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Update on the Migraine & Chronic Daily Headache Treatments I’ve Tried Since February

I’ve tried a variety of treatments since February, but haven’t kept you updated. It’s like I don’t want to talk about them at the outset because I might jinx it. After a treatment has failed, I push it aside so I don’t have to think about it. Here’s the surprisingly long update.

Naturopath
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.

Chiropractor
I gave the chiropractor two months, which is the maximum time she told me it would take 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 and focused on pain in my lower back, I knew she had given up.

By treating me as a challenge for which she was sure she had the solution, the chiropractor made the classic mistake of nearly every “alternative” care provider and many physicians I have seen. That always makes me laugh, but leaves me wary that the overconfident provider is setting him or herself up for a fall. Which is what always happens.

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
A Seattle-based headache specialist that I’d never seen before was recommended highly, so I saw her 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 and with a potential advertiser for The Daily Headache, but without having discussed any of my questions or other treatment options.

I already had Monday’s appointment with my first Seattle headache specialist, so I didn’t make another appointment with specialist #2. Seeing specialist #1 again reminded me that she’s the right doctor for me.

Lyrica Trial
In the spirit of giving back — and possibly finding an effective drug — I enrolled in a clinical trial of Lyrica. Currently I’m keeping a headache diary and am to start the meds (Lyrica or a placebo) at the end of the month. I’m pretty sure I’ll drop out before then.

Six months, the length of the study, is a long time to wait before I can get a prescription and test Lyrica out on my own. I have other treatments in the works and don’t want to confound the equation. Besides my impatience makes waiting more than a year to find out if I took Lyrica or the placebo agonizing. I can’t decide.

Wheat-Free, Dairy-Free Diet
This one needs it’s own post, which I’m working on. In sum, it looked like there could be a connection, then it looked clear there wasn’t. Now I have no clue.

That’s the update. Disappointing, huh? I have another round of ideas percolating. They seem like good ones this time, not acts of desperation. We’ll see.

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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)

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This Time Last Year, April 9-14 & 2-8

Year_reviewApril 9 to 14

Broadway Play Examines Issues of Illness
An insightful and moving New York Times article describes the blurred lines between wellness and illness shown in the play Well. An excerpt: “‘. . . [W]henever the cause of an illness is mysterious, it’s assumed to come from psychological problems or a moral weakness? And once science finally figures out the medical root of the illness, that assumption disappears.'”

Partnering With Your Health Care Provider
Recognizing your relationship with your health care providers as a partnership is a way to feel empowered and get the most useful information from your doctor.

Too Much Sleep as Headache Trigger
Sleeping in can relieve a migraine for me, but sleeping late without a migraine can trigger one.

Lyrica Aids Sleep
In addition to its role as a chronic pain reliever, Lyrica (pregabalin) may also be an effective sleep aid for people with chronic pain. In turn, better sleep may also help relieve chronic pain

Trapped
For the last few years, we’ve gotten season tickets to the theater. . . . I’m filled with anxiety in the days before each show. What if my headache is bad? What if I’m stuck next to someone wearing too much perfume? What if…?

April 2 to April 8

Inconclusive
X-rays showed that the leads of my occipital nerve stimulator hadn’t slipped significantly, but they would certainly slip more.

A Waiting Game
After meeting with my pain specialist and neurosurgeon left me with the simple decision that I should wait and see.

High Frequency & Severity of Migraine in Teens
A nationwide study of 18,714 adolescents found that headaches are causing a lot of disability for kids 12 to 19 years. Researchers found that adolescents’ migraines often go from one or two times a month to 10 to 15 times a month within a couple years.

Trexima Study Presented at AAN Meeting
I first ask the question I posed last week: If the treatment that most accurately compares to Trexima is Imitrex taken simultaneously with naproxen, why wasn’t the combination studied?
My comments about the patent was based on misunderstanding how the process works. See my latest Trexima post for an accurate explanation how it works.

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Sleep, Sweet Elusive Sleep

Not sleeping enough can trigger headaches, so can sleeping too long. Getting the right amount at the wrong time can also be a trigger. Headaches can also disrupt your sleep. You may simply not be able to sleep. If you can, you may be so restless — even though you may not realize it — that you don’t get a good night’s rest. Relying on sleep medication is tempting, but they can make you feel groggy throughout the day.

How to solve these dilemmas? The December issue of Healthy Women Take 10, a newsletter published by the National Women’s Health Resource Center, has an article about sleeping well without medication. You don’t even have to
be a woman to get benefit from the article. It’s got good suggestions and explains the “why” behind the recommendations.

The Headache and Migraine News blog has a great suggestion that I’ve never heard of — splash water on your skin if you are having trouble falling asleep. Cooling off your skin will help you settle down and relax enough to drift off to the land of nod.

Here’s my trick: When you’re lying in bed and the sheep aren’t putting you to sleep, take three deep breaths, inhaling and exhaling slowly. After your third
inhalation, hold your breath for a count a three then slowly exhale. The magazine said to do it three times, but I usually do it until I fall asleep. This tip is the only useful information that I got from reading Teen magazine. (Contrary to what the editors and advertisers would like you to believe, it’s not helpful to learn that everyone else is prettier than you are or that you could be much more appealing, thus a better person, if you only wore these clothes or had the right length of hair or an acceptable thigh circumference).

To learn about insomnia or get more tips on getting to sleep, see what the American Insomnia Association has to say. The Michigan Head Pain and Neurological Institute explains more about headaches and sleep.

Here’s hoping that one of these suggestions will help you sleep better tonight.

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Sleep Medicine

When I have a bad headache coming on, sleeping for an hour or two is usually the best abortive I’ve ever tried. I’ve noticed this pattern over the last nine months. My headaches worsen in the afternoon, usually between 1 and 5 p.m. If I let myself nap and wake up on my own, I almost always have less of a headache than I fell asleep with.

I think of it as my version of sleep medicine. The key is letting myself nap, but only when I need to. Bad headaches for me are always accompanied by extreme sleepiness. In the past, I’ve made myself push through. Part of this is because I didn’t want to waste time sleeping, but mostly I didn’t want to mess up my sleep cycle.

Changes in sleep — too much, too little or at the wrong times — trigger headaches for a lot of people, so going to be and waking up at the same times each day can help tame them. I’ve found that, if my naps are dictated by pain and the associated sleepiness, my nighttime sleep patterns don’t change. If it’s just a lazy day and I feel OK, I will get a headache if my nap is longer than half an hour.

I’ve put my medicine to the test each of the last three days. It helped every time and twice the change was dramatic. Saturday I napped while Hart picked his sister and her husband up at the airport. I was hoping to at least be able to sit around the house and chat with them. Instead, we went out to dinner and got cupcakes and I was still able to hang out when we got home.

In the wee hours of Monday morning, I awoke with a migraine. I slept until 10 a.m. and was then able to play tour guide for most of the day. At about 5 p.m. I crashed with a headache. At 7:30 we went out to dinner and for after-dinner doughnuts. I was chipper and felt good — and stayed that way until I went to bed at my usual time.

I’m thrilled that this helps me, but also think it’s kind of strange. I’ve never heard anyone else report a similar effect. Have you? Is there some other unusual “treatment” that works for you? For example, Peter wrote in a comment that chewing gum reduces his pain.