This is a picture that I took of Greg not too long after we started dating. It was around this time that I saw him have a migraine. I'd never seen anyone have a migraine before, and it was truly scary. He started having migraines when he was fourteen. The first one was so severe that he could not walk or talk. His parents took him to the ER because they thought he was having a stroke.He gets classic migraines. They start with visual symptoms. He gets a small, central blind spot with an aura that gets bigger and moves to his peripheral vision before the headache starts. I just asked him to describe it again, and he said it looks like tv static with lights going through a rotating fan blade in his peripheral vision. He can't drive when he gets the visual symptoms.
Thankfully, he knows what most of his triggers are, and he avoids those. Also, the intensity of the headache has decreased as he has gotten older.When I did a rotation through the ophthalmology department at William Beaumont Army Medical Center, the chief of ophthalmology, Dr. Bill Davitt, had tons of handouts that he gave to patients. He invited me to take copies of them, and I used his migraine handout for years. It explained that the visual symptoms are caused by constriction of the blood vessels in the brain, and then the headache part is caused by dilation of those blood vessels. Some people only get the visual part but not the headache, and that is called an ophthalmic migraine.
Some common triggers are the sulfites and tannins in red wine, nitrates in processed meats, chocolate, msg, some cheeses, and stress. One day when we were dating, we wanted to get a special dessert for a dinner we were making, so we bought some Vienetta ice-cream. It triggered a severe migraine for Greg. Other times when he got a migraine we were able to track back what he ate, and found that something he ate had msg as an ingredient. For Greg being careful not to buy or eat anything with msg has made a big difference.Greg talked to a doctor at one point about trying Imitrex. This doctor didn't recommend it. I think the problem with Imitrex is that you really have to take it before the pain starts for it to be effective, and it doesn't help everyone who tries it. Imitrex is in a class of drugs called Triptans, and it stops the pain signal from traveling from the brain stem into the thalamus and cortex that control how a person feels pain or handles sensory inputs like light and noise. If you don't take it in time to prevent that signal from getting to the pain and sensory centers, then it's too late. The Imitrex won't help at all.
Another medication that is being used for migraines that has helped some people is Topamax. It is a drug used for epilepsy. For some it is effective at preventing migraines when taken daily. It does not help everyone and may take a couple of months to know if it will work for you. Most doctors will try it for two or three months, and if it has not been effective, they will have you stop taking it.
There are some people who should not use it. One possible side effect is angle closure glaucoma. People who are very farsighted are more likely to have an eye anatomy that makes them more prone to angle closure glaucoma, so if you are farsighted, you should avoid taking Topamax.Calcium channel blockers have also been used as a medication to prevent migraines. When the initial stage of a migraine occurs, the constriction of the blood vessels leads to reduction in oxygen which causes the aura, but it also leads to an influx of calcium which causes cellular dysfunction. Beta-blockers are also sometimes used to prevent migraines.
There are some natural treatments that seem to help quite a few people. Magnesium does help some migraine sufferers. The nervous system uses magnesium to switch nerve cells off, and magnesium is thought to be a natural calcium channel blocker. From what I am reading, there are lots of migraine sufferers who say magnesium supplementation has been beneficial.
Feverfew is an herb that has been used for centuries for headaches. It is thought to cause a decrease in the release of chemicals that cause inflammation of the blood vessels in the brain. Like all herbal remedies (and medications) there are possible side effects, so read up on those before trying it. Here is what Sloan Kettering had to say about feverfew http://www.mskcc.org/mskcc/html/69219.cfm.
Some other supplements that may help are Co-Q 10, B-6, Riboflavin (B-2), Taurine, 5-HTP, and an herb called butterbur. Some people feel anti-histamines help them with their migraines.
update 1/25/2013: For people who are sensitive to MSG and foods with natural glutamates, you can try a supplement called N-Acetyl Cysteine or NAC. It is a precursor to glutathione which is produced in the liver. Glutathione helps remove glutamates from your body.
Also, you might try going grain free or even trying an elimination diet. Here is a blog post about how one woman cured her migraines by going grain/gluten free; http://www.marksdailyapple.com/no-grains-equals-no-migraines/#axzz2J0RJodJG. Some people benefit from doing a detox. There are different ways to do this. My recommendation: slow and easy detox using organic raw fruit/veggie smoothies and juices. Watch this for free on hulu to watch one man's story about his path back to health and how he helped someone else to do the same; http://www.hulu.com/watch/289122.
We've heard people say that if they drink lots of fluids, like Gatorade, at the initial onset, the headache isn't as severe. Greg has tried that, and it did seem to help him. We've also read that Red Bull (the regular kind NOT the sugar free kind) helps. It has taurine and vitamin B-6 in it.
There is a supplement that has magnesium, feverfew, and riboflavin (B2) in it called Migrelief. Greg has never tried it, but there are over 70 positive reviews about it on amazon. There is another one called Migralex, but it is just magnesium and aspirin.
Other treatments that have brought relief to many migraine sufferers are chiropractic care, acupuncture, and massage therapy. Also botox injections have been effective for some migraine sufferers. It couldn't hurt to try this, and it could help make those worry lines on your forehead disappear.
For women who seem to get migraines at certain times in their cycle, they may have a problem with the balance between estrogen and progesterone. This was the best article that I could find on that subject; http://www.womentowomen.com/womenshealth/menstrualmigraines.aspx, and there is a progesterone cream on amazon that has over 100 positive reviews, three of which specifically mention that it relieved their migraines. I would recommend that you see a doctor and have your hormones tested before you try this. Progesterone cream does seem to be very beneficial for some women, but not for all women.
Thankfully, Greg's migraines are only a rare inconvenience these days. He absolutely avoids anything with msg, and we haven't seen Vienetta in the stores for years (I think they still make it in Europe). I am so glad he is eating healthier than he ever has, and I think that is helping. I don't ever want to see him in the kind of pain that he used to have. Whenever I have a patient tell me that they get migraines, I always feel for them. If you suffer from migraines, ask your doctor about some of the medications and alternative treatments for them. There might be something that can bring you relief. See you soon!
