Head injury
March 3, 2005 1:38 pm
It's a good thing you can't see me at the moment - I have a large bandage on my upper right temple - no good way to hide that. But it has given me reason to think a little about head injury. My 9 month old son had a fall this week too. What are the signs that someone is seriously injured? When is medical treatment needed?
There are two basic kinds of head injury. Obviously, if something has actually broken through the skull, that's serious! But it's harder to tell when someone's head is just banged.
If someone actually loses consciousness, or if there's memory loss, they should be checked out right away. Other than that, the person should be watched closely over the next 24 hours for the following symptoms:
seizures
paralysis/weakness
difficulty speaking, smelling or tasting
vision problems
severe headache or stiff neck that doesn't improve
dizziness
vomiting after the first 2 hours
extreme sleepiness, or trouble waking up
unusual behavior (in kids specifically)
These things apply to people of any age. Deal with the bleeding, check for injuries, apply ice, and watch for any of the above symptoms. If in doubt, call the ambulance or hospital, or call 911 if it's available in your area.
Thanks to MedLine Plus and WebMD for these tips.
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Listen to your thyroid...
March 4, 2005 10:59 am
In February I wrote about thyroid problems and the relation to headaches and migraine. I heard from someone that said that some doctors would not even talk about the connection. This is a little bit disturbing, and rather strange. At this point in time it should seem obvious that changes in body chemistry have the potential to trigger migraine symptoms in certain people.
Your thyroid is an important part of the endocrine system. This system in the body is involved in sending chemical messages all over the body. We know that somehow the body is getting wrong messages when migraine is triggered (as is mentioned right on the home page. Hormones have been long linked to migraine. Problems are apparent in some people who experience migraine changes with pregnancy, or with HRT (hormone replacement therapy).
All the cells in your body depend on the proper function of thyroid. Thyroid hormones control the regulation of energy in your body. The thing that we are slowly coming to terms with is that the body is a complex thing - everything effects everything else. It will take a long time to understand how all these things influence migraine. But it will help us understand if we listen to one another. You just may hold an important key to the next break-through in migraine treatment!
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Hitting your head and "subdural hematoma"
March 11, 2005 12:04 pm
The recent health news about former Illinois Governor James Thompson is a good reminder that you need to check with your doctor when you get new headaches.
James Thompson slipped on the ice in December, and hit his head. He got a black eye, and he thought that was the worst of it. More than a month later, his mother passed away and he started getting headaches. Naturally, he thought that the headaches were just coming as a result of the emotion surrounding his mother's death, so he simply started taking Tylenol and didn't worry. He tried Advil, but the pain continued to get worse over the next few days. Finally, he saw his doctor, who prescribed Tylenol with Codeine, which didn't help.
What neither Thompson or his doctor knew was that the blow to the head in December had started bleeding between the brain and skull, otherwise known as subdural hematoma. The condition puts pressure on the brain, and the condition can quickly become life threatening.
A CAT scan found the problem, and the clot was removed. After a few days Thompson was doing much better. If he had waited much longer to call his doctor, he might not be.
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Computer breaks
March 14, 2005 6:47 pm
How long have you been sitting there at the computer? Is it time to get up and take a break? Sitting for a long time in a rigid position can be asking for trouble. It can cause problems especially in your upper back and neck, and the twisting and turning of tense muscles can cause problems throughout the body, but especially in your head.
Dianne Stafford and Dr Jennifer Shoquist offer this advice for a quick self-massage in the excellent Migraines for Dummies:
Feel the base of your neck and your upper back for tight muscles. After you find them, press down with your fingers and give those knots a gentle but firm massage. Think of what you're doing as a way of softening the knots in your neck and back. Then use your fingers to massage your neck. Be sure to address your skull, temples, and ears. Be very gentle. Stop massaging occasionally to move your head up and down, and side to side.
Of course, it would be great if you could get up and walk around during your massage. A break every once in a while will do a world of difference. KidsHealth.org has an article about children and computer use, which suggests that kids take a break every 30 minutes. That's good advice for any of us. Better yet, take a quick stretch break every 10 minutes too. If you have trouble remembering, get a little alarm clock or timer for your computer, such as ClocX, a neat desktop clock, or SoundBreak from Leon Matthews in New Zealand, which is specifically designed to remind you to take breaks.
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Narcotics tip
March 15, 2005 8:43 am
 Here's a quick tip for those of you using some form of narcotic for pain relief. This would include codeine, an "opiate agonist" which is a componant of Tylenol #1. Narcotics can relax the muscles, and perhaps help you sleep, which could be good for someone with a headache. But there's a slight problem for some people - narcotics can make you itchy! There's nothing worse than trying to get to sleep when you have an itch here and an itch there.
One way to improve the situation is to simply take your pills just before you go to sleep. Now I do say this with precautions - first, remember that with migraine it's usually best to catch the headache in the early stages. For some people, if you wait until bedtime it may be too late to do much good. Also, remember that overall narcotics are generally a poor long term solution. If you find you're taking them more than a couple of times a month, keep looking for a better solution.
For more on getting to sleep in general, check out the October 2004 issue of HeadWay, the free newsletter from Relieve-Migraine-Headache.com.
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Avoiding the trial-and-error method
March 15, 2005 9:06 am
I used to joke that I was in the drug-of-the-month-club, as doctors tried various migraine treatments on me a few years ago. Wouldn't it be nice if there was a way to avoid the trial-and-error method, which actually takes years (since many drugs and supplements must be tried for several months before they help)? Well, a new wave of testing is trying to take out some of the guesswork. Many of the problems that individuals have with drugs are genetic in nature. For example, for those with a specific genetic variation, codeine will provide no pain relief at all. If patients can be tested ahead of time, they might be able to drastically shorten the time to effective treatment.
The SEYX company is one group that has developed a testing procedure known as Signature Genetics. Part of the idea is that certain drugs are eliminated after a patient is tested by analyzing a cheek swab. Common genetic variants are identified by genetic testing.
The testing is still very expensive, but here's hoping that the idea will be further thought through and developed, and that the price will go down and availability will go up. In the years ahead, testing like this could save a lot of wasted time trying risky treatments that aren't right for you.
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More funding for Canadian migraine research
March 16, 2005 5:56 pm
Here in Canada, the government is increasing funding to migraine research. Among many other things, of course. This isn't a political blog, so don't worry, I'm not going to get into health care and which government does a better job and all that. But this is a headache and migraine blog, and naturally I do think that study of migraine is important! It tends to be overlooked because it's not perceived to be "dangerous" (of course, it is dangerous in a number of ways).
So when governments and hospitals and individuals and employers are thinking about migraine, they need to remember the financial costs. The mental trauma. The related problems. The possibility of long term problems connected with migraine. And a little compassion for the pain people go through should be thrown in.
No, migraine is not the greatest threat to mankind. But it traditionally hasn't been given the attention it deserves. It's time for that to change.
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No-pain clusters?
March 17, 2005 9:33 pm
You knew that you can have migraine and yet no pain. But did you know that you can have cluster "headaches" without pain too? That was the news from Neurology, in a report from Neurologist Dr Rolf Salvensen in August 2000. The report follows a man who experienced other symptoms of clusters - a stuffed up nose, drooping eyelid, and pupil contraction on one side, and yet no pain.
This is important to know, because first it will help us better diagnose clusters. Second, it will help us better understand them. Many have theorized that the other symptoms are simply a reaction to the pain. Now it seems that this isn't true - the other symptoms have a life of their own! This is old news now to the neurology world, but clusters themselves are still a mystery being investigated.
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Child migraine research goes forward
March 18, 2005 8:35 am
More good news about funding toward migraine research comes out of the UK. £20 million is being put toward an initiative to focus on children's medicine. With migraine, as with many other diseases that children and adults get, the children tend to be an afterthought. This worked for adults, let's see if it works for kids too. But this new initiative will focus on medicine specifically for children. This will include medicine for children's migraine.
Read more about this grant at the Royal Liverpool Children's NHS Trust's website. One of the current projects going on involves Dr Steven Ryan, a consultant Pediatrition at Alder Hey Hospital. His research involves children and questionnaires related to migraine.
Read more about child migraines here.
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Internet headache
March 19, 2005 8:12 am
There's a lot of information out there on the internet. Unfortunately, there's a lot of bad information out there on the internet. So how do you avoid it?
A common problem for headache sufferers is that they misdiagnose their own problem. If you're looking for information before visiting a doctor, this isn't necessarily a problem. But if you act on the misdiagnosis, it could be a huge problem. This isn't always a matter of bad information. Doctors simply have a well rounded health education that most people don't have. Neither does that mean that they're right and you're wrong - often doctors misdiagnose headache problems. That's why it's important for you to be educated too.
One thing to remember is that when you're looking for information on the web, you find what you want to find. For any given treatment, you can usually find articles praising it as the answer to life's problems, and articles claiming it's the cause of the fall of civilization. Look for a balanced approach, from sites you trust. Be aware of the way you search. Talk to your doctor - not to believe everything she says, but to get a balanced perspective from someone who will take the time to listen to you. And don't waste all your time playing games. :-)
Tips on choosing a doctor
Diagnosing migraine
Other headaches
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Long term effects of migraine
March 19, 2005 7:07 pm
In recent months, studies have begun to raise concerns about the cumulative effects of migraine. Once upon a time migraine was just considered to be a bad headache that just had to be endured, or perhaps dulled by drugs. Now we know that it's not just a bad headache (sometimes it's not a headache at all!), and it may do more damage than was once believed.
Researchers are finding things like mini-strokes going on in the brain, risk of future strokes, and heart problem-like symptoms (although not actual heart problems). These studies are vague reasons for concern and future study. If migraine is causing minor brain damage (as some research seems to show), what will the effect be over time? Are some migraine attacks worse than others for these problems? Or does this point to another link that we don't yet understand? Regarding this concern, HealthDay reporter Mark Bloom writes:
Migraine should be conceptualized not just as an episodic disorder but as a chronic-episodic and sometimes chronic progressive disorder, wrote Drs. Richard B. Lipton and Jullie Pan of the Albert Einstein College of Medicine in New York City in an editorial in the Journal of the American Medical Association.
In other words, we shouldn't consider migraine attacks to be something that just comes and goes, but something that keeps coming back and often keeps doing worse damage.
Don't forget, the pain itself can cause a great deal of damage. You may find knots and tightness in your muscles, emotional concerns, a lack of proper exercise, the effects of medications on the body. Your body may be going through a lot more than you think - much more than just pain in the head.
So as the research continues, let this be motivation for all of us to not just "put up with it", but to fight back. Time may only be making things worse. What's your "spring resolution" going to be?
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More on hemiplegic migraine
March 19, 2005 10:48 pm
One area that has benefitted from genetic study is in the rare form of migraine known as familial hemiplegic migraine. As genetic mutations have been discovered, we have gained a better understanding of how this type of migraine works, how to diagnose it and how to treat it.
Familial hemiplegic migraine is a type of migraine with aura, and is one of the more severe types of migraine that can cause stroke-like symptoms - weakness on one side of the body, trouble speaking, and a pins-and-needles sensation. There is a genetic (family-familial) connection, related to the calcium channels in the body. As seems to be the case in many migraine types, the body is getting the wrong neurological signals. Some of this testing is still in the research stages, and it's not yet foolproof, but it's a tremendous advantage to earlier guesswork.
There's a bit of an update now online of the original December article on headache and hemiplegic migraine, including more specifics and references. It's still just an overview - watch for more!
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Butterbur for kids
March 21, 2005 8:40 am
Back in January I told you about the new research on the herb butterbur. A regular dosage of butterbur reduced headache frequency by almost 50%.
Now, butterbur is being tried with children, and the results are encouraging. In this month's issue of Headache: The Journal of Head and Face Pain, German researchers did a study with children (ages 6 and older) and adolescents. Now the researchers admit that the results of the study may be influenced by the fact that the children knew what they were taking. However, they were encouraged by two factors. First, the butterbur was tolerated well, and second the study results were similar to the studies that have been done with adults (which were controlled).
About 77% of the children in the trial had at least a 50% drop in migraine attacks.
As you probably know, when you buy any herbal formula at the store the ingredients can vary drasticly, and so can the results. So the research team used Petadolex, which is a reliable standardized and safe form of butterbur. The dosages were between 50-150mg per day. Click on the Petadolex link for more on this butterbur extract.
So far, it seems that similar dosages are effective in children, teenagers and adults. Check here for more herbs for headache.
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Brand new book!
March 29, 2005 2:14 pm
This month a long-anticipated book about migraine and diet hit the shelves. It was written by dietician Elaine Magee, a contributor to WebMD. One of the associate directors for the Diamond Headache Clinic, Frederick Freitag, wrote the forward, and he sums up basically the same impression of the book that I had:
If you are looking for a cookbook for a headache sufferer, this is not the book for you--although Ms. Magee does include a chapter full of tasty recipes. If you are looking for a book to help you handle migraines better by managing your diet better, then this is the book for you.
That's pretty much it. There are some great recipes in here, but there is also an incredible amount of information, charts, stats and up-to-date research that will help you know how to better adapt the recipes you already have.
This book was a great excuse to update my page of migraine cookbooks, and even *gasp* fix a few spelling errors. You can read my review of the book there, as well as three other cookbooks that may be a help to you, depending on what you're looking for. Click here for more on headache and diet...
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Building your emergency kit
March 30, 2005 12:30 pm
I got an email from Roy in South Africa, who pointed out a major omission in the last issue of HeadWay. One of the things we were doing this month was preparing for that trip to emergency. Of course, there are all kinds of things that you may choose to take with you, but one of the most important is the contact information for your doctor(s). That way, if they're on the ball at the hospital, they can call right away and find out what treatment she or he recommends for your case. Of course, the MedicAlert bracelet does much the same thing, this is more of a low-tech way of doing it.
What Roy was actually suggesting was having all this information in your mobile/cell phone. That would include the number for the nearest hospital, medical clinic, doctor's office, and so on. That way you can call when you need to, or a friend can, or someone at the hospital can access the information as well.
I appreciate the feedback of HeadWay subscribers in the HeadWay MailRoom. Keep thinking about this topic, it's very important to all of us. I'm sure we can think of ways to put together our "medical emergency kits" that will make things more efficient and useful.
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