ChronicBabe: In the Kitchen

Jennifer Hess, a ChronicBabe contributor, knows that eating minimally processed foods without many additives helps keep her pain under control. Instead of eating junk when she’s exhausted, in pain and can’t think, she has invested in good kitchen tools and always has easy-to-prepare, good-for-you food on hand. Jennifer shares her secrets in Chronic in the Kitchen! Tips to Keep You Cooking.

Critical Thinking

Posting links to news reports related to headaches and pain has made me increasingly uncomfortable. It is important to stay on top of what’s happening with our disease, but reading headlines and brief, one-sided reports isn’t enough.

Media outlets do serve the important role of messenger, but the primary goal of newspapers and radio and TV stations is financial gain. Hailing the miracle cure, shocking study results or any extreme position gets attention, which in turn brings in money. I don’t say this to be critical, but to point out the inherent contradictions in reporting.

Reporters and news sources do have a responsibility to improve the quality of medical reporting, but we’re doing ourselves a disservice waiting for the industry to change. Patients have a responsibility to digest information critically. As I wrote in yesterday’s post about nerve stimulators, we have to question what we learn – no matter if we learn it from the media, doctors or alternative health care providers.

These are some questions I ask when I evaluate news.

  • Is the proclamation in the headline supported by the findings described in the article?
  • Is only one point-of-view presented? Who else may provide a valuable perspective?
  • If it’s about a study, is it the first one to have these results? If not, are the findings consistent with those in other studies?
  • Is cause and effect stated or implied in the article? If so, does the information in the article support this conclusion?
  • Are the side effects covered adequately? Could there be side effects or complications that aren’t addressed?

While writing this post, I found Health Compass, an excellent resource on how to evaluate the reliability of health information. Although the focus of the site is aging, the lessons apply to anyone seeking medical knowledge.

As for The Daily Headache, I sometimes blog about news that doesn’t hold up to these standards. I actively decide if it’s worth sharing even if it doesn’t fit, but I don’t always tell you why or even that I’m doing this. I’ll try to be clearer in the future.

A Willing Guinea Pig

Desperation makes ignoring pitfalls easy. Choosing a treatment without much clinical research to back it up or expose its shortcomings, like nerve stimulation, shouldn’t be done lightly.

The downsides that aren’t covered in the media? Just as the body tends to "outsmart" meds after a while, a nerve stimulator may stop working over time. Also, the surgery itself, or having a device implanted in your body over the long haul, may complicate or increase your pain. Notice that both of these sentences contain the word "may." Studies on nerve stimulation for chronic headache are underway, but these are among the many questions yet to be answered.

The first of the occipital nerve stimulators are being tested now. One may prove to be better than another or all of them may need to be modified to work effectively in the future. Stimulators available five years from now will almost certainly be better equipped for this particular application. Or they may be abandoned altogether as a nonviable option.

Any doctor researching nerve stimulation, no matter how pure his or her intentions may be, would love to be the one to find The Answer for chronic headache. Of course they are excited about implanting a nerve stimulator. Not only do they have a chance to help you, they can also learn more about the device. This isn’t necessarily bad; just make sure your reason isn’t lost in their enthusiasm.

Docs aren’t all-knowing, particularly in an area that’s so new. Ask questions and make sure the answers are satisfactory. "We don’t know that yet" is an acceptable response only if you’re willing to take that risk. I was and I’m glad for that, but I do wonder if I will have regrets in the future.

Claire’s Head: The Life of a Migraineur

Claire’s Head, a novel that will be released in the US in September, is a stunning depiction headache pain and treatment, desperation, and hope. Written by Catherine Bush, a migraineur, the novel is an examination of the relationship that someone with migraines has with him or herself and with others. Even if your headaches aren’t migraines, the struggle is probably familiar.

An Amazon review I read said that the first 150 pages are good, but the descriptions of headaches get old. The repetition might be annoying, but that’s the point. Frequent disabling headaches are bothersome and do interrupt the plot – whether it is the plot of fictional characters or real people.

If you have a hard time telling your loved ones what your headaches are like, pass this book on to them. There’s no way anyone can deny the reality of the pain after seeing it spelled out so well in this novel.

I feel like I’m writing an 8th grade book report when I say this, but reading Claire’s Head was like reading my own diary.

Note added Aug. 16, 2005: I copied this review so I could include it in an Amazon review and realized that I didn’t include a major part of it. While my ego would prefer if I just ignored this fact, I can’t mislead my dear readers.

The truth is, the book is great for showing the agony of headache, but isn’t a compelling novel. The plot isn’t believable, which makes the story boring. I still recommend the book, as it is great for showing headache pain, but don’t expect to have your socks knocked off. Despite this, the characters’ agony was enough to engage me for the first two-thirds of the book.

Sorry for the oversight.

New Findings on Brain Cell Communication in Migraineurs

Research examining how gene mutations influence brain cell communications of migraineurs has been published in the Canadian journal, Proceedings of the National Academy of Sciences.

Researchers Make Headway in Mystery of Migraines

Why Stimulate the Occipital Nerve?

News reports have lauded trigeminal, peripheral and supraorbital nerve stimulation, but there hasn’t been much coverage of occipital nerve stimulation. This isn’t an endorsement of one type over another, but I talk about ONS because that’s what I have. When I have a grasp on the other options, I’ll write about them.

The occipital nerve is targeted because it is a sort of gatekeeper that refers migraine pain to other nerves. Dr. David Dodick of the Mayo Clinic in Scottsdale explains, “The occipital and trigeminal nerves converge. These nerves connect with all of the pain-sensitive structures in the skull. [S]timulating the occipital nerve inhibits activity in the trigeminal nerve.” (This quote is from an an article that was on OUCH‘s old website, which is no longer available. Even though the article focuses on occipital stimulation for cluster headaches, the information applies to migraines.)

From what I’ve learned – and what the quote from Dr. Dodick above indicates, it appears that the occipital nerve connects to all other nerves, therefore is the widest-reaching option. I’m by no means a definitive source on this. At the very least, if you’re considering nerve stimulation, it’s a good idea to research all the possible types and work with your doctor to determine the best for your pain.

Advance Warning

About a month ago, I was in a nasty cycle where I’d have a migraine, have three hours off, then have another migraine. On the third day of this, I already had plans to go out for coffee with a friend and thought I was coming out of the cycle, so I went. I expected to be dragging a little, but I had tons of energy. I couldn’t keep a train of thought and I had a terrible time finding words, but I couldn’t stop talking. No more than 10 minutes after I got home, another migraine hit.

Not long after that, I went to my book club meeting and, again, was charged. I felt like energy was practically flowing out of my joints. When I got home that night, a migraine hit.

I’ve since realized these bursts are part of prodrome, the period before a migraine. I’m always fascinated when I learn how migraines affect the body beyond pain, but more importantly, abortants are most effective when taken during prodrome. Figuring out what your prodrome symptoms are is easier said than done. They’re a study of contradictions.

You could be sad, easily annoyed, yawning and tired or hyper, talkative, having trouble finding words and slurring the ones you do find. You might be hungry or have no appetite, have food cravings (especially for carbohydrates) or be disgusted by certain foods. Maybe you’re sensitive to light or sound and your muscles are stiff. You might have constipation, bloating, diarrhea and have to pee all the time. You could have any of these symptoms in any sort of combination and they aren’t necessarily consistent from one event to another.

Tempting as it is to dismiss these as just a funk, a good mood or an upset stomach, being aware of prodrome symptoms might help you get better treatment. If your migraines are close together, something that seems like a hangover from the previous headache (postdrome) could actually be prodrome. Knowing that taking a triptan early may keep your headache bay makes a good case for keeping a headache diary. I definitely know now that when I’m bouncing off the walls, I should have a triptan handy.