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Why “Heal Your Headache” by David Buchholz Infuriates Me
By Kerrie | November 8, 2007
I remember just how angry Heal Your Headache: The 1-2-3 Approach for Taking Charge of Your Pain makes me by the impassioned responses I get whenever I mention the book. I know David Buchholz’s treatment approach is effective for a lot of people. I am
truly happy for them. Buchholz’s snarky attitude and shaky underlying
evidence is the problem.
His conviction that that people who “fail” with his approach likely don’t follow it to the letter or are attention-seekers is offensive. And, oh yeah, he dismisses scientific research that he doesn’t agree with and blames other doctors for making themselves not believe in food triggers.
Perhaps Buchholz would label me as someone whose migraine and chronic daily headache result from a “hidden agenda.” Having a blog about it probably makes it look like my identity is
so tied to migraine that I can’t possibly be “healed.” Sorry, folks,
but I’d be thrilled to stop blogging because my migraines stopped sucking the life out of me.
Ignorance is his explanation for why most doctors don’t believe in a headache trigger diet:
The impression of most doctors that dietary modification doesn’t work to control headaches is based in part on misunderstanding and in part on misuse of the dietary approach. Doctors generally share their patients’ failure to recognize the important role of dietary triggers and are therefore unequipped to educate their patients appropriately.
Guess what happens? It’s yet another example of how low expectations preordain headache treatment failure (p. 72, non-contiguous paragraphs)
A few pages later, he explains why the scientific studies of food triggers aren’t true:
The failure of most of the few scientific studies that have looked at migraine dietary triggers to demonstrate a clear effect is a good example of the limitations on science in identifying truth that is otherwise obvious. Try telling a headache suffer who has had killer headaches after eating chocolate or drinking red wine that it’s all in his or her imagination. (p 77)
Can you say “false attribution”? How many people swear off a certain kind of alcohol after one horrendous night? Tequila itself isn’t the cause, but the person’s association of tequila with alcohol poisoning! The consistent lack of a clear effect in studies could be that there’s no effect. High school biology provides that lesson.
I even have food triggers, albeit none have been identified through an elimination diet, so I don’t disagree with him entirely. His poorly argued claims are unprofessional and condescending. Too bad many people overlook this because he is affiliated with a famous hospital. I know how desperation for relief drives can drive you to put faith in any treatment. While this one isn’t physically harmful, internalizing such criticism can be even more damaging.
See The Migraine Diet: Judith Warner & “Heal Your Headache” for context.
Topics: Coping, Society, Treatment |
November 8th, 2007 at 12:30 pm
That’s pretty classic behavior in doctors who DO have a god complex…if you can’t solve it, blame the patient. Certainly makes the numbers in your studies go up, doesn’t it.
I’m so glad there are wonderful docs out there who don’t buy into such tripe. And whatever happened to all things in moderation?
November 8th, 2007 at 1:32 pm
As you already know, I can’t stand him or his self-important book. I’ve come to the conclusion that he’s so money hungry and in love with himself that he can’t see straight. He does us such a disservice with his blathering.
November 8th, 2007 at 2:38 pm
Here, here!
It annoys me just how many doctors think MD means major deity. I thought science was about changing the *theory* to fit the *facts*.
::rollseyes::
November 8th, 2007 at 4:35 pm
Hi Kerrie,
I recently found your blog and have been following for about a month.
Thank you for the information, reviews, and your honestly.
-kl
November 8th, 2007 at 8:36 pm
He’s also wrong when he says “The impression of most doctors that dietary modification doesn’t work to control headaches is based in part on misunderstanding and in part on misuse of the dietary approach.” Most Migraine specialists DO recommend working to identify food triggers. But, many Migraineurs have NO food triggers. Buchholz goes overboard with the strictness of his “diet,” which means most Migraineurs wouldn’t stick with it. There are other elimination diets that are just as effective, and far less draconian.
Then there are his absurd comments about medications…
“Acetaminophen, aspirin, ibuprofen, and naproxen sodium do not cause rebound headaches.” Yeah, right. All of the true clinical trials on rebound and the peer-reviewed journal articles that say they do cause rebound are wrong, and he’s right. I think not.
Plus, he says that triptans and opioids have to be limited to two days a MONTH to avoid rebound. No, two days a week will keep most people out of rebound. Wouldn’t you hate to be one of his patients with frequent Migraines? What does he tell them? To go home and take acetaminophen or ibuprofen?
Ugh!
Teri
November 8th, 2007 at 8:47 pm
I was lucky to have a pain doctor who said every individual is a case of “N.” — meaning that the world of medicine really knows very little about pain management and the infinite variables associated with any one person make it almost impossible to definitively know what type and dose of medication will work for that person. So you try, change, try again, change, and hopefully find a combination that works. One thing that worked for me was this doctor’s combination of great knowledge and genuine humility.
November 9th, 2007 at 10:05 am
I have been reading this blog for only a short while and I haven’t read the book, but two things stand out for me.
1- I don’t see how any doctor could say that OTC drugs do not cause rebound headaches. But I even cringe at taking a triptan drug twice a week. I’ve had rebound from those and it isn’t pretty.
2- In my opinion, food triggers are not the whole story on food and migraine. It is possible for a migraineur to think they have no food triggers because they do not see a correlation between food and their headache within a two hour time frame. Delayed food allergies or intolerances can cause a reaction 12-24 hours later or even 2-3 days later. In my case, I couldn’t see the correlation until I was tested for IgG allergie and gluten intolerance (I was positive on the latter). Then I saw a good deal of it. Food intolerances do not cause chemical changes in the brain the way that neurologists think chocolate does. Instead, the immune system responds to something it thinks is a toxin. Each person’s response is unique to them. My body’s reaction is to cause inflammation, water retention and swelling, nasal congestion, tooth and jaw pain that eventually triggers a headache that will only be relieved by a triptan drug. I have also gotten migraine with aura 12 hours or more after eating yogurt.
The other thing about food allergies is that moderation will not always work. Even one speck of an almond or piece of ginger and I am getting a headache for sure…maybe not immediately, but in the next 24 hours.
Just something to think about. You may not like this guy’s book, but don’t dismiss the whole subject. I think there is something there that can help. You might be surprised to see how many migraineurs are out there on Celiac and food allergy sites.
November 10th, 2007 at 2:59 am
Kerrie, I love you. It seems that whenever I’m having a horrible time, you write something that reminds me that I’m not alone. I 100% agree about the book. It’s one of the 100s that I have bought with my limited disability income trying to find a way to get rid of this hellish headpain, only to be told by an author that if the pain doesn’t go away, I must really want to stay in agony, trapped in my house, having lost a job I loved (and the hefty six figure income that went with it:() If I hadn’t found Vipassana (insight) meditation, which is a school of Buddhist meditation and teaching, and your blog, I think I would have killed myself or someone else by now. I’m torn between hoping you keep up the great writing and praying that you’re relieved of your suffering. I’m going to have to go with the latter - I pray that you will be relieved of your pain and suffering.
Thank you again for your inspiration. Namaste and metta,
Kelly
November 11th, 2007 at 11:00 pm
I found your site while doing my “usual” headache research for my newest headache and it is comforing to know I am not alone.
I started having them in my 20’s but they became frequent in 30’s and now I am 48, they occur every couple weeks. The worst for me is that I am unable to take any pain meds for them as I become violently ill on them. One of my last headaches lasted 5 days, and I finally broke down and took two baby asprin and ended up in the hospital for several days. They ran all sorts of tests trying to find the cause. They suggested feverfew and it actually works a little. It takes away some of the intensity. Migraine meds didn’t work for me either. I recently went gluten-free and am very strict about it ,too. I thought I finally found the answer , but I had a headache yesterday from eating a gluten-free
rice crust pizza. Right after eating it I started getting a reaction. It was weird. I am back to researching food allergies and such. I definetely know what you mean about condesending doctors. I have been so fed up with all of it. I was told I must be depressed at one point. I told the doctor the only thing that was depressing me was the headache. I can really relate to your housewife blog. I have expressed alot of the same feelings about not working full-time. Thanks for your supportive site.
November 12th, 2007 at 9:48 am
Just found this site an love it. I was beginning to feel alone in my daily struggle to figure out what drugs to take and which ball to drop because my brian is being held hostage by the big M.
The GP that I saw was trying to tell me to spend two weeks on a rice and water diet…and to take 800mg motrin during the monthly cycle breakthrough. I won’t be spending my money on this book, it is still obvious that there isn’t enought concrete evidence and everyone’s body chemistry is just different enough that these things aren’t likely to work for most. And the root cause of migraine headaches are still just elusive enought thatthese ideas are just ideas at best.
November 12th, 2007 at 1:00 pm
I have my first neuro appt. tomorrow evening to start finding out about these headaches. They don’t fit the profile of either migraine or tension… they started after repeated cases of strep throat and then a really bad sinus infection, and never went away. The ENT says there is nothing on the sinus CT scan that would be causing these headaches (even though there are some abnormalities). I’m scared, very scared about going tomorrow. I don’t know what to ask or what they will say/do. I also take meds for depression/anxiety so I hope they don’t put this headache off on that. If anything I was doing OK and these headaches are now causing me to be more depressed and anxious b/c I am grouchy with my family and don’t feel like the best wife or mother. I hate being this way, but I don’t know what to do about it. Sorry, just scared and worried and venting.
November 12th, 2007 at 9:17 pm
Hi Kerrie!
I am SO glad that you are posting about this book again. I have commented in the past about it. I continue to be totally bewildered when people discuss this guy’s dietary ideas but never mention his harmful attitudes. Yes - it’s Chapter 9 that I’m talking about. I’m so relieved to see so many people writing to you re: his insulting “hidden agenda” theory for those who don’t get better. This guy is a real piece of work.
November 13th, 2007 at 11:39 am
Wow, I’m lucky - two of my favorite migraine bloggers in one post. Kerrie — you always have amazing information and I read your blog every day. And for those of you who don’t know who Teri Roberts is — you should check out her sound advice and info also.
FYI: I have been doing a migraine elimination diet. It hasn’t really helped the migraines or triggers, but anyone who suffers from Chronic Daily Headaches may want to rethink their eating habits. I’ve found so far that I have a problem with soy and wheat (i.e. everything I used to eat as I don’t eat meat). So although the migraines are necessarily gone, the daily headaches are down to a dull roar (major improvement!).
November 14th, 2007 at 8:31 am
I read the book over the weekend. The guy is a piece of work. I can see why he pushes so many people’s buttons. But…I think he may have a point about rebound and I am giving it and the elimination diet a try. I am already eliminating gluten, dairy, eggs, some nuts, yogurt, caffeine, etc. so it wasn’t too much of a stretch to add the rest. I have recently come to the conclusion that I need to eliminate chocolate, although it pains me.
I suffered through the weekend with a low to moderate headache and took nothing for it. It finally went away on Monday and with it the neck and shoulder pain and the sinus congestion and all the rest of the migraine-like symptoms. I seem to easily slip into rebound situations, so I think I am a good candidate for this. We’ll see if it works. Luckily, I haven’t had a full-on migraine with aura since May.
November 16th, 2007 at 11:44 pm
Heather, Thanks!
Karla, New Daily Persistent Headache (NDPH) sometimes starts after an illness and sounds a lot like what you’re describing. It’s worth asking your doctor about it.
Teri
November 22nd, 2007 at 1:02 am
HELP.
I have had daily migraines (I think this is migraine) for 17 years. Each time it is triggered by sleep. I feel well before I fall asleep..sleep a short time..wake up with extreme temple pain, sinus fullness, heart symptoms, and now lung tightness and achy body. I have tried everything it seems…
Anyone heard of a migraine always triggered by sleep. I have had 3 sleep studies and they say I have abnormally high amounts of deep sleep. My mom has migraines but not like this. My life is a shell of what it could be due to severe pain and symptoms every day for 8+hours each day.
Thanks.
********
Sleep can definitely be a migraine trigger. I’m not sure how high amounts of deep sleep interacts with migraine, though. Have you shared your sleep study results with a neurologist?
Take care,
Kerrie
November 28th, 2007 at 3:06 pm
Excellent comments, everyone! Thanks.
Joe - sleep is a very common migraine trigger. It is definitely something to talk to your doctor about.
Kerrie
November 28th, 2007 at 3:07 pm
Excellent comments, everyone! Thanks.
Joe - sleep is a very common migraine trigger. It is definitely something to talk to your doctor about.
Kerrie
December 8th, 2007 at 4:24 am
I have been suffering with Migraine that included Vertigo and aura. I didn’t have pain but now that the doctor has put me on channel blocker, I am having very bad headaches but no vertigo and aura. I am not sure what you is worst. Thanks for the info.
December 13th, 2007 at 11:49 pm
Here’s the thing: we are FINALLY doing research–yes, actual research–on migraine. And the genetic studies done to date suggest that there are going to be multiple types of migraine sufferers. Now, mind you, we are just in the early stages of this research. So we don’t have all the answers yet.
But it appears likely that each of us with migraine inherits several genes that lower the migraine threshold. However, I may have a different batch than you do. So, I might have different food tiggers than you do. Or no food triggers. Or a food trigger that is active only in the presence of another trigger, like sleep deprivation or something.
And yes, gluten intolerance is a special case. But that’s not really what Buchholz is addressing–which is too bad. It’s worth discussing in detail, and without blaming anyone–patients or colleagues. Our understanding of it is evolving.
May 15th, 2008 at 9:25 am
I read the book after a recommendation from my ENT doctor who suggested that the neurological issues I was having (which did not include headaches specifically) might be migraine-activity. I was skeptical, but read the book & surprised to find that “migraine” doesn’t always mean a headache, but can include so many of the problems I’m having. So the book was helpful in that for once I found someone who thought my symptoms actually added up to something other than heart disease or a blood clot. Not to say the book gave me any helpful advice on how to control this…I’m still looking for those answers.
May 28th, 2008 at 11:05 pm
I have to say, while I found his personal attitude to be a bit pompous, I am two months on his diet and it is working. Did not happen right away. But my headaches are down to about three a month from 20 a month and I feel I have my life back. It is the combination of triggers that reaches a tipping point and thus a migraine event occurs. I understand that now. I am off all meds. Now I could care less if he is pompous,egotistical or a just an arse…what he says is valuable.
May 29th, 2008 at 6:40 am
I have just read the book, hoping for a positive outcome. I have eliminated all medicine (I have tried everything and nothing helped) and ready for step two. I am having trouble preparing meals for my spouse and I that eliminates the certain diet items. Does anyone have any recipes? If so please please share. Neeb5688@hotmail.com I went to a whole foods store a week ago and it was mind boggling.
July 10th, 2008 at 12:48 pm
It’s ok to be upset or angry, but don’t take it out on Dr. Buchholz. Most of what the initial blog posted were based on the messages the poster believed to be implied - but Buchholz doesn’t actually say or write it. Buchholz NEVER blames the patient - in fact, his point is that OTHER doctors blame the patient. He repudiates THEM - not the patient.
I have had the privilege of both reading his book AND being treated directly by him, thanks to my proximity to his offices and I must tell you that all of the negative character points made in ANY of the above blogs are simply misinformed. He’s actually a very kind and gentle individual - and I will admit that it almost surprised me after reading his unwavering comments in the book.
IF YOU ARE SUFFERING from headaches, and you have tried everything else and it didn’t work - try his method. Don’t try a little bit - or even 90% of it - and then bemoan his perceived lack of sensitivity. DO it. Do the whole thing, and recognize that you have to do it for MONTHS - not days or weeks.
I have seen 6 different neuros the last 4 years in which I have had migraines EVERY DAY - really EVERY day. The first week of Buchholz’s program, I was out of work I was so debilitated. BUT, the clouds began to lift and I just had my four month follow up where things have so dramatically improved. I’m not done yet and I’ll have to continue to be militaristic about the diet for probably another YEAR minimum, but I am no longer controlled by the headaches.
Buchholz is not for the faint of heart, and his writing is so pointed that it will ruffle some feathers, but DON’T let that stand in the way of what may be … truth.
Blessings, Tim
July 17th, 2008 at 9:08 am
I to suffered from migraines for years and then they got tremendously worse, daily migraines for hours. I went to a regular doctor for months and then a neurologist for months. We tried all kinds of meds and nothing worked. Then they recommended I read this book and give it a try. Within a month I was migraine free and have only had one REAL migraine since then and that was 3 years ago. My trigger was artifical sweetners.
August 4th, 2008 at 11:59 pm
At first i found some of the comments very condescending, but then i realised he has just written it so it is easily understandable for the majority of readers, and not just fellow md’s and neurologists. You have to accept a certain amount of arrogance from him as he hasnt ever had a migraine. HOWEVER, the ultimate outcome for me(and it may be different for others) is that i worked out my main triggers
citris being the big one. Maybe im stupid for needing this book to find my triggers, but it has succeeded in eliminating most of my blinding, paralysing and agonisingly painful migraines where expensive neuologists and drugs have failed.
TIP : Ur not looking for 1 migraine trigger, ur looking for a list of prolly about 10, where a combination of 5 in a 48 hr period results in a migraine.
August 26th, 2008 at 11:05 am
I thought for awhile that you had read a different book than I did because I didn’t find this book to be anything but helpful. I was pleased to see the more recent comments posted. I did not find Dr. Buchholz to be arogant and disagreed with many of the points about his book published on this site. I find his approach and the diet to be liberating, as in freedom from daily migraine, and I am forever grateful that he took the time and effort to write it. I just hope the negative things written here do not keep someone from trying his approach and finding the help they deserve.