Misery of Migraine NY Times article

Discussion in 'Fibromyalgia Main Forum' started by ephemera, Aug 9, 2006.

  1. ephemera

    ephemera New Member

    Article on headaches from NY Times August 8, 2006 in
    Personal Health section. Worth reading & I thought it might be helpful.

    Scientists Cast Misery of Migraine in a New Light
    By JANE E. BRODY

    Everything you thought you knew about migraine headaches — except that they are among the worst nonfatal afflictions of humankind — may be wrong. At least that’s what headache researchers now maintain. From long-maligned dietary triggers to the underlying cause of the headaches themselves, longstanding beliefs have been brought into question by recent studies.

    As if that were not enough dogma to overturn, there is growing evidence that almost all so-called sinus headaches are really migraines. No wonder then that the plethora of sinus remedies on the market and the endless prescriptions for antibiotics have yielded so little relief for the millions of supposed sinus sufferers.

    While these findings may not be an obvious cause for joy among the afflicted, the good news is that there are available many drugs that can either prevent migraine attacks in the frequently afflicted or abort the headaches once they start.

    Knowing Where to Turn

    Migraine therapy has come a long way in two decades, and those who know or suspect that they have migraines would be wise to see a neurologist or a headache specialist to obtain a proper diagnosis and the best treatment now available.

    Surveys have indicated that only about half of “classic” migraine sufferers are reaping the benefits of what modern medicine offers. If those presumed to have sinus headaches are included, the numbers of underserved migraine sufferers could easily be doubled.

    The World Health Organization ranks migraines among the most disabling ills. About 28 million Americans suffer from severe migraines that leave them temporarily unable to function at work, at home or at play. Many more millions have them in milder forms. All told they cost employers about $13 billion a year in lost productivity, with another $1 billion spent on medical care.

    A migraine is more than a headache. The throbbing pain of a migraine, which typically occurs on one side of the head, is often accompanied by nausea, vomiting and extreme sensitivity to light and sound. A person feels sick all over.

    Symptoms may include nasal stuffiness, blurry vision, diarrhea, abdominal cramps, abnormal sensations of heat or cold, anxiety, depression, irritability and inability to concentrate.

    Without effective treatment, those most severely affected are unable to cope with even the simplest tasks and must take to their beds until the attack ends. Afterward, people often feel tired, irritable, listless or depressed, though some feel unusually refreshed and energized.

    About 4 percent of prepubescent children have migraines. After puberty, the incidence rises to 6 percent among men and 18 percent among women and gradually declines after age 40.

    The higher rate among women is linked to fluctuations in blood levels of estrogen; the drop in estrogen just before menstruation sets off menstrual migraines, which tend to be more severe and longer lasting than other forms. I suffered from estrogen withdrawal migraines three times a month from age 11 until menopause. Each attack lasted three days. Pregnancy, when estrogen levels remain high, was my only respite until menopause ended the estrogen fluctuations.

    Though long believed to be primary vascular headaches, the result of constriction then expansion of blood vessels in the head, migraines are now recognized to stem from neural changes in the brain and the release of neuroinflammatory peptides that in turn constrict blood vessels. The headache often begins before these vessels dilate. The inflammatory peptides sensitize nerve fibers that then respond to innocuous stimuli, like blood vessel pulses, causing the pain of migraine.

    In some people, the headache is preceded by an aura of visual, sensory or motor symptoms that last for less than an hour. They include seeing flashing lights or specks, numbness in the hand, dizziness and an inability to speak. People who experience these have a doubled risk of cardiovascular diseases, according to findings published last month in The Journal of the American Medical Association.

    Migraines sometimes run in families, and these familial migraines have been traced thus far to mutations in either of two genes.

    Although hard to mistake in their classic form, migraines can be — and apparently often are — misclassified as sinus or tension headaches, probably because they can cause nasal congestion, pressure or pain in the forehead or below the eyes, and discomfort on both sides of the face.

    Getting the Right Diagnosis

    In one study by Dr. Eric Eross of Scottsdale, Ariz., 90 of 100 people with self-diagnosed sinus headaches were found to have migraines. On average, they had seen more than four physicians for their headaches before getting the correct diagnosis and significant relief. Neither the American Academy of Allergy, Asthma and Immunology nor the American Academy of Otolaryngology recognizes “sinus headache”; headaches only sometimes occur with sinus infections.

    Migraine sufferers have long been cautioned to avoid certain foods believed to bring on attacks, especially chocolate, alcohol (red wine in particular) and aged cheese. But the evidence supporting this notion is meager. More common causes include stress (positive or negative), weather changes, estrogen withdrawal, fatigue and sleep disturbances (hence, perhaps, the association with alcohol, which can disrupt sleep), as well as overuse of over-the-counter pain medications.

    Finding the Cause

    To determine what may set off your headaches, keep a calendar to record occurrences, noting foods you ate or the circumstances preceding each one. If you are a woman of childbearing age, record the stages of your menstrual cycles. If necessary, to uncover foods that may cause your headaches, try an elimination diet, cutting sharply on various foods, then reintroducing them one at a time. This way, a friend discovered that her migraines were set off by corn and corn products.

    Preventives and treatments are numerous. If one doesn’t work, try another. If your migraines are rare, using a drug in triptans class at the very onset of a headache can usually abort it or reduce its severity and duration. Frequent migraines are best treated preventively, with rescue medication — like a triptan or an opiate, perhaps combined with aspirin, amphetamine and caffeine to relieve a breakthrough headache.

    Among the medications most effective as preventives are tricyclic antidepressants, beta blockers like propranolol and anti-epileptic drugs like gabapentin. Some people are helped by relaxation therapy, biofeedback or stress management. Several good studies have shown benefits from supplements of the B vitamin riboflavin (400 milligrams a day) or the herb butterbur (50 to 75 milligrams twice daily).

    Perhaps most important in finding relief is seeing a doctor highly experienced in diagnosing and treating migraines. Too many people try to muddle through, sometimes causing more frequent migraines by overusing self-prescribed medications. Others may see a physician who fails to help and then conclude that their headaches are beyond help. Even if an expert was unable to help you years ago, there are now so many new therapies — and a far better understanding of the nature of migraines — that you’d be wise to try again.

  2. Greenbean7

    Greenbean7 New Member

    Thank you for posting this. It is really interesting.

    I encourage everyone who is afflicted with headaches to go to your doc and ask what can be done.

    The newer stuff doesn't always work for me, but when it does I am very thankful!

    Hugzz
    Greenbean
  3. pam_d

    pam_d New Member

    I've had the hormone-related migraines for years, though not always co-inciding with my period or at the same time every month. I take the triptan class of drugs (Maxalt) usually with success, since mine aren't the daily type.

    I recently have gone through what I call "instant menopause" due to chemotherapy for cancer. The upside of my treatment is, my migraines aren't gone entirely, but have been greatly reduced since my estrogen has done a 180 degree turn.

    The bad part (besides the cancer!) is that I have "instant hot flashes" too, and they are almost worse than the chemo effects. After I'm done with cancer treatment, I'm going to see my OB/GYN for these hot flashes, since my sleep & life are a mess from them.

    But the migraines have definitely been affected by the change in hormone levels---in a good way. Other than changes in barometric pressure, I've never found any other real triggers besides hormones.

    Thanks for the article!

    Hugs,
    Pam
  4. lenasvn

    lenasvn New Member

    is sudden swelling (nasal) and sometimes my left eye. Then I know I'm starting the "cycle"- for me it's chronic migraines for 3-16 days in the row. I have other types of migraines too.

    I figured too after years that the sinus pain was accually migraines, because when I took my Imitrex the pain/ swelling in the sinus went away with the migraine!
  5. sandyblue

    sandyblue New Member

    Thank you for putting this article in here. I have been a migraine sufferer since a car accident in 1996 and a head injury 2 months before that I got from my former husband. For me, they have been pure heck since I also have a bad heart. I've had dbl-by-pass surgery, about 5 or 6 angioplastys and have had one of my by pass graffs colapse already. I have a very rare defect to which all of the arteries and veins throughout my body are 1/2 the size that they should be and no cure in sight. It is due to all of this that I cannot take things such as immitrex or other new meds because of my heart and arteries.
    It does my heart good (no pun intended) that someone has put it into words how excrutiating the pain is.
    What the article neglected to mention though is that there are two types of migraines in my experience. One you are born with and ones that come from head injuries. But thanks for posting this, I'm going to make a copy of it to give to my Doc.
    God bless.
    sandy
  6. kjfms

    kjfms Member

    I just wanted to share a great site for Migraineurs. I have posted it before and thought I would post it again-I have used it for several years being a Migraineur from the age of about 14 and they run in my family.

    MAGNUM: Migraine Awareness Group: A National Understanding for Migraineurs

    www dot migraines dot org



    There are several types of migraines:

    *Migraine with aura
    *Migraine without aura
    *Basilar artery migraine
    *Carotidynia
    *Headache-free migraine
    *Ophthalmoplegic migraine
    *Status migraine
    *Menstrual migraines




    MYTH: A MIGRAINE IS JUST A BAD HEADACHE.

    REALITY: MIGRAINE IS A DISEASE, A HEADACHE IS ONLY A SYMPTOM. IN ADDITION, THE CAUSE OF MIGRAINE PAIN IS THE OPPOSITE OF THE CAUSE OF HEADACHE PAIN.



    MYTH: MIGRAINE IS NOT LIFE THREATENING, JUST ANNOYING.

    REALITY: MIGRAINE CAN BE LIFE THREATENING, INDUCING SUCH CONDITIONS AS STROKE AND COMA.


    Thanks,

    Karen :)







  7. ephemera

    ephemera New Member

    Pam, Greenbean, leansun, Kjfms & all,

    Glad the article was helpful, I found it informative.

    My sleep doctor suffers from migraines, so she's always asking about my sinus problems & facial numbness, pain, etc.
  8. jake123

    jake123 New Member

    sinus headaches. Then, having my menstrual period was a whole separate thing of massive hell. Throwing up, severe pain for hours and hours, headaches, sweating, unable to do anything except lie in a dark room. With all of that I missed out on several days of school or was miserable while I was there.
    Now when my students tell me that they have a headache and I can see they are suffering, I call their parents to bring them some Ibuprofen or something to take, most often they will take them home. We have days when we turn the lights out in the afternoon for me. I have had three students with chronic migraines. I really feel for them.
  9. optimistic1

    optimistic1 New Member

    I am one of the lucky ones who doesn't suffer from mighraines anymore. However, my daughter just finished a series of Acupuncture treatments and just after the first one hasn't had another. If it would be convenient and not too costly I would strongly recommend seeking out a good Acupuncturist who can treat migraines. My daughter is a different, happy person.

    Best of luck,
    Arlene