NOVEMBER  1999 MEETING
TOPIC:  “TALK IT OVER NIGHT”

The East Bay Headache Support Group met on November 9, 1999 in the Sequoia I Meeting Room at John Muir Medical Center.  The meeting was a “Talk It Over Night” facilitated by Michael Stein, M.D., a neurologist in Walnut Creek who specializes in the treatment of headache patients, and is co-founder and medical advisor of the East Bay Headache Support Group. 

The 19 participants first discussed their headache triggers, listed as follows:

Hormones

Sleep disturbances

Food:  Two women said they had problems with calcium with magnesium.

Dehydration

Altitude

Weather changes

cigarette and cigar smoke

Strong sunlight

Pattern sensitivity:  Dr. Stein said he has found that many migraine patients say they experience visual discomfort when told to look at a picture depicting a very strong pattern, like a black and white checkerboard.  Migraineurs tend to wear solid color clothing, with little or no pattern.

 Staring at the computer monitor

Missing meals

Let-down headache:  a headache that begins after a stressful period, not during.

Stuffy air (for instance, recirculated air on an airplane)

One woman said she gets headaches from bone spurs in her neck

Motion sickness:  Many children who have motion sickness later have migraine headaches.

One woman said she wakes up with a headache every morning--she said it was from sleeping with her head in an awkward position.

Emotional upset.

Closing windows at night has helped one woman.

Barometric pressure

Rain:  if it goes from nice weather to rainy weather.

Dr. Stein asked how much of that is suggestion.  Two women said “no.”

Back to hormones: 

Estrogen

Progesterone:  Dr. Stein said it helps if you don’t take synthetic hormones.  Natural hormones tend to trigger less headaches.

Tubal ligation:  Two women said that they experience more headaches since they each had a tubal ligation, and Dr. Stein said he’s had patients with this problem.  He said that some of the blood flow from the ovaries is changed as a result of this operation.

Dr. Stein commented that birth control pills have much less hormone in them so they probably don’t cause as many headaches.

Dr. Stein told the group about the “prodrome,” the first stage of a headache.  The prodrome is experienced up to a day before and may include an aura or excessive yawning or clumsiness.  Dr. Stein asked if anyone in the room had auras prior to their headaches, and two women said they did.  There is also a “postdrome” phase, where the patient feels washed out, and is more prone to getting another headache.

Treatment:  Dr. Stein was asked how the triptans work.  He explained that Imitrex causes blood vessels to constrict and causes the release of ______ which are pain producing.  Imitrex is a synthetic serotonin.

One woman commented that her hands are sensitive to hot water when she has taken a Zomig (another triptan).  We discussed how frequently one can take a triptan drug safely.  One woman said she has taken as many as nine tablets in three weeks.  Is that too many?  Dr. Stein answered that he thinks nine tablets in a month is a lot of headaches, but he said that some people take as many as thirty in a month.  Some people even take a triptan drug as a preventative.

Ice:  Several participants said they use ice packs when they’re having a headache.  A new product, called “Migraine Ice,” was discussed.  One woman said she tried it and that it is OK, but it’s not as cold as an icepack.  She mentioned that it has a slight aroma of menthol.

Donna Johnson told the group she uses nasal Imitrex.  It it very fast-acting, but it makes her very sleepy and acts as a diuretic.

Dr. Stein asked if any in the group had tried Migrainal nasal spray, and no one had.

A couple of participants said they had tried Stadol nasal spray, and both described unpleasant side effects, such as dizziness.

Dr. Stein asked if any of the participants had tried feverfew with any success.  Several said they tried it, but found it didn’t help them to reduce their headaches.

One women went to an acupuncturist who gave her an herbal brew.  She said she felt better after ingesting the herbal brew, but she had to do it three times a week, which she couldn’t handle.

Massage one to two times per month (acupressure/reflexology) helped one woman.  She also found lavender oil and lavender bath helps.

One woman read that if you put a drop of lavender oil on your pillow that it will help headaches and helps you to sleep.  Lavender and chamomile.

Depakote is an anti-epileptic medicine which is used as a preventative.  Dosage 125 mg at two times per day on up.  One side effect is hair loss.

One woman takes Inderal prophylactically, and Maxalt.  No doctor told her that she shouldn’t take a lower dose of Imitrex when taking Inderal.  Stein said no interaction between Inderal and Imitrex, only with Maxalt (can only take 5 mg).

One woman always took Excedrin and bruised too much.  Now she takes aspirin-free Excedrin only.

Vicodin was one woman’s drug of choice for ten years (she took six to eight per day).  She had rebound headaches.  She stopped in January after ten days of tapering off.

When do rebound headaches happen?  Mostly happens in people who are migraine-predisposed, said Dr. Stein.  It works up over time.  Arthritis sufferers taking a lot of aspirin don’t typically get rebound headaches.

If you take 100 mg of caffeine (like NoDoz), you’ll get the same effect as Excedrin (which contains 65 mg caffeine).  Caffeine is used a lot in medications.  Caffeine is a drug.  If you take a coke (40 mg caffeine) and aspirin, it’s the same as Excedrin.

Depakote:  always lose hair?  No, not always.

Question on cervicogenic headaches:  One woman said she has daily headaches and she thinks they are cervicogenic.  Dr. Stein said there is a “Cervicogenic Headache Society” on the Internet.

One women was told she should never allow a chiropractor to work on her neck.  Dr. Stein said, yes, arteries in the neck can get damaged during a chiropractic adjustment.  She went to a chiropractor years and it didn’t help her headaches.  Another women said she has bone spurs in her neck and her chiropractor aligns her neck for her.

One woman taking Depakote said that her doctor told her to take Centrum Silver, another said to take zinc and selenium.

Another woman asked if she was damaging her body by taking Excedrin.  Dr. Stein answered that one Excedrin per day over the long term is probably OK.

The intention of the East Bay Headache Support Group is to provide information and resources.  It does not provide medical advice, which should be obtained directly from a physician.