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Battling the Migraine

Posted on April 15, 2012 | No Comments on Battling the Migraine

Migraine is more common than asthma, diabetes or even congestive heart failure and it is diagnosed on the basis of symptoms and that no procedure can confirm the diagnosis.

We take a closer look at migraine, dubbed as the headache from hell, and learn how to manage it in a jiffy.

The first time Elsa had a migraine, she wanted to die. “I was nauseated, the light was killing my eyes, and I couldn’t even listen to the radio,” she recalled. “I was only 25 years old, and I thought I had a brain tumor. But I did nothing since the pain went away after a day. I figured I just had a really, really bad headache.”

She didn’t have another attack for several months. Then, it happened again and the pain lasted for several days. “I really started to get scared,” she said. “But I still didn’t tell my doctor about the headaches – even when I would go in for routine physicals. I was afraid they were due to something awful, and I didn’t want to know about it.”

Unknowingly, she’s not alone. In fact, great many famous people, past and present, have had migraines. To name a few: Immanuel Kant, Thomas Jefferson, George Bernard Shaw, and Sigmund Freud. Author Lewis Carroll experienced migraines, as did Elvis Presley. Some current famous people who know all about migraine are Lisa Kudrow, Terrell Davis, Whoopi Goldberg, and Princess Margaret.

The word “migraine” is derived from the Greek hemicrania which, loosely translated, means half a head. It alludes to the fact that a migraine typically affects only one side of the head —usually around the eye—and caused by changes in the blood vessels. They may be accompanied by nausea and vomiting and preceded by warning signs, usually flashing lights or numbness and tingling in the arms. Occasionally, speech may be impaired, and the attack may be disabling.

“Although migraines can start at any age, they usually begin between the ages of 10 and 40,” informed the second home edition of The Merck Manual of Medical Information. “In most people, migraines recur periodically, but they usually become significantly less severe or resolve entirely after age 50 or 60.”

The exact cause of migraine is unknown. According to one theory, migraines occur when arteries in the brain become narrow (constrict) and then widen (dilate); dilation is thought to activate nearby pain receptors. “However, this theory is too simple to explain the complex changes in blood flow that occur in the brain during a migraine,” explains the Merck manual. “Furthermore, a series of changes in the nerve cells of the brain occur before the changes in blood flow.”

Estrogen, the female hormone, appears to trigger migraines. This must be the reason why migraines are more common among women. Some studies showed that most women get hit during their menstrual periods. As menopause approaches (when estrogen levels increase), migraines become particularly difficult to control.

Some foods and drinks may also trigger migraines. Nutritionists have identified the following: wine, chocolate, coconut oil, coffee, dairy products, food preservatives, nuts, salt, and citrus fruits.

A migraine is like a story–with a beginning, a middle, and an end. “But the story is different for each person who experiences migraines,” writes Joan Raymond in her book, Migraine. “Not everyone will experience an episode in the way, nor will an episode be experienced the same way every time.” Here is the most likely sequence of a migraine attack:

The preheadache phase, called prodome, beginning hours or even days before the headache. This is the period when you are most vulnerable to developing a full-blown migraine.

Sensory disturbances, called the aura, begin after the prodome, lasting less than one hour. (The aura occurs in about 20 percent of people who get migraines. If you have a migraine with aura, that is called a classic migraine. A migraine without the aura is a common migraine.)

The pain of the headache follows the aura and can last from one hour to three days in rare instances.

Once pain stops, you enter the postdrome phase, during which you can feel fatigued or “hung over” for up to a day.

To relieve symptoms or prevent attacks, most migraine sufferers take drugs. “Different drugs are used in, each approach, but none cures the underlying disorder,” says the American Medical Association (AMA). “However, the migraine can clear up spontaneously, and if you are taking drugs regularly to prevent attacks, your physician may recommend that you stop them after a few months to see whether this has happened.”

In most people, migraine headaches can be relieved by a mild analgesic such as aspirin and acetaminophen, or a stronger one like codeine. But because the migraine may be accompanied by nausea and vomiting, these drugs may not be absorbed sufficiently to provide relief. Thus, suppository forms of these drugs may be used. Preparations containing caffeine have been used for decades to suppress the headache when the early warning symptoms are present but before the pain is manifest. Ergotamine, a more powerful drug, is prescribed in this combination or alone by injection once the headache starts.

when attacks occure more often than once a month, daily drug therapy for a period of weeks or months with emthysergide (a drug similar to ergotamine) or propranolol (a beta blocker) may be advised to prevent them.

Anxiety or depression, which can accompany migraine may be treated with other drugs. Nausea and vomiting may be controlled with an anti-emetic drug (metoclopramide, the antihistamines, and the phenothiazines).

All these drugs have their own side effects, though. Ergotamine, for instance, may cause drowsiness, and by constricting bloood vessels throughout the body, often produces a variety of side effects including burning, tingling sensations in the skin, cramps, weakness in the legs, and pain in the abdomen, arms and legs.

Methysergide, on the other hand, can produce pain in the abdomen or lower back, and also shortness of breath due to an unusual type of damage to tissues.

There are other ways of beating the pain without using drugs, according to Dr. Philip Goldber. “To manage migraines effectively, you must take steps to prevent attacks and to minimize pain when one does occur,” he says.

Other health experts advise that relaxation and meditation can help a lot of migraine sufferers. Practicing deep breathing – inhaling thru the nose and slowly exhaling thru the mouth with pursed lips – can also give one a relaxed feeling that can help prevent migraine attacks.

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