Category: migraine

What I wish you knew about migraines

It isn’t just a severe headache. Info for those that don’t know.

March 23, 2022

Migraines not only affect the person that has them, it also affects their loved ones. Everyone’s emotional health and well-being are affected. Irritation, negative feelings and sometimes anger shows up. That is normal. The problems arise when we don’t deal with the irritation, negative feelings and anger appropriately.

Look, the person that has migraines does not want to have them. They are sometimes debilitating and their quality-of-life sucks. Remember, it is not just a severe headache, it is a brain disorder. I have been on both sides of this issue. I have only had three debilitating migraines in my life. I also have had many migraines that were annoyances and I have had some that you cannot think clearly for hours. When you can’t think clearly, it takes about four times as long to work on a project than it normally does. Sometimes, you can push through and sometimes you can’t. Sometimes, medications work and sometimes they don’t.

Triggers

I know what most of my triggers are and I can do a pre-emptive strike with over-the-counter and prescription meds when I feel the familiar pain beginning.  I call it, the cocktail. I usually only have to take the cocktail once and the pain decreases to where I can function almost normally. The great thing about the cocktail, I use less medication overall. My migraines are acute. If they were chronic, then I would have to take preventative measures all of the time. Preventative measures include prescription medications, supplements, massage, running, walking, stretching, etc. As you can see, there are many things that may help with preventative measures. You have to find the group of things that will work for you. We will talk more about treatments and prevention next time.

I am thankful that I do not have chronic migraines. For those that do, I can empathize with you. I can also empathize with your family. It is hard on the family when you have plans and then a debilitating migraine flares-up. The plans go out the window or the one that is having the migraine flare-up is left at home. It sucks.

If someone is having a severe migraine, they probably should not be left alone. They should be watched. Why? Because they usually cannot get liquids or crackers safely on their own. A person that is having a severe migraine may be having neurological deficit problems and they could even have a stroke. If a person gets to status migrainosus (severe pain, lasting 3 days or more) they can have a stroke. They usually need to be in the hospital at this stage with a neurologist monitoring their condition.

As you can see, migraine is not just a bad headache. It takes the whole family working together to help get a handle on calming down migraine. Learning and understanding what a migraine disorder is and the ways in which each of you can help makes it much less stressful on all involved.

Eating nutritionally better, regular exercise, staying hydrated, learning more effective ways to deal with stress will help all involved. Help lighten the load at home for the one that has migraines. Be supportive. Ask how you can help them. Don’t be an ass. This is hard when you have been dealing with migraines for a while. During an attack is not the time to go through all the preventive measures “they should be doing.” Learning their own preventive measures takes time.

For those that have migraine flare-ups. Are you actively doing anything to try and find ways to decrease your attacks? Are you open to trying two or three things for 3 months to see if they help? Some of you have hurt for so long, that you don’t feel like you have the energy to find things that help. Maybe, you need help in getting plans of action that are unique to you and your needs.

**Shameless plug – I help with these types of plans. – Shameless plug over.**

If you have given up, I hope that you reconsider. Will you be open to the possibility that you can be helped? That you can get better and feel better? Yes, it will take time and effort on your part. You deserve to have fun and a good quality of life. If you are looking for an end to all the flare-ups and pain, that is not realistic, at this point in time. A decrease in migraine days and a decrease in the severity of pain is possible.

I encourage you to share this with others. Especially those that do not understand what happens during a migraine attack. My goal for this article is to help others better understand what a person that has migraines goes through.

Headache Types – Migraine, Non-migraine and Mixed

There are many types of headaches, about 150 different types. First, we have to figure out if the headache is a primary headache or a secondary headache. A primary headache has no known underlying cause. A secondary headache is the result of another condition. The other conditions are things like, inflammation, bacterial or viral infections, a trauma to the head or neck, sinusitis, etc.

Examples of the most common primary headaches:

    • Cluster headache

    • Migraine (with and without aura)

    • Tension headache (medically known as tension-type headache)

    • Trigeminal autonomic cephalalgia (TAC), including cluster headache and paroxysmal hemicrania

    • Silent migraine

    • Basilar migraine

    • Abdominal

    • Ocular

    • Vestibular

    • Status Migrainosus – ongoing pain lasting for more than 3 days

Examples of the most common secondary headaches related to another medical condition:

    • Disease of blood vessels in the brain

    • Head injury

    • High blood pressure (hypertension)

    • Infection

    • Medication overuse

    • Sinus congestion

    • Trauma

    • Tumor

    • Hangover

    • Menstrual

    • Exertional

There is a mixed type of headache, a migraine and a tension type headache that happen at the same time. Some call it a mixed tension migraine.

A migraine can occur in four different phases. Not everyone will experience every phase.

Premonitory phase – also known as the prodrome phase

Non-painful symptoms that may occur a few hours of a few days Before the headache arrives.

    • Unexplained mood changes

    • Food cravings

    • Neck stiffness

    • Increased yawning

    • Diarrhea or Constipation

    • Increased sensitivity to light, sound, or smells

Aura phase – sensory disturbances that may occur before or during an attack

Visual auras may occur in one or both eyes

    • flashing lights

    • zig-zagging lines

    • blurred vision

    • blind spots that expand over time

Sensory auras cause numbness or tingling that starts in the arm and radiates to the face.

Motor auras cause problems in the person’s ability to think clearly and communicate verbally.

    • slurred or jumbled speech

    • difficulty understanding what others say

    • difficulty writing words or sentences

    • having trouble thinking clearly

Headache phase – pain ranges from mild to sever (not everyone will have a headache, but they may have all of the other symptoms such as nausea, vomiting, off balance, etc.

Postdrome phase – happens after the headache subsides and lasting a few hours to a few days

    • exhaustion

    • confusion

    • generally feeling like crap

 

Migraine Triggers:

    • lack of sleep or jet lag

    • hunger or dehydration

    • foods

    • additives

    • alcohol

    • caffeine

    • medication overuse

    • smells

    • lights and sounds

    • weather

    • female hormones

    • physical activity
    • stress

Unusual signs and symptoms of migraine:

    • Body chills

    • Phantom smells

    • Brain fog

    • Insomnia

    • Stuffy or Runny nose

    • Watery eyes

    • Your skin or hair hurts – Allodynia – pain from things that do not normally hurt

    • Hiccups

    • Ringing in your ears

    • Double vision

    • Trouble hearing or understanding what others are saying

    • Sparks of light in vision

The Complete Headache Chart

Type Symptoms Precipitating Factors Treatment Prevention
  Hangover Headaches   Migraine‐like symptoms of throbbing pain and nausea not localized to one side. Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue. Liquids (including broth). Consumption of fructose (honey, tomato juice are good sources) to help burn alcohol.   Drink alcohol only in moderation.
  Caffeine‐ Withdrawal Headaches Throbbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.     Caffeine.   In extreme cases, treat by terminating caffeine consumption.     Avoiding excess use of caffeine.
        Exertion Headaches Generalized head pain of short duration (minutes to 1 hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.).   10% caused by organic diseases (aneurysms, tumors, or bloodvessel malformation). 90% are related to migraine or cluster headaches. Cause must be accurately determined. Most commonly treated with aspirin, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery to correct organic disease is occasionally indicated.       Alternative forms of exercise. Avoid jarring exercises.
    Post‐Traumatic Headaches Localized or generalized pain, can mimic migraine or tension‐type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.   Pain can occur after relatively minor traumas. Cause of pain is often difficult to diagnose.     Possible treatment by use of antiinflammatory drugs, propranolol, or biofeedback.     Standard precautions against trauma.
    Hunger Headaches Pain strikes just before mealtime. Caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping or missing a meal.     Strenuous dieting or skipping meals.   Regular, nourishing meals containing adequate protein and complex carbohydrates.     Same as treatment.
  Temporomandibul ar Joint (TMJ) Headaches A muscle‐contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening the jaw. Infrequent cause of headache.   Caused by malocclusion (poor bite), stress, and jaw clenching.   Relaxation, biofeedback, use of bite plate. In extreme cases, correction of malocclusion.     Same as treatment.
      Tic Douloureux Headaches Short, jab like pain in trigger areas found in the face around the mouth or jaw. Frequency and longevity of pain varies. Relatively rare disease of the neural impulses; more common in women after age 55.   Cause unknown. Pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.       Anticonvulsants and muscle relaxants. Neurosurgery.       None.
  Fever Headaches Generalized head pain that develops with fever. Caused by swelling of the blood vessels of the head.   Caused by infection.   Aspirin, acetaminophen, NSAIDs, antibiotics.   None.

      Arthritis Headaches Pain at the back of head or neck. Intensifies on movement. Caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.     Cause of pain is unknown.     Anti‐inflammatory drugs, muscle relaxants.       None.
Eyestrain Headaches Usually frontal, bilateral pain, directly related to eyestrain. Rare cause of headache. Muscle imbalance. Uncorrected vision, astigmatism.   Correction of vision.   Same as treatment.
      Temporal Arteritis A boring, burning, or jabbing pain caused by inflammation of the temporal arteries. Pain, often around ear, on chewing. Weight loss, eyesight problems. Rarely affects people under 50.     Cause is unknown. May be due to immune disorder.     Steroids after diagnosis. Confirmed by biopsy.       None.
      Tumor Headache Pain progressively worsens, projectile vomiting, possible visual disturbances speech or personality changes; problems with equilibrium, gait, or coordination; seizures. Extremely rare condition.       Cause of tumor is usually unknown.     If discovered early, treat with surgery or newer radiological methods.       None.
      Tension‐Type Headaches     Dull, non‐throbbing pain, frequently bilateral, associated with tightness of scalp or neck. Degree of severity remains constant.       Emotional stress. Hidden depression. Rest, aspirin, acetaminophen, ibuprofen, naproxen sodium, combinations of analgesics with caffeine, ice packs, muscle relaxants. Antidepressants if appropriate, biofeedback, psychotherapy. If necessary, temporary use of stronger prescription analgesics.     Avoidance of stress. Use of biofeedback, relaxation techniques or antidepressant medication.
      Migraine without Aura     Severe, one‐sided throbbing pain, often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light. Certain foods, the Pill or menopausal hormones, excessive hunger, changes in altitude, weather, lights, excessive smoking, and emotional stress. Hereditary component. Ice packs; isometheptene mucate, combination products containing caffeine, ergotamine, DHE injectable and nasal spray, 5‐HT agonists; analgesics or medications, which constrict the blood vessels. For prolonged attacks steroids may be helpful. Biofeedback, betablockers (propranolol, timolol), anti‐convulsant (divalproex sodium). Calcium blockers and NSAIDs may prevent or treat migraine headaches.
      Migraine with Aura Similar to migraine without aura, except warning symptoms develop. May include visual disturbances, numbness in arm or leg. Warning symptoms subside within one‐half hour, followed by severe pain.       Same as migraine without aura.   At earliest onset of symptoms, treat using biofeedback, ergotamine, dihydroergotamine or a 5‐HT agonist. Once pain has begun, treatment is identical to migraine without aura.     Prevent with same techniques as migraine without aura.

          Cluster Headaches Excruciating pain in vicinity of eye. Tearing of eye, nose congestion, flushing of face. Pain frequently develops during sleep and may last for several hours. Attacks occur every day for weeks/month, then disappear for up to a year. 80% of cluster patients are male, most ages 20‐50.         Alcoholic beverages, excessive smoking.       Oxygen, ergotamine, sumatriptan or intranasal application of local anesthetic agent.       Use of steroids, ergotamine, calcium channel blockers and lithium.
      Menstrual Headaches     Migraine‐type pain that occurs shortly before, during, or immediately after menstruation or at mid‐cycle (at time of ovulation).       Variances in estrogen levels.         Same treatment as migraine. Small doses of vasoconstrictors and/or anti‐inflammatory drugs before and during menstrual period may prevent headaches. Hysterectomy does not cure menstrual headaches.
  Hypertension Headaches Generalized or “hairband” type pain, most severe in the morning. Diminishes throughout day. Severe hypertension: over 200 systolic and 110 diastolic.   Treat with appropriate blood pressure medication.   To prevent, keep blood pressure under control.
          Aneurysm Symptoms may mimic frequent migraine or cluster headaches, caused by balloon‐like weakness or bulge in blood‐vessel wall. May rupture (stroke) or allow blood to leak slowly resulting in a sudden, unbearable headache, double vision, rigid neck. Individual rapidly becomes unconscious.           Congenital tendency. Extreme hypertension.           If aneurysm is discovered early, treat with surgery.           To prevent, keep blood pressure under control.
            Sinus Headaches Gnawing pain over nasal area, often increasing in severity throughout day. Caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin.       Infection, nasal polyps, anatomical deformities, such as a deviated septum, that block the sinus ducts.           Treat with antibiotics, decongestants, surgical drainage if necessary.             None.
  Allergy Headaches   Generalized headache. Nasal congestion, watery eyes. Seasonal allergens, such as pollen, molds. Allergies to food are not usually a factor. Antihistamine medication; topical, nasal cortisone related sprays or desensitization injections.   None.

Source: http://www.headaches.org/press/NHF_Press_Kits/Press_Kits_‐_The_Complete_Headache_Chart

Sometimes the dang chart does not completely transmit correctly, so you can use the link above.

Pat

Describing a migraine to a non-migraine person & Which Time is best, Standard or Daylight-Saving?

You get a “two fer” today.

03/16/2022

A migraine is NOT just a bad headache. Did you know that there are people in the world that have never had any type of headache? I have met a few. I could not believe that there were people that had never had any type of headache. Well, I had to talk to them and explore further. Sure enough, they had never had any type of headache. One thing that I learned is that it is very difficult to explain a pain that they have never experienced, so that they can understand that pain.

Pain is subjective.. It depends on the type of pain and the person experiencing the pain. Why is it so hard to explain? I think one of the reasons is that we need a base reference. What are the different types of pain you have experienced? Tension headache, broken arm, broken leg, broken toe, kidney stone, childbirth, arthroscopic surgery, major surgery, heart attack, arthritis flare-up, etc.

Even if someone has the same kind of injury, the pain may still be different than yours. I know. It is crazy, isn’t it? What if we learn how to better state the pain we are experiencing and how to help others understand what a migraine is? They may never understand the pain you experience, but let’s try to help them understand what a migraine is and what a migraine is not.

Here is the definition of a migraine by the National Institute of Neurological Disorders and Stroke. “The pain of a migraine headache is often described as an intense pulsing or throbbing pain in one area of the head. However, it is much more; the International Headache Society diagnoses a migraine by its pain and number of attacks (at least 5, lasting 4-72 hours if untreated), and additional symptoms including nausea and/or vomiting, or sensitivity to both light and sound. Migraine is three times more common in women than in men and affects more than 10 percent of people worldwide. Roughly one-third of affected individuals can predict the onset of a migraine because it is preceded by an “aura,” visual disturbances that appear as flashing lights, zig-zag lines or a temporary loss of vision. People with migraine tend to have recurring attacks triggered by a number of different factors, including stress, anxiety, hormonal changes, bright or flashing lights, lack of food or sleep, and dietary substances.  Migraine in some women may relate to changes in hormones and hormonal levels during their menstrual cycle.  For many years, scientists believed that migraines were linked to the dilation and constriction of blood vessels in the head. Investigators now believe that migraine has a genetic cause.”

Look at that. Does that look like just a bad headache? No! It is a brain disorder. It can cause a stroke. It can be debilitating for hours, days and sometimes months.

Look at this information from the Cleveland Clinic. “A migraine is much more than a bad headache. This neurological disease can cause debilitating throbbing pain that can leave you in bed for days! Movement, light, sound and other triggers may cause symptoms like pain, tiredness, nausea, visual disturbances, numbness and tingling, irritability, difficulty speaking, temporary loss of vision and many more.

What’s a migraine? What does a migraine feel like?

A migraine is a common neurological disease that causes a variety of symptoms, most notably a throbbing, pulsing headache on one side of your head. Your migraine will likely get worse with physical activity, lights, sounds or smells. It may last at least four hours or even days. About 12% of Americans have this genetic disorder. Research shows that it’s the sixth most disabling disease in the world.

What are the types of headaches? What type of headache is a migraine?

There are over 150 types of headaches, divided into two categories: primary headaches and secondary headaches. A migraine is a primary headache, meaning that it isn’t caused by a different medical condition. Primary headache disorders are clinical diagnoses, meaning there’s no blood test or imaging study to diagnose it. A secondary headache is a symptom of another health issue.”

https://my.clevelandclinic.org/health/diseases/5005-migraine-headaches

Learning to describe your pain more effectively.

THE FOUR MAJOR TYPES OF PAIN:

    1. Nociceptive Pain: Typically, the result of tissue injury. Common types of nociceptive pain are arthritis pain, mechanical back pain, or post-surgical pain.

    1. Inflammatory Pain: An abnormal inflammation caused by an inappropriate response by the body’s immune system. Conditions in this category include gout and rheumatoid arthritis.

    1. Neuropathic Pain: Pain caused by nerve irritation. This includes conditions such as neuropathy, radicular pain, and trigeminal neuralgia.

    1. Functional Pain: Pain without obvious origin, but can cause pain. Examples of such conditions are fibromyalgia and irritable bowel syndrome.

Words used to describe pain.

    • pressure

    • aching

    • squeezing

    • cramping

    • burning

    • freezing

    • numbness

    • tingling

    • shooting

    • stabbing

    • electric shocks (jolts)

    • burning

    • sharp

    • dull

    • intense

    • aching

    • cramping

    • shooting

    • stabbing

    • gnawing

    • gripping

    • pressure

    • heavy

    • tender

    • prickly

    • stinging

    • pounding

    • pulsating

    • throbbing

    • sick (associated with nausea)

    • tightness

    • vise-like

    • jabbing

    • lightning bolts

    • constant

    • constant with jabs

Record your Migraine

Keep a record. Clues are very valuable.

Date

Time (how long did it last)

Where is the pain located?

Are there triggers? List them.

How quickly does the headache develop? (Suddenly, over time, starts low and increases, etc.) Describe the start. You may have to think back before the pain started, what was going on?

Is there a family history of migraines or headaches?

What do you take? What works? What does not work?

Things that may happen Before a migraine

Can you recognize some of the lesser-known symptoms of a migraine? The things that may happen before the pain begins.

    • Intense throbbing or dull aching pain on one side of your head or both sides.

    • Pain that worsens with physical activity.

    • Nausea or vomiting.

    • Changes in how you see, including blurred vision or blind spots.

    • Being bothered by light, noise, or odors.

    • Feeling tired and/or confused.

    • Stopped-up nose.

    • Feeling cold or sweaty.

    • Stiff or tender neck.

    • Lightheadedness.

    • Tender scalp.

We should talk about the different types of migraines and medication overuse headaches next time.

Next is the time change debate.

Time Change Stuff

Everybody has an opinion. Especially the two weekends a year we change our clocks. Most of us are out of sorts for a week or two. The “reasons” that are used to change the time twice a year are plentiful and are usually exaggerated or down right wrong.

We aren’t gaining any daylight. The amount of daylight is still the same, our time of day has changed. I am a night owl, but I think that I would prefer the Standard Time to be the one we stay with. Settle down, you can have your say later and I hope that you do. It is much more interesting when we can have a discussion.

When I was younger, I would ask why do we do this? I was told it was to help the farmers and conserve energy. The very next questions was, you guessed it, “how?” So, we would have more time in the evening to do hay. Since most of my family had other jobs during the day and did the farming chores after work and on the weekends, that made sense to me. As for the energy conserving … well, that did not get a good explanation. We stayed out until dark-thirty so I guess we didn’t have to use as much electricity for air conditioning. I know now that there isn’t a good explanation. We no longer use coal to heat. We have much better light bulbs now. It is much better to set the thermostat and leave it alone.

Our body’s circadian rhythm is closer to Standard Time

What happens if the change to Daylight-Saving Time is made permanent? I guess we need to decide if that hour of daylight is better for us to use in the morning or the evening. Our circadian rhythm is closer to Standard Time. It seems as though it is better health wise for us to stay on Standard Time. Kids catching the bus would benefit more from Standard Time. When it is dark out, I don’t want to get up and I know that it is harder to get the kids up. It is hard to get them to bed when it is daylight outside and they have school the next day. Even if you can get them in bed, they don’t go to sleep. They are getting a double whammy. They lose out on sleep time and they are hard to get up in the morning while it is still dark outside.

Maybe the farmers want more light in the mornings. It is really hot outside after two or three.

Now I hear that Congress is getting ready to get in to the time change game. This may be interesting. It looks like our representatives are leaning towards Daylight-Saving Time. If it passes then Hawaii and Arizona will have to change their clocks. Whichever group has the best lobby will probably win.

I do like the idea of never having to change our clocks forward and back. I prefer us to be on Standard Time for health reasons and kids that have to get up early and catch a bus. For the parents that have to get them to bed, it will be easier on you to get them to bed when it is dark outside.

Yes, I do know that Daylight-Saving Time gives us more daylight in the evening to be active or “do stuff.” Is that one hour in the evening worth all the other issues we will have to deal with?

I don’t know 100% which is best, but I am leaning towards Standard Time. If Daylight-Saving Time is picked, then we will make the best of it, do some studies over 10 years and see. Just pick one!

And your thoughts?

Pat