Community, Coping, Diet, Doctors, News & Research, Patient Education, Resources, Treatment, Triggers

National Headache Awareness Week, June 3-9

As part of National Headache Awareness Week, the National Headache Foundation has identified seven healthy habits of headache sufferers. NHF’s goal is to help headache sufferers reduce headache risk and live a happy life despite headaches.

Seven Healthy Habits of Headache Sufferers

  1. Diet: Eat regular meals, avoiding foods and drinks that are known to trigger headache attacks
  2. Sleep: Maintain a regular sleeping schedule, including weekends and vacations
  3. Stress: Implement stress reduction techniques into your daily life
  4. Headache diary: Keep a headache diary of when your headaches occur, along with any triggers, and share the information with your healthcare provider
  5. See your healthcare provider: Make an appointment with your healthcare provider to specifically discuss your headache
  6. Be a partner in your headache care: Be informed, be a participant in your treatment and be an advocate for your headache care
  7. Education: Stay apprised of the latest headache news and treatment options (by reading The Daily Headache, of course!)

NHF will be hosting three podcasts this week to describe these tips in detail.

Monday, June 4
Lisa Mannix, MD, medical director of Headache Associates in Cincinnati, Ohio and an NHF board member will provide an overview of the seven habits.

Wednesday, June 6
Roger Cady, MD, medical director of the Headache Care Center in Springfield, Missouri and an NHF board member will provide an in-depth focus on the first three of the healthy habits and discuss the importance of diet, regular sleep and stress reduction in managing headaches.

Friday, June 8
Dr. Mannix will conclude the series by focusing on the remaining four healthy habits. She will discuss how to keep a headache diary, making an appointment with your doctor, being a partner in your headache care and staying educated. Judy Brown will also speak from her personal experience as a headache sufferer who has lived with headaches for years.

Adapted from a National Headache Foundation press release. (It’s a doc file, not a pdf)

News & Research, Society

National Headache Awareness Week 2006: Reflections

The media have paid little attention to headaches during this year’s National Headache Awareness Week, which ends tomorrow. Everything I’ve seen is a variation on the National Headache Foundation’s 12 tips press release. Scrounging around for coverage, I found a couple interesting things.

First, there are a gazillion health-related awareness days/weeks/months. With all of them competing for attention, it’s not surprising that only the most well-recognized illnesses are covered. Doesn’t do much for awareness, does it?

Second, in 2000 Bristol-Myers Squibb released “a timeline of the false starts, red herrings and ahead-of-their-time discoveries that have led to today’s highly effective and accessible migraine therapies,” according to a press release from the company. Highly effective and accessible? Yeah, right!

But that’s beside the point; some of the historical information is interesting. Just remember that it was issued by a major player in the pharmaceutical industry. Specifically, the company that makes Excedrin Migraine. You’ll see what I mean.

‘Milestones in Migraine Management’ Introduced During National Headache  Awareness Week

In ancient civilizations, headaches were believed to be caused by evil spirits who inhabited the head. The spirits were chased away with prayer or the application of some unpleasant substance, such as goat dung. Severe headache was sometimes treated by trepanning — boring a hole into the skull to release the evil inhabitant.

Incredibly, this unscientific notion of pain being “all in your head” persisted all the way into the late 20th century. Migraine was largely thought to be psychosomatic; sufferers were told to relax and sent to therapists and hypnotists. Thankfully, contemporary research has revealed precise physical events that bring about migraine pain, legitimizing the condition and providing long overdue relief.

500 B.C. Hippocratic “Humors”
Hippocrates asserted that headaches could be traced to “humors” (fluids or vapors circulating in the body). To release the humors, he recommended bleeding and the application of herbs to the head.

100 A.D. Migraine Gets its Name
The Roman physician Galen described and named the one-sided headaches characteristic of migraine. His term “hemicrania” eventually evolved into our familiar word “migraine.” Treatment with “liver pills” becomes popular and remains so all the way into the 20th century.

1600’s: Swelled Heads
English physician Thomas Willis suggested that the pain of “megrim,” or migraine, was caused by swelling of blood vessels in the head … an astonishingly accurate theory that was not scientifically confirmed until the 1940’s by Dr. Harold Wolff.

1920’s: Gotta Get Ergotamines
Ergot extracts — a product of moldy bread — had been used to treat headaches since the late 19th century. In 1918, they were synthesized into ergotamine tartrate, a vasoconstrictive treatment initially used to control bleeding after childbirth. In the 20’s, however, ergotamines became the first pharmacological treatment for migraines.

1950’s: Suddenly Seratonin
Scientists first began to uncover the true nature of migraines in the 1950’s, when it was proposed that migraine attacks might be associated with abnormalities of the neurotransmitter seratonin. Methysergide was developed to act on what was incorrectly thought to be one, simple seratonin system in the brain. The success of this drug in alleviating migraine provided the first proof that the condition might be more physical than psychosomatic.

1960’s: Polypharmacy
As research into the seratonin system progressed, it was thought that there may be as many as six different neurotransmitters involved in the production of a migraine, prompting some physicians to prescribe three or four drugs simultaneously.

1970’s: The Holistic Approach
Perhaps as a backlash to the overmedicated 1960’s, the 1970’s brought on a wave of holistic approaches to migraine management: stress reduction, relaxation, meditation, yoga, herbal remedies, acupuncture and various self-help methods using the will or the mind, aided by the newly developed techniques of bio-feedback.

1980’s: Progress in Isolating the Cause of Migraine
Scientists finally fully charted the complicated system of neurotransmitters and seratonin receptors, identifying one of them — 5-HT1 — as the primary receptor responsible for migraine pain. This important discovery led to the development of an agent called sumatriptan, which had its first highly successful trials in 1988, and paved the way for effective migraine treatments in the 1990s.

1990’s: From Doctor’s Office to Drugstore Shelf
January 1998
OTC Pain Relief … and a Superbowl Stunner
For the first time, the FDA approves a non-prescription medication for relief of migraine pain: Excedrin Migraine. Finally, a quick trip to the corner drugstore can provide migraine pain relief. That same month, Denver Broncos star running back Terrell Davis is forced to leave Superbowl XXXII due to a migraine, opening many people’s eyes to the seriousness of the condition.

October 1999: OTC Rivals Rx
Another “first” as the FDA grants an OTC treatment the same indication as prescription drugs. Excedrin Migraine received an expanded indication to include the full migraine syndrome: pain plus associated symptoms of nausea, sensitivity to light and sound, and difficulty performing everyday activities.

May 2000: New Migraine Guidelines
The U.S. Headache Consortium issues new Migraine Treatment Guidelines, intended to help doctors diagnose and treat tension and migraine headaches. For the first time, an OTC treatment, Excedrin Migraine, is recognized as a first-line therapy for migraine headache.

Hmm… Why do most people think a migraine is “just a headache” that an OTC painkiller will wipe out? And just how many of these so-called awareness weeks were developed for advertising purposes?

It’s good that National Headache Awareness Week is now orchestrated by the National Headache Foundation, an organization that seeks to “gain recognition of headache pain as a real and legitimate neurobiological condition.” And they are doing a good job. The program seems to build more steam each year. Although there hasn’t been much media coverage, headache education sessions were hosted around the US this week.

Coping, Friends & Family

12 Tips for Coping With Headache

In support of National Headache Awareness Week (which is this week), the National Headache Foundation seeks to increase the quality of life for headache suffers. Based on the findings of the American Migraine Prevalence and Prevention survey, the NHF offers 12 lifestyle-related tips to help all headache patients, migraineurs or not, cope with and, ideally, reduce their headaches.

Work
The NHF asked which work situations might cause added stress and 50% replied worrying about deadlines, with 47% noting unpleasant tasks that they face.

  • Schedule a realistic day. Avoid the tendency to schedule back-to-back appointments for a breathing spell.
  • Allow 15 minutes of extra time to get to appointments. This way, unexpected delays won’t make you late.
  • Make sure your work space is ergonomically designed from your chair to your computer keyboard. Using a non-glare computer screen and proper lighting can also be helpful.
  • If an especially unpleasant task faces you, do it early in the day; then the rest of your day will be free of anxiety.

Home
When asked which home situations might increase their stress levels, 64% highlighted financial worries, while 55% answered fighting with their spouse and/or children. On a positive note, 43% said that spending time with family and friends helps them cope better.

  • Get up fifteen minutes earlier in the morning. The inevitable morning mishaps will be less stressful.
  • Prepare for the morning the evening before. Set the breakfast table, make lunches, put out the clothes you plan to wear, etc.
  • Don’t rely on your memory. Write down appointment times, when to pick up the laundry, when library books are due, etc. Crossing tasks off of your list gives a sense of accomplishment.
  • Don’t put up with something that doesn’t work. If your toaster, alarm clock, windshield wipers-or other item-is a source of aggravation, get them fixed or replace them.

Play
The NHF survey results reported that 63% of respondents felt that not having personal time was a stressor and 60% fail to schedule time out from their activities.

  • Check your breathing throughout the day, and before, during, and after high pressure situations. If you find your stomach muscles are knotted and your breathing is shallow, relax all your muscles and take several deep, slow breaths.
  • Try a yoga technique. Inhale deeply through your nose to the count of eight. Then, with lips puckered, exhale very slowly through your mouth for 16 counts, or for as long as you can. Concentrate on the long sighing sound and feel the tension dissolve. Repeat 10 times.
  • Use your weekend time for a change of pace. If your work week is slow and patterned, build action and time for spontaneity into your weekends. If your work week is fast-paced and full of deadlines, seek peace and solitude during your days off.
  • Allow yourself time every day for privacy, quiet and introspection.

Some of these tips suggest making major changes to your life and routines; not exactly easy, especially if you have severe headaches frequently. As with anytime you make big changes, adopting one new habit at a time will increase your chance of success. After all, you’re trying to reduce stress, not add to it.

Thanks to Teri Robert for the reminder that it’s National Headache Awareness Week.

Patient Education, Resources

Headaches 101

Throbbing, pulsing, pounding, stabbing, tightening, squeezing, jabbing, piercing, paralyzing. You may dismiss the pain as a sinus or allergy headache or panic that you have a tumor or a ruptured aneurysm. In either case, the odds are that you have tension-type headache or migraine that doesn’t follow the typical pattern, but you still have to quell the nagging doubt. Besides, whatever your self-diagnosis or fear, headaches are easier to treat the sooner you find their actual cause.

ABC News has some overview videos that can help you understand your headaches better. These links will take you to each video transcript, where there’s an option to view the video.

The National Headache Foundation is a great resource for more detailed headache information.

2/16/10: It is no longer possible to link directly to the videos. You can access the videos by following the link, then searching for the video title.