Rein Your Migraine

Yes, a migraine is a very bad headache. Yes, it's difficult to know what a migraine really feels like until you've had one. But to call any bad headache a migraine is not just incorrect; it's also insensitive to the people who struggle with colossal migraine pain and other frightening and uncomfortable symptoms. I have migraine and the headaches are so bad that my brain literally stops functioning. Having such close encounters with severe pain myself where it feels like death is just momentary away from you, I have been trying to do my share of research on why migraine is caused and how can it be prevented. There are a lot of papers and articles written on how to avoid the migraines that one can always research online, but with my experience with severe migraines, I thought to list out certain facts about migraine and its medication through this post to help my family and friends fight this mutual enemy of ours.

The underlying causes of migraines are unknown, however, they are believed to be related to a mix of environmental and genetic factors. The exact mechanisms of migraine are not known either. It is, however, believed to be a neurovascular disorder. The primary theory is related to increased excitability of the cerebral cortex and abnormal control of pain neurons in the trigeminal nucleus of the brainstem. The throbbing or pulsing head pain is often indicative of a migraine as opposed to another type of headache; often accompanied by sensitivity to light and sound and, occasionally, nausea or vomiting. Some migraine sufferers also deal with constipation or diarrhea, confusion, irritability, muscle stiffness, fatigue or aura in the hours before the pain starts (at times I too have experienced the aura before the attack), and once the pain starts, it can last up to 72 hours.

Like every other attack, there are certain ‘triggers’ which can set off the migraine attack. A trigger can be any event, change, external stimulus or physical act which seems to result in migraine. It precedes the attack by a short interval which could be as much as up to 6 to 8 hours. For people who experience from migraines, certain foods, strong perfumes, flickering lights, certain sounds, weather changes and other environmental factors can trigger the migraine. But one thing here worth mentioning is that not everyone has the same triggers, and not every time—and that makes the migraine trigger a frustrating prey to hunt down. There is, however, general agreement about the most common triggers that can cause headache and I have tried to list most of them in this post. The causes and triggers can vary from individual to individual so it is important to figure out your trigger and avoid it. Not to forget that the foods and various stressors listed here are the suspects, and not convicts: So it is important that you narrow it down to your own personal triggers which will help in reducing your headache frequency.
Hope it helps!

Triggers

Food triggers

·         Ripened cheeses (such as cheddar, Emmental, Stilton, Brie, and Camembert)

·         Chocolate

·         Marinated, pickled, or fermented food

·         Foods that contain nitrites or nitrates (bacon, hot dogs) or MSG (soy sauce, meat tenderizers, seasoned salt)

·         Sour cream

·         Nuts, peanut butter

·         Sourdough bread/baked goods

·         Broad beans, lima beans, fava beans, snow peas

·         Figs, raisins, papayas, avocados, red plums

·         Citrus fruits

·         Excessive amounts (more than 2 cups total) of caffeinated beverages such as tea, coffee, or cola

·         Alcohol (including red wine and beer)

·         Missed Meals

·         Caffeine withdrawal

Allergic reactions

Allergic rhinitis  [an allergic inflammation of the nasal airways occurred when an allergen, such as pollen, dust, or animal dander (particles of shed skin and hair) is inhaled by an individual triggering the production of the antibody immunoglobulin E (IgE), which binds to mast cells and basophiles containing histamine] may often lead to a “sinus headache”. The release of histamine due to the allergic reactions can also lead to the dilation of blood vessels in the brain, and therefore cause or worsen a migraine headache.

Menstruation

More often known as ‘Menstrual migraine’ in women, this is associated with falling levels of estrogen.  The two most accepted theories on the cause for menstrual migraine at the moment are:

·         The withdrawal of estrogen as part of the normal menstrual cycle and

·         The normal release of prostaglandin during the first 48 hours of menstruation

There are no tests available to confirm the diagnosis, so the only accurate way to tell if you have menstrual migraine is to keep a diary for at least three months recording both your migraine attacks and the days you menstruate. This will also help you to identify non-hormonal triggers that you can try to avoid during the most vulnerable times of your menstrual cycle.

Environment

·         Weather changes including: temperature changes, extreme heat or extreme cold weather, humidity, barometric pressure changes and storms

·         Odors, pollution and smells including: smog, cigarette smoke, perfumes and chemical odors

·         Lights, such as: bright lights or glaring lights, fluorescent lights, flashing lights or screens

·         High altitudes

·         Flying, jet lag, travel or motion

·         Dusty conditions

·         Dry conditions

·         Patterns, including: stripes, checkers or zigzag lines

Stress

Migraines and stress are strongly linked. Indeed, anxiety, excitement and any form of tension and shock may all lead to a migraine attack. Also, some people experience something called “weekend headaches” when, after a busy and stressful week at work; an individual might experience a migraine at the weekend when they are more relaxed. Physical stress or certain exercises can also trigger the attack.

Medication
There is no specific cure for migraine headaches. But one thing you can definitely do is treat your migraine symptoms right away, and prevent symptoms by avoiding or changing your triggers. If you feel the need, you can always take medication which can help in reliving the pain. Over-the-counter pain medications such as acetaminophen, ibuprofen, or aspirin are often helpful when your migraine is mild. However, if you have frequent migraines, it is recommended that you visit your doctor who may prescribe medicine to reduce the number of attacks depending on your condition and other medications.

The migraine medication is classified in two major categories: those designed to prevent attacks, and those designed to relieve pain.

Drugs for prevention

·         Beta-blockers -- also used to treat heart disease; researchers aren't sure why they also work for migraines, although they may help keep blood vessels in the brain from constricting and dilating. Beta-blockers include:

·         Atenolol (Tenormin)

·         Metoprolol (Lopressor, Toprol-XL)

·         Propranolol (Inderal, Inderal LA)

·         Calcium-channel blockers -- another type of heart disease drug that can help prevent migraines, including:

·         Verapamil (Calan, Isoptin)

·         Diltiazem (Cardizem, Dilacor)

·         Antidepressants -- Tricyclic antidepressants are helpful in preventing all kinds of headaches, including migraines. Tricyclic antidepressants include:

·         Amitriptyline (Elavil)

·         Nortriptyline (Pamelor)

·         Doxepin (Sinequan)

·         Imipramine (Tofranil)

·         Anticonvulsants -- Some antiseizure drugs help prevent migraines, although researchers aren't sure why:

·         Divalproex sodium (Depakote)

·         Gabapentin (Neurontin)

·         Topiramate (Topamax)

·         Botox -- Botox, a medication made from a purified form of botulinum toxin, has been approved to treat migraines. Researchers aren't sure why it helps some people. To treat migraines, botox is given as a series of injections in the forehead, temples, back of the neck, and shoulders. Injections are given about every 3 months.

Drugs for treatment

·   Triptans -- These medications are often the first ones prescribed to relieve pain, nausea, and sensitivity to light and sound. They work by constricting the blood vessels in the brain. Triptans include:

·         Almotriptan (Axert)

·         Eletriptan (Relpax)

·         Frovatriptan (Frova)

·         Naratriptan (Amerge)

·         Rizatriptan (Maxalt)

·         Sumatriptan (Imitrex)

·         Zolmitriptan (Zomig)

·   Ergots -- Ergots also work by constricting blood vessels, but tend to have more side effects than triptans. Ergots include:

·         Dihydroergotamine (Migranal)

·         Ergotamine (Ergomar, Cafergot)

·   Isometheptene, dichloralphenazone, and acetaminophen (Midrin) -- Midrin combines a pain reliever (acetaminophen) and sedative (dichloralphenazone) with a medication that constricts blood vessels (isometheptene) to prevent migraines.

Herbal Remedies

·         Skullcap

·         Butterbur root

·         Feverfew

Researchers and doctors are still trying to find the exact cause of migraine. Treatment for the same is still uncertain, however, there is always a ray of hope since there are people who have been completely cured and are living a perfectly healthy life. So, don’t give up yet because you may never know when and what will work for you. And with brilliant breakthroughs in medical science every day, I am sure we would soon have the antidote to defeat one of our worst arcane enemies.

Speaking about headaches, Love itself can be a reason for one. Ergo, in the spirit of staying healthy, my best and heartiest wishes to you this Valentine!

Stay Well!