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Air Cycling Through Cooling & Heating Ducts a Migraine Trigger

I’d like you to think I’ve been absent from the blog because I’ve felt so great that I’ve been living it up. Actually, I’ve continued to feel pretty crappy since right before Christmas. There’s always an excuse. In early January was the stomach bug that caused horrendous nausea every time I ate, then triggered an equally bad migraine. Right after I recovered from that, my mom dislocated her shoulder and broke her humerus. Then Hart and I moved into the house…. You get the point. Unfortunately, the migraines continued even after the stress settled. Until Hart and I made a brilliant connection — our AC/heating ducts are making my migraines worse.

We turned off the heat when our roof was patched last week to make sure no chemicals or odors entered the house. I had a good day after the first night with it off, though I need to see a pattern before I jump to conclusions. I forgot to turn the heat back on and the good days began piling up. I’d get pretty tired for a couple hours every afternoon, perhaps because I was doing so much, but few migraines followed (and they were mild if they did). The night we ran the heat, I had a migraine in the night and was headachey and blechy the next day. We turned the heat off again for the next night and voila, I awoke feeling better!

As always, “feeling better” doesn’t mean migraine-free, nor does it mean I’m operating with full energy. Still, I don’t spend much extra time in bed, afternoon naps generally abort oncoming migraines, and the migraines I do have are relatively mild. This all adds up to going out for fun excursions and errands, settling into my new house, and cooking up a storm.

This discovery coincided with getting the results of an energy audit. Not surprisingly, our 1945 house has many gaps in the ducts and the attic has lots of dust and broken-down insulation. The heat runs and pulls all that yuck into the air. Because I’m so sensitive to environmental triggers, Hart and I already budgeted to seal the ducts and use chemical-free products on any household improvements. Soon we will seal the ducts with formaldehyde-, PVC- and VOC-free products, then have them cleaned. I hope, hope, hope that does the trick. I can go without heat, but a Phoenix summer is impossible without air conditioning.

Dirty ducts are a fuzzy sort of trigger. Is whatever is in the air the trigger or does it stir up allergies, which then trigger the migraines? The latter is most logical, but why don’t I have allergy symptoms? As always, I have many more questions than answers. What I’m sure of is that I haven’t had a raging migraine in 10 days. That’s enough of an answer for now.

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Crossing Allergies Off the Migraine Trigger List & Adding Nasal Irrigation as a New Treatment

Of the 33 allergens tested for in a basic allergy panel, I’m allergic to nothing. I’m happy with the results, even though it means crossing yet another possibility off the list. I used to get discouraged when I hit a dead end. I’m not now; just glad to not have to deal with allergy shots.

The allergist thinks I’m one of about 20% of people who have nonallergic rhinitis. These folks aren’t bothered by typical allergenic inhalants, but by a host of other possibilities, including odors, irritants in the air, weather changes, medications… Mayo Clinic’s definition of rhinitis:

If you do have rhinitis, the lining of your nose swells due to expanding blood vessels. The mucus glands in your nose get stimulated, causing a congested, drippy nose. The symptoms of nonallergic rhinitis are similar to those of hay fever (allergic rhinitis), but there’s no allergic reaction involved.

The treatment is a simple spray of intranasal corticosteroids, like Flonase. Great news, right? Except that a study written up in this month’s issue of the journal Cephalalgia indicates nasal steriod sprays can trigger migraines! I’m going to try it, but nasal irrigation (with a neti pot) might be a better solution. You may have heard of nasal irrigation about a year ago, when Oprah praised its benefits.

Using a neti pot is simple. Basically, you pour a saline solution up one nostril and it comes out the other. I won’t lie — it feels bad and weird at first. It takes patience to put up with the initial unpleasantness. Once you get the hang of it, nasal irrigation actually becomes pleasurable! Here’s how it works:

I’ve never used a neti pot consistently, but am always pleasantly surprised by how my sinuses feel afterward. It’s an easy, inexpensive treatment to try. Neti pots, some of which come with salt packets, are $10-20 on Amazon. Making your own saline solution is simple and much less expensive. The basic recipe is 1/4 teaspoon non-iodized salt to 1 cup warm water. (Distilled or purified water is preferred. To use tap water, bring it to a boil, then let it cool before using it.) You can choose to add extra ingredients. A 1/4 teaspoon baking soda makes the solution more soothing. You can keep your nose from drying out by adding 1/4 teaspoon glycerin.

I’m dedicated to giving nasal irrigation another shot. I’ll do it every day for a week, starting today. If you’re interested, you can track my progress on Twitter. How about you? Does it sound like a good treatment or does it just gross you out?

Check out neti pots on Amazon and help support The Daily Headache!

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Terrible Migraines: Is it birth control pills? Allergies? A bad spell?

My brain has had a rough month. I’ve had brief reprieves, but most of my time has been occupied by terrible migraines. I feel better this morning and am taking full advantage of it.

I’m in my fourth week of birth control pills. I’ve been spotting for the last 10 days, which I assume has contributed to the migraines. I plan to give the experiment a couple more months, but am not sure if I can make it that long.

I’m increasingly certain that allergies trigger at least some of my migraines. You may remember last spring was also horrible for me. Magnesium certainly was a factor. I wonder if allergies were also involved. Taking a Zyrtec yesterday appears to have reduced my agony tremendously. I had to reschedule yesterday’s appointment for allergy tests (for the third time) for later this month. (Please note that although allergies don’t cause migraines, they can be a trigger.)

My outlook is surprisingly good. Especially considering a bad appointment with my headache specialist Monday. The gist of the appointment: I have headaches and migraines that haven’t responded to treatment. With time, headache research will uncover more clues. Until then, why not try some more things in case they help? And I should think about medication to “make life bearable,” like morphine. (That’s a can o’ worms I can’t open right now.)

Back to the good outlook: If I have to live with migraines and headaches, at least I can do it the best way possible. I have a comfortable home; supportive, patient friends and family; and an understanding husband. My insurance covers a variety of treatments. I can stream NPR and audiobooks from the library. I eat good food that I don’t have to make. My life is as good as it can be right now.

I’m sad to not post more on the blog. I want to write about news and research. I want to share resources. I want to write about myself less. I want the blog to be like it was two years ago. Change is inevitable, so I’m trying to not worry about it much. Maybe I’ll get there again, maybe not.

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What’s With My Head: New Headache Specialist, Menstrual Migraine, Allergies & Reading

New Headache Specialist
I saw the headache specialist several readers have recommended and really liked him. After more than two hours with me (we had to schedule a second appointment to fit it all in!) he speculated that some of my headaches are actually caused by new daily persistent headache. In the past, my chronic daily headache was always attributed to migraine transforming to everyday.

Although the doctor wants to see me monthly, the next available appointment is in March. Before then I’m supposed to get a lumbar puncture (spinal tap) and more blood work. My last lumbar puncture resulted in a three-week headache and wasn’t responsive to a blood patch. I’m not looking forward to it.

Menstrual Migraine
I got a birth control pill prescription to see if it will manage the two-day migraines I get when my period starts. In typical fashion, I haven’t filled the prescription. The migraine that kept me in bed my first two days of vacation in Mexico should motivate me to to take it to the pharmacy.

Allergies
After always feeling worse after vacation, I finally admitted my headaches and migraines are worse in Seattle than elsewhere. I was in Kansas for a funeral the last weekend of October. I was shocked to wake up two mornings in a row with a barely perceptible headache. Nor was I as congested as I always am at home. I took Zyrtec for a few days and both my congestion and migraines were less. Not a reliable experiment. It unfortunately made me nauseated, so I couldn’t keep taking it. I’m trying Claritin now.

When I was tested for allergies when I was 14, I responded most strongly to mold. That wasn’t an issue in Phoenix — quite the opposite in Seattle. Studies indicate than while allergies don’t cause headache, they can trigger migraines. Thursday I’m seeing an allergist and will probably get tested for allergies. Maybe she can sort something out.

Migraines Triggered By Reading & Working on the Computer
These are still in full-force, hence my infrequent posts. A loved one who is an ophthalmologist gave me a thorough vision and eyestrain exam when I was in Phoenix for Thanksgiving. The diagnosis was convergence insufficiency. That means:

Convergence insufficiency occurs when your eyes don’t turn inward properly when you focus on a nearby object. When you read or look at a nearby object, your eyes should turn inward while you focus, so you can see a single image. But if you have convergence insufficiency, you need to use extra effort to move your eyes inward for focusing. This extra effort results in various symptoms, including eyestrain.

I’m now using an eye patch when I read or am on the computer. So far, I’ve been able to squeak out about an hour on computer with it. I still get a headache if I push it, but it is mild and doesn’t explode into a migraine. If the eye patch continues to be OK, I’ll get prescription reading glasses with a prism, which I can wear over my contacts.

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Allergies & Migraine

People with nasal allergies may have a greater incidence of migraine, according to a recent study. The study, which had 294 participants, found that 34% of people with hay fever (aka allergic rhinitis) had migraine symptoms; only 4% of participants without hay fever had such symptoms.

But don’t jump to conclusions!

This study doesn’t prove that migraines are caused by allergies. Instead it’s that people who have migraine might have the condition triggered by hay fever. These folks already have headache disorders, but the allergies may be what triggers them to come out of the woodwork. (This is how all triggers work — they don’t cause migraine, but put an already present condition into action.)

These findings also do not contradict research that says that 90% of what patients and doctors classify as sinus headache is actually migraine. That’s not necessarily true. The results may in fact reinforce the previous studies. People with allergies may be more likely to have migraine-like symptoms than those without. That doesn’t mean that those in the 34% were suffering from sinus headaches. They could be having migraines that are triggered by the allergies.

Debates about allergies and headaches are likely to go on forever. In addition to the research that I’ve read, my obvious bias is also influenced by anecdotal “evidence.” I spent a long time treating allergies and visiting allergists to treat my headaches. After two allergists in one practice said I didn’t have allergies, I found another one who did. I did this before I was diagnosed with migraine, but, migraine or not, allergy treatments didn’t help. Many people tell me similar stories. Again, stories aren’t enough to make something medical fact, but they may help you not waste precious time in treating your headaches.

Tanks, Pam for bringing this important article to my attention!