Tips

27 September 2008

Migraine triggers: The Onion

If onion is a trigger for you, how in the world do you stay away from it?

Recently I was flipping through an ethnic cookbook, and found that almost every recipe contained onion. For many people, onion contributes to that next migraine attack. If you want to cook but are being confronted by an onion on every page of your cookbook, here are some ways to fight back:

Reduce: You may find that having only a small percentage of onion in your food isn’t a problem. What I’ve done is cut the amount of onion in the recipe in half. If there was a lot of onion, you can sometimes replace what you take out by adding a little more of the other vegetables in the recipe.
Replace (option 1): There are actually a lot of "onion-like" vegetables that you can use in the place of the onion. One popular and easy choice is garlic (though depending on the recipe you may want to use less garlic than you would have used onion). But there are other things more like onions that you may be able to use. Though many people find onion to be a trigger, far fewer seem to have problems with leeks, scallions (spring onions) and shallots. Try using these in your recipes instead of onion.

Leeks
Scallion
Shallots
Replace (option 2): You could flavour your food with Asafoetida. Asafoetida is sold as a powder, and when cooked in a recipe adds a flavour similar to onion.

Asafoetida Powder

It has added benefits, because it is believed to help with digestion, and helps to lessen gas from things like beans and lentils. If you live in the Middle East or India, you shouldn’t have trouble finding it. If you don’t, you may be able to find asafetida in an Indian market, or with the ethnic foods in your grocery store. Often people who are alergic to onion will use asafetida.
Avoid: Of course, you can avoid onion altogether. Some people find that raw onions are a problem, but cooked onions are all right. Many recipes really just use onion as extra flavour – most of the time you can simply take it out and the recipe will still work fine.

Do you find onion to be a trigger? What have you done to solve the problem?

22 September 2008

Demerol for Migraine in the Emergency room

James Discoveries & Stats, Medications, Tips 84

If you end up in the emergency room here in North America, and you’re diagnosed with migraine, there’s a very good chance you’ll end up with an injection. That injection is usually something called Demerol, or meperidine hydrochloride. But is that the best way to go?

Of course, Demerol for migraine is nothing new. Basically, it’s prescribed for the pain (usually headache pain). Meperidine is a powerful, fast-acting opiod (narcotic) drug.

Though Demerol may help with the pain, there are problems. It doesn’t tend to last as long as some drugs, there are issues with toxicity, and concerns about dependence. Is Demerol really the best drug to take in an emergency situation?

Though it’s being used less and less in many countries around the world, it’s still prescribed for migraine in the emergency room. A study over the summer set out to find out what other options might be better.

This was a meta-study – a review of information on the use of drugs for migraine in emergency (11 clinical trials were studied in all). The study found that many of the alternative drugs already used were more effective (or similarly effective) than Demerol at killing the headache pain itself (for example, a DHE (dihydroergotamine mesylate or Migranal) injection). (overview here)

Surely there are many options for dealing with advanced migraine symptoms, far beyond DHE and Meperidine. I hope more studies are done to find the best, fastest treatment for someone who so urgently needs it.

There may not be much we can do in the meantime. However, if you have ended up in emergency before, it would be a good idea to take a note of what worked for you (I remember being in emergency and going through a lot before finding real help!). You could make the information part of an emergency card or medicine log that you carry around and can pull out at the hospital (after all, you don’t want to try to explain it in the middle of an attack!). Remember, what worked well for someone else may not work well for you – these studies are simply looking for what is generally most effective.

1 September 2008

Taking certain drugs with juice could be dangerous

James Discoveries & Stats, Medications, Tips 3

Do you take your medicine with juice? It might be time to rethink that habit.

Professor David Bailey from the University of Western Ontario specializes in clinical pharmacology. He has been involved in studies about how drugs interact with other things you put in your mouth, like herbal supplements and, of course, juice.

Doctors already caution their patients about taking grapefruit juice with certain medicines. The fear is that the juice will actually enhance the drug – meaning you’ll get more of the drug than you should be getting, possibly causing an overdose.

But the new study had surprising results. When taking an antihistamine with grapefruit juice, only about half of the drug was absorbed! Far from an overdose, this was instead making the drug far less effective.

Bailey, the author of the study, is concerned about other juices that contain similar chemicals. Orange juice and apple juice might have a similar effect – either decreasing the drug absorption or increasing it to dangerous levels.

Some drugs that might be affected include antihistamines (allergy headaches) and beta-blockers (often used for migraine prevention).

My medication? I think I might just stick to water, unless my doctor says otherwise.

See the BBC report Fruit juice ‘could affect drugs’, the University of Western Ontario report Fruit juice restricts drug absorption. via ChronicBabe.com

22 August 2008

Have your child draw their headache (why and how)

James Discoveries & Stats, Tips 2

Diagnosing headache and migraine in children isn’t easy – especially in young children. And as many parents know from experience, it’s a challenge to even understand what’s happening in your own child. Should they go to the doctor? Are they just imitating someone else’s behaviour? Is this something new, or a headache they’ve had before?

There is increasing interest in using art to diagnose headache and migraine in children. So far, the results are encouraging.

A little background

Early last century, using drawings from children to diagnose mental illness began to become popular. Many of you are familiar with this approach (if only from the movies). There is some debate over how effective this type of diagnosis is, but the idea is spreading beyond just emotional and mental issues.

Having children "draw their headaches" is turning out to be surprisingly helpful. Investigations particularly in the 80s and recent years have confirmed this. Take for example the 2002 study The Usefulness of Children’s Drawings in the Diagnosis of Headache, which used the method with 226 children. The authors of the study found the method to be very accurate, and recommended it be used, though in conjunction with the normal medical histories and oral exams.

Earlier this year, a study of 48 children evaluated the use of art in the diagnosis of migraine (see Children and adolescent’s drawing for the diagnosis of migraine). Again, diagnosing with the drawings was found to be very accurate, meaning that artistic diagnosis used together with normal examinations could be very helpful.

Children tend to communicate many things better through drawing. They know something is happening to them, but don’t understand all the words we often use (like stabbing pain, nausea, throbbing).

Try it!

So my advice? Couldn’t hurt to try it. Try some of the methods used in these studies. In the 2002 study, this was the method (highlight mine):

At the beginning of the visit, before any history was obtained from the child or parent, each child was provided with a blank, unlined piece of white paper (8.5 x 11 inches) and a number 2 pencil with an eraser. The child was then asked to "Please draw a picture of yourself having a headache. Where is your pain? What does your pain feel like? Are there any other changes or symptoms that come before or during your headache that you can show me in a picture?" To minimize bias, no leading questions or additional instructions were given. Most children participated willingly; the remainder complied after a bit of encouragement. There were no refusals. Additional embellishment of the drawing (eg, words of explanation, labels) was neither encouraged nor prohibited, and many children added such explanatory notes to their picture.

Take the picture(s) to your doctor, as an extra tool for them to use. Children in these studies ranged from age 4 up to 19.

Additional thanks to Understanding Children’s Drawings by Cathy A. Malchiodi for some of this information. Read more about child migraine and child headache issues.

1 August 2008

Little tips add up

James Tips 3

Sometimes just a few seconds of relief can make a big difference. Many of the tips you hear about don’t help everyone, or don’t help for long, but may help a little.

I just heard this tip from Terri from the USA. Here’s what she had to say:

Accidentally found a method that temporarily (at least) relieves some of the pain of my migraine (does not take away the headache) I apply pressure to the bottom of my nose…the piece of cartilage where the nose attaches to the face at the bottom. A steady upward pressure and the pain in my eye goes away…as long as I’m pressing…obviously not a practical long term solution…but just to feel some relief…a break from the pain…helps. Hope it helps someone else.

Actually, it does seem to work, at least a little. Thanks for the tip, Terri!

Do you have a tip to share? Leave a comment!