Your Medication Didn’t Work: The Surprising Reason Why
Today’s podcast will focus on something everyone taking medication needs to be aware of – gastric stasis. This is especially important for migraineurs – find out why…
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Needing Your Input: Migraine Diary via Mobile Phone
What if keeping a headache or migraine diary was easy, fast, and you could do it from anywhere? What if it was all electronic, so that you could get instant trends and statistics? What would your perfect diary look like, and what would it include?
I recently got an email from Jacqueline, a Canadian studying in France. She’s working on developing diaries for people with chronic illness, and became especially interested in migraine patients.
Her idea is to take advantage of the internet, and mobile phones, to better collect and use information.
Knowledge is power, folks. Not just for the individual patient, but for all of us who share the knowledge with one another.
Jacqueline wants to give you the opportunity to give suggestions. What would it take for you to use a diary like this? What would make it useful? What kinds of information would you want to include?
You can give your input by taking part in the survey now (it’s short):
We’ve talked about different diary options before. Check out Headache or Migraine diary – by phone? and Calculating triggers online? For a paper version that I find useful, check out this diary headache migraine solution.
Hopefully Jacqueline will keep us up to date on how this project develops!
Juice and Blood Sugar Spikes
Many changes in the body seem to have the potential to trigger a migraine attack. One of the familiar ones is changes in blood sugar levels.
For example, skipping a meal is notorious for triggering migraine attacks. But you are also asking for trouble if you eat, or drink, the wrong things.
Anything that may spike your sugar levels, causing them to plummet soon after, could cause a problem. When it comes to migraine, children and adolescents seem to be the most susceptible, but really this applies to anyone.
We’re most familiar with the food side. Avoid sugars and white flours, stick to fruits, veggies, grains, nuts – small snacks of proteins and complex carbohydrates (the ones that break down slowly, not suddenly).
 Photo courtesy of ximenacab |
But with all this talk about food, we sometimes forget drinks. You’ve probably heard before that a glass of apple juice has more calories and carbohydrates than a glass of Coke. And natural sugars can cause just as much of a sugar spike as added sugars.
So – what to do? Some ideas for you:
- Try to drink your juices and other drinks with sugar during a meal. Don’t drink them by themselves – at least include a healthy snack.
- Have half a glass of 100% juice, and half a glass of sparkling mineral water. Fun, classy, and only half the sugar!
- As much as possible, eat an actual piece of fruit instead, or a vegetable. Crazy, I know – but they come all packaged up with fibre, and are a lot better for you. Some of the best fruits for a migraineur are apples, cantaloupe, and mango.
Another reason to be cautious about juice: taking your medication with some juices could be dangerous.
FDA Warning: Reglan (Metoclopramide)
On the 26th of February 2009, the FDA issued a warning about metoclopramide, commonly sold under the brand name of Reglan, as well as many others (Clopra, Maxolon, Reclomide, and Octamide). The warning is for patients taking high doses, or taking it over the long term.
Reglan is commonly used for migraine, particularly migraine in children, because of its ability to treat both nausea and pain. It also is given along side other migraine medications, because it can help them absorb better.
It is an antiemetic and gastrointestinal stimulant, and is also prescribed for things like gastroesophageal reflux disease (GERD), stomach ulcer, and even to increase milk production in nursing mothers.
The FDA warning says that too much metoclopramide can cause tardive dyskinesia, which causes patients to make involuntary, repetitive, purposeless motions. This has actually been known for some time, and there are other drugs that cause the same thing. However, according to the FDA press release, a recent analysis has suggested that metoclopramide is the most common cause. The symptoms often go away several weeks after the medication is stopped, but not always. The effect can be permanent.
The concern is especially with patients who are taking metoclopramide for more than three months. If you’re taking an unusually high dosage, or are taking the medication regularly over a long period of time, be sure you know the risks.
The concerns about Reglan are just a reminder that many drugs that are fairly safe for a short period of time can cause problems over a longer period. More is not always better. Be sure to know the risks, and take your medication only as directed by a doctor who understands your medical history and knows what other medication you’re taking.
Cluster or Migraine: What’s the Difference?
Spending a bit of time on Twitter lately, I’ve noticed that there still seems to be quite a bit of confusion over what migraine is, as opposed to what cluster is.
Sometimes in the past the two have been used interchangeably. Or sometimes, just based on imprecise information. For example, sometimes people think of any bad headache as a "migraine headache", or think of certain types of pain as a "cluster headache".
In reality, these two are very different, and require different types of treatment. Let’s take a quick look at cluster and migraine, and see if we can clear up a few misconceptions.
Similar
Different
Very Different
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Similar
Different
Very Different
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You’ll see right away that I used terms like "usually" and "typically" a lot, and I probably could have used them more. There is a lot of variation from person to person, so we’re just hitting on some of the more common, typical traits of each. But just a reminder – either of these can include pain that’s not just on one side, sometimes there is no pain in migraine, sometimes it’s not throbbing pain, etc.
Key differences
You can see highlighted some of the key differences between migraine and cluster. Cluster headaches come on faster and leave quicker than migraine attacks. It’s unusual for a migraine attack to last less than 4 hours, and unusual for a cluster attack to last more than 3 hours.
Another key difference – migraine patients tend to avoid light and movement. They’ll often go lie down in a dark room.
That’s the last thing a cluster patient wants to do – good luck getting them to lie down! They become restless and may rock or pace.
But the last highlighted item is especially key. Clusters get their name not from where the pain is or what it feels like, but from the cycles of pain.
You’re not going to get just one cluster headache. You’ll get several in a series – maybe one a day, or several a day, regularly. This can go on for weeks and even months, but then completely disappear for months or years.
Sad to say, there are also chronic cluster headache sufferers who have no periods of remission (as this recent news story on cluster headache illustrates).
Hopefully that clears up some misconceptions, especially regarding cluster. Cluster is an incredibly painful condition. There is treatment for cluster, but the treatment has had limited success in many people. Much more research needs to be done to fight what has been rightly called the suicide headache.