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Dealing with Migraines

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by Sarah Dorrance

Someone wrote:

"I have a lot of trouble with migraine headaches. They visit me and stay for days at a time. I take Immetrex by injection for them but there are times like the last 4 days when it doesn't work."

* * *

Imitrex is actually NOT the best drug you can take -- it's pretty crude. Its cousins (naratriptan, Maxalt, etc.) are more effective and cause less side effects. Sumatriptan always made me dizzy and nauseous and paranoid, even when it didn't work (which was about half the time). Maxalt has the added advantage of being a dissolvable lozenge -- if swallowing water and a pill makes you sick, this saves you from having to do so, and I think it's less trouble to pop a tablet out of a pill pack than to try and fight the childproofing on the Imitrex ampoules.

Preventive drugs also exist, and work with varying results. Men seem to do better with beta blockers than women do. (Perhaps because men get classic migraine with aura and so on more frequently than women, and women get "common" migraine more frequently than men, which often comes with a short prodome but has no aura). Other preventive drugs include pitzotifen (Sansert in the USA), which I used to swear by until I developed a tolerance; calcium blockers; and antidepressants (specifically, Prozac and Zoloft and their cousins, which somehow work because migraine is frequently associated with seratonin imbalance).

Feverfew is a preventive herb that has a high rate of success, so much so that German doctors now prescribe it; however, it usually takes several weeks to take effect...sometimes months. You have to be patient.

I do not recommend gingko biloba unless caffeine helps your headaches rather than triggering them. Gingko constricts the blood vessels, as does caffeine.

St John's Wort is the raw form of Prozac and sometimes helps, especially if mood swings are a part of your prodome. The mood swings would be a sign that seratonin imbalance is linked to your migraines.

Skullcap is a fairly powerful sedative and if you mix it with valerian, you might be able to knock yourself out, and the valerian might help the blood vessels in your scalp relax, along with your muscles.

I don't bother with willow bark tea -- it's just the natural form of aspirin.

Ginger and pennyroyal leaves both help settle the stomach, but if you can't swallow anything without getting sick, don't bother.

If you can get a prescription for T3, Percodan, Demerol, or something of that nature to take when you have really crippling, screaming pain, it will save you a trip to the hospital.

I find that Motilium helps the nausea and wooziness -- the really strong prescription-strength variety comes in suppository form, in case you are currently puking your guts out and can't risk swallowing anything. The only two times I was able to ride on a plane without going into severe motion sickness and near-delirium, I took Motilium suppositories that I had left over from when I had food poisoning. Motion sickness is one of the biggest triggers of my own migraine headaches -- something in me rebels at the very thought of leaving the ground. I can't even ride swingsets without getting sick. Apparently my inner ears are really messed up.

The best cure for migraine, however, is finding out what triggers the pain, and avoiding it religiously if you can. Do you know of any foods that you might be allergic to? The most common food triggers are caffeine (including chocolate), sulfites (wine, smoked meats, ripe cheese), MSG, aspartame, bananas, and citrus fruit. You may or may not have problems with any or all of these. If you do have problems, they may be constant, or they may come and go. There have been times that I could drink a cup of espresso without getting at all dizzy or headachey, and there have been times when a mere Hershey's kiss nearly put me in the emergency room screaming for a shot of something to knock me out. Dairy products sometimes bother people, too. Strong odours (perfume, petrol, etc) and secondhand smoke (including incense smoke) have also been known to cause problems. Aromatherapy might therefore not be a good idea. If you can handle odour, try lemon verbena or lavender, or something that you find personally comforting. The psychological comfort value is very important. It will subliminally help you to get rid of the pain yourself.

Hypnosis tapes (which are the most effective form of self hypnosis) can work wonders if you can get around the pain and concentrate on the sound of the voice that is speaking to you via tape. If you can't do this, don't worry about it, but if you can, by all means try.

Hunger is a notorious trigger (both food hunger and otherwise). So is stress, lack of sleep, too much sleep, eyestrain, bright light, and flashing light (migraines are actually brain seizures, and therefore apparently share common triggers with epilepsy). Hangovers are not exactly something to seek out for fun, either. The dehydration causes dizziness and nausea and headache, and the photosensitivity that you get when hung over only combines with the photosensitivity you already have to make exposure to light a very painful experience. If you drink (if you can drink without getting a headache) be sure to drink lots of water or fruit juice glass of water for every unit of alcohol. Take a multivitamin with lots of B complex stuff in it to replenish what you lose.

All your efforts to prevent or avoid triggering a migraine may only help you halfway; then again, it's better to get blinding, sickening headaches at occasional and unpredictable intervals than it is to get them all the time.

I've suffered from migraines since late puberty. I have them mostly under control and only get them a few times a year, and I usually can catch them before they get bad. In fact, my CFIDS tension/exhaustion headaches are more painful and crippling than my migraines, which I would classify as "mild to moderate." It wasn't always that way. I used to be taken to the hospital two or three times a year, delirious with pain. Eventually I learned what triggered my headaches and learned to avoid the triggers; and I got a free prescription for various great experimental drugs when I went to England and availed myself of the services of NHS. There was a time when I thought being branded with a hot iron would be a cake walk because after all, a third degree burn only lasts for a few seconds, plus the time it needs to heal.

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