Cluster headache and routines
April 2, 2005 8:48 pm
Cluster headaches are extremely painful. They come all at once, stay for a period of time, and then may disappear for months. But the interesting thing about clusters is that, even during a time when you're getting them, you can still make them better or worse. Many of the same rules apply for clusters that apply for migraines and various kinds of headaches.
The best thing to do when it comes to clusters is stick to your normal routine. Of course, migraineurs are familiar with this concept - many of us are guaranteed a very painful experience if we sleep in on the weekend, or even if there's a time change. But the same goes for people with cluster. You may not be able to avoid the pain altogether, but you can avoid some of it.
By the way, if you want to be reminded of the major symptoms of clusters so that you never forget them, check out this picture of a cluster sufferer from Aurora Health Care.
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A second bite
April 4, 2005 8:55 pm
 Back in January I mentioned to you an article by Dr David Leader on misaligned teeth. This is an important topic to understand because problems with your teeth can give you headaches. Sometimes headaches can be caused by a variety of things, and if your teeth are part of the problem, it may take a long time for you to detect the trigger.
The link to the article is out of date now, since the article has been archived by the news source. Dr Leader was thoughtful enough to write me last month and offer the article for use on this website. Since this topic is so important to headache sufferers, I have now included it on the site. So, if you missed it the first time, read about tooth malocclusion and other bite problems here.
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Restless leg syndrome
April 5, 2005 9:04 am
Some conditions just seem to go together. One of those that seems to hit migraineurs more often than most is restless leg syndrome. Restless leg syndrome (RLS) is a condition causing discomfort in the legs (sometimes arms) when you're trying to sleep. Your legs just have to move a little bit, and you may have to get up and walk around. Because you're awake at night, you also end up being tired during the day. RLS often runs in families, as does migraine.
Standford University Medical Center has announced a new study on the treatment of RLS. They'll be trying a drug for Parkinsons, ropinirole. This will be a 12 week study, and volunteers between 18 and 70 are being recruited. [Edit: volunteers no longer needed]
Antiparkinsonion drugs are a common treatment for RLS. This class of drugs raise the brain levels of dopamine, a neurotransmitter. Dopamine seems to play a role in migraine as well, and raised levels may make migraine worse. Iron pills may also help alleviate RLS. A migraineur will have to look at the big picture and not just treat everything separatley.
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Managing time with headaches
April 6, 2005 8:02 am
How can headache sufferers manage their time? I know, someone is going to throw up their hands and say,"This doesn't belong on a website about headaches!" But, in an effort to be a full featured website, I really do think this will be a help to many of you.
One of the problems of the chronic headache sufferer is a difficulty scheduling time. Think about it - you plan to get these three things done tomorrow, and these four things the next day. But then tomorrow, you get a migraine attack. Now what? Do seven things the following day? What if you get an attack then too? How can you schedule?
Scheduling is difficult for many of us. There are times when we can plow through in spite of the pain, but at those times productivity may go down, or there may only be certain things we're capable of. There are a lot of great time management "systems" out there, but most don't work well for us.
However, I found Getting Things Done by David Allan to be the exception. The book is a goldmine of tips and ideas, and the way that David suggests you organize your life is, in my opinion, excellent for the migrainuer, cluster or headache sufferer. If you're feeling out of control, this book may just give you the handles on your time to get in control again. Click the book cover and check it out, you may be surprised!
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Find what you're looking for!
April 7, 2005 5:13 am
I'm trying out a new search tool that should help you find what you're looking for a little easier. On the main search page you'll find a search box from FreeFind. It allows you to search every page on this site. You can also generate a full site map after you search, and even refine your search. You may also like the fact that the advertising has been removed from the results page, making everything much easier to navigate.
But why go all the way to the search page? Try searching for something that interests you about headaches right now:
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Bye, Bextra...
April 7, 2005 8:52 am
Today the US Food and Drug Administration announced that Bextra (valdexocib) would be removed from the market, because the health risks outweigh the benefits. Others, such as Canadian and European governments are also asking for Bextra to be taken off the shelves. As I heard on the radio this morning, part of the issue is that there are other drugs that can provide the same benefits with fewer risks. Also, the FDA wants clearer warning labels on Celebrex (celecoxib). Not only that, all non-steroidal anti-inflammatory drugs (NSAIDs) will have to include labels warning about potential cardiovascular and gastrointestinal health issues.
No matter what you may think about this decision, it is a reminder that these drugs are not simply "safe", end of story. In other words, you can't just keep putting drugs in your body without an impact. The question is, is the benefit better than the risks and side effects? And, is there a better way to get the same results? Don't be satisfied by the same treatment for 20 years. Stay informed! New dangers may come to light, and new solutions may be discovered.
Read the FDA press release here, or, if you want links to more indepth information, try this page on COX-2s and NSAIDs.
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Botox and CDH
April 8, 2005 8:44 am
A new study published in the Headache journal is suggesting a still wider use for Botox. The makers of Botox, Allergan Inc, sponsored a study using Botox in patients with Chronic Daily Headache and migraine. The controlled study involved 355 patients, about 85% women. Each patient had at least one migraine attack during the trial period, so all of them had migraine with chronic daily headache as well. Patients had a Botox treatment every 90 days for 9 months. The patients that got Botox (rather than a placebo) did seem to get fewer headaches. However, Dr David W. Dodick from the Mayo Clinic College of Medicine (who was involved in the project) warns that results are difficult to interpret. More studies are needed.
There is very little treatment actually designed for those with chronic daily headache. Research in this area as a whole is needed, although the causes no doubt vary from person to person.
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Are migraines making you dumber?
April 11, 2005 5:09 am
If you think migraine attacks are fogging up your brain, take heart. Neurology reported on a study to find out if people with migraine were actually suffering from cognitive damage. In other words, is your power to think and reason and learn decreasing because of migraine symptoms? The answer is, according to this study, no.
The study was done in the country of Denmark with twins. If a twin had migraine, she/he and the other twin were invited in for the study. They were given tests on things like fluency and word recall. These subjects were middle aged, and about 1400 took part. The discovery was, in the words of the report, that "A lifetime diagnosis of migraine was not associated with cognitive deficits in middle-aged subjects." So, if you're feeling dumb, I guess you can't blame it on those headaches!
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Fibromyalgia
April 11, 2005 6:09 am
Earlier this month I mentioned another disorder that seems to be related to migraine - restless leg syndrome. Now if you check out the Migraine and Headache Dictionary you'll find another - Fibromyalgia. Fibromyalgia can be difficult to diagnose since the symptoms are so much like other illnesses. However, there are specific tests that can be done by an informed physician. New brain imaging techniques may help us to understand exactly what is going on in this particular chronic pain problem. Hopefully fibromyalgia, along with headaches, will soon be history.
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Image-guided radiosurgery
April 11, 2005 10:18 pm
One of the goals of surgery is to be more precise - to treat the problem without causing more problems. One new technique that is allowing doctors to do this is called image-guided radiosurgery (IGRS). This technology is being marketed by companies such as Varian Medical Systems and Accuray.
Here's how it works: special imagining technology uses focused beams of radiation to target a specific area of the brain, for example. It uses real-time x-rays to target the treatment properly. Radiosurgery can be used to target cancer tumours. One head-related disorder that is being treated using this new surgery is trigeminal neuralgia.
Trigeminal neuralgia causes extreme bolts of pain in the face, along the trigeminal nerve. Although anticonvulsant medication has often been a successful treatment, in rare cases surgery is needed. Newer techniques are allowing patients to be treated with greater precision.
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More help through the Cox-2 maze...
April 13, 2005 8:08 pm
If you're still trying to sort through the Cox-2 maze, you're not alone. What's safe to take and what isn't? What's worth the risk? Are there alternatives? What should I take for what?
There's a good overview of the current situation in the USA by Dr Eric Matteson, a Mayo Clinic specialist. Even if you don't live in the USA, most of the information is still relevant. Dr Matteson gives information in Question and Answer format, and answers such questions as: Why was Bextra taken off the market?
Is Celebrex safe?
Aleve has also been in the news. Is it safe?
What if Vioxx or Bextra was the only medication that worked for you? What do you do then?
Read the article right at the Mayo Clinic website by following this link.
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A contest is coming!
April 14, 2005 8:41 pm
Since it's spring where I live and everyone's in a cheerful mood, I've decided to run a contest! This contest will be announced in the next issue of HeadWay, so make sure you're subscribed. This will be the "Spring Away from Headaches Contest", and yes, there will be prizes! So watch for HeadWay to arrive in your Inbox around the middle of next week, and the fun will begin. I won't tell you what the prize will be, but it will be especially helpful for people with migraine and/or chronic headache.
HeadWay is free, the contest is free, and I hope that you will soon be free from headaches. So celebrate spring with me, even if it isn't spring where you are!
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Migraine and sunlight
April 15, 2005 5:56 pm
Do you live in the far north? What about the far south? You may be interested in the findings of a new study done in Norway, announced at the American Academy of Neurology meeting this week. The discovery was that people who had migraine with aura were more likely to have attacks during the summer "light" months than in the winter "dark" months. Why?
This seems to support the growing theory that the neurons in the brain of a migraineur are hypersensitive. To quote Dr Karl Alstadhaug,"This supports the theory that, in people with migraine, the neurons in the occipital lobe of the brain, which is the part that is the primary site for vision, are hyperexcitable or easier to trigger"
The migraineurs with aura were also more sensitive to light during and even in between attacks. Many wore sunglasses to try to avoid migraine symptoms.
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Keppra and migraine in children
April 18, 2005 8:01 am
A small study has indicated that there may be a benefit from the antiepileptic drug levetiracetam in children with migraine. Levetiracetam, sold as Keppra, is being reviewed for epilepsy use in children, and recently the makers of the drug funded a study to check out its use for migraine. The study involved only 30 people, but most did have a decrease in the frequency of their headaches.
Although the study is too small to give a conclusive result, it does point to the need for more study, and it's encouraging to see that children with migraine are starting to be "noticed".
Keppra is approved in many countries and is used to control seizures while it's being taken regularly. It controls excessive activity in the brain. It's different than other antiepileptic drugs and may help us understand what's happening in the "migraine brain" as well.
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Headache almost every day? What kind?
April 19, 2005 7:53 am
Two types of headache that are similar, but usually should be treated differently: Transformed migraine and Chronic tension-type headache. The second type happens to many people from time to time. Every day or every other day you find yourself with a tension headache. It's usually on both sides of the head and has that pressing pain. It doesn't get worse with activity, and you're usually not sick to your stomach - it's just there. Still there.
Transformed migraine is now often called chronic migraine. It occurs in patients that have a history of migraine. Over the years, attacks become more frequent, until they end up with something similar to chronic tension-type headache. They may or may not have migraine attacks like they used to - just this daily or near daily background headache. If this is you, you probably actually are getting mild migraine attacks, not tension headache at all.
The causes of these headaches are different with everyone, but it's important to know which you have in order to be treated. Generally, you won't be "cured" of your headaches, but they can be very much reduced. In the case of transformed migraine, many sufferers have a form of rebound headache. This means that painkiller use can be tapered off and the headaches can taper off as well. But there can be other causes as well, such as a virus or a drug you're taking or food you're eating.
Other types of chronic headache include Hemicrania continua (a one sided headache usually treated with Indomethacin) and new daily persistent headache(typically in patients with no history of headache).
Both these headaches are of the kind that you need to see a doctor about. Make sure she knows your medical history so that an accurate diagnosis can be made.
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Let the games begin!
April 22, 2005 5:01 pm
The contest has begun! If you're a HeadWay subscriber, you already know about the Spring Away from Headaches Contest! By answering a few simple questions (based on past blog entries) you have a chance to win a brand new book and an exclusive headache diary (with instructions and tips). Do you want to enter? There's still time! The contest ends on the 19th of May, and winners will be announced in the May edition of HeadWay.
To find out more about the contest and prizes, and to enter today, visit the main contest page. Let the games begin!
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Omega 3 for Migraine and headache
April 23, 2005 11:41 am
The evidence is mounting that omega-3 fatty acids are good for your short term as well as long term health. But most people don't know that there is evidence that omega-3s are beneficial to the migraineur as well. There is some clinical evidence that increasing your omega-3 intake may lessen your migraine attacks. On top of this, there's evidence for many other benefits, including guarding against heart disease, blood clots, arthritis, and even certain types of cancer. New recommendations in the USA encourage Americans to double their intake of fish, the primary source of these beneficial fatty acids. Especially good are salmon, mackerel, trout and herring. Flaxseed, canola, walnut and soya oils are also good. Remember if you're taking flax, the seeds will go right through you - use a whole grain flour.
So, for your health, don't go crazy with the omega 3 supplements - try eating fish 2-3 times a week. You may find both short term and long term benefits. Omega-3s may also have an anti-inflammatory effect, making it good for people suffering headaches of various kinds.
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More types of headache
April 23, 2005 5:57 pm
If you haven't visited the page listing various types of headaches lately, you're in for a surprise. Little by little new headaches are being listed. Of course the list of what may cause headaches is almost endless, so I'm starting with some of the more common ones, or ones that people are interested in learning about.
Among the less common is headache in cerebral venous thrombosis (what was that?). Another one that can cause concern is a headache that occurs when you have a nosebleed. Thunderclap headache is there, along with many others. In spite of the fact that many of these are fairly rare, it's important to learn about them because, first, they can be serious, and second, it can take a lot off your mind if you know you don't have one of the more serious causes.
So check it out, and watch for more causes of headache in the future. That's what we're all about here at Relieve-Migraine-Headache.com!
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Larry King Live today
April 26, 2005 8:26 am
If you're able to get the US television station CNN (Cable News Network), you may want to catch Larry King Live today. The topic is migraine. There will be a whole collection of migraine advocates and medical professionals there, including Dr. Seymour Diamond, founder of the Diamond Headache Clinic, Susan Olson, former Brady Bunch star, migraine sufferer and spokesperson for migraine awareness, Lee Grant (actress/director), Dr Frank Lawlis, and Shawn King.
Check your listings for the time of the show. I believe in North America it comes on from 9-10pm Eastern Time. Check out the official Larry King Live page for information about the show. If you can't catch it, check this CNN page tomorrow for a transcript. Then come back here to look around the site for more information on what you've heard! ;-)
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Quick thoughts after Larry King Live
April 26, 2005 10:02 pm
There are going to be lots of comments going around the internet regarding the Larry King Live show on migraine, so rather than a complete analysis I'm just going to fire out a few initial thoughts. I don't get Larry King where I am, but I did read the "rush" transcript.
First, I thought that overall it was a good show. You never know what you're going to get on a talk show - you really can't give a balanced overview of any topic in a format like that, but they did very well overall. I think the show will generally be helpful to people trying to understand friends that are suffering from migraine and cluster headaches.
Second observation. When they're talking about causes of migraine, they're really talking about what triggers the symptoms themselves. It can be confusing, but the cause of the disease is something different from what causes a specific attack.
Third, it was great to have Shawn King (Larry's wife) on the show. We were able to see those who have found tremendous success and those who are still looking (like myself).
Some really interesting nuggets were brought up. Hemiplegic migraine was mentioned. Cluster headaches were mentioned quite a bit. Several different treatments were mentioned, such as preventative and abortive medications, new medications such as Botox, and alternative treatments such as biofeedback, and acupuncture.
Susan Olson brought up an interesting point about taking different medications at different times. It's a reminded again to make sure your doctor knows your medical history and symptoms, and that if there are any changes you let your doctor know. Imitrex was mentioned quite a bit - this is now an older triptan medication that has done wonders for many people, but hasn't helped everyone. There are many newer triptans out there that may help you if Imitrex (sumatriptan) hasn't helped.
There's lots more in the transcript. I encourage you to print it out and give it a read, or get a copy of the program and see what else relates to you. It's a great starting point for several issues. If you're a HeadWay subscriber, be sure to stop by the HeadWay MailRoom to give me your thoughts.
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Hangover help
April 29, 2005 8:31 am
Ah yes, the old hangover headache. It's actually caused by a number of things. If you're prone to other problems such as migraine, you could get more than you bargain for. But the hangover that most people are familiar with, after drinking too much the night before, is mostly a result of dehydration. Dr. Dan Small, a neurobiologist with the National Research Council in Canada, explains what this dehydration does to your brain: Dehydration makes it difficult for your body to produce cerebrospinal fluid (CSF), the clear watery fluid in which the brain floats. There is about 150ml of CSF in your body, but it is replaced at a very high rate, about four times a day. When you are dehydrated by alcohol, you produce less CSF and there is less fluid in your cranium to cushion the brain. Your hangover/headache after your evening of overindulgence is actually a signal that your CSF levels are low and your brain is banging around inside your skull.
So what can help? Drink some water before you go to bed to help counteract the diuretic effect of the alcohol. (Or, better yet, drink water in the first place!)
A medical procedure actually causes the same problem - a lumbar puncture. The purpose of a puncture is to take out CSF, usually to test for things like meningitis or encephalitis.
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