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Hoping for a Hole in My Heart

Every night since my headache specialist recommended I get tested for a patent foramen ovale (PFO), I have lain in bed at night visualizing my heart with a hole in it. As if imagining and hoping for this defect would make it so. I so desperately want to have this hole in my heart because many migraineurs have experienced a reduction in the frequency and severity of their migraines after having their PFOs closed. This exemplifies one of the strange ways chronic intractable migraine has changed my thinking: I want to need heart surgery because there is a chance that it might finally offer an effective treatment for the migraines.

Wondering what in the world a PFO is and how it relates to migraine? Here’s what I wrote about it in 2008:

The hole, called a patent foramen ovale (or, more commonly, PFO), is an opening between the upper chambers of one’s heart. Some migraineurs who had PFOs closed for another reason reported that their migraine attacks stopped or were much less frequent after the surgery.

The hole is present in fetuses to allow blood to pass from one side to the other. In most people, the gap closes at or after birth. For an estimated 25% of the US population, it doesn’t close completely and the PFO forms. This remaining tunnel functions as a valve. Normally the valve is shut, but sometimes remains open, sending blood that’s supposed to go to the lungs off to the brain and other parts of the body.

Are Migraines Linked to a Heart Defect? is a helpful Q & A in the New York Times from 2010. I can’t find any recent stories on it. What I understand from talking with my headache specialist is that PFO closure has been helpful for migraine with or without aura (most early reports focus only on migraine with aura) and — though I have a hard time believing I heard this correctly — 80% of migraineurs who have PFOs closed report some degree of migraine relief following the surgery.

My fingers are crossed until I get the test results tomorrow.

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Prevention of Headaches or Migraines Triggered By Sex or Orgasm

Having a headache or migraine triggered by sex or an orgasm is a pretty cruel emotional injustice. Fortunately, preventing a sex-induced headache or migraine is surprisingly simple. And, no, the answer is not to avoid having sex. The most commonly prescribed treatment is indomethacin, a nonsteroidal anti-inflammatory that’s a close relative to ibuprofen, taken an hour before sex.

Those of you who don’t want to go to the doctor may deduce that you can pop a couple Advil and avoid the headache. Please don’t! The headache or migraine may be triggered by benign causes like a tightening of the head and neck muscles or a response to increased blood pressure and heart rate during orgasm. However, it could also be the sign of a brain hemorrhage,  stroke, heart disease, glaucoma, or other disorder. Instead of attempting to treat it yourself, please see a doctor to make sure there’s not a serious background cause.

Several trustworthy online sources say that taking a triptan an hour before sex is an effective treatment for orgasm-induced migraines. I asked a headache specialist about this and was told that this could cause a stroke. The specialist said that because both triptans and orgasms constrict blood vessels, the blood vessels could constrict too much during an orgasm. I’m not sure which source is correct here, but I stay on the side of caution and only take a triptan after an orgasm has triggered a migraine.

More information:

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Dear Magnesium, Will You Be My Valentine?

My head pain is currently at a level 3. Yes, you read that correctly. Yesterday it was at a level 2 for six hours and level 3 for four hours. Level 2? Level 3? I haven’t had pain levels this low in all the years I’ve been rating it.

I’m kinda afraid that acknowledging the improvement will somehow negate it, but a friend pointed out that if I could have a mental or cosmic affect on the migraines, I would have done so by now. So, I’ll take a deep breath. . . and shout MAGNESIUM! Magnesium is the difference. Last Tuesday I increased my magnesium dose from 500 mg to 700 mg per day and I’ve noticed a change in how the headaches feel as well as their severity.

I’ve still had headaches, but they feel different. The pain is more of a tight band of pressure around my head and moving doesn’t worsen the pain. Stretching under a warm shower and massaging my neck often relieves the pain. These factors add up to tension-type headaches, which, considering how tight my neck and shoulders are (something I was only vaguely aware of when the migraines commanded all my attention), makes sense.

The migraines aren’t gone altogether. Last week I had a couple I’m convinced were triggered by muscle spasms (I was experimenting with pillows) and spent Thursday as a couch zombie. I’ve also aborted a couple migraines when I noticed prodrome symptoms of feeling overheated, trembling, or ice-cold hands and feet.

I haven’t been absent from the blog because of this newfound relief. January was a rough month for me with both migraines and depression. The depression got pretty scary and really pulled me down the last couple weeks, though the last few days have been better. There appears to be a strong connection between how severe the migraines are or how long they last and my degree of depression. I’m not saying I’m depressed because of the pain, but I think something happens in the brain during a migraine that kicks up the depression. I don’t know if there’s any scientific evidence to back this up; I intend to ask my headache specialist about it.

I’m thrilled that my head pain is better, though still not convinced it will last. I am trying to enjoy it in the moment without assuming I will continue on an upward trajectory. This is a new challenge in my mindfulness practice — a challenge I am grateful to pursue!

Enough about me. Could magnesium help you? In addition to headache specialist Christina Peterson’s article Should You Be Taking Magnesium?, look into The Magnesium Solution for Migraine Headachesby Jay Cohen. This short, inexpensive book is my preferred resource on magnesium and migraine. I’m working on a summary of the information I’ve gleaned from it, though don’t know when it will be ready to post. If you decide to try magnesium, it is important note to note that different types of magnesium supplements have different absorption rates and side effects. I am using Bluebonnet’s buffered magnesium glycinate chelate with no problem. It is more expensive than other kinds, but doesn’t make me nauseated.

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Kerrie’s Latest Post on Migraine.com: The Many Symptoms of Migraine

Migraine is far more than “just a headache.” Skin sensitivity, difficulty finding words, inability to concentrate, constipation, stuffy nose, and dizziness are but a few of the many symptoms of migraine. Check out my full article on Migraine.com, Migraine is More Than a Headache: The Many Symptoms of Migraine.

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Migraine Musings, Bedhead & Social Media

Horrible migraine last night. Can’t tell if it has let up temporarily and is going to resurge or if I’m in an ugly postdrome. Not up to writing much, but I’m excited about the posts I’m working through in my mind. A preview: My additions to Ellen’s excellent list of The Migraine Dirty Dozen – Things Not to Say to a Chronic Migraineur on Migraine.com and a summary of Head Agony, Science News’ fantastic article on current understandings of the physiology of migraine, which reader Timothy sent me.

Also wanted to let you know that The Daily Headache is on Facebook and Twitter. As a special “treat” for Facebook friends, I’ve posted a picture of today’s impressive migraine bedhead!