Bruce Paterson, M.D., a specialist in the treatment of allergy and asthma in his private practice in

Walnut Creek, will be our featured speaker in March. He graduated from the Loyola University Stritch School of Medicine in 1980, completed his residency in internal medicine at U. C. Davis, and then studied Allergy and Immunology at Northwestern University Medical School in Chicago. Since 1985 Dr. Paterson has been an Associate Clinical Professor at Stanford University Medical School.

Headache is a common sequel to head injury and it might persist for months or years following even mild head trauma. Although it is most frequently associated with a variety of symptoms such as dizziness, insomnia, difficulties in concentration and mood and personality changes, headache dominates the clinical picture. In most patients, the frequency and severity of the headache diminishes with the passage of time, and the headache usually disappears within six to twelve months.

The most frequent cause of chronic headache after trauma is muscle contraction, specifically sustained contraction of the muscles of the neck and scalp. This is usually associated with an adverse reaction to the stress. Another type is characterized by vascular changes that may give rise to vascular headache that pulsates or is dull and constant. It has not been proven that the vascular headache following injury is related to pre-existent migraine in those migraineurs who suffered injury to their heads, nor is there any increase in the frequency of migraine in such patients.

An understanding of psychological factors involved is of great importance in post-traumatic headache for the head has a symbolic significance and injury to it usually generates more anxiety, fear and resentment than injury to any other part of the body. The accompanying muscle contraction and vascular changes to the emotional reactions produce further anxiety and the fear leads to a self-perpetuating cycle.

My experience with migraines dates back to my earliest memories but I will focus only on my recent head trauma headaches.

In 1994 I was hit head-on by a drunk driver and had two Near Death Experiences (NDEs). Years before I had published a novel on NDEs, so I knew I had to focus on survival or die—period. I swam in my own blood as the victim/survivor of head trauma. The wreck created both physical and—as would later prove to be just as costly—emotional pain. I had gashes and bruises, a broken ribcage, rotated spine, torn back ligaments/muscles, a crippled right hand, a broken left foot and a really goofy hair cut where they removed glass that was still embedded in my scalp. To top it off they sewed me up despite my complaints I felt every tug.

I went to over twenty-five doctors (a GP and specialists) and started a steady diet of pain killers which didn’t kill much but a previously chipper mood. I had to risk permanent damage to my hand to complete my new book, proving I was foolish enough to put career over health...but I didn’t see anyone giving out free cash to injured authors just to keep them afloat. As it was we had to go to the length of the law just to find the drunk driver and ended up...well, I think I’m far behind in capital on this one. Life went on but events hit and hit hard. The first friend in my true inner circle died young. My father died young, suddenly and unexpectedly. My friends either avoided me or saw this battle as inspiration. Kiss-of-death or hero: I was neither. But the dynamic of physical and emotional pain coupled with friends distancing or abandoning me only increased the chronic migraines and added raw ache.

I saw three neurologists before I found an outstanding one. The idea of taking Imitrex three times a week and NOTHING four days a week seemed inhumane. The Reasonable Neurologist (this discovery after four years of non-stop right-down-in-bed migraine, mind you) tapered me, not cold turkeyed me, and then brought in Depakote until I’m at 3000 mgs a day. I’m knocking on the very woods I hope I am out of. Is a renewed life going to be possible?

I know I’m not alone in the Horrible Occurrences Department. One has to get past the "Why Me’s?" in life and find some faith, then relentlessly cling to it.

Perhaps the best medicine is not medicine at all. Nature, friends, even loud music can oddly provide solace (and give one some other themes and ideas to get wrapped up in). The music need not be Windham Hill, but something as titanic as Beethoven or as meaningful as Beatles lyrics: how often I’ve recalled Paul singing, "In my Hour of Darkness...There will be an answer/Let It Be..."

Glaucoma is a disease of the eyes that can cause headaches. The fluid from the eyes does not drain properly, or there is over-production of fluid, which causes pressure within the eye. This increased pressure can lead to blindness if not corrected.

The headache caused by glaucoma may be felt in the region of one or both eyes or the forehead, and may be mild or severe in intensity. Nausea and vomiting may accompany the headache.