Caffeine & Headache

Espresso_cupCaffeine is often cited as a headache trigger, but it can be an effective abortive too. Many headache medicines even contain caffeine. Some books say to avoid caffeine at all costs, others warn that you not go over two cups a day.

As with every other headache treatment, it seems, the answer lies in your knowledge of your body. For years I thought my headaches were caused by withdrawal. Turns out I just have chronic daily headaches and caffeine reduces the pain.

I can drink caffeine daily without apparent ill effects, but I prefer to save it to use as a headache abortive. For many other people, drinking it regularly triggers headaches.

Part of finding the right balance between a helpful level and an excessive amount is figuring out just how much caffeine you consume. There are charts of caffeine levels in foods and drinks, but the solution is murkier than it seems.

  • Sensitivity varies widely from one person to the next. Researchers attribute this to genetics and weight.
  • Consuming caffeine right after eating a meal can slow down its effect.
  • Nicotine is thought to stimulate enzymes that break caffeine down, so smokers can often tolerate higher doses of caffeine.
  • Espresso doesn’t have more caffeine than drip coffee; it just has a stronger taste.
  • Coffee and espresso at Starbucks have a higher caffeine content than what you make at home or get at a fast food restaurant or another coffeehouse.
  • Chocolate has more caffeine than you think it does (at least more than I thought it did).
  • Green tea has less caffeine than black tea. White tea has even less.

I was only able to figure out my body’s relationship to caffeine by going off it. My strategy is to gradually decreasing the amount that I drank until I was caffeine-free. (Some people go cold turkey, but that’s more misery than I care to bear. The nasty withdrawal headache can last from a few days to several weeks.) After that I played around with different levels of consumption.

What are your experiences with caffeine? Does it help, hurt or is it somewhere in between?


Bizarre & Amusing

I’m still going to make a real post today, but thought you should know there’s a website dedicated to urinals. Where would we be without the internet?

Posted in Coping. 1 Comment »

Happy Birthday to Me!

Most important news: Tonight’s my first post-stimulator yoga class!

As of 7:34 this morning, I am 30. Hart’s working, so we had a great dinner last night and I’ll have dinner with friends tonight.

I went to Top Pot, a local “gourmet” doughnut shop. I’ve always wanted to try their Boston cream doughnuts, but they never have any left by the time I get there. Oh my yum. I sat in the sun and enjoyed the fabulous doughnut and a latte.

My totally self-indulgent trip to England was my birthday gift, so I forbade Hart from buying me anything. He apologized last night, worried that I would miss having something to open. I convinced him not to worry — going to England was, obviously, the best gift I’ve ever had. The crowning glory is that I (legally) downloaded my favorite show and now listen to it all the time.

Today has been great so far and the last year was fantastic, even with my headaches. Here’s hoping next year brings the same.

(The image is from Get Fuzzy. My grandpa asked me if I was up to no good all the time. I wish I’d thought of this response — it’s so perfect.)

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An MD’s Suggestions for Effective Advocacy

Dr. Christina Peterson, headache specialist and founder of HEADQuarters Migraine Management and Migraine Survival, commented on the Effective Advocates post with great advice for all of us:

There is no excuse for doctors or other health care providers to be jerks. However, please be aware that under current HIPAA laws we are somewhat restricted regarding how much information we are allowed to release to anyone who is not the patient without the patient’s written permission. If you are in the room, obviously there is a level of implied consent–unless there is reason to suspect an abusive relationship, which we are also obligated by law to report. And…between 1/5 to 1/3 of women reporting to Emergency Departments have been victims of some sort of sexual or domestic violence or abuse. So–it becomes complicated.

In today’s deteriorating health care environment, the Emergency Department has become something of a war zone, inundated by trauma victims. And with the general lack of awareness and poor attitude regarding the headache sufferer, we tend to fare poorly in the Emergency Department and are treated, at best, as a nuisance, and more often, as a drug seeker. This is why I try to give my patients the tools they need to manage their headaches on their own without resorting to Emergency Department treatment unless they have become dehydrated and require IV hydration.

If you do go to an ER, take an advocate who can remain calm but persistent, while keeping these points in mind–and someone who can educate regarding headache/migraine wouldn’t hurt!

Another point: if you think you might be too impaired to call your physician’s office during a headache, and you are going to want a family member to call on your behalf, please sign a consent form for that person to talk to the physician when you are in the office. We really are not trying to be difficult about this–it’s federal law intended to protect your confidentiality.

Getting Back on Track

It’s easy to beat yourself up after you do something your body doesn’t like. You think you should know better than to have wine with dinner or sleep in or skip the gym to go to a movie. Don’t be so hard on yourself. As ChronicBabe Editrix Jenni reminds us, progress is not linear.

After recent setbacks added up to frustration, stress and depression, Jenni’s figuring out how to get her self-care back on track. She’s got some great insight and a list of pledges that may help you when you slip. And, perhaps more important, she reminds us that berating ourselves does more harm than good.

Update on Beans

Poison_1I’ve finally tested beans as a food trigger and the results aren’t good. The culprit was a delicious black bean breakfast burrito from a meal delivery service. I enjoyed it so, but my head sure didn’t.

In the words of the 80s hair band Poison, better to have loved and lost than to have never loved at. (I know they weren’t the first to say that, but that’s what I thought of when the phrase popped to mind.) In the spirit of sheer denial, I’m holding out hope that other beans might be OK.

Posted in Coping. 4 Comments »

Effective Advocates

When I’m asked about making sure a doctor’s visit is helpful for the patient, my primary suggestion is to take a family member or friend along as an advocate. Overattentive Families May Be Underrated, from the New York Times, illustrates how important it is for a patient to have an effective advocate.

I’m using the term “effective advocate” intentionally. Overaggressive, rude or otherwise irritating family members can harm more than they help.

Trying to help a friend who had been in a car accident, I overstepped that boundary — at least the doctor thought I did. We waited more than two hours for her to have a cast removed. She had a head injury, so was sensitive to sound and bright lights, and she couldn’t stay upright for long without nausea. The waiting room, practically floodlit with fluorescents, was full of patients and, thus, noise.

No rooms were available, so we moved to the bathroom across the hall. There we stayed, lying on the tile floor with the lights out. Periodically I checked on the doctor’s schedule. By the time he got to the room, I was furious and he was none too pleased by my pushiness.

He barely acknowledged her and began to saw the cast off with little explanation. His answers to our questions were curt. When I pressed for more information, he repeated previous answers, closed the chart and bolted out the door.

He was angry with me, but seemed to be and egotistical jerk anyway. What he saw as belligerent another doc could have called assertive. Nonetheless, it was the wrong move in this situation.

I can’t imagine any of my doctors being as rude as my friend’s doc, but Hart is a great advocate. Faking it is my default mode in public. Hart’s assessment of my pain levels are more accurate than mine and he knows I underestimate on pain scales. He also thinks to ask questions that I have forgotten or not even thought of.

Take someone to your appointments if you can, but be sure to choose carefully. While your mom may know you best, a friend can advocate for you without the clouded judgment of a mother who wants her baby “fixed.” The person you take should have accurate knowledge of your pain levels, know what your goals for the appointment are and be able to talk to you about what they got from the appointment.