JANUARY 2005 MEETING NOTES

TOPIC:  “BIOFEEDBACK OVERVIEW FOR HEADACHE SUFFERERS”

The East Bay Headache Support Group welcomed back Ms. Ellen Place, R.N., as its speaker for the January 11, 2005 meeting.  The meeting was held in the Lesher Auditorium at Mt. Diablo Medical Center, with 16 in attendance.

Slide #1:  Ellen began her presentation by asking the audience, “What is biofeedback?”  And she answered saying that it is mind/body processes.  Everything about biofeedback makes sense.  It is medically sensible and physiologically sensible.  Ellen works a lot with headache patients, as well as people with other problems.  She showed a picture of some of her biofeedback equipment—a box with sensors attached to the body, which provides information that is fed into a computer.  Her job is to make it make sense to you.

Slide #2:  For every thought we have, our body responds physiologically.

Slide #3:  External/Internal Stressors

External stressors:  chemicals, nutritional factors, life changes, heredity, environmental factors.

Internal stressors (more powerful):  anger, worry, frustration.  You need to acknowledge the impact anger or other emotions have on the body.

Slide #4:  Overview of her approach to headaches:  Headache is the end result of a full body phenomena.”  The ouch itself isn’t the only physiological upset.

What are causes for the body to get out of balance?

All things count—no one magic thing.  Most of the time, it’s a combination of triggers that will start your headache.  Say, you’re allowed 10 points—if you experience more than 10, you’re going to get a headache.  So we have to become very aware.  It’s all about balance.

Ellen explained that she has to eat something at least every 3 hours or she has a good chance of getting a headache.  She has to keep her body in balance.

Caffeine also causes rebound headaches.  Ellen advised that we not go “cold turkey” when getting off caffeine.  She said that caffeine in moderation can be OK—just make certain that every day you have the same amount, at the same time.

Balancers: 

An audience member told the group that her neurologist said she couldn’t get rebound headaches from ibuprofen.  She takes about 2000 mg per day.  Ellen responded that any change should be done gradually.  Migraineurs don’t tolerate shifts (in weather, hormones, etc.).

Slide #5:  The question was asked about how to keep from having let-down headaches, and Ellen responded that the only way is to not hype up.  She said again, “It’s all about balance.  Homeostatis means healthy balance, physiologically speaking.  She stated that headache is the result of disregulation somewhere in the body.

We have to manage what we’ve got.

Slide #6: 

Slide #7:  Cave man and bear.  The cave man was built for survival—he had to either flee or flight when confronted by a bear.  More than 1,400 physical changes occur in the body.

The cave man sees the bear, activates, uses chemicals of activation (either run or fight), and resolution.  Nowadays we put a lid on the hundreds to thousands of activation responses, without a resolution.  We dump the chemicals in, and then put a lid on it.

Slide #8:  Fight or flight response.

Slide #9:  Sympathetic nervous systems “the whispers.”  Blood vessels in hands, feet and head constrict so that blood can be pumped.  When hands are cold, that’s a red flag that we’re constricted.  If hands are constricted, probably our blood pressure is up.  And the GI system shuts down.

If we activate and then put the lid on…

One doctor told Ellen about 2 things:  Stop being perfect.  If in the midst of a migraine, do something to have a bowel movement.

Your body whispers, then it talks, then it screams.  Do something when it’s only whispering.

Slide #10:  Brain – pituitary – adrenal glands.  Activation of stress response.

Slide #11:  Taken from Hormone Headache by Seymour Diamond.  Headaches and Your Hormones, page 31.  Diagram of glands. Stress disregulation.

Slide #12:  From “Smart Medicine for Menopause.”  Same physiology is being disregulated.

As an example, Ellen suggested looking at a watch or clock—take the back off to view the gears.  If one gear is missing one cog, then it affects the other gears.

How does biofeedback fit into all of this?

Slide #13:  Skin temperature feedback.  Start with breathing first.  If you’re efforting, your body is activating.  Let go—to truly relax you must learn to let go—you can’t make it.

Slide #14:  Electro-myography feedback.  Allows us to see if the muscle is expanding or contracting.

Slide #15:  Ballerina.  Muscles are made to contract for movement and balance.  It is important to know the difference between a healthy contraction and a stress-driven contraction (holding—can’t voluntarily let go of).

Slide #16:  “Bracing”

A percentage of activation chemicals are put into muscles—if sustained we get sore tight uncomfortable muscles.  We have a poor understanding of muscle bracing.

Writer’s cramp theory:  We create function (move the hand after getting writer’s cramp) and it doesn’t stay sore.  But we don’t know how to create movement for muscles in our backs.

Slide #17:  RSA  Breathing diagram.  At first most patients do upper chest breathing instead of chest breathing.  Needed—autonomic nervous system balance.

Slide #18:  Balloons.  Ellen’s three favorites:

All of you imagine you have more power than before melting started.

Ellen recommended the book, Imagery and Peak Performance.  The author might be Chad Holmstetter.  This book is good at describing how to do imagery.

Ellen stated that breathing is the most important thing in biofeedback, and then she presented an exercise in diaphragmatic breathing.  She said average human adults breathe in the upper chest, not diaphragmatically—which is wrong. At the rate of 16-18 breaths per minutes (20,000 per day).  The minute we confine the abdomen, we’re breathing wrong.  The lungs need to go down.

The first thing we all do when focusing on something is we stop breathing. 

Breathing exercise:  Shift back to diaphragm breathing.  Lean pack, pretend you have a balloon in your abdomen and put your hands on it.  Then breathe in while pushing out the abdomen.   Fill up and then empty it.

Final slide:  “Don’t sweat the small stuff.  It’s all small stuff.”

Questions and Answers:

Q:  How many biofeedback sessions can I expect as a headache patient?   

A:  Generally about 10 for headache patients, but there is no magic number.  She stated this is probably because Kaiser only allows 10 sessions for its members.  The sessions last 50 minutes.  The patient needs to do the work, but Ellen is flexible if you can’t do it every week.

Q:  How do I get a Kaiser referral to see a biofeedback therapist?

A:  Get your doctor’s request to the Outside Authorization Group.  Ellen stated that the Kaiser Neurology Department refers headache patients to her all the time.  You cannot see her for biofeedback on your own, though.  Because she’s a nurse, legally she needs to first receive a prescription from an MD, a PhD, or a dentist.

NOTE:  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.

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