Monday, November 29, 2010

Migraines

If you're anything like me, then you've experienced migraines for many different reasons. People are always looking for cures and remedies.

Well, in the 11+ years I've been dealing with them, I've found the easiest way to deal with them is to discover the trigger and eliminate that trigger from your life.

Before I get into that, I thought I should help answer a question some readers might have: How do I know I have a migraine and not just a regular headache?

Well, it's usually subjective because, despite what some people might think, not all migraines are the same, and not every migraine will display every symptom.

Huh?

Let's start with the symptoms of migraines (taken from the Mayo Clinic website):
- Moderate to severe pain, which may be confined to one side of the head or may affect both sides
- Head pain with a pulsating or throbbing quality
- Pain that worsens with physical activity
- Pain that interferes with your regular activities
- Nausea with or without vomiting
- Sensitivity to light and sound

Many people tend to think that migraines come with sensitivity to light and sound as well as nausea and/or vomiting.

That's not true. Basically, the term migraine is used to describe the level of pain. Minor headaches tend to be dealt with by Tylenol, Advil (Ibuprofen) or Aleve (Naproxen Sodium). It's when these medications don't work, or don't work for long that should be an indicator that you might be suffering from migraines.

Okay, if I think I'm suffering from migraines, should I just take that over-the-counter (OTC) Excedrin for my pain?

Well, only your doctor can help you with that.

Why shouldn't I just take it without going to the doctor?

Because persisting headaches can be a symptom of something much worse, and only a trained medical physician can truly make that distinction.

Besides that, most medical websites, like Web MD will tell you that caffeine can hurt as much as it might help your migraine pain.

Many OTC painkillers do contain caffeine, even in small amounts. The problem with regular caffeine consumption is that it's addictive and causes withdrawals. Even though you're only talking about painkillers, unless you drink water only and eat zero chocolate (no chocolate, tea, soda or coffee - even decaf varieties have some caffeine in it), then chances are you have a bit of caffeine in your system.

Not only that, but the more you use these OTC varieties to treat your headaches, the more likely you are to suffer headaches caused by these pain relievers.

How do I know this?

Well, for over 20 years of my life, I was a soda drinker. Not just any soda, but Coca Cola Classic regular. I love the soda, but my body wasn't loving it, so I figured it was time to quit. So I did on roughly October 16th, 2010.

I feel like I've been paying for it ever since. Well, when I first went off, even though I was drinking iced tea to keep caffeine flowing into my system, it wasn't nearly enough and I soon suffered withdrawal symptoms which lasted a little less than a week.

However, the extensive amounts of caffeine I was consuming (4 to 8 cans a day at 35mg caffeine per can, according to wilstar.com) must have been keeping the headache pain I'd been dealing with at bay because once I got over the withdrawal symptoms, I started suffering from one long continuous headache that quickly morphed into a continuous migraine.

I say "feel like" because I figured out that this never ending migraine I'm currently dealing with is really from a sinus infection of some sort, and I must have had it for some time, but never really felt it.

Now I know I Suffer from Migraines, What do I do?

This leads me to my next point. You need to find the trigger for your migraine and eliminate it.

Right now, for me, the cause of my never ending migraine is my sinus infection. Before the migraine will stop, I need to take care of the infection. My doctor gave me doxycycline. It's not working. It only serves to increase the headache pain and the nausea and I soon learned after missing a dose last night that it's not working one bit. I stopped taking it because it's stupid to continue meds that aren't working or making other symptoms worse. (I did call my doctor and let him know this.)

However, there are many other triggers that cause migraines as one can find on the Mayo Clinic's website:
- Fluctuations in Hormones (mainly women) as in during menstruation, pregnancy or menopause.
- Foods are a Huge Problem for both sexes:
1. alcohol (beer and red wine)
2. aged cheeses (sharp, x-sharp, etc.) www.oukosher.org has a nice list of aging times
3. chocolate
4. aspartame (I'm tempted to put all artificial sweeteners here, including Splenda)
5. excess caffeine
6. monosodium glutamate (msg), but I wouldn't rule out other flavor enhancers such as disodium inosinate and disodium guanylate. READ FOOD LABELS TO BE SURE NO FLAVOR ENHANCERS ARE USED!
7. salty foods
8. processed foods
- Skipping Meals
- Stress
- Sensory Stimuli
1. bright lights
2. sun glare
3. loud sounds
4. aromas or strange smells - perfume, food, secondhand smoke, paint thinner
- Changes in Sleep Patterns
1. too much
2. too little
3. change in pattern due to changing work shifts
4. jet lag
- Intense Physical Exertion
1. extensive exercise or training
2. sports
3. sexual activity
- Environmental Changes
1. weather
2. barometric pressure
- Medications
How Do I Determine My Triggers?

Don't know which ones do? Then you must determine the answer through trial and error. You may not like all varieties of cheeses, but try the ones you do to see if any of them might be a trigger.

The best way to determine which foods, activities and stressors are triggers for you, you need to keep a journal of everything you eat, when you eat it (save food labels or write down all the ingredients), how much you eat (few sips, a cup, a bowl, a slice, etc) and what you do (e.g. - fly, play video games, spend time outside on a bright day...).

Not only do you need to keep track of food and activities, but you need to keep track of your sleeping habits and the amount of stress. Write down your personal feelings as your feeling them - try to list exact times - because those could be indicators of the types of headaches you're dealing with, including migraines with aura (visual indicators such as flashes of lights, zigzag patterns or blind spots).

It's important to be able to make this distinction because the treatment/prevention is different - again, talk to your physician and bring your diary with you (it's best to give a copy of the diary to your doctor so he/she can study it, he/she may ask for it, but not always).

Once you figure out your triggers and begin to eliminate them from your diet, others may surface, which is why it's always important to continue to keep track of your eating habits and activities.

Trial and Error

Food diaries are great, but they can't always tell you exactly what food or additive might be causing your migraines. That's where trial and error comes in.

Once you know your questionable foods, you need to isolate your body's reaction to each one because, it might not be just one of your favorite foods, but a combination of them. You isolate your body's reaction by having a diet consisting of foods with no known triggers in them, and then for about a week (you may need much less time) or at least a 5 days.

Why at least 5 days? To eliminate the possibility of a stray headache or migraine. You need to be sure that the migraine is caused by the food you're consuming, and 5 to 7 instances is the best way to indicate a surefire trigger.

For most of the foods, eliminating them from your diet is the best course of action. However, if you (like me), realize that only the most aged cheeses can give you problems, then you must eliminate them from your diet or severely limit them to once in a great while. Look at the aged cheese list from www.oukosher.org and make a list of the cheeses that tend to cause migraines the most. Again, trial and error is the best method to determine what foods bother you.

In Depth Look at Triggers and What they Mean

Not every person has every trigger, which is another reason why it's important to know your triggers and not just assume that what's on the above list is a trigger. To help you get an idea of what I'm talking about, I'll give you some of my experiences.

For example, I've found that mass produced beer (especially pale lagers) or poorly made microbrews tend to aggravate my migraines. As long as I drink water while I'm drinking my favorite craft beers I can usually wake up pain free. But it must be more than one glass. I find at least 3 glasses of water works best. Yes, you might get up frequently to pee, but better that than a migraine! :)

For years, I've been able to eat chocolate without much recourse. In fact, I love dark chocolate. Unlike most women, I never craved chocolate during my menstrual cycle and I could take it or leave it. However, in the past year, I began to crave it during my menstrual cycle, and it became a migraine trigger. That means new triggers can develop all the time, just like food allergies.

Something interesting I found out is that I can't consume artificial sweeteners like splenda or aspartame because they do give me headaches or make me feel all around crappy. However, natural sugars (sucrose, lactose[milk sugar], dextrose[malt sugar]) and honey are fine.

Let's talk about a trigger we may not be considering - computer usage and video games.

That's right. Computer usage falls under the category of sensory stimuli. That's right video games, emails, websites - especially those annoying flashing ones - can cause migraines. Limit your usage, dull the brightness on your screen and you may reduce the risk of your computer/video games causing migraines. Also, avoid games with lots of flashing light/graphic effects because those are the worst offenders.

Let's not forget TV shows and movies. The more action and CGI graphics involved, the worse it can be, especially if those graphics move quickly, change view point too quickly or are too bright (explosions, or bright lights).

I'm not saying give it up altogether, just limit them. I have to avoid anything visual that flashes, like a camera, strobe light, etc or I will suffer from a migraine.

Aromas can be one of the quickest triggers, especially if you suffer from allergies. I can end up with an instant headache when in the presence of smoke of any kind or strong perfume. If I don't exit an area immediately, I will end up with a full-blown migraine.

Living in Wisconsin and growing up eating cheese, I find it hard to give up cheese altogether. For this reason, I've tried many different cheeses.

I can eat mozzarella, provolone, mild and medium cheddar, Widmer's mild brick (this cheese is awesome!), Colby and Monterey Jack. Of course, all the caffeine I've consumed on a regular basis may have hidden the headaches so I never knew they were triggers, so we'll see.

How do I Deal With Migraines?

Outside of changing your diet and activities to avoid stressors, there's not much else you can do. Of course there are painkillers like Imitrex (Sumatriptan), but they do take time to kick in.

Some people like to use a heating pad. I don't, and I don't recommend it either. Here's why:
Most headaches are caused by enlarged blood vessels passing through your regular sized veins or regular sized blood vessels trying to navigate tightened or narrowed veins.

Heat tends to excite most molecules, making them move farther away from each other (expand or enlarge). In muscles, this effect is akin to inflammation. In a sense, that's what's going on, inflammation. Heat can make inflammation worse, especially with a headache. The reason I feel heat doesn't work the best is because if your vessels are the enlarged particles, the heat will only serve to excite and engorge the vessels further, causing even more pain.

I find ice tends to work best because it does two things: numbs the area in pain and shrinks the blood vessels and can shrink the veins if they are inflamed.

What about you, what are your triggers?

Any questions I didn't answer? Don't be afraid to ask them.

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