HEADLINES

VOLUME 3, ISSUE 4, FEBRUARY 1998

A Publication of the East Bay Headache Support Group

(The text of this newsletter has been simplified with all graphics removed to suit all users' browsers and computer speeds.)

February 10th Meeting:

Tension Headaches

Tension headaches are probably the most common form of head pain. What causes them and how can we get relief from the pain—and prevent them in the first place? We are pleased to have Michael Stein, M.D., a neurologist, talk about tension headaches at the next meeting of the support group. Dr. Stein has been interested in headache since he was in training at UCLA in the mid 1970’s. He has been in practice since 1977 and established the Headache Clinic of the East Bay, and also co-founded the East Bay Headache Support Group. Join us in the Sequoia I Conference Room, downstairs at John Muir Medical Center, on Tuesday, February 10th, 1998.

MSG’s Aliases

Q. Can you give me a listing of the various monikers that MSG goes under in food labels?

A. Yes, MSG goes by a perplexing variety of names, including hydrolyzed soy (or wheat or vegetable or plant) protein, hydrolyzed soy (or wheat) gluten, and Kombu extract. Because MSG can be listed simply as natural flavor, your best bet is to limit your intake of processed foods if you have a known sensitivity to MSG. A great variety of these "convenience foods" (including canned soups and sauces, frozen dinners, snack chips and pizzas) contain MSG, which may not be identified on the list of ingredients. Although MSG is a common dietary trigger, not all headache sufferers are affected by it. Keeping a headache journal in which you record the foods and beverages you consume will help you to identify your individual triggers. That way you won’t have to deprive yourself of foods you enjoy that may be harmless.

Elizabeth Loder, M.D., The Headache Management Program, Spaulding Hospital, Boston, MA.

Excerpted from the December 1995 issue of Headache, the newsletter of the American Council for Headache Education (ACHE).

Way to Go, Terrell!

Did you watch Superbowl XXXII on Sunday? In last month’s newsletter we told you about Terrell Davis, the super star running back for the Denver Broncos who suffers from migraine headaches. Leslie Davis, our editor, is a great prognosticator, too. She added an Editor’s Note stating "Terrell may suffer from headaches, but he...can cause big headaches for opposing teams," which is exactly what he did in the Super Bowl when the Denver Broncos defeated the Green Bay Packers, 31 to 24. Terrell scored three running touchdowns (a Super Bowl record) and picked up 157 total yards, and was awarded the coveted MVP Award (Most Valuable Player).

Did you see Terrell leaving the field with a towel over his head? According to the next day’s newspaper account of the game, Terrell had to sit out most of the second quarter because he had a migraine headache. Doesn’t that sound familiar? The biggest day of your life and you have a headache. But Terrell used the brand new Dihydroergotamine nasal spray to relieve his headache and go on to win the game. DHE, as it is known, has been on the market in the United States for many years as an injectable medicine, and just this week it became available as a nasal spray. Ask your doctor about Migranal.

Terrell’s story helps fellow headache sufferers, and others, understand that we are achievers and can overcome any obstacle on our way to success!

By Richard Tomchalk

Ten Stress Busters

1) Cut down (or cut out) caffeine, 2) Make sure you get enough rest, 3) Plan to get to appointments fifteen minutes early,

4) Exercise!, 5) Organize your home and work, 6) Choose environments to reduce frustration levels, 6) Don’t rely on your memory to keep track of appointments, due dates, etc. Write them down in a calendar, 7.) Talk, talk, talk. Discussing your problems and concerns with a trusted friend can diffuse negative emotions, 8.) Get unpleasant chores done early in the day. Avoid procrastination, 9.) Lower your standards and expectations of others. Know what you can and can’t change, 10.) Take time every day to tend to your emotional and spiritual needs.

Excerpted from the September 1996 issue of Making Headway, the news-letter published by Help for Headaches, Windsor, Ontario, Canada.

VENDOR NIGHT

The East Bay Headache Support Group is currently organizing its first Vendor Night, scheduled for Tuesday, May 12, 1998, in the Ball Auditorium at John Muir Medical Center. We are inviting people who sell products or services for headache relief to set up booths, at which they can distribute literature, and explain their product/service to the support group attendees. So far, we have had a number of people reserve booths, but would like more participants. Call (510) 938-5252 with your name, phone number, and a description of your product or service, and we’ll get back to you.

New Weapons Aid in Fight Against Pain of Migraines

Soon, migraine sufferers will have more options in gaining relief. Expect to see the approval of three new prescription-only drugs—plus a familiar over-the-counter pain reliever—as anti-migraine agents.

The new prescription-only drugs work similarly to sumatriptan (Imitrex), which is currently available. It’s believed that migraine pain results when cranial blood vessels become inflamed and dilated. These agents cause blood vessels to constrict by activating specific brain receptors associated with the neurotransmitter serotonin.

Naratriptan (Amerge) is said to offer long-term relief to patients who have lengthy or recurrent migraine pain. Studies show that up to 81 percent of patients get relief for 24 hours after a single dose. According to Dr. Arthur Klassen of the University of Minnesota, the drug was found to be highly effective, with virtually no side effects. Because of its long stay in the body, there were fewer headache recurrences than expected.

Rizatriptan (Maxalt) is said to give fast-acting relief while also improving quality of life in migraine sufferers. In a study comparing it to sumatriptan, patients reported a lower rate of nausea and a higher rate of normal functioning after two hours. In treating multiple attacks, 77 percent of patients got pain relief within two hours after the first attack. Relief rates for their second through third migraine attacks ranged from 75 percent to 80 percent. Patients reported significant improvement in quality of life issues such as work functioning, mental health and energy/vitality—compared to their usual migraine therapies. Rizatriptan will be available in two dosage forms: a tablet and a wafer that melts in the mouth.

Zolmitriptan (Zomig) has two action modes. In addition to constricting blood vessels in the brain, it acts in the brain stem. Dr. Glen D. Solomon of the Cleveland Clinic in Ohio said this agent seems "remarkably effective" in treating morning migraine, which suggests patients can take the drug at any time during the migraine and get relief. It may also be effective in menstrual migraine. Another researcher said that patients may be able to take the drug during the aura stage and never get head pain at all.

Yet a fourth agent, eletriptan, is a year or two away.

The maker of sumatriptan isn’t resting on its laurels. Coming soon will be a new nasal spray form of sumatriptan. In clinical trials, the spray gave relief in as little as 15 minutes.

Making big news also is the coming FDA approval of Excedrin Extra Strength as an effective migraine treatment. It will be the first over-the-counter pain reliever indicated for such use. The product contains aspirin, acetaminophen, and caffeine. In clinical studies, Excedrin matched up respectably with the prescription agents. Two hours after taking Excedrin, 59 percent of patients with moderate to severe pain reported their pain had diminished to mild or none. After six hours, 79 percent reported the same results.

By Richard Harkness, a consultant pharmacist, who writes on health care topics. Excerpted from the September 9, 1997 issue of the Contra Costa Times.

Editor’s Note: This article was published in September 1997, and is outdated already. We are happy to report that in the past month, Glaxo Wellcome introduced sumatriptan (Imitrex) nasal spray, and zolmitriptan (Zomig) was introduced by Zeneca. Ask your doctor about them, as they are only available by prescription. Also, Bristol-Myers has received FDA approval to market Excedrin® Extra Strength under its new name Excedrin Migraine. This is the only over-the-counter medication indicated for migraine headache pain.

Notes

Michael Stein, M.D., facilitated a Talk It Over Night on January 14th. Notes taken of that discussion will be available at the February meeting, as well as notes from other past meetings covering the following topics: Biofeedback therapy, genetics, caregiving, dietary triggers, chiropractic treatment, pharmaceutical remedies, hormonal triggers, reducing stress in the workplace, dealing with holiday stress (and all stressors), acupuncture, children’s head-

aches, temporomandibular joint disease (TMJ), somatic headache relief, compounding medications, allergies, experimental drugs, stress relief, and non-traditional therapies. Suggested donation is $2 for each set of notes.

The East Bay Headache Support Group is a nonprofit organization dedicated to providing a forum for headache sufferers. The support group meets the second Tuesday of each month at John Muir Medical Center from 7:30 to 9:00 p.m. It is open to all headache sufferers and their families; the meetings are free (however, donations to cover printing, postage, and web site expenses are appreciated!). The support group meetings include lectures by guest speakers, question and answer sessions, and informational materials.

Directions to John Muir Medical Center: Take Highway 680 to the Ygnacio Valley Road exit in Walnut Creek; go East approximately 1-1/2 miles, and turn right onto La Casa Via. Turn left into the Medical Center parking lot, and enter at the Main Lobby. Take stairs or elevator to the lower level and follow signs to the Ball Auditorium.

We value your input! Call, fax, write, or e-mail us if you have any comments or suggestions, or would like to help. The planning committee meets the third Tuesday evening each month and welcomes new members. Michael Stein, MD, Advisor; Leslie Davis, Editor; Dana Giese, Webmaster; Donna Johnson, Treasurer; Dick Tomchalk, Postmaster; Tracy Titus.