Part 4

Patience, sacrifice and diligence: these three distinguishing qualities are helpful in any endeavor in life. When trying to unravel the enigma surrounding migraines … patience, sacrifice and diligence are indispensable. Don’t rule out anything as a possible trigger. There are some excellent articles on triggers on this website.

The only thing I would add in regards to triggers is that sometimes there is a synergistic pattern of not just one, but multiple triggers that exacerbates the onset and duration of a migraine. For example maybe chemical changes could sometimes trigger a mild migraine or no migraine at all – while the addition physical stress or emotional triggers in conjunction with certain foods would guarantee the onset of a migraine.

This is where the daily use of a journal to identify possible triggers is invaluable. Not only do you want to include your diet and medications but anything that is going on and how you feel about the events occurring in your life – especially when you start your doctor’s prescribed medication to treat your migraines. As a woman you might discover that while on a certain type of birth control medication attributes to the onset of your migraine. However, when you add in the stress of children (yours or others’), divorce, family problems, work, etc. to birth control pills you have a “whopper-doozie” migraine cocktail.

Part 3

The first doctor’s visit was to our family doctor. I was surprised to learn that migraines can come for a variety of reasons: Current medications, Stress, Different foods to name a few. The list went on and on. When we left we not only had a referral visit to a neurologist but more questions than answers.

When we met the neurologist he confirmed the advice that we got from our family doctor. There are many triggers associated with migraines. The neurologist wanted to do some blood work and suggested that my wife keep a journal to help identify any triggers specific to her migraine attacks. My wife was told that is equally important to write in the journal diet, sleeping patterns and everyday events as well as writing daily and not just when she felt a migraine coming on. The daily entries were vital as they could show triggers or combination of triggers that led up to the migraine. Also, when a migraine starts you probably don’t care to do anything much less write in a journal.

So we left the neurologist’s office with an appointment for a follow up visit and headed to the store to buy a journal. I was a little skeptical and was confused how in this day and age of technological advancement there was not another way. How could we cook food in 30 seconds, put a man on the moon and internet on computers and not have a cure for migraines?

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Part 2

While my wife was recuperating from her migraine I searched the internet. Upon further investigation I discovered that the onset or cause of migraines is idiopathic, meaning that triggers can be spontaneous and unknown or obscure at best.

In addition to triggers there are four phases of a migraine: the prodrome phase; the aura phase; the pain phase and the postdrome phone. Even though there are four phases not every person that suffers from a migraine experiences each one.

In my wife’s case we later discovered she does not typically experience the prodrome phase, but during the aura phase she feels a dull pain behind her left eye. Also, migraines can last from a few hours to as long as 3 days during the pain phase and be accompanied with a migraine hangover also know as the postdrome phase.

My wife gingerly emerged from the bedroom around dinnertime, which was eight hours later. We discussed her migraine and I found out that she has a history of migraines since she was very little. We agreed to schedule a doctor’s visit to see if help was available.

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Part 1

My wife has a lifelong history of migraine headaches. Before meeting her I never knew anyone that suffered from migraines. But I still remember the first time I witnessed my wife with a full-blown migraine. We were just starting our day and I came into the bedroom to let her know that breakfast was ready.

At first I thought that she had stroke and was aphasic. Her speech was slurred and she had lost some muscle control on the left side of her face. Both my grandmother and mother had strokes. “What can I do to help?” “Are you having a stroke?” I asked franticly.

She slowly lifted her finger to her lips as she looked up. “Shhh … I’ve got a migraine.” I remembered hearing that people with migraines were very sensitive to light (photophobia) and sound (phonophobia). I quietly closed the Venetian blind and snuck out of the bedroom.

You may have some triggers that start your headache attack at one time, and then these triggers can change. Triggers can be divided into different groups, including:

Emotional triggers: These are triggers that have to do with emotions and your state of mind. Some examples of emotional triggers are: family problems, problems at work, success at work or school, anticipation, anxiety, an emotional crisis, the post-crisis period, a new job, a new school, weekends, and so on.

Stress triggers: These have to do with physical effort, such as strenuous exercise, excessive physical work at the work place or at school, physical sickness, not enough sleep, too much sleep, and so on.

Environmental triggers: These triggers are responses to our surroundings. For example, bright lights, different kinds of aromas like perfume, tobacco, or any kind of odor. We can also include loud noises, altitude, weather, and barometric pressure changes. I have a patient who can predict rain two hours before it starts because of the barometric pressure change that triggers her headaches.

Chemical triggers: The most common chemical triggers are hormonal changes that occur during the premenstrual period, during a woman’s period, or during the post-menstrual period. These triggers are extremely common in women who suffer headache. But there are a variety of chemical triggers, such as low blood sugar that results after not having eaten for many hours. This is a very common trigger for headache.

Food and beverage triggers: Rarely do we connect our eating habits with headaches, but there is a strong relationship that often goes unnoticed. Some foods are commonly related to headaches.

• Some of the most common trigger foods are:
  • Hard cheese
  • Hot dogs
  • Chocolate
  • Nuts
• Less common food triggers are:
  • Smoked fish
  • Vinegar
  • Fermented food (cream, yogurt)
  • Freshly baked yeast products
  • Peanuts (and peanut butter)
  • Monosodium glutamate (commonly found in Chinese food)
  • Soybean
  • Onion
  • Canned figs
  • Citric food
  • Bananas
  • Pork
  • Caffeinated beverages
  • Avocado
  • Liver

I have noticed that a few of the above-mentioned triggers are more common than others. Bananas, pork, and Chinese food seem to be high on the list. You have to take into account that certain foods may serve as intermittent triggers, but once a food has affected you once, it becomes a risk factor. In addition, almost any alcohol drink may trigger a headache, but red wine is the most common culprit.

How Can You Recognize Your Triggers?

One of the most important aspects of headache treatment is your own control over your headache, and control starts with identifying your own triggers, and learning to avoid them.

I recommend writing down your triggers in a trigger diary. Each time you have a headache, try to relate it to one or more of the triggers that are listed above. At the end of the month you can sit down and analyze your results to see which are the most common triggers in your case.

Fun Fact: An average mattress can harbor as many as 10 million dust mites. Sweet dreams!

Allergens produced by dust mite detritus are on of the common triggers of asthma and are also to blame for a variety of other respiratory ailments. Symptoms of dust mite allergies can include itchiness, sneezing, inflamed or infected eczema, watering eyes, runny nose, hay fever, headaches, and clogging in the lungs.

Fun Fact: 80% of that dust you see in a sun beam is … yeah, mite feces and dead skin

So how do you eliminate this dread infestation from your home? Well, you don’t really. You can, however, minimize their impact by making a few changes around the house.

Getting Rid of Dust Mites

1. May sound obvious, but get rid of the dust. Give your entire house a thorough cleaning, especially the bed room.
2. Throw away all of you pillows and buy hypo allergenic pillows with mite resistant pillow cases and mattress cover. Mites love the mattresses and pillow ’cause it’s all nice an warm up in there.
3. Splurge for the HEPA filter. They can be pricey, but they do make a difference.
4. Keep the pets confined to certain portions of the house. Pets greatly increase the amount of dust mites in a home so if Fido has to stay inside, best to keep him confined to one or two rooms. Preferably not the bedrooms.
5. Get rid of your collection of stuffed animals from the state fair. These things are mite hotels. Well, actually more like birthing centers.
6. Vacuum all the time. Every spare minute. The mites are your enemy!  And since you will be vacuuming so much go ahead and get a nice hypoallergenic vacuum cleaner.

cluster headache

Sufferers of chronic cluster headaches have been known to have nine or more headaches in a day. The pain is located around the eye socket and temple and is so severe that the condition is considered a neurological disease since many chronic cluster headache sufferers eventually kill themselves.

The exact causes of cluster headaches are not known and therapies vary according to the patient. Over the counter medications often prove ineffectual so many cluster headache sufferers take any number of medications including ranging from inhaling pure oxygen, to taking beta-blockers and anti-depressants. Some more traditional methods that have worked include inhaling pure oxygen, caffeine, exercise, taking hot showers, and even sex.

Headache Causes: Any type of sexual activity can cause a migraine headache. In many cases, the cause is simply a side effect of birth control or some other over the counter or prescription medication.

Headache Risk Factors: Sex headaches tend to effect those who already suffer from some sort of chronic headaches. Having sex multiple times in succession or having sex when particularly stressed or tense can also increase the risk of a sex headache.

Headache Treatment: Occasional headaches during sex is typically not a cause for concern but if they continue or increase in intensity, then you seek the advice of a medical professional.

Withdrawal symptoms can include:

• Dysphoria or depression
• Severe Headaches
• Nausea
• Paranoia
• Weight Loss
• Changes in Blood Pressure
• Diarrhea
• Anxiety
• Abdominal Pain

Withdrawal symptoms vary depending on the individual and the drug that has been abused.  Opiate withdrawals can be radically different from alcohol withdrawals. The length of time that the individual has consumed the drug and their current state of physical health also play a critical role in the degree of withdrawal symptoms that manifest.
Withdrawal from opiates or alcohol should only be conducted under the supervision of trained professionals in a reputable center. Never attempt to assist an addict with withdrawal on your own.