William R. Danzig, D.D.S., a dentist with a practice limited to orofacial pain and temporomandibular disorders (commonly known as "TMJ") will be our featured speaker at the December meeting. Dr. Danzig will be talking about the differential diagnosis of headaches caused by temporomandibular joint pathology, teeth, and the muscles that are responsible for jaw movement.

A short video and slides illustrating diseased TMJ’s will also be shown.   Join us in the Ball Auditorium at John Muir Medical Center on Tuesday, December 8th, from 7:30 to 9:00 pm. For more information, call (925) 938-5252.

Whatever we may think of alternative medicine, there is no doubt that people are looking to it—the authors cite a 1993 survey in the New England Journal of Medicine indicating that 34% of the U. S. population have sought alternative therapies. There is also no doubt that this book fills a gap in the market: it is relatively difficult to find books about alternative therapies written by authors with conventional medical qualifications.

Alexander Mauskop, Director of the New York Headache Center, and Marietta Abrams Brill, a freelance medical writer, have written principally for headache sufferers in North America. They answer questions like "is Rolfing covered by medical insurance?", and include an excellent resource section in the back of the book which lists American organizations for the various therapies.... In covering most of the more common alternative therapies—like herbs, acupuncture, massage, Ayuverda and Eastern medicine, and qigong—they aim to inform rather than judge, cite research evidence where it exists, and point to potential dangers as well as benefits....

After general background on pain theories and headache diagnosis, common alternative approaches are covered in turn and there is...oodles of advice on diet and nutrition. A helpful glossary guides readers through words...like Scotoma, Qi, Vatta, and Pitta.... A comprehensive resource section and selected bibliography give useful directions to readers wanting more information about specific therapies.

I was diagnosed with migraine twelve years ago at age 25. Once diagnosed, I remembered many of the headaches I had when I was younger and finally understood them.

The first doctor I went to prescribed various calcium channel and beta blockers and none of them worked. Frustrated, I changed doctors and started seeing Dr. Michael Stein. Immediately, I started keeping a "migraine calendar", which included noting the intensity of each, what I was doing prior, and the dates of my menstrual cycles.

After a few months of keeping the migraine calendar, I was able to pinpoint the obvious triggers, such as menstrual cycle, not enough sleep, and overexerting while exercising.

I now get plenty of sleep, do not teach aerobics, and try to schedule important events around my menstrual cycle.

Over the years, my list of migraine triggers has grown, and now includes exposure to some perfumes, the preservative used on clothing, and stress. I think a lot about ways to modify my lifestyle to avoid these additional triggers, but many times it is out of my control. But certainly, a career as a saleswoman in a department store is out of the question for me (perfume, formaldehyde and stress!).

Migraines have completely changed the course of my life. I am not doing some things I would love to do, such as teaching aerobics and running, and I am more cautious in terms of taking risks and going for broke on personal/career goals. I believe I am afraid to suffer on any level because I suffer so much with migraine pain. However, when I start feeling sorry for myself or get frustrated, I focus on anything positive having to do with my experience with migraines, and I think of ways to improve the situation. 

I plan on writing another personal profile for the EBHSG's newsletter in the future, only it will begin, "I, too, suffered from migraines—maybe my personal profile will help one of you..."

Q. I am 63 years old and have had migraine headaches for over 50 years. I also have Raynaud’s disease, which leaves my fingers cold during the winter. My migraines begin suddenly, with hazy eyes and extreme pain at the base of the neck radiating to the shoulders. There are jagged spots in my eyes and it looks as though I’m swimming under water. I take ergotamine (Cafergot®) and my eyesight will usually come back in about an hour. I then experience a dull headache and sensitivity to light.

I don’t get a lot of migraines (13 last year), but there are times when I will have two or three a week, in a cluster. I keep a diary of food I eat before I have a migraine. I do know chocolate is bad, and stay away from it. I also have allergies, and took shots for 22 years.

Do you think my migraines could be allergy-related or stress-related? Could they be cluster headaches?

L. S., Danville, CA

Answer by Glen D. Solomon, M.D.Cleveland Clinic Foundation,Cleveland, OH

Question: I am 37 years old and have had migraines since age 4. Since I stopped nursing my last child 8 years ago, I have had daily headaches. As needed, I take hydrocodone (Vicodin®) and Axocet. Most days,

I repeat this 3 to 4 times. Also, I am taking amitriptyline (Elavil®) and chlorzoxazone (Parafon®) daily. I use sumatriptan (Imitrex®) as needed. I am very concerned about the medications that I have been taking for this long period. I have tried several other medications in the past with no benefit. R. K., Rutland, VT

Answer: The use of pain medications on a daily or near-daily basis can lead to rebound headaches. This occurs most commonly with pain medications that contain caffeine as a part of the formulation and with medications, such as yours, which contain an opiate and a barbiturate.

One of the phenomena seen in a rebound headache is headache at or near awakening. In a rebound headache, the pain characteristically responds to the medication causing the rebound. In individuals with a history of migraine, the headaches from rebound will usually either progress to a migraine if untreated, or have characteristics that resemble migraine headaches.