. In this way, they won’t be such bullies.

I’m going to try this approach. It certainly won’t give me any bad side effects.

The song is by Beck. The director is enigmatically called “Megna”. The performers are marionettes. Beyond that, I really haven’t a clue as to what this video is all about. But there is a lot of flashes, bright colors and disorientating camera work, which can induce the feeling of nausea so often associated with motion sickness, migraines or chronic headaches. If you are feeling nauseous and someone asks you how you are doing and you’re too afraid to talk, lest you loose control, show them this video.

I suppose my age is showing, but I’m not entirely sure who Beck is. I do know that there is a beer in Europe called Beck’s. I also thought “Beck” was a girl’s name (short for “Rebecca”). I remember hearing the name flung about over the years, usually on BBC radio, but other than that, I’m a complete newbie to Beck. Apparently, whoever he is, he’s popular. Google lists 75,500,000 websites with Beck’s name on it. (In contrast, Google only lists three for “Megna”).

When you are in the grip of nausea, it sure does feel like someone else is pulling the strings of your body parts. Enjoy.

If there’s any profession guarenteed to give you migraines, it’s being a soldier. That, and being a professional boxer. However, a lot of America’s Army personnel do not seem to be getting an accurate diagnosis for dealing with their pain. This is the finding of not one, but two studies.

And you can’t get proper help unless you get a proper diagnosis. There have been many reports of soldiers getting the medical shaft when they return from duty, and this seems to be even more proof.

Study Details

Both studies came out in Headache, the appropriately named journal for the American Headache Society. (I guss it could also work as a title for a journal about jackhammers, too). Although the studies concentrated on soldiers who returned from Iraq, they also looked at other Army personnel.

Some of their findings include:

• Although 19% had been diagnosed with migraines, the study showed that 17% of soldiers who did have migraines but weren’t diagnosed with it did indeed have it.
• 76% of miliatry cadets surveyed had migraines but were not diagnosed by Army doctors as having migraines.
• 18% of Army officer trainees had migraines for over a year
• Migraines usually knocked a soldier out an average of 5.3 days a month. Ouch. Even I average only four migraine attacks a month.

When Attacks Begin

Although the studies did include Army recruits and those in training, the studies did come up with something interesting. Their findings showed that the migraines often began after coming back home and not during combat. This is probably due to what’s sometimes called “Friday night migraines.”

The body is working so hard and has to stay in the best possible physical shape it can in order to survive Iraq. It’s not until a tour of duty is over until the soldier begins to feel the migraines. It’s yet another reminder that life sucks.

Personally, I think the best way to treat our soldiers for migraine is to get them out of Iraq and back home, but then again, I’m not a doctor.

Today, I was reminded of the importance of eating regularly in the management of migraines. Yes, you still need to take the medication, see your doctor and get a decent amount of sleep, but you also need to eat at times your body is used to. This is harder to do when you’re broke from paying for medication and doctor bills, but if you can afford to eat at least twice a day (even just a slice of bread) then you may be able to help prevent migraine attacks.

Dog Fancy Sucks

I’ve only subscribed to Dog Fancy since June and noticed things were getting weirder and weirder. This morning, I cracked open my October 2008 issue and read a huge editorial denouncing animal rights groups, even animal rights groups working hard to shut down puppy mills, ban chaining dogs to trees for years on end and prosecute dog abusers.

Guess who’s a member of a few animal rights groups.

Now, I don’t mean to turn this post into a discussion of animal rights. Just take the words “animal rights” and insert your favorite cause there — gun rights, free speech rights, human rights, whatever. The point is, the Dog Fancy editorial got me very upset. I was so upset that I couldn’t eat. I decided to burn off the nerves by walking my dog, Pony.

When I came home is when I felt a migraine coming on.

Nausea Sucks

By that time, I could barely look at food, let alone shove it down my gob. But if you manage to get the first three bites down, it gets easier to eat. Your nausea may even subside just from the first couple of bites. If you can’t take pills on an empty stomach, than you need to first take a couple of bites of food (or at least a good swallow of milk) and THEN take your pills.

And then you can go cancel your subscription to Dog Fancy and send the money to the Humane Society of the United States or your favorite charity.

Oh, uh, I guess that last point doesn’t actually help manage migraine pain — although it certainly helped in my case.

Migraines, auras and epilepsy are often inspiration for visual artists, as in this YouTube slideshow clip pairing migraine-inspired art to REM’s Losing My Religion. Granted, not all migraine art is pretty to look at, but that’s art for you. Perhaps you have created such art.

And just how does migraines or epilepsy influence art? Jim Chambliss at Sparks of Creativity would love to know. He’s currently working on a PhD about just that, with (as he puts it) “in
association with the University of Melbourne and St. Vincent’s Health in
Australia.”

Where You Can help

Not only is Jim Chambliss working on a PhD in creative arts and medicine, but he’s also working on a book and an online exhibition about migraines and epilepsy’s influence on artists and their creations. And they are open to submissions. You can live anywhere to submit 8 to 10 pieces of art. Submissions close on September 30, 2008, so you better get your skates on. There is a $1000 and $500 prize up for grabs (in Oz dollars). Please check out Sparks of Creativity for further details.

Speaking from Experience

Jim Chambliss is an epilieptic and Australian artist (as well as a rather ambitions student) that uses his condition to help fuel his ceramic sculptures. His best known piece is called “Puzzled”, which has events of his life (including an EEG readout of his brainwaves) pasted on the squares of a turning Rubik’s Cube. The images are all mixed up. He says that this was how he felt after a particularly violent seizure:

“The side with my face is a representation of when I had a seizure in December 1998. I stiffened and fell flat on my face on a hardwood floor, but I have no memory of the event. Later my face and persona were not recognizable to me. I had a broken nose, chipped teeth, and one eye swollen closed.”

Chambliss has said in interviews that people with chronic conditions like migraines or epilepsy can’t describe in words what their lives are like to people who have never been through it. But they can describe how they feel through art.

My thanks to Jim Chambliss himself for sending an email about the study and the art competition.

Behold: before there was Peter Gabriel to put words to wordless feelings, there was John Lennon (1940 - 80). It came to pass that one day John Lennon doth wrote a song called “Cold Turkey”, which went on about the pain and lamentations of heroin withdrawal.

And it was good.

But, Seriously

One of the reasons I like this song so much is that I can relate — sorta. I’ve never done heroin (not that I know of, anyway) but I have been accused of faking about how bad I feel when suffering from migraine pain. I’ve been accussed of faking so much that when I get a migraine, I automatically hear in my head, “You’re faking it.”

When I was homeless in England, I met a lot of drug users, some of which I sat right next to as they were “clucking” (going through withdrawal pains). If someone hadn’t told me that they were clucking, I never would have known. I knew something was wrong, as they were quiet and still and sometimes kept clenching their jaws and slightly rocking back and forth, but I wouldn’t have guessed that they were going through the agony of heroin withdrawal. It just doesn’t look that dramatic (and when it does, they usually try to not appear in public.)

Anyone who goes through pain and doesn’t get any sympathy for it can relate to “Cold Turkey.” Although I do not get cluster headaches, I imagine the pain is like the pain described in “Cold Turkey”. If someone wonders what migraine or cluster headache pain is like, play them this clip. This is from a 1972 benefit performance in New York City. Thanks goes out to “Corportate Tube” (whoever you are) for putting this up. Enjoy.

This post is an apology to you, Gentle Readers. It is over the spelling in this blog of the brand names for the migraine medication zolmitriptan. I’ve even seen two different spellings on the Zomig nasal spray sample box. I have seen on the web many spellings for Zomig and even though I know I typed z-o-m-i-g, I see Zolmig, with an “l” sneaking in. This has been going on for months, I confess. The proper spelling has only just been pointed out to me by my health insurance company (who wondered what medicine I was trying to get coverage for).

I’m Going Crazy

Perhaps I’m getting dyslexia in my old age. It’s a really selective dyslexia that only pops up when reading about triptans. Or perhaps it’s a form of dementia where, instead of seeing space aliens or Tom Cruise trying to get me, it’s a band of rogue “l”s.

From Now On

So, from now on in this blog, I’m going to just bite the bullet and type out the entire active ingredient name, zolmitriptan. I’m going back through this blog to try to make the necessary spelling corrections, but hey, I’m only human and you know I’m going to screw up the spelling of Zomig somewhere.

Again, my apologies for the confusion. I do try to spell the drug names correctly (usually by running the spelling through Drugs.com) but somehow I think the Spelling Gods are out to get me. This is the curse of anyone with a Bachelor’s in English (of which I am one). All of us make fun of spelling errors in others and yet can’t spell our way out of a wet paper bag. This is the deal we make with the Spelling Gods. We get the degree and then look like a bonehead for the rest of our lives.

Many posts ago, I talked a bit about biofeedback for tension-type headaches. It was difficult to find accurate information for that blog post. (Come to think of it, it was also hard to find innaccurate information on biofeedback for migraines, but I digress). This news story done by Washington, DC ABC affiliate WJLA gives a bit more information for those who could be interested in neurofeedback for migraines.

You do have to get past the stutters and stumbles at the very start of the clip, but once you’re past that, it’s all systems go. They show PacMan as helping you learn how to control your brainwave activity, but there are also other games available. However, you probably won’t get to choose what game you play when you go to a certified specialist.

The clip does go on to claim that “doctors report patients having as much as 90% improvement with neruofeedback”, but they didn’t name their sources. However, if you’ve ever been able to will yourself not to sneeze, cough or vomit, than you already know how powerful the mind can be in controlling some bodily functions once assumed to be involuntary.

If you are interested in neurofeedback or biofeedback for migraines or tension-type headaches, then you could ask your doctor for a recommendation or try checking the virtual Yellow Pages.

Greetings, Gentle Dealing With Headaches Readers:

If you enjoy this blog, then I ask that you take a peek at Depression Talk, which is also part of the 451 Press blog network. I been given the official nod to take over that blog as of today (11 August 2008). The previous blogger, Amanda, had done a lovely job with the blog, but for some reason (I don’t know what reason — don’t ask me) decided to leave the blog in November of 2007. I do not know if she will eventually be co-blogging with me or if she has left the blogosphere entirely.

Why Mention Depression Talk Here?

One of the reasons I applied for Depression Talk is that a lot of people who have chronic headaches or migraines also has clinical depression (also known as major depression). Not everybody does, of course, but there is often what’s called “a strong link of co-morbidity” between migraines and depression. I don’t beleive in the myth of a “migraine personality”, whereby anyone with chronic headaches or migraines also are doomed to have a mental disorder.

Another reason I’m mentioning the depression blog here is that one of the family of medications used to treat migraines and chronic headaches as abortive medications are anti-depressants (usually Prozac, Zoloft or Paxil). If you can’t find the anti-depressant information you are looking for in this blog, odds are you will it on Deprtession Talk. Remember also to look at Drugs.com for any information about side effects or warnings.

Am I Leaving?

Sorry, no. I currently have no plans to leave Dealing with Headaches. I am going to see if I can spruce it up a bit. Hopefully, the two blogs I’m doing for 451 Press now will compliment each other. Well, and get me some more money, anyway.

Better get your skates on. You have until midnight tonight to submit your blog post to August’s Headache Blog Carnival to be published on Monday, August 11. This month, it hopes to be hosted by Atomic City (cross your fingers, everyone. Anytime the Blog Carnival isn’t hosted by Somebody Heal Me, things get dicey.)

August’s Theme

This month’s theme? “How You Handle People Who Don’t ‘Get’ Migraine Disease”. Personally, I just bang them in the head with a cast-iron frying pan and say, “There. You’re enlightened,” but I haven’t been able to string that into enough words for an entire blog post. Hmmm — an idea for a future blog post, perhaps?

Of course, you don;t have to stick with that particular theme in order to sumbit a post, but submissions that to address the theme will get precedence. You should look at your post and think, “Hmm. Would this be of interest to someone with migraines or chronic headaches?” If the answer is, “Yes,” by all means, go for it. There have been some really interesting “off topic” posts in past Headache Blog Carnivals. More information about submitting can be found on Somebody Heal Me (Diana Lee).

More Particulars

A Blog Carnival is, basically, a collection of links beased around a certain topic. Because it’s based on links, your article or blog post needs to already be up on the web. Your blog or web site doesn’t have to just be about head pains, just the particular post.

Diana Lee is looking for volunteers to host future Headache Blog Carnivals. If you would like to do so, then please contact her through the links provided throughout this particular blog post. In case you’re wondering, I haven’t volunteered and don’t intend to do so because I can’t commit to such an activity when I wonder if I’m going to get a migraine that day or not. Such are the joys of being a migraineur.

I do have to admit, sometimes I get a kind of perverse pleasure finding out whenever is something is wrong with topiramate (best known as the brand Topamax). I really don’t know why this is. Perhaps because my doctor thinks I’m a poor candidate for the medicine and so I’m trying not to miss what I can’t have. Anyway, an article in the July 22, 2008 issue of Neurology Today indicate that Topamax may cause birth defects. It concentrates on women who take Topamax during pregnancy instead of any long term results.

With or Without Valproic Acid?

One thing that’s not clear yet is that the birth defects may not come from just taking Topamax during pregnancy. It could be taking a combination of Topamax and valproic acid (valproate). It’s been known for a while that valproic acid can be repsonsible for birth defects (as well as liver failure, so you need to keep taking regular liver function checks when on valproic acid).

What Can A Pregnant Migraineur Do?

Topamax was originally developed to help manage epileptic seizures, so pregnant eplieptic women have a really bad choice to face. Of course, I could be flip here and say that ALL women could avoid this problem by not getting pregnant, but some omen really don’t have any choice in the matter. And then again, that instinctive drive to perpetuate the species can be annyingly persistant.

If youo have migraines and not epilepsy and take Topamax, then there are other drug choices available to you. Please don’t use this blog post as a substitute for your doctor’s advice. But here’s a short list of some drugs currently considered okay for pregnant women:

• Paracetomol/acetominophen (Tylenol)
• Opiods
• Anti-ementics
• Zofran (for nausea)

Hope this helps

Whoops. I forgot to do a “YouTube Clip of the Week” last week, so I’m making it up now. Fortunately, the information in this clip is good for all of the summer weeks of the year, depending on where you live. For migraine sufferers, heat and humidity make life particularly miserable — well, come to think of it, heat and humidity can make ANYONE miserable, but not everyone has migraines to look forward to when the summer gets particularly nasty.

“How to Fight a Summer Migraine” focuses on UK migraineurs and how to avoid migraine triggers, but the information given is applicable to almost any country in the world where there’s both migraineurs and high heat. The clip mentions that blood sugar levels may play a role in migraine triggers. That’s a new one for me, but it does make some kind of sense, so I’ll be looking into that in more detail in a future article.

In case the link doesn’t work when you click it, here is a quick summary of the recommendations on how to fight a summer migraine:

• Avoid going outside if you can
• Eat something every three hours in the daytime and every 12 hours at night
• Take any painkillers, even over the counter painkillers, as soon as possible when you realize that a migraine attack is coming
• Avoid getting too much or too little sleep (both of which is tempting to do on vacations). Make your sleep pattern as regular as possible
• Try to relax
• Don’t be afraid to ask other migraineurs for help

Hope this helps.

It’s looking like 2008 is shaping up to be a good year for more drug choice for migraine treatment. First, we had Stavzor approved in January, then it was announced that a generic Imitrex will hit the market in December and now a generic version of Depakote (delayed release divalproex sodium) has now received FDA approval for migraine treatment. This was a conviniently fast approval, since Depakote’s patent just expired in July.

What Is This Stuff?

This is an anti-convuslant also known as Depacon, Nu-Valproic and Depakene) that’s also used to treat seizures and bipolar disorder (In other words, “Kids — don’t do this at home”.) It’s also one of the ingredients that make up Stavzor. Now that Depakote’s patent has expired and it’s been aprroved for migraine treatment, doctors can also prescribe Stavzor for migraines. (Not that that didn’t stop them before, but things and just that little bit more legal now).

The generic Depakote is coming out with a black box warning (ooh ahh) about some of the nastier side effects that can possibly happen. These include liver damage, birth defects, pancreatitis and death. I’m not sure why “death” is listed last, but that’s Big Pharma for you. However, thinking back on some of the migraines I’ve had, I would be willing to try Depakote, despite the black box warning.

Keep in mind that all anti-convulsants or anti-seizure medications have recently been given an FDA warning in that they may give you suicidal thoughts and nightmares. Kids under 2 should NEVER be given this stuff.

In Case You’re Not Paranoid Enough

The warnings and cautions with Depakote are quite daunting. You can’t take a wide variety of medications when on this stuff, inlcuding Tylenol (acetominphen), blood thiners like Wafarin or Lasix, Topamax (topimirate), and anything from the Valium family. It is also recommended that you wear a bracelet that tells emergency medical workers that you are on this medication. Depakote can dry up your bodily fluids, so you need to drink plenty of water when on this medication.

As always, please don’t self-medicate and do not use this blog post in the place of your doctor’s diagnosis.

There’s a lot of headaches dealing with any aspect of traveling by airplaine, but for now we’ll just focus on the pain in your head during (and often after) a flight. Of course, you could avoid it all by not traveling by airplane, but that’s an option not open to a lot of us.

Cluster Headaches

If you have been diagnosed with cluster headaches (and God Bless you if you’ve got them), then you are understandably wary about traveling by airplane. The change in air pressure can sometimes trigger an attack. There have been reports that breathing the oxygen from those little masks can help abort a cluster headache. This only makes sense, as there is growing proof that breathig pure oxygen (called oxygen therapy) can help abort this excrutiating condition.

Migraines

If you have been diagnosed with migraines, then going out of your home is a bit like placing all of your money on one number at a roulette wheel. You need to expect that you will begin to get a migraine while in the air. If you are able to sleep during air travel, then you have a distinct advantage over the rest of us who are wide awake the entire trip (no matter how long it takes). You need to take medicines with you in your carry on bag or even your clothes pockets.

It also helps to try and stay as relaxed as possible. If you expect the flight to be miserable, then you won’t tense up in discovering that the flight is miserable. If you can learn meditation, have a good bout of daydreaming or even listen to your favorite music on your own headphones (because music is not available anymore on many airlines), then at least you can help yourself relax.

Personally, I think the change in air pressure can trigger a migraine, but there isn’t any scientific evidence to back this theory up. There are some cases where change in air pressure seems to be all it takes to trigger an attack.

Sinus Headache

It’s really painful to have a sinus headache and then have to travel by airplane. If you can contact your regular doctor before the flight, please do. There may be a medicine or nasal spray you can take during the flight to help ease the pressure on your sinuses. You also need to drink plenty of water (not other drinks) in order to keep the sinuses moving and draiing as oppossed to clogging up.