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.
A new podcast discussing some key articles from past years here at Headache and Migraine News that you might want to check out. A wide variety of topics – brace yourself! 🙂
Is daith piercing something that you should try as a migraine treatment? Many people are saying yes.
Back in to 2015, a post I wrote criticized articles that touted the benefits of daith piercing, even though they cited little to no evidence. As a result, a huge discussing has started about the benefits and evidence behind daith piercing.
Photo courtesy MreeowSo we’re going to investigate daith piercing for migraine, on an ongoing basis, with your help.
I’m starting off with some of the information shared in the comments on the original post.
Richard pointed us to a YouTube series about daith piercing for migraine from Tanya Welch. See those here: Daith piercing and migraines
Danny Buchta, who does piercings, wrote: I have done this piercing for about 50 migraine sufferers in the past two months and all but one have found total relief in the short term and that one still said her migraines have been reduced.
Stephen Stratton has offered to watch the situation closely: Hi guys , I’m from England and came across this thread when searching for related articles, I am a qualified nurse and have a degree in Health Studies, I am also a Body Piercer, over the past few months I have had an increasing amount of migraine sufferer’s contact me for the Daith Piercing as a possibility that it may reduce the frequency or severity of their migraines, as with many comments in this thread, when all else fails … I am now intrigued by the possibility if any casual link, research is virtually non existent and so I have decided to conduct, hopefully, a study – its very early days yet , through social media I have requested that sufferers contact me for the piercing and I will over the next two years monitor any results, if anyone has any information or suggestions that may help me form a sound study, then please get in touch – thank you – steve (migrainestudy@mail.com)
This from Amanda: I was a migraine sufferer, constantly having migraines everyday for months at a time. If the weather became cloudy I was hurting. I heard about this piercing and decided a $30 piercing that WAS NOT PERMANENT was well worth the trial after so many meds and hospital visit. It has now been one full month and the only way I can tell when its gonna rain is because of my ankle, not my head any longer. Yes one full month no migraines, it feels amazing to wake up with no pain, I was one willing to try anything…the piercings don’t look too bad and definitely was well worth the $30. If you are suffering and willing to try something that can be undone then by all means try this it helped me
Emily wrote: Hi! I wanted to write and tell you my personal experience. I get migraine headaches. I was in the emergency room once a week for headaches so debilitating I could not even speak. I got my daith pierced because $40 is less than my copay. I am about four months post piercing and have not suffered a migraine since. I do get headaches occasionally but pulling on the ring and massaging the area helps to calm it down and gets it to go away within minutes…
This from body art tatoos: I have been doing body piercings for over 23 years, I have recently had a increase in the daith piercing ( migraine piercing ). I have been asking customers to keep me informed on there progress, 8 out of 10 customers after one month claim they still are migraine free, several are local nurses that there doctors suggested for the to try it, and so far has worked on most, most have been women and said the pain is very little, and it is a harder piercing to take care of because that part of the ear collects dirt much more than the rest so keep it clean, we have noticed that you must Pierce the side the migraine starts on, but if your migraine starts in the back or front of the head in the center it’s best to Pierce both sides, last week I pierced both sides of one of my tattoo artist daiths for his migraine and to his surprise his migraine went away on the spot, but since then he has only had one small headache that didn’t require him to take medication , so far so good, but like I said in the being it seems to work only for about 80 percent of people who get it done, 10 percent claims of a decrease in pain and other 10 percent claims did not work for them, good luck to those who choose to try it.
This is a representative list – there were a few who said the piercing didn’t help (in one case made things worse), but in most cases the reports were positive.
Your Turn
If you have a story, positive or negative, please share it. If you are aware of any trials, or any doctors who have been reporting on patients who have had daith piercings, please share that as well.
Headache is actually a common, well-known side effect of PPIs. Other side effects include diarrhea, nausea, and abdominal pain.
