James

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Posts by James Cottrill:

8 September 2016

Is Your Child With Migraine Tired and Depressed?

Is your child, who has migraine attacks, also tired and depressed? I don’t mean just during a migraine attack, but a lot of the time.

Empty Desks: How many students are missing school due to chronic illness this September?

It is critically important to be aware of other symptoms besides the obvious ones, like headache and nausea. Why? Because, as with adults, migraine doesn’t always come alone, it brings its “friends”.

A recent study on children with myalgic encephalomyelitis (also called chronic fatigue syndrome) highlights the need, once again, to be aware of other symptoms.

In the study, patients with both ME/CFS and diabetes were studied. What other symptoms/disorders/diseases did they have? It may not be surprising that many also had migraine. Other common symptoms were depression, weakness, muscle pain and the obvious one – fatigue.

Almost half of the patients were dealing with general tiredness for a year before they were actually diagnosed with ME/CFS.

Another interesting finding – many had had an infection (such as infectious mononucleosis) in the two year period before their diagnosis with ME/CFS.

In other words, if your child just doesn’t seem to be getting his or her energy back, there may be a good reason. Their infection may have be related to longer term problems.

It’s very hard, especially in children, to recognize symptoms – especially when there are a bunch of symptoms happening together. It’s easy to focus on the most debilitating ones.

But the more we can be aware – both as children and adults – of the various symptoms we may be experiencing, the shorter the path will be to good treatment.

Study abstract: Comorbidities treated in primary care in children with chronic fatigue syndrome / myalgic encephalomyelitis

5 September 2016

More Research on Vagus Nerve Stimulation (and a video)

James Discoveries & Stats, Treatments 0

If you could get rid of just one day of migraine agony, would you? Of course you would. But what’s the best way to do it?

One of the new treatments for migraine that is being developed, and even used today, is vagus nerve stimulation.

gammaCore non-invasive vagus nerve stimulation Now this type of treatment has actually been around for a while. A device is implanted that stimulates the vagus nerve, which runs on two sides of the body from your brain stem through your neck, chest, and abdomen. This type of treatment is used for hard-to-treat cases of epilepsy and depression.

But the latest thing is non-invasive vagus nerve stimulation, which means no surgery, and no implants.

A company known as gammaCore has developed such a device, which is already sold in Europe and Canada, though not yet approved in the United States.

So far, the device has certainly helped people with both migraine and cluster headache. And the bonus is that the treatment is very well tolerated, with few side effects. Plus, it takes less than 2 minutes to use.

A new study of the device showed some improvement in patients (see Chronic migraine headache prevention with noninvasive vagus nerve stimulation). After 2 months, almost 10% of the patients had a 50% treatment response. They basically had a day or two that were migraine-free, which otherwise would not have been. (These were patients chronic migraine, so originally they had at least 15 days with migraine attacks per month, some with attacks almost every day)

The interesting thing about this study was that patients continued to improve over 8 months. After 6 months, patients had 6-7 more days symptom-free. And after 8 months, 7-8. Would the improvement continue? It looks like it might.

So researchers are preparing for longer and better trials.

To see what using the device is like, take a look at this video:

1 September 2016

Getting the SpringTMS device for Migraine (and a video description)

James Tips, Treatments 0

It’s been a while since we talked about SpringTMS, so it’s time to bring it up again. SpringTMS is a transcranial magnetic stimulation (TMS) device which you use as soon as you feel a migraine attack coming on.

Devices like SpringTMS are increasingly popular because they lessen your need for medication, they’re easy to use, and there are few if any side effects. Of course the main benefit is that, in many patients, it stops the symptoms of migraine. Read more about SpringTMS here.

SpringTMS The device is currently available in the USA and the UK. I’m not sure about its availability or the logistics of getting it elsewhere, but if you have experience outside of the UK or US leave a comment.

In the UK, SpringTMS is available by prescription through a cost sharing program. It’s available at certain clinics in London and other locations in England. For more information, visit the official UK website here. The company is eNeura.

In August, Kerrie Smyres did the legwork for us to get information about obtaining (and paying for!) the device in the USA. Essentially, SpringTMS is available by prescription under a rental program, and so the price will vary depending on the rental plan. There may be reimbursement through your insurance plan.

But I will let you read Kerrie’s post for more details. Some of the information is applicable in the UK as well, so check it out if you’re interested: Your Guide to Getting a Spring TMS

The official US website is here.

Here’s a video made for US customers about the device:

29 August 2016

Magnesium for Migraine: More Study Needed

James Tips, Treatments 1

We’ve talked often about magnesium for migraine, as one of the best treatments for migraine available today. As with any treatment, however, it works for some people and not for others.

Of course, in spite of our clumsy comparisons of the body with a machine or a computer, each human body is actually incredibly unique and complex. So nailing down the “whys” is sometimes almost impossible.

Fatigue: An early sign of magnesium deficiency

Part of the reason may have to do with the level of deficiency in each person. A magnesium deficiency may contribute to migraine attacks in some patients, but not all actually have a deficiency.

There are many other factors as well. The type of magnesium, when you take it, what you take it with (for example, if you’re taking magnesium for migraine, avoid taking it along with calcium) (more tips here).

Dr. Alexander Mauskop at the New York Headache Center has shared some interesting observations, which point to the need for further research into magnesium for migraine.

Here are some of his thoughts:

Magnesium seems to help less than 50% of migraine patients (Dr. Mauskop feels that this is because the rest do not absorb the magnesium).
About 90% of patients with an actual magnesium deficiency improve with magnesium supplements.
The other 10% require regular infusions of magnesium, and “these infusions are often life-changing”.

Now there is another interesting new observation here. Of these last 10%, two patients recently noticed a significant difference between two methods of infusion. Dr. Mauskop explains:

These patients tell me that when we give them an infusion of magnesium by “slow push” over 5 minutes they get excellent relief, but when they end up in an emergency room or another doctor’s office where they receive the same amount of magnesium through an intravenous drip over a half an hour or longer, there is no relief.

A likely explanation is that a push results in a high blood level, which overcomes the blood-brain barrier and delivers magnesium into the brain, while during a drip, magnesium level does not increase to a high enough level to reach the brain.

Essentially, and this seems to be the case sometimes with sumatriptan as well, two patients may take the same amount of medication or magnesium, but one has a “quicker” dose. The one who has the “quicker” dose responds better than the other patient.

While we wait for more studies to be done (and a good question is – does generic plain old inexpensive magnesium get the funding that the fancy new medications do?), how can we use this information?

First, if you have tried some magnesium supplements without success, consider actually being tested for a magnesium deficiency. If you are deficient, it will definitely be worth trying more magnesium options, even if it takes time.

Second, remember that there are a lot of options when it comes to magnesium treatments. Try some different supplements, and consider talking to your doctor about infusions.

Finally, if you do receive infusions, ask about the 5 minute “slow push” method that Dr. Mauskop mentions. It may do more to stop those symptoms than the slow-drip method.

For tips from our community, check out:

For the full article from Dr. Mauskop, see More on intravenous magnesium for migraines, muscle cramps, PMS, and other symptoms

25 August 2016

10 Highlights from the past 3 Months (August 2016 edition)

James Highlights 0

August will soon be coming to an end, so it’s time to see which posts have generated the most interest over the past three months. Here they are – the most popular first. The three in bold currently have the most “likes” on Facebook.