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Headache & Migraine News

Harvard Medical School researchers have found brain changes in patients with migraine. For a more accessible article about the study, read The Migrainous Brain: What You See Is Not All You Get? by Peter Goadsby of the Institute of Neurology. I fear this more than living the rest of my life in pain. It doesn’t necessarily mean changes in brain function, but the possibility is unsettling.

Using two forms of magnetic resonance imaging the researchers studied 24 patients with migraine (12 who had migraine with aura and 12 without aura) and 15 age-matched healthy controls.

There were no differences in cortical thickness in motion-related areas between the participants with migraine who had aura (neurological disturbances such as illusions of flashing lights, zig-zag lines, or blind spots) and those who did not, but the area of cortical thickening in one area corresponded to the source of cortical spreading depression previously identified in a person who had migraine with aura.

As well as showing that there are some structural differences in the brains of people with migraine, the position of the changes could help to explain why some people with migraine have problems with visual processing even in between attacks.

In 2004, Teri Robert of About.com‘s Headache and Migraine section wrote about a study examining the risk of brain lesions in people with migraine. It’s different than the current study, but scary nonetheless.

In case you’re not scared enough: Taking Topamax on a long-term basis increases your risk of developing kidney stones, according to a recent study.

Researchers found that taking topiramate on a long-term basis, or for about one year, caused systemic metabolic acidosis — a buildup of excessive acid in the blood — as a result of the inability of the kidney to excrete acid. Topiramate use also increased the urine pH and lowered urine citrate, an important inhibitor of kidney-stone formation.

“These changes increase the propensity to form calcium phosphate stones,” Dr. Sakhaee said.

In the short-term study, urinary calcium and oxalate — a chemical compound that binds strongly with calcium and is found in most calcium stones — did not significantly change in people taking topiramate.

Kidney stones are solid deposits that form in the kidneys from substances excreted in the urine. When waste materials in urine do not dissolve completely, microscopic particles begin to form and, over time, grow into kidney stones.

Some sort of good news: Sumatriptan, the generic for Imitrex has been approved in Sweden. It will be available as soon as the European patent expires in 2007. Few of you actually live in Sweden, but it could indicate the likelihood of other European countries to follow their lead.

The graphic is from the motor cortex page of PBS‘s Probe the Brain section.

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Migraine Design Project, Questions 2 & 3

Here’s the second installment of my answers to Molly’s questions. The third question was pretty tough for me to answer, so I’m taking a few days off before I answer the last two.

2. What sort of drugs have you been on and what were the side effects? Are the side effects worth it?

My drug list is long and probably best summarized in classes: Antidepressants, mood stabilizers, anticonvulsants, triptans, opioids/narcotics, OTC painkillers, anitnauseants, botox, ergots, vasocontrictors, prescription painkillers, calcium channel blockers, vitamins, natural Chinese remedies — including tea made from ground scorpions.

I’m extremely lucky in that side effects often pass me by. If I get them, they only last a month at the most. I’m able to take pretty much anything (obviously) except beta blockers because my blood pressure is on the low side. Knock on wood.

3. What might you give up to make your migraines go away?

Sorry, but my first response is to laugh. Headache and migraine have made me give up so much that I’m not sure there’s much left. But I do like the idea of a bargaining chip.

I’m going to start with a list of things left that I could trade. Reading, living in Seattle, having a home I love, concerts, travel, friends, writing, coffee, wheat products, TV, movies, listening to Dave Matthews, the internet, wearing jeans, appreciating design, listening to music while on an airplane, blogging, dancing, owning a car, eating at restaurants (which is already compromised by a restricted diet), baking, walking, talking, sleeping, breathing.

Of this list, I’d reluctantly consider trading a few of them. TV is an easy one and movies are a close second. I could probably handle wheat products. The internet, although that would make blogging impossible. Maybe dancing, but that would preclude concerts and remove a major stress release for me. Owning a car as long as I live in a place where I can walk everywhere.

If push came to shove and this would ensure that I’d be pain-free for the rest of my life, I’d consider more items to barter. But it’s agonizing to even imagine life without them. Too many are vital to my happiness. (Even though it might seem like I am, I’m not being melodramatic.)

The most recent thing I’ve given up is yoga, which may be one of the most significant losses yet. It was the one time when I focused on how strong and functional my body could be, not how broken it is. Unfortunately going without yoga doesn’t make my headaches any better.

I also can’t forget that the symptoms of this disease may eventually force me to give up travel, concerts, reading, TV or movies.

To help with Molly’s design project, send your answers to her at mmcgee@risd.edu.

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Speedy = Smart

Three weeks ago I decided what to send my mom for her birthday. But I never bought it, even though I really wanted her to get it on her birthday and for her to have something to open, not just a phone call telling her about it.

Monday was the last day possible day I could make this goal. I didn’t wake up until noon, so I had to rush to shower, set up an account online with FedEx, buy the gift certificate, get a card and FedEx it by 3 p.m. Actually, I needed to send it by 2:30 so I’d have time to go to a nearby bakery to get a latte and cheese-filled brioche for dinner.

I made it to the Fed Ex drop box at 2:15, but still feeling rushed, I parked and walked to the box on high speed, then turned around and sped back to the car.

As I drove away, a woman who had been sitting in her car, which faced the sidewalk I charged down moments before, hopped out of her car and waved her arms at me, indicating that I should stop. She came to my window and said that she was a teacher. She then told me that in her 30+ years of teaching, her most intelligent students were the ones who walked quickly. Thus, I must be very intelligent and she admired my purposeful walk.

I didn’t have the heart to tell her that I was so amped up from my new meds that I couldn’t do anything fast enough to quell my energy. I was all but bouncing off the walls.

In any case, it was very kind of her, but also one of those strange moments that make up an interesting life. Next time someone tells me to slow down, I’ll let them know that my intelligence makes it impossible.

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Sidelined by Side Effects

Yesterday I increased my Wellbutrin, started taking Lamictal and cut my Cymbalta dosage in half. And I’m feeling it. I’m shaking, my mouth is dry, my brain is fuzzy, and I’m a little nauseated and lightheaded. Based on my previous pattern, it should all wear off in a couple weeks, so I’m not worried about these symptoms. I’m just not thrilled with them.

Tonight a friend is having a party she’s referring to as the Gaggle of Gals. The last gaggle gathering was an outrageous blast. I think instead I will spend the evening reading and watching a baseball game.

I hope you all are enjoying the weekend and feeling relatively well.

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Weight Gain from Preventives

Weight gain is a common side effect of headache prevention meds and a patient can gain enough that the weight itself becomes health problem. Today’s NY Times article, Is Your Medicine Cabinet Making You Fat?, advises patients who gain weight while taking a new drug to talk with their doctors about changing meds or strategies to avoid gaining more weight. This rather obvious advice is supported by current medical research that has docs worried about the cumulative effects of weight gain.

WebMD provides a list of specific side effects for specific headache preventives. ACHE lists side effects by type of drug and guides patients on what they should talk to their docs about before beginning a new preventive.