Teri Leichenger is a registered nurse, licensed acupuncturist, and certified herbalist. She will discuss the effectiveness of Chinese Medicine in the treatment of headaches.

Ms. Leichenger graduated from the University of California Berkeley in 1978 with a B.A. in Psychology, then went on to get a B.S.N. from the Columbia School of Nursing in New York in 1982, and worked as an Obstetrical Nurse for 13 years. In 1997 she obtained a Masters of Science degree in Traditional Chinese Medicine from the Academy of Chinese Culture and Health Sciences in Oakland, CA, and has an active acupuncture practice in Walnut Creek.

The May 11th meeting of the East Bay Headache Support Group will be held at a different location, in the Concord 1/Board Room at Mount Diablo Medical Center, instead of our normal meeting place at John Muir Medical Center. Richard Sankary, M.D., head of the Sleep Disorders Center at Doctors Hospital in Pinole, will be speaking on sleep disorders and headache. Directions to Mount Diablo will be given in next month’s newsletter.

Then, on June 8th, we are back in the Ball Auditorium at John Muir Medical Center for a special two-hour meeting sponsored by Glaxo Wellcome Inc. This is a patient information program entitled, "Take Charge!" A short video will be shown, a migraine sufferer will speak about her experiences, and Michael Stein, M.D., will outline specific steps a migraineur can take to defend her/his lifestyle against the often devastating effects of migraine headaches.

Mild pain feels unpleasant, and can be a minor annoyance. Severe pain captures our attention. It can control behavior, energize frantic efforts at avoidance, and arouse feelings ranging from fear or irritability to depression and despair. In contrast, a sense of self-control over chronic headaches can be enhanced when the individual with headache understands his or her negative emotional responses and develops a systematic plan to address them.

Headache sufferers may have a high level of general pain tolerance compared to other people, yet experience significant distress on account of their severe headaches.

Research has revealed that patients with chronic headache actually report significantly less fear of minor pains than is typical for a comparison group of people who do not have frequent headaches. In contrast, headache sufferers note significantly more fear of severe, medical pain than the comparison group. The fear of pain is more closely tied to how greatly the headaches disrupt life activities and pleasurable events than to their frequency, severity, and duration. Headache sufferers with greater fear of pain are also more likely to experience depression, anxiety, and overall emotional distress.

At best, the fear of pain is unpleasant. At its worst, what might be called headache fear or cephalgia-phobia (a term we have used for several years) can both intensify the experience of headache and lead to pain-avoidance strategies that are counterproductive. Fear of pain drives some patients to take more medication than prescribed. Overuse of pain relievers can result in a chronic daily headache by the development of analgesic rebound headache. Fear of an oncoming headache can motivate overly energetic attempts to get as much done as possible before the real headache hits—behavior that may actually accelerate or intensify the head pain. Fear of headache can lead to avoidance of school, work, social events and other activities, resulting in isolation, poor school performance, job-related problems, and overall depression.

What can be done about it? Some patients say, "If you will just take care of my headaches, everything else will be fine." While medical science continues to provide new and effective treatments, unfortunately we do not have a cure for chronic headache. Effective therapy must often target two related but distinct goals: the reduction of both pain and emotional distress. The acronym

I AM U R³ can serve as a helpful guide to reduce fear of pain and other negative emotional responses.  Identify your negative emotions. Take the time to analyze your thoughts and feelings, and the courage to be honest with yourself.

Accept the fact that you have negative thoughts and feelings. Some people find it hard to acknowledge that they are fearful or upset, and blame themselves for not having enough emotional control. Remind yourself that you are human, not perfect, and while fear of pain or headache-related emotional distress are unpleasant feelings, they are certainly understandable.

Motivate yourself to work on reducing your fears and any negative emotional behavior. Review the reasons why you would want to change your emotional responses, even when they seem understandable and justifiable.

Use behavioral approaches to cope with pain, associated fears, and negative feelings and use pain medication appropriately. It is often helpful to make a pain plan with specific examples of how you intend to cope with varying levels of head pain....Coach yourself to follow the plan, to relax, to focus on the moment and "one step at a time" rather than project negatively into the future.

Review the process. Reward yourself for the effort made and even small steps toward modifying fear and other negative reactions. Repeat it with the next headache episode. Results take effort and repetition.

In summary, some level of headache-related fear is common when faced with a chronic condition. Will it ever end? How much worse will it get? Will I be able to take it? How will others react? Appropriate drug and non-drug treatment, combined with an action plan to understand and reduce distress, can often provide significant hope and relief for the chronic headache sufferer.

In 1988, my headaches began. I was working at a job that was full of stress. I had decided that stress seemed to be a natural part of work. Lots of my friends and associates also seemed to have headaches, so I didn’t feel that I was very different. I took over-the-counter medication that seemed to do a pretty good job. I would take a couple of Extra Strength Excedrins and soon the pressure would be relieved.

In September 1996, I began to experience an extreme pain in the left side of my neck. I could not get rid of the pain using a number of techniques such as Excedrins, massage, cold and hot wraps, and anything I could think of. On the 30th of September, I was scheduled for an appointment with a chiropractor. I was hurting badly so I was willing to try anything.

Early that morning, my husband and I were out walking our dogs. It was a beautiful, sunny morning. After finishing our walk and coming back into the house, I was on the phone calling a store to order some bedding material. As I was speaking, I began to realize that the clerk did not understand my conversation. I got off the phone and walked into my husband’s office. He also said I was not making much sense, but got up to take me to the chiropractor’s office.

As we drove down the street, my husband said I was not able to tell him where the office was. I really don’t remember much about the details, but I know we stopped at my brother-in-law’s house to get the necessary directions. I clearly remember sitting in the car when my brother-in-law came out to see me. I know that I held my hands on the back of my head and said, "I have a terrible headache."

That is about all I remember except for a quick flash of memory when we walked into Emergency at John Muir Medical Center. Evidently, my husband realized that this was not just another headache. In fact, I was having a cerebral hemorrhage.

I don’t remember anything at all for the next four days. Apparently the evening I was admitted, I had a grand mal seizure which was severe enough that a priest was called for me. My family and friends were on their knees and I think their prayers were definitely heard.

On the fourth day, I was moved to the rehabilitation floor and my work began. I left the hospital on October 15th. My husband, family and friends were at my side for many, many days and months. I had lost my license so my husband was a taxi wonder!

My stroke did not cause any physical problems, but my speech was definitely impacted. Because of the many skilled speech therapists that I was fortunate to work with, recovery moved at an amazing pace. I have been called a miracle. I am very grateful.

Do I have headaches now? I’m sorry to say—yes—but I am beginning to have a better understanding of the cause. Fatigue seems to have a dramatic effect. The more tired I am, the longer and painful the headache. I can no longer take Excedrin because I can’t take a risk with anything that might dilute my blood. Dr. Stein has prescribed a painkiller for me which helps a great deal.

So that’s my story. Never let anyone say to you, "That’s just another headache." You and I know that it could be more than just another headache. By Mary Jane Laufenberg

The two main types of stroke occur when a blood vessel to the brain bleeds (a cerebral hemorrhage), or when a blood vessel is blocked (a cerebral infarction). Cerebral hemorrhage patients almost always suffer from head-ache, especially if blood enters the area surrounding the brain, displacing pain-sensitive blood vessels. The pain is sudden, severe and persistent. A recent survey of physicians found that sufferers who had severe migraines had a greater propensity to suffer a stroke than those who did not.