After all the research, after all the scans and genetic testing and developing treatments, why is it that some people still think that emotions, especially *gasp* female emotions, somehow cause migraine attacks?
I would like to say that this is just a misconception that has persisted among the “uneducated”. After all, even before the rise of modern neurology, it should have been obvious that many, many very “emotional” people had no migraine attacks whatsoever. A particularly thoughtful person might have noted that a migraine attack might actually stir up an emotion or two in a normal person.
Oh, incredible pain and nausea is coming my way in a few minutes? The room is spinning? The kitchen lights feel like lasers drilling into my skull? Fascinating. Next?
No, surely it would be normal for most people to become mildly – or majorly – sad or upset at such a prospect.
But even being kind to people living 200 years ago who maybe have never given it much thought, the truth is that some doctors, even in modern times, have made the claim that Emily or Hannah or Kayla just needs to control her emotions and everything will go away.
This in spite of the fact that we can now “see” much of what happens during an attack in the body, that neurological changes have been measured, and even genetic bases for migraine have been documented.
Do emotions play any part in migraine at all? Of course they do. But that doesn’t mean that they cause attacks, or that “controlling” them will make the pain go away (the insinuation being, of course, that the patient is 100% to blame for every attack, and that each attach is the patient’s choice!).
That was a inordinately long introduction to an article posted in the New York Times last month, titled simply “Women’s Emotions Do Not Cause Their Migraines“. Take the time to check it out.
Also linked to in the article is a website I should highlight – 100 Migraines. The site is the work of university professor and artist Lorie Novak, who made the decision to photograph herself every time she had a migraine attack. The results will look familiar to many of us, but that makes them no less disturbing.
But sometimes we need to be a little disturbed to be reminded just how serious migraine really is.
It’s coming up on Friday – the Migraine World Summit! And you’re not going to want to miss it.
Don’t want to travel and be in a room with other people’s perfume and cell phones? Don’t worry, this is a virtual event. Which really allows the summit to include migraine experts in various fields from around the world. You’ll get to hear some of the cutting-edge research about migraine treatment, cluster headache treatment, and more.
Worried about the ticket price? After all, this is a 6 day event, from the 15th to 20th of April. No worries, you can attend for free – get your tickets right here.
Here are just a few of the big names that are going to be at this summit:
Dr. Merle Diamond: speaking on emergency room treatments and status migraine, as well as other treatments.
Dr. Richard Lipton: speaking on chronic migraine, risk factors, and the question of a “cure”.
Dr. Alexander Mauskop: speaking on drug-free migraine relief.
Professor Lynn Griffiths: speaking on clinic trials and genetics.
Dr. Stephen Silberstein: speaking on hemiplegic migraine and innovative new migraine treatments
Those are only a few of the topics from a few of the 30+ speakers.
And guess what? I’ll be there too! You can see me interviewed, speaking about my own migraine experiences and some of the things I’ve learned in 13+ years of researching migraine. The full schedule can be found here.
Let me say, I have a whole new respect for people who are interviewed all the time – it’s not easy (yes, it was pre-recorded)! I’ve been obsessing over everything I forgot to say, or shouldn’t have said and so on and so on – so be kind. 🙂
But seriously, don’t go to hear me, go to hear some of the many people that I have a lot of respect for. You may not agree with everything they have to say – listen critically, but also listen with an open mind.
I’ll be there watching too. I won’t be able to hang around for every session, but thankfully there are videos, MP3s (yay! No computer screen!) and transcripts being made available for a reasonable price as well. I’ll be getting the VIP Access Pass, so maybe we’ll be able to talk more about all the information from the summit in the future.
Again, get your free tickets right here: Migraine World Summit. Once you get your tickets, you’ll also see what’s available in the special passes.
I’m looking forward to “being with you” as we explore the latest in headache and migraine research and treatment!
It was over 10 years ago that Ortho-McNeil Neurologics, Inc. set up the “migraine simulator” as a part of their campaign to promote Topomax. Now, the makers of Excedrin, Novartis, have used the power of virtual reality to make a new migraine simulator with a difference.
This time, it’s not a simulator for the general public. It was make specifically for certain people. The Excedrin website explains it this way:
Because every migraine is personal, Excedrin® collaborated with each sufferer to mirror exactly what she usually goes through. A virtual reality specialist programmed the simulator to replicate each sufferer’s individual migraine symptoms, whether they were sensitivity to light or aura (or both).
Excedrin® then asked the non-sufferers to take on a regular day with a migraine.
Obviously the headache pain could not be duplicated, so the focus was on visual aura (which not all migraine patients experience) and sensitivity to light (much more common).
Do not miss watching this video. If you’ve experienced either of these symptoms, or even other similar symptoms, it may even be hard for you to watch. But I’m guessing many of you will want to show this to a friend and/or family member. It shows, in a unique way, how powerfully disabling migraine can be.
Thankfully, the simulator can be taken off. My favourite part is “I’ve got to stop … that … “
Heartburn medications, such as esomeprazole (Nexium and other brand names), are so common, it’s not surprising that they get blamed for quite a number of symptoms. But some recent studies are making headache patients wonder – is the stomach cure making my head worse?
Esomeprazole belongs to a class of medications known as proton-pump inhibitors (PPIs). Other medications in this class include omeprazole (e.g. Prilosec, Losec), lansoprazole (e.g. Prevacid), and rabeprazole (e.g. AcipHex), among many others.
Headache is actually a common, well-known side effect of PPIs. Other side effects include diarrhea, nausea, and abdominal pain.
If taken for more than three months, PPIs can also lead to low magnesium levels. Migraine sufferers in particular are familiar with the connection between magnesium and their condition. Low magnesium can also lead to general muscle stiffness.
In 2013, a study out of the USA showed that PPI use was related to B12 deficiency. B12 deficiency has been linked not only to cases of migraine, but also dementia. Interestingly, the risk of deficiency was especially high in young adults.
It seems that the PPIs interfere with the absorption of the vitamin.
Last month a study in Germany linked the use of PPIs with dementia yet again.
This does not mean that patients taking PPIs will automatically get dementia, or will automatically have B12 deficiency. And certainly there are people who benefit from at least short term use of PPIs.
However, the risks exist, especially for long term users. With concerns about risk of bone fractures, muscle stiffness, headache and dementia, it might be time to look into other options.
Writing about the recent studies, Dr. Alexander Mauskop of the New York Headache Clinic expressed concerns that tests for B12 levels are often not accurate, and that many doctors will be satisfied with lower vitamin D levels (also associated with dementia) than they should be.
Quitting PPIs
Getting off the PPI treadmill can be a challenge (talk to your doctor), but many patients have done it. The problem is that there can be rebound symptoms after a few days.
Dr. Mauskop’s recommendation – switch to a histamine-2 blocker (such as ranitidine or famotidine (Zantac and Pepcid) and an antacid such as Tums. Watch your diet, and after a few weeks you can stop taking the Zantac and rely only on atacids. Eventually you may be able to avoid the antacids as well.
Another suggestion is to start lowering your dosage of PPIs, for example going to one every day, to one every two days, and so on. Again, you can rely on antacids to get over the hump.
There are many other tips out there – probiotics, for one. Of course a healthy diet is key. But every patient is different.
Whether you’re suffering from a lumbar puncture headache, or you just want to avoid one, this article will help you find the solution. First, let’s take a brief look at why these headaches happen in the first place.
Cerebrospinal fluid (CSP) is a clear liquid that surrounds the brain and spinal cord. It acts in part as a cushion of protection. The body keeps your CSP at a certain pressure.
When this pressure is too high or too low, headaches may warn you of the problem. A number of things might cause the pressure to change, but we won’t get into all of those here.
Courtesy Blausen.com staff. “Blausen gallery 2014“. Wikiversity Journal of MedicineA lumbar puncture, also known as a spinal tap, is often performed in order to get a sample of the cerebrospinal fluid or measure pressure. A needle is inserted into the lower back, between two vertebrae, and the fluid is removed. The same can be used to help diagnose serious infections, cancers and other conditions.
Your doctor may also perform a lumbar puncture in order to inject medicine.
The lumbar puncture itself shouldn’t lead to a significant headache. The problem comes when there is leakage of the CSP after the procedure, leading to an unexpected drop in pressure. The headache that often results is known as a post-dural puncture headache (and in the past has also been called a post-lumbar puncture headache or just lumbar puncture headache).
Incidentally, even an epidural anesthesia can lead to this type of headache. It shouldn’t, but at times the membrane containing the CSP is punctured unintentionally.
Risks, and Avoiding the Lumbar Puncture Headache
The headache is more common in women between 31 and 50 years (older sources indicate a higher risk for young adults – check your sources for more information), and the risk increases if they’ve had the post-dural puncture headache in the past. A small body mass also increases your risk.
The best thing to do to lower your risk is to see a doctor who has experience doing the procedure. Details such as the way the procedure is done and the type of needle used may affect the outcome. Feel free to ask your doctor about these things.
When the Headache Comes
To be diagnosed with a post-dural puncture headache, your headache symptoms must begin within 5 days of the procedure.
One clue to the source of this headache may be that it gets worse when you sit or stand, but gets better when you lie down. This is only a clue – but it isn’t always the case. If that is your experience, it will help your doctor to rule out other possible causes.
It is possible that a headache will start more than 5 days after the lumbar puncture, but you may not get the same diagnosis in that case. There are several related headache types that are very similar.
These headaches may last for a few days, or continue for weeks.
Symptoms often include a stiff neck and even some trouble hearing.
Treatment
For some immediate relief, try lying on your back. If the case isn’t too severe, your doctor may recommend over the counter medication to help with the pain. Most of these headaches should go away without the need of any further treatment.
If you’ve had three days of pain and it’s still going strong, your doctor will probably recommend further treatment. However, do tell your doctor right away if you have a new headache – depending on your situation, some treatments are recommended to be done within the first 24 hours.
A clever procedure known as an epidural blood patch is quite common. A small amount of your blood will be injected to seal the leak with a a blood clot. The pressure should soon be restored, and your headache symptoms will go away.
There are several other treatments that may be tried, whether to quickly seal the leak or to diminish the lumbar puncture headache pain while the problem resolves on its own. If the normal treatments do not work, surgery may be required.
Final notes
Again, the lumbar puncture headache (officially known as a post-dural puncture headache) is only one of the headaches caused by low CSP pressure. The timing of the headaches and the studies your doctor may call for may vary, but the overall idea is similar.
If you’re prone to these headaches, it may be something you need to plan for for the few days after your procedure. However, if possible you should talk to your doctor before the procedure is done about the risks, and see your doctor right away if any headache symptoms develop. If you live with a headache like this for too long, it could end up being a very serious or even fatal condition.
But for most people who are under a doctor’s care, the condition is temporary and will not require any risky treatments.