Month: July 2005

Treatment

Why Stimulate the Occipital Nerve?

Kerrie Smyres

News reports have lauded trigeminal, peripheral and supraorbital nerve stimulation, but there hasn’t been much coverage of occipital nerve stimulation. This isn’t an endorsement of one type over another, but I talk about ONS because that’s what I have. When I have a grasp on the other options, I’ll write about them.

The occipital nerve is targeted because it is a sort of gatekeeper that refers migraine pain to other nerves. Dr. David Dodick of the Mayo Clinic in Scottsdale explains, “The occipital and trigeminal nerves converge. These nerves connect with all of the pain-sensitive structures in the skull. [S]timulating the occipital nerve inhibits activity in the trigeminal nerve.” (This quote is from an an article that was on OUCH‘s old website, which is no longer available. Even though the article focuses on occipital stimulation for cluster headaches, the information applies to migraines.)

From what I’ve learned – and what the quote from Dr. Dodick above indicates, it appears that the occipital nerve connects to all other nerves, therefore is the widest-reaching option. I’m by no means a definitive source on this. At the very least, if you’re considering nerve stimulation, it’s a good idea to research all the possible types and work with your doctor to determine the best for your pain.

Symptoms

Advance Warning

Kerrie Smyres

About a month ago, I was in a nasty cycle where I’d have a migraine, have three hours off, then have another migraine. On the third day of this, I already had plans to go out for coffee with a friend and thought I was coming out of the cycle, so I went. I expected to be dragging a little, but I had tons of energy. I couldn’t keep a train of thought and I had a terrible time finding words, but I couldn’t stop talking. No more than 10 minutes after I got home, another migraine hit.

Not long after that, I went to my book club meeting and, again, was charged. I felt like energy was practically flowing out of my joints. When I got home that night, a migraine hit.

I’ve since realized these bursts are part of prodrome, the period before a migraine. I’m always fascinated when I learn how migraines affect the body beyond pain, but more importantly, abortants are most effective when taken during prodrome. Figuring out what your prodrome symptoms are is easier said than done. They’re a study of contradictions.

You could be sad, easily annoyed, yawning and tired or hyper, talkative, having trouble finding words and slurring the ones you do find. You might be hungry or have no appetite, have food cravings (especially for carbohydrates) or be disgusted by certain foods. Maybe you’re sensitive to light or sound and your muscles are stiff. You might have constipation, bloating, diarrhea and have to pee all the time. You could have any of these symptoms in any sort of combination and they aren’t necessarily consistent from one event to another.

Tempting as it is to dismiss these as just a funk, a good mood or an upset stomach, being aware of prodrome symptoms might help you get better treatment. If your migraines are close together, something that seems like a hangover from the previous headache (postdrome) could actually be prodrome. Knowing that taking a triptan early may keep your headache bay makes a good case for keeping a headache diary. I definitely know now that when I’m bouncing off the walls, I should have a triptan handy.

Coping, Mental Health

Semantics: Depression vs. Sadness

Kerrie Smyres

It’s not uncommon to ask a friend how she’s doing and have her response be, “Depressed.” She’s probably sad or down, but not actually depressed. This same sort of thing happens with migraines. If someone has a bad headache, he’ll call it a migraine, even if it’s not.

Popular word choices can make understanding and recognizing actual diseases difficult. If Joe can pop a Tylenol and wipe out his “migraine,” then maybe the rest of us are just whiners. Similarly, the common use of “depression” as a synonym for “sadness” makes it hard to know if you’re in a funk or struggling with clinical depression.

So that’s why I chose “sadness” instead of “depression” in yesterday’s post. Yes, I’m being nitpicky, but with good reason. Chronic headache and depression often occur together because they involve the same brain chemistry. Your docs don’t (necessarily) think you’re “hysterical” when they prescribe anti-depressants, but are targeting serotonin to treat your headaches. And, you may be depressed as well as in pain because the same brain chemistry is under attack.

Much more on this later. I’m off to catch a plane. My internet access will be spotty the rest of the week, but I’ll be posting and checking e-mail as often as I can.

Coping

Looking for Good

Kerrie Smyres

Tracy, of Moogle’s Thoughts, blogged on Saturday about the constructive ways she deals with sadness and tries to find something positive in all the sadness of pain.

“Basically, you have to CHOOSE to see the positives no matter the situation. It doesn’t just happen. It is a choice that you must struggle with to make reality. Every thought must be captured. It is something that you work on every minute of every day.”

For Jess — Positives shows Moogle’s great attitude and is full of specific examples.

But I’m pretty sure that I have the best husband ever.

😉

Coping, Mental Health

Dealing With Sadness

Kerrie Smyres

A reader asked me, “How do you and others with daily migraines have a life and not be so depressed?”

I don’t think any of us do avoid it. Sadness is just part of the disease. This is a frustrating answer, but time is the only thing that has made it easier.

I’ve learned to accept what I can and can’t do, and to give in to the pain when I need to. I also give in to the sadness sometimes because there’s no denying that chronic pain sucks. Sure, I spend more time in bed than I’d like, and I’d prefer to cry a little less, but this is my life whether I like it or not.

I try to not get down on myself or feel guilty when I feel bad so that I can enjoy the time that I feel good. And some days I can even convince myself that it’s good to have a day in bed. How else would I find the time to devour books?

Submit a comment to share how do you deal with the sadness.