Health Care and Migraines

Have you ever had a migraine? Are you headache prone and sometimes have head splitting pain that causes severe medical symptoms? Migraines and other types of headache -- such as tension headache and sinus headache -- are painful and can rob you of quality of life, according to WebMD.com. Migraine symptoms include a pounding headache, nausea, vomiting, and light sensitivity. Headache remedies include various types of pain relievers. Migraine treatments may also include antinausea drugs and medications to prevent or stop headaches.

Migraines are chronic headaches that can cause significant pain for hours or even days, according to the Mayo Clinic. Symptoms can be so severe that all you can think about is finding a dark, quiet place to lie down. Some migraines are preceded or accompanied by sensory warning symptoms or signs (auras), such as flashes of light, blind spots or tingling in your arm or leg. Although there's no cure, medications can help reduce the frequency and severity of migraines. If treatment hasn't worked for you in the past, it's worth talking to your doctor about trying a different migraine medication. The right medicines combined with self-help remedies and lifestyle changes may make a tremendous difference. Migraines usually begin in childhood, adolescence or early adulthood. A typical migraine attack produces some or all of these signs and symptoms:
---Moderate to severe pain, which may be confined to one side of the head or may affect both sides.
--Head pain with a pulsating or throbbing quality.
--Pain that worsens with physical activity.
--Pain that interferes with your regular activities.
--Nausea with or without vomiting.

According to the National Headache Foundation (NHF), more than 29.5 million Americans suffer from migraine, with women being affected three times more often than men. This vascular headache is most commonly experienced between the ages of 15 and 55, and 70% to 80% of sufferers have a family history of migraine. Less than half of all migraine sufferers have received a diagnosis of migraine from their healthcare provider. Migraine is often misdiagnosed as sinus headache or tension-type headache.

According to the Mayo Clinic, when untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently. Not all migraines are the same. Most people experience migraines without auras, which were previously called common migraines. Some people have migraines with auras, which were previously called classic migraines. Auras can include changes to your vision, such as seeing flashes of light, and feeling pins and needles in an arm or leg. Whether or not you have auras, you may have one or more sensations of premonition (prodrome) several hours or a day or so before your headache actually strikes, including:
--Feelings of elation or intense energy.
--Cravings for sweets.
--Thirst.
--Drowsiness.
--Irritability or depression.
--Sensitivity to light and sound.

According to the Migraine Awareness Group, after a century of society and the medical community blaming Migraines on their sufferers, advanced technology and the age of information gave us the knowledge to begin to understand this debilitating disease. However, dangerous and outdated myths surrounding the Migraine disease have not yet been dispelled on a widespread basis. Not only are such myths believed by many loved ones and co-workers of those with Migraines, but by those with Migraines themselves (Migraineurs). Furthermore, such myths continue to be unwittingly reported in the media. The Migraine disease is a serious health and disability problem that affects approximately 32 million Americans, most of whom are women, with up to 38 million Americans having Migraine genetic propensity. There is no known cure for the Migraine disease, only treatments for the symptoms. Furthermore, such treatments are not yet wholly effective and Migraineurs may show a diminished tolerance to a variety of medications, treatments, and pain management regiments. More information about this disease can be found on their site at http://www.migraines.org/myth/mythreal.htm .

Approximately one-fifth of migraine sufferers experience aura, the warning associated with migraine, prior to the headache pain, according to the National Headache Foundation. Visual disturbances such as wavy lines, dots or flashing lights and blind spots begin from twenty minutes to one hour before the actual onset of migraine. Some people will have tingling in their arm or face or difficulty speaking. Aura was once thought to be caused by constriction of small arteries supplying specific areas of the brain. Now we know that aura is due to transient changes in the activity of specific nerve cells. The pain of migraine occurs when excited brain cells trigger the trigeminal nerve to release chemicals that irritate and cause swelling of blood vessels on the surface of the brain. These swollen blood vessels send pain signals to the brainstem, an area of the brain that processes pain information. The pain of migraine is a referred pain that is typically felt around the eye or temple area. Pain can also occur in the face, sinus, jaw or neck area. Once the attack is full-blown, many people will be sensitive to anything touching their head. Activities such as combing their hair or shaving may be painful or unpleasant. Diagnosis of migraine headache is made by establishing the history of the migraine-related symptoms and other headache characteristics as well as a family history of similar headaches. By definition, the physical examination of a patient with migraine headache in between the attacks of migraine does not reveal any organic causes for the headaches. Tests such as the CT scan and MRI are useful to confirm the lack of organic causes for the headaches. There is currently no test to confirm the diagnosis of migraine.

According to the Mayo Clinic, migraines are often undiagnosed and untreated. If you experience signs and symptoms of migraine, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan. Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different. See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:
--An abrupt, severe headache like a thunderclap.
--Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking.
--Headache after a head injury, especially if the headache gets worse.
--A chronic headache that is worse after coughing, exertion, straining or a sudden movement.
--New headache pain if you're older than 50.

Abortive medications are most effective when taken early in an attack, while the pain is still mild and before skin sensitivity increases, according to the NHF. The goal is complete relief of pain and associated symptoms, allowing the sufferer to quickly return to normal functioning. If patients have frequent migraine attacks, if the attacks do not respond consistently to migraine specific acute treatments, or if the migraine specific medications are ineffective or contraindicated because of other medical problems, then preventive medications should be given to reduce the migraine frequency and improve the response to the acute migraine medicines. Cost considerations also may lead to increased use of preventive medications. The FDA has approved four drugs for migraine prevention. These include propranolol (Inderal®), timolol (Blocadren®), topiramate (Topamax®) and divalproex sodium (Depakote®). These have had many years of use and make up the majority of the items considered 'first line' therapy for migraine prevention. Amitriptyline, which is an antidepressant, may also be very effective as a migraine preventive. All migraine preventive medications require that adequate doses of the medicine be given for a sufficient length of time to determine the effectiveness. Titration of the doses may be needed to reduce adverse effects to medicines. There are a host of alternative choices for patients whose headaches do not respond to the first line medications. These include calcium channel blockers, NSAIDs, a variety of antidepressants and several miscellaneous medications. As an alternative to drug therapy, bio-feeback training uses special equipment that monitors physical tension to teach the patient how to control the physical processes that are related to stress. Once familiar with this technique, people can use it, without the monitoring equipment, to stop an attack or reduce its effects. Self-hypnosis exercises are also taught to control both muscle contraction and the swelling of blood vessels. This patient-directed therapy, with the clinician serving as a guide or teacher, should be practiced daily. Children have an excellent response to biofeedback training, since they are open to new methods, learn quickly and have not become firmly entrenched in a chronic pain pattern.

Any way you go, migraines are extremely painful, and can lead to other more serious health issues--some of which can be life threatening. If you are prone to migraines on a regular or frequent basis, visit your health care provider or primary care physician to receive care. Although no cure exists, you can certainly take preventive measures to help alleviate the pain.

Until next time. Let me know what you think.