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Kerrie’s 2007: A Year to Forget

There was a theme consistently underlying my 2007 posts: My migraines were BAD. The year started with five months of being woken up by a migraine nearly every night and ended with more than two months of horrendous all-the-time migraines. I felt more beaten down than I have in the last three years.

Before you get discouraged by the following review, know that I am more optimistic about treating my migraines than I have been since I got my occipital nerve stimulator in December 2003. (Read more on that following the treatment review.)

Acupuncture
I revisited acupuncture, but my superhero acupuncturist told me that more sessions would be a waste of time and money.

Naturopathy/Homeopathy
Shedding tears in the naturopath’s office the first time was enough to keep me from seeing her again. Against my hard fast rule that I not take anything I can’t identify (which I also broke with the acupuncturist), I took the homeopathic remedy, vitamin D and magnesium supplements she suggested. They did nothing.

Chiropractic
I gave the chiropractor two months, which she said was the maximum time to see results. I went five times one week, four the next, three for a couple weeks and so on. Turns out I hold my adjustments very well. Unfortunately my migraines didn’t changed and having my neck adjusted freaked me out. Once she stopped asking about my headaches, I knew she had given up.

Sleep Specialist
Many people with treatment-resistant headache disorders become much more treatable once they have sleep problems resolved. Although my sleep seemed fine, I saw a sleep specialist with a background in neurology. Sadly, my sleep is practically perfect. I sleep eight hours, wake up rested, nap when I need to without having it interfere with that night’s sleep.

New Headache Specialist
I saw a new Seattle-based headache specialist in May. We hit it off immediately. Too bad we focused on my blog, headache patients in general and clinical trials. I left enrolled in a clinical trial for Lyrica (which I quit) and with a potential advertiser for The Daily Headache, but without having discussed any of my questions or other treatment options.

Food Trigger Diets
Food triggers were my obsession, even though I’ve always thought them to hog the spotlight in headache treatment (only about 25% of people actually have food triggers).

Although wheat and dairy aren’t considered headache triggers in the general sense, they were my target for months. My no-dairy foray lasted six weeks — until I discovered that I’d dropped 12 pounds in that time. Testing wheat lasted three months, yet I had no ill-effects when I reintroduced it.

After a couple years of avoiding them, I’m almost positive that beans, nuts and legumes are triggers for me. But berries, squash, sunflower and soy oil, barley, pineapple, onions. . . are all questionable.

I declared that I was going on a drastic food trigger elimination diet. A couple weeks later came this post: Drastic Elimination Diet for Migraine Triggers: What Was I Thinking? You get the point.

Myofascial Release
Finally some good news. In August I started myofascial release and noticed results quickly. The changes aren’t dramatic, but each treatment usually gives me some relief. The effects have never lasted more than two days — and sometimes only a couple hours — but I’m not complaining.

Craniosacral Therapy
Two sessions weren’t enough to judge if craniosacral will be effective. I’ll definitely try again, but it just didn’t work out this time. The woman I saw was wonderful and spent an extra 30 minutes with me each visit. Unfortunately, driving to her practice takes 30 minutes. After spending 20 minutes lost on the way there and another hour on the way home, the negative associations were too strong for me to go back.

What Now?
When the last migraine spell lifted in mid-December I remembered how good I could feel. Thinking about what I love about my life was no longer a reminder of what I couldn’t have, but of how wonderful it truly is. I am happy and getting out of the house more. I even get to see friends!

This year’s list of treatments to try is as long as it was last year. Its like I’ve spent the last 10 years whittling down possibilities and arrived at the most promising therapies. Having had this faith shattered in the past, I am cautious. Nonetheless, I’m positive a brighter path is ahead.

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Trying New Treatments: A Long, Long List

Physical therapy, craniosacral therapy, cognitive behavioral therapy, biofeedback, hypnotherapy, tai chi, pilates, meditation, chiropractic. While my migraines were too bad to keep appointments this fall, I kept a running list of the new treatments and therapies I’d like to try.

I have fantasies of doing nothing else than jumping in and trying all these therapies at once. They’d have to add up to more than 40 hours a week. Reality quickly usurps the fantasy: No blog, no decent meals, no organizing and downsizing. You know, all the other activities of my life.

Prioritizing treatments is more challenging than it seems.

  • My massage therapist’s physical therapist has aborted her migraines and his techniques are different than I’ve had in the past. No question I’m seeing him as soon as possible..
  • I tried a bit of craniosacral last year and the results were promising, so that’s in.
  • Cognitive behavioral therapy, biofeedback and hypnotherapy have common threads. With my depression, cognitive behavioral therapy is the natural starting point. I expect that biofeedback and hypnotherapy will flow from that.
  • Tai chi, pilates and meditation also have similarities. I want to exercise more and learn to be mentally quiet. Pilates is more about relieving pain in my lower back, but tai chi is the perfect fit.
  • Chiropractic is last on my list. Last year’s attempt was a
    bust
    , but I’m planning to see a different chiropractor, whose approach
    is quite different than the one I saw last spring. Still, having not
    been effective in the past, I’m in no rush to try it.

Choosing one from each group leaves me with physical therapy, craniosacral, cognitive behavioral therapy and tai chi. Is that still too much? Combined with myofascial release and a yoga home practice, which are having good results, I’m afraid I’m overdoing it.

In fact, I know I am. This “narrowed” list would require appointments four days a week plus three tai chi classes. Ha! Like that’s possible. But they all seem absolutely necessary.

I’m stuck. What do you recommend?

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Pain Receptors in the Bone, Skull & Scalp Pain, and Botox

Headache specialist Christina Peterson‘s comments on the news that a patient’s skin sensitivity may help predict Botox’s effectiveness for migraine explains the exciting research behind the story. Dr. Peterson attended the lecture on the topic at the International Headache Society’s annual conference. She wrote:

This was far and away the coolest lecture, although it was also given at the American Headache Society Meeting. Dr. Rami Burstein, who is a basic science researcher at Harvard, has done some ground-breaking research.

It has been conventional wisdom that there are no pain receptors within bone; the only pain receptors are on the periosteum–the lining on the bone. Dr. Burstein took it into his head to wonder if this were actually true of the skull, and set out to trace the pain pathways in rats. He showed amazing slides of fluorescent lime green nerve fibers shooting right through holes in the bone of the skull (so, yes, your skull can hurt), and terminating at the hair follicle.

So–when people say they have headaches that feel as if their hair hurts, it can be literally true. These nerve fibers were most dense at the sutures in the skull, where the bony plates of the skull come together. And now we know why craniosacral therapy works!

Dr. Burstein has also determined that there are three major types of headache pain:

  • Explosive pain (like you feel as if your brain is too big and will explode out of your head)
  • Implosive pain (as if your head will cave in the pressure is so great)
  • Orbital/eye pain (your eye hurts, or it hurts behind your eye, or it hurts to move your eye)

Unfortunately, you are permitted to have more than one of these in a given headache. He has found that it is the implosive type of pain that is most likely to respond to Botox. [all emphasis mine]

Dr. Peterson’s latest e-mail newsletter, which arrived in my inbox today, explains more about the research. If you aren’t subscribed to the newsletter, you’re missing out on an excellent, up-to-date resource. Take a look at previous newsletters and sign up for future issues.

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Cautiously Optimistic

Eliminating triggers, particularly food triggers, is the main headache treatment that all the naturopaths I’ve seen use. While effective for some, only about 25% of people with migraine have food triggers. In recent years, certain supplements — magnesium, riboflavin, coenzyme Q10 and feverfew — have also been added to the naturopaths’ arsenal.

To my immense relief, the naturopath I saw yesterday wanted to move beyond the obvious (and mostly ineffective for me) treatments. The first step is to equalize my elimination pathways. That’s all I’m going to tell you about my bowels, but I think you get the picture.

While I’m glad she wants to treat different pathways (a word she used at least 20 times), I am a little skeptical about her knowledge of and beliefs about migraine. She always referred to a problem, like toxicity in the body or postural alignment, as causing headaches. The cause of headaches is a neurological malfunction, everything else is a trigger.

Foods, stress, weather, toxic blood can all trigger a particular headache, but they are not the underlying cause of the headaches. If they were, it follows that anyone with one of these issues would have headache, particularly migraine in this case. But only people with a neurological predisposition to headaches will actually have them.

But since she’s working on other areas, I’m not too concerned about this. I’m also more lenient because the friend who recommended her will only see excellent health care providers. And this friend’s recommendations, from acupuncturist to general practitioner to restaurants, are always spot on.

Before I tell you about my treatment, a disclaimer is required. I’m not recommending that you take any particular product, nor do I work for any of these companies. Infomercials and the like are evil and do nothing to persuade me. The more hyped up a claim is, the more skeptical I am of it. But I’m willing to try anything that doesn’t harm my body.

My treatment includes a “greens drink,” which are said to “contain grasses, sprouted grains and green vegetables which infuse your body with easily absorbed vitamins, minerals and amino acids.” The website of the drink I’m using, Greens First, claims that “one serving of Greens First contains more phytonutrients (health promoting chemicals in plants) than ten servings of fruits and vegetables and much more!” In any case, it tastes good and doesn’t appear to be harmful so I’m trying it.

Next I’m taking a probiotic called “Fortefy.” The best description I can find of it is on a website selling the stuff: “. . . contains elite strains of friendly Lactobacillus and bifidobacterium. . . . Proprietary blend of 20 billion organisms: lactobacillus acidophillus, bifidobacterium bifidum, lactobacillus salivarius.” Funny how the description doesn’t explain the product.

The other two things are ones that I’ve taken off and on before, magnesium and fish oil. If you’re interested, I recommend Pharmax fish oil with orange essential oils. It is good mixed in a smoothie and doesn’t make you burp fish oil. Sorry to break my promises by recommending a specific product and also mentioning digestive functions, but the orange makes this oil far superior to any others I’ve tried.

These are on top of Migratrol and Gentiana Complex, which my acupuncturist (who is also a licensed Chinese herbal medicine practitioner) prescribed on Monday. Migratrol is self-explanatory, the connection between gentiana and headache is more complicated. The quick explanation is that a blockage of chi (energy) at the liver contributes to headaches.

The naturopath also recommended having my posture checked and having craniosacral therapy. I’ll probably check these out in the future, but I’m going to focus on acupuncture for now. If I’m shelling out lots of money for all this bodywork, I want to be able to figure out which ones are worth the cost.

I’ve gotten to the point that I know so much about headache and it’s characterization in western medicine that it’s easy for me to understand it in those terms. Even if I don’t understand something I know how to learn about it and which resources are accurate. With “alternative” medicine, I’ve been plunged into the deep end without knowing how to swim. Where are my water wings?