A Joyous Return to Yoga

Last week I went to my first yoga class in more than a year. It was amazing.

My body felt better. My mind felt better. My head even felt a little better. At home, my practice is always half-hearted and rushed. It is more about getting through what I need to do. What I’ve always loved about yoga is focusing on the good my body can do instead of how my health drags me down. I feel strong and whole. I haven’t found that in my home practice, but I felt it in class.

Maybe because I felt safe with the teacher walking me through everything I had to do. I pushed myself, but gently. My neck and shoulders, already loosened up after a massage on Monday, felt better than they have in a year. Seriously.

Having only a few good hours most days, usually in the morning, has kept me from class. If I devote that time to class, then I don’t get anything else done. Tuesday I went to class, then had a great rest of the day. More energy and strength followed. I got my good hours and then some.

Maybe it was a fluke, but Monday and Tuesday were great days. I felt good physically and mentally. I’d like to attribute it to massage and yoga. Or maybe it was the return to exercise, as not exercising contributes to headaches. (Although I doubt one day made much difference!)

In any case, I’ve planned a new routine. Such plans aren’t usually successful for me, but I think I can do this. Massage at 9:30 a.m. Monday and yoga in that time slot on Tuesday and Thursday.

Just like that I swung from despair to hopefulness. I’m trying to temper my excitement, but it is hard. Not only did I do something I love last week, I think it actually helped my head. *fingers crossed*

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Negative Thoughts, Part Two: If Only I Worked Harder…

There’s a common wisdom that illness can be overcome through hard work. Work is definitely involved, but effort isn’t the only factor. I know this, just as I know I’m not lazy or faking it. I also know I work really hard to improve my health. Still there’s a nagging thought: I must not be getting better because I’m not dedicated enough.

To reassure myself, I looked at the review of my 2007 treatments and treatments I planned for 2008. The lists are so long I tire remembering all appointments I’ve been to. This should be proof that I’m trying to get better. Too bad my inner perfectionist tells me I should be able to do more, no matter what the project.

During my (mild) meltdown last night, Hart asked how he could help. I asked him to tell me that I do work hard at getting better. He looked so pained when he told me I work as hard as I possibly can. Having him say that was so reassuring. If he thinks I’m trying hard enough, I must be.

I wish I didn’t need outside confirmation for things like this. Ha! That sentence makes me laugh. Of course I’m too stubborn and independent to ask for help. Of course I want to do it all on my own. I simply can’t — none of us can. Maybe I’ll remember that for a few days at least.

And maybe I’ll remember I’m working my butt off to get better.

What’s With My Head: New Headache Specialist, Menstrual Migraine, Allergies & Reading

New Headache Specialist
I saw the headache specialist several readers have recommended and really liked him. After more than two hours with me (we had to schedule a second appointment to fit it all in!) he speculated that some of my headaches are actually caused by new daily persistent headache. In the past, my chronic daily headache was always attributed to migraine transforming to everyday.

Although the doctor wants to see me monthly, the next available appointment is in March. Before then I’m supposed to get a lumbar puncture (spinal tap) and more blood work. My last lumbar puncture resulted in a three-week headache and wasn’t responsive to a blood patch. I’m not looking forward to it.

Menstrual Migraine
I got a birth control pill prescription to see if it will manage the two-day migraines I get when my period starts. In typical fashion, I haven’t filled the prescription. The migraine that kept me in bed my first two days of vacation in Mexico should motivate me to to take it to the pharmacy.

Allergies
After always feeling worse after vacation, I finally admitted my headaches and migraines are worse in Seattle than elsewhere. I was in Kansas for a funeral the last weekend of October. I was shocked to wake up two mornings in a row with a barely perceptible headache. Nor was I as congested as I always am at home. I took Zyrtec for a few days and both my congestion and migraines were less. Not a reliable experiment. It unfortunately made me nauseated, so I couldn’t keep taking it. I’m trying Claritin now.

When I was tested for allergies when I was 14, I responded most strongly to mold. That wasn’t an issue in Phoenix — quite the opposite in Seattle. Studies indicate than while allergies don’t cause headache, they can trigger migraines. Thursday I’m seeing an allergist and will probably get tested for allergies. Maybe she can sort something out.

Migraines Triggered By Reading & Working on the Computer
These are still in full-force, hence my infrequent posts. A loved one who is an ophthalmologist gave me a thorough vision and eyestrain exam when I was in Phoenix for Thanksgiving. The diagnosis was convergence insufficiency. That means:

Convergence insufficiency occurs when your eyes don’t turn inward properly when you focus on a nearby object. When you read or look at a nearby object, your eyes should turn inward while you focus, so you can see a single image. But if you have convergence insufficiency, you need to use extra effort to move your eyes inward for focusing. This extra effort results in various symptoms, including eyestrain.

I’m now using an eye patch when I read or am on the computer. So far, I’ve been able to squeak out about an hour on computer with it. I still get a headache if I push it, but it is mild and doesn’t explode into a migraine. If the eye patch continues to be OK, I’ll get prescription reading glasses with a prism, which I can wear over my contacts.

Generic Injectable Imitrex (Sumatriptan) Now Available

The generic version of Imitrex Injection (called sumatriptan) is now shipping in the US. I don’t know if it is available in other countries, nor do I know when/if the tablets will be available. I doubt all pharmacies have it in stock yet. I recommend calling your pharmacy before taking your prescription in.

From Par Phamaceutical’s press release:

Par Pharmaceutical Begins Shipment of Sumatriptan Injection
November 6, 2008 – Par Pharmaceutical Companies, Inc. today announced that it will begin shipping generic versions of Imitrex® Injection (sumatriptan succinate injection) 4mg and 6mg starter kits and 4mg and 6mg prefilled syringe cartridges to the trade immediately.  In addition, Par anticipates launching the 6mg vials early next year.

Maybe Birth Control Pills Would Be OK

Talking to Hart about hormonal birth control, migraine and stroke risk got me wondering what my risk really is. If it is low, multiplying the number by eight isn’t that big of a deal. Kersti explains this well in her comment on the post:

[T]he problem with statistics is that they’re misleading. 8 times more likely… 8 times what? You need to find out what the baseline actually is, and you need to find it out for your own ethnicity, gender, circumstances before you know if this is a problem. If for example the baseline is 10% then 8 times is pretty ghastly, however, if the baseline is 0.01% then you’re still at 8 times 99.92% likely to NOT get one.

I’m kind of embarrassed I didn’t think this through before I wrote the post. I’m always urging readers to think critically. No matter how much I recommend caution, I too fall into the trap of fear. “Stroke? Eight times more likely? No way!” is how I reacted yesterday.

According to the American Heart Association’s stroke risk factors, I’m at very little risk. That’s reassuring. I’ll talk with the doctor on Monday and see what she recommends.

Check out the this BBC article on understanding — and critically evaluating — statistics, which Kersti suggested.

Sorting Out My Hormonal/Menstrually Associated Migraines

As the frequency of my migraine episodes has reduced this year, I was finally able to tell that I always get a migraine the first and second or third day of my period. Today once again provided confirmation.

My plan was to try hormonal birth control, like the pill, as a preventive. Researching this post has me reconsidering. Turns out women with migraine who use birth control pills are eight times more likely to have a stroke than women who don’t. This applies to everyone with migraine, not just those with aura (who are twice as likely to have a stroke than migraineurs who don’t have visual auras).

Other treatment options exist. Most of them I’ve already taken without success. Magnesium, which I think is responsible for decreasing the frequency of my migraines, is a common treatment. Unfortunately I’m already at the highest dose of magnesium I appear to be able to tolerate without extreme nausea.

I found on headache specialist Christina Peterson’s website that a small study of black cohosh shows it may be effective in treating menstrually associated migraine. Because there has only been one study, there is no confirmation that it works. Nonetheless, I’ll be researching black cohosh extensively. It is in the same family as rununculus, one of my favorite flowers — maybe that’s a sign it will help my head!

I thought hormonal birth control would be the ticket. A stroke would certainly be worse than having two more migraines a month.

If your migraines are associated with your menstrual cycle, please let me know if you’ve found an effective treatment. Leave a comment below or respond to the forum post with your suggestions.

Clinical Trials for Treating All Sorts of Headache Disorders

ClinicalTrials.gov is the place to go if you’ve considered participating in a clinical trial for your headache disorder, These are just the latest in 142 headache studies recruiting participants or will be recruiting soon.

Nearly every headache disorder is represented: cluster, tension-type, post-traumatic, migraine, cervicogenic, lumbar-puncture, medication overuse (rebound)…. Treatments range from medication and surgery to diet, coping skills training, relaxation, meditation, yoga, exercise… Again the list goes on.

The diverse collection of current studies include:

Even if you’re not interested in any of these studies, checking the government’s clinical database regularly may turn up something new that works for you. Searching for “headache” gets the most results, but you can also search by specific headache type. For example, there are 74 active studies on migraine and seven on cluster headaches.