Hiding Out With Bad Migraines

The last couple weeks have been so bad that I haven’t even updated my Twitter with my headache/migraine status. I’ve had some great swings — particularly after a massage — but they’ve only lasted a short time.

An irritating symptom right now is that I don’t get tired, but completely worn out, which then triggers the rest of the migraine cycle. With diversions like writing posts for when I’m gone in September, sleuthing for cat messes and packing for vacation, I have plenty of opportunities for exhaustion.

I apologize for whining. My bursts of energy ensure that I’m seeing a bright side and I’ve kept myself from being not not happy. But I’m still worn down from the cycle and am ready for it to pass.

I’m sorry if you’ve e-mailed me and I haven’t gotten back to you. You’re on my mind, but I just can’t get to it.

Posted in Coping. 1 Comment »

The Curse of a Nose Made Sensitive By Migraine

Cat_smells
A sensitive sniffer comes in handy to search the basement for presents left behind by the neighborhood cat, who must have slipped in while Hart was taking out the trash. Since one of my migraine symptoms is sensitivity to smell, I’m a natural for the task. Ew.

The cat had to leave more than one gift in the 18 hours he spent there. Right? I’m trolling around our disaster of a basement, trying to find where it might be. The nooks and crannies and junk piled high make the space a cat’s dream. They also prevent me from getting close enough to sniff out the remaining presents.

Some believe that migraineurs always have a keen sense of smell, whether they have a migraine or not. It seems that this belief is held more by patients than researchers. More common is that right before or during a migraine, people have a heightened sense of smell. This could be related to smells being a migraine trigger for many of us. Olfactory hallucinations right before or during a migraine is the idea best supported by research. These tend to be bad smells, like garbage or dog messes.

(An interesting aside: Migraineurs and other people with headache, particularly those who have odor triggers may develop a fear of or aversion to certain smells, called osmophobia.)

Unfortunately, my migraine has worsened. It will be difficult to
tell if I smell real odors better or am hallucinating them.In any case, my scent-sleuthing skills will ensure that I experience all the smells a basement has to offer.

I can’t find good online resources about migraine and smell. If you have any information or want to share your experience with smell, please leave a comment.

What Do You Do With Compliments?

Last week, my friend and yoga teacher used some wonderful adjectives to describe me. We were in class, so all I could do was thank her. There was no chance for me to shrug her off, which I probably would have otherwise. In the meditation at the end of class, her kindness sunk in without judgment or dismissal.

How many times have you been told to “just take the compliment”? Our need to shrug them off is so strong that usually the person who is paying you the compliment has to tell you to shut up and take what he or she is saying. At least that’s how it is for me.

Think about the language I just used. Taking a compliment is merely putting up with what you’re being told. Compare this to accepting a compliment: you not only receive the words from the complimenter, you accept that the description may apply to you. Believing the compliment is exactly as it sounds — and it is really hard to do.

When someone pays you a compliment, they believe what they’re saying, otherwise they wouldn’t be saying it. (OK, this isn’t always true, but think about nice things people have said about you — I bet you’ll find most people have meant what they said.)

I cringe remembering all the times someone told me I was brave to face my illness head-on and I responded that I have no choice. I finally realize that I do have a choice. I could be hiding under the covers or complaining about how how bad I’ve got it.

Self-esteem suffers with the emotional ups and downs of any life-changing illness, which includes migraine and other headache disorders. When someone gives you a boost, believe it! I’m trying to.

Posted in Coping. Tags: . 4 Comments »

Love to ChronicBabe Editrix Jenni

ChronicBabe Editrix Jenni and her husband Steve’s condo was destroyed in Chicago’s storms. The are displaced from their home for at least six months. Please keep them in your thoughts and prayers as they rebuild their home and lives.

To send your love, please leave a comment on this post and I’ll make sure she sees it. That will make her overflowing inbox a little less daunting.

Posted in Coping. Tags: . 8 Comments »

Preventive Drugs Improve Quality of Life for People With Migraine

Preventive medications can significantly improve the quality of life for people with migraine, but their quality of life is still below that of people without migraine. The study tested quality of life for patients taking nadolol (Corgard) and topiramate (Topamax). The article, Impact of Preventive Therapy with Nadolol and Topiramate on the Quality of Life of Migraine Patients, appears in the August issue of Cephalalgia.

[R]esearchers studied 76 consecutive migraine patients at least 16 years of age, evaluating them at the beginning of the study and again after 16 weeks of treatment with nadolol at 40 milligrams per day or topiramate at 100 milligrams per day. The study was completed by 61 of the patients.

The results of the Hospital Anxiety and Depression Scale revealed a mild anxiety state and a moderate depressive state at the beginning of the study, which both remained unchanged after therapy.

The migraine-related quality of life questionnaire score indicated statistically significant improvements with treatment.

Insurance Coverage of Triptans

Insurance_triptans
Insurance is an ongoing nightmare for practically everyone. If you need more triptans (a common type of migraine abortive) a month than your plan allows, you’re in for a real hassle. Without insurance they are, of course, mighty pricey.

Kathy, a reader, is faced with a new bureaucratic hurdle that I’ve never seen before. Her story follows. She’d appreciate any advice you can give.

I just had to share this with someone that could understand, and
maybe you have some suggestions as to whether anything can be done. I was just
informed by my insurance company that I can now only get 4 Maxalt tablets at a
time. I can get 8 per month (down from the 9 per month it used to be) but I
have to go in to the pharmacy TWICE per month. Maxalt is the least troublesome
of the triptans for me and enables me to keep working with a migraine. My
migraines usually last 3 days (requiring 6 Maxalt) and CAN last 5 – 6
days. It is so infuriating that an insurance company can do this.

Their explanation was that studies have shown that most people (?)
only refill their prescription of 9 tablets once every 3 months. 38% of the
prescriptions are never refilled. So they decided that 3 pills is a 30 day
supply. Have you ever heard of anyone being successful in fighting something
like this? Any ideas on what to do?

Even if you don’t have suggestions for Kathy, eave a comment with your story — whether good or bad — about getting the meds you need. I and other readers will certainly benefit from your experience.

Photo by Buster McLeod

Myofascial Release: A Massage Technique for Tissue Relaxation

Myofascial release is one of the new therapies I’m trying now. The three sessions I’ve had have been mentally and physically relaxing. A severe migraine dropped to a mild headache after Saturday’s session. The relief only lasted an hour, but what a wonderful hour it was. I went into today’s session with a severe migraine and left with a mild one. Nearly three hours later, the pain is hovering between mild and moderate.

Never heard of myofascial release? Neither had I until a reader mentioned it to me. It’s a massage technique that uses friction and sustained pressure to release fascia. Fascia is a connective tissue that envelopes or binds internal body structures to support, separate and protect them.

Normal fascia is relaxed and stretches and moves easily. Injury, tight muscles, hunched shoulders and slouching contribute to tightening fascia. Effects are cumulative, so repetitive motions or bad posture stiffen fascia more and more over time. The therapy seeks to release the fascia, returning it to a relaxed state.

It may seem strange to target connective tissue to treat headaches. Is there anyone who has headaches or migraines, but completely relaxed muscles? Tight muscles indicate that fascia is tight, too. (That’s my take on it at least.)

Whether my constantly tight neck, jaw and shoulders is a result of my migraines or a trigger of them (or both), they are still sore. The therapy won’t cure my headache disorder, but it may reduce the intensity of my headaches. At the very least, it soothes the pain in my shoulders and neck.

As with nearly every alternative or complementary therapy, myofascial release is often called
quackery. Whatever. It feels good and helps me unwind more than other types of massage ever have.

Physical therapist John F. Barnes, a practitioner and educator of the technique, has an in-depth explanation of myofascial therapy and fascia. (I know nothing about him as a practitioner or his clinics, but the explanation fits with what I’ve learned from my massage therapist.)

Why Women Have More Migraines Than Men

Three times as many women have migraine as do men. That translates to 18% to 25% of women worldwide. A new study shows that this discrepancy might be because women’s brains are faster to activate the cascading waves of activity thought to cause migraine pain and other migraine symptoms.

The strength of the stimulus required to trigger these waves of activity, called cortical spreading depression (CSD), was two to three times higher for men than for women. This excitability indicates that women’s propensity toward migraine is linked to more than just menstrual cycle.

I have the mental ability of a three-year-old today. See A Woman’s Brain Wired for More Migraines? from CBS/WebMD and Why Women Get More Migraines Than Men, a UCLA press release, for details.

Posted in Biology, News. Tags: . 2 Comments »

Cluster Headache Drug Verapamil May Cause Heart Problems

People who take verapamil for cluster headaches may be at greater risk of irregular heartbeats than those who don’t, according to a study published in the August issue of the journal Neurology. Researchers recommend that those who take the drug should have frequent EKGs to watch for possible heart problems.

The study of 108 people with cluster headache specifically looked at high doses of verapamil. 21% showed an irregular heartbeat while taking high dose verapamil. 37% of participants had slower than normal heart rates while on the drug. Most cases were not considered serious.

The study abstract and the press release from the American Academy of Neurology (below) provide details.

Drug for Cluster Headaches May Cause Heart Problems

ST. PAUL, Minn. – A drug increasingly used to prevent cluster headaches can cause heart problems, according to a study published in the August 14, 2007, issue of Neurology®, the medical journal of the American Academy of Neurology. Those taking the drug verapamil for cluster headaches should be closely monitored with frequent electrocardiograms (EKGs) for potential development of irregular heartbeats.

Cluster headache is a rare, severe form of headache that is more common in men. The attacks usually occur in cyclical patterns, with frequent attacks over weeks or months generally followed by a period of remission when the headaches stop.

“The benefit of taking verapamil to alleviate the devastating pain of cluster headaches has to be balanced against the risk of causing a heart abnormality that could progress into a more serious problem,” said study author Peter Goadsby, MD, PhD, DSc, of the National Hospital for Neurology and Neurosurgery in Queen Square, London, UK, and the University of California, San Francisco and a member of the American Academy of Neurology.

The study involved 108 people with an average age of 44. The participants started taking verapamil and then had an EKG and an increase in the dosage of the drug every two weeks until the headaches were stopped or they started having side effects.

A total of 21 patients, or 19 percent, had problems with the electrical activity of the heart, or irregular heartbeats, while taking the drug. Most of the cases were not considered serious; however, one person required a permanent pacemaker due to the problem. A total of 37 percent of the participants had slower than normal heart rates while on the drug, but the condition was severe enough to warrant stopping the use of the drug in only four cases.

Goadsby noted that 217 people taking the drug were initially supposed to take part in the study, but 42 percent of them did not have the EKGs done to monitor their heart activity. “Many of them said either they or their local services were reluctant to undertake such frequent tests, or they were not aware of the need for the heart monitoring,” he said. “Since this drug is relatively new for use in cluster headaches, it’s possible that some health care providers are not aware of the problems that can come with its use.”

emphasis added

Caffeine Withdrawal Headaches

Caffeine_withdrawal_headaches
Caffeine can be a wonderful headache and migraine abortive. Use it too much and the withdrawal headache can be an unspeakable hell. Good thing I was in need of a post topic for today when the caffeine headache fairy visited me last night.

As with all of my abortives, I use caffeine no more than twice a week. Less than once a month I indulge when I need energy or really want coffee and the only decaf available is chemically processed. I stretch these rules when I’m traveling or have something big going on. Like when my niece was here last week.

I’ve been testing my caffeine boundaries in the last couple months anyway. I noticed in May that it didn’t seem to be working as well as it used to (and neither was Advil, my other abortive of choice). Before I realized I had a headache disorder, I drank caffeine when I felt a headache coming on, thinking that I was staying on top of caffeine withdrawal. Hart maintains — and I’ve come to agree — that the caffeine aborted migraines, not treated caffeine withdrawal headaches.

So I haven’t been as strict with my rules in the last couple months. Then when my niece was here, I was even more lax with my caffeine intake. After she left, the old guidelines didn’t kick in. And last night I had a horrendous caffeine withdrawal headache.

I assumed it was a migraine, even though it felt different than migraines that have been plaguing my sleep for the last year. I tried to sleep it off, but felt worse each time I woke up — not characteristic of my migraines at all. At 12:45 this afternoon, I finally acknowledged that I had a caffeine headache and dragged myself out of bed to medicate.

90 minutes later, I’ve finished my cup of tea. It took the edge off, but the dramatic soothing that caffeine brings to a withdrawal headache was absent. Maybe it was a migraine all along. In any case, I have a post written and now I can go back to being like the man who has been hiccuping for 45 years: