- - Monday, October 16, 2017

ANALYSIS/OPINION:

Stress from demanding deadlines to overbooked time schedules, back-to-back activities, addressing family concerns – all, can cause the sudden onset of a throbbing, painful migraine headache for hours or even days. And so can family history, change in wake-sleep patterns, certain foods, dehydration and “screen time,” along with other factors. For years, migraines have been poorly understood and challenging to treat effectively – but today, modern techniques have helped to advance our understanding of what causes migraines.

Classified by the World Health Organizations, migraine attacks are the 6th most disabling illness in the world – and if you or someone you care for has migraines, you understand the effects of the extremely incapacitating neurological symptoms. They can come on suddenly — often with vision loss or disturbances, sensitivity to light and sound, and tingling in arms and legs that accompany a severe throbbing headache– literally shutting sufferers down to the point they cannot function.

While there is as yet no “cure” for migraines, doctors agree that medical research has come a long way in the areas of prevention and treatment, looking at lifestyles, eating and sleeping and related triggers. It is important to understand the facts as they can strike at any age, even if you have never experienced one in the past.

Dr. Nina’s What You Need To Know About Headaches

What is a migraine headache?
More than just a bad headache—it is a neurological condition with incapacitating symptoms. Migraines generally cause moderate to severe throbbing pain on one side of the head (but can affect both sides) and frequently are accompanied by:
    •    Visual disturbances (seeing flashing lights or spots, temporary vision loss)
    •    Sensitivity to light, smell, touch and sound
    •    Nausea and vomiting
And, approximately a quarter of migraine sufferers experience an “aura”—visual, sensory, motor or verbal disturbances soon before the onset of pain.

What causes migraine headaches?
While we still do not completely understand, it is believed that nerves, blood vessels, and chemicals in the brain play a role. Some factors that may trigger a migraine include: hormonal changes, certain foods and drinks, stress, sensory stimuli, allergy, air quality, changes in the wake-sleep pattern, certain medications and add to this too, time in front of screens with our phones and computer devices.

Additionally, our body is “connected” and spinal cord problems such as herniated discs and temporomandibular joint disorder (the hinge that connects your jaw to the temporal bones of your skull) can contribute.

When should I consult my doctor?
Many migraine sufferers have no idea that they have them. As a result, they often go untreated and the symptoms can interfere with work, school, and other activities—migraines can prevent you from living life to your fullest potential. The good news is that your healthcare provider has a number of tools in their arsenal to help you resume control over them. In addition to medications to treat a migraine once it starts, there are a number of things that can be done to prevent them, known as prophylactic treatment. These can range from lifestyle changes, avoiding triggers, and medications.
 
If you are experiencing frequent moderate or severe throbbing headaches and other migraine symptoms, keep a diary of your attacks and note frequency, duration, symptoms, if there was an aura, along with potential triggers, and how you treated them. And make an appointment with your doctor to discuss your headache. Primary care doctors are at the “frontline” of migraine treatment. If your condition is severe or complicated, you may be referred to a neurologist (a doctor that specializes in the brain and nervous system).

And, you should see your doctor immediately or go to the emergency room if you experience: an abrupt, severe headache like a “thunderclap”; a headache with fever, stiff neck, mental confusion, seizures, double vision, weakness, numbness or trouble speaking; headache after a head injury, especially if the headache gets worse; or a chronic headache that is worse after coughing, exertion, straining or a sudden movement.

What are some triggers you may be able to control?
    •    Stress. Everyday stressors (work, finances, school, family and relationship dynamics) as well as major life changes (divorce, death, losing a job, starting a new job, getting married) can trigger both migraine and tension-type headaches. Stressful situations will always come our way. The key is to learn how to manage them and blunt their impact on our health and wellness—figuring out what causes you to feel stressed out, adapting or adjusting things that are within your control, accepting the things you cannot change, and coping mechanisms.
    •    Sleep. Science has shown that common brain regions control sleep, headache, and mood—hence too little, too much, or not the right quality of ZZZ’s can cause headaches, depression, and anxiety. And, too, changes in sleep patterns such as going to bed late, waking up before the roosters do, or time changes can trigger a migraine attack. Experts recommend that adults get 8 hours of sleep a night. Some tips to attain regular and restful sleep include: creating a “cave-like” environment where you slumber (cool, quiet, dark) and going to bed and waking up at the same time every day (and not deviating greatly on weekends or holidays).
    •    Hydration. One of the most avoidable causes of a migraine is dehydration. In fact, a study published in the journal Neurology showed that the frequency of migraines jump almost 8 percent for every 9 degree rise in temperature! There are varying theories as to why this happens: when blood volume drops, there is less blood and oxygen flow to the brain and to compensate, the brain’s blood vessels dilate causing an increase in volume; the loss of electrolytes such as sodium causes nerves in the brain to produce pain signals; and dehydration causes our brain to temporarily contract and pull away from the skull causing pain. Consequently, hydration can be an effective treatment for someone whose migraine was triggered by dehydration.  
    •    Certain foods. Some potential migraine-triggering foods include cheese (contains tyramine), chocolate (contains beta-phenylethylamine), and processed meats (contains nitrates). Additionally, additives such as monosodium glutamate (MSG) and aspartame (artificial sweetener) have been linked to migraines. And, too, the lack of certain nutrients such as folate may contribute. The American Migraine Foundation states that “Perhaps the best migraine prevention diet is one that is as wholesome, fresh and unprocessed as possible.” Consider boosting the intake of foods rich in folate such as green leafy veggies, legumes, seeds, chicken, eggs, and citrus foods while avoiding above-mentioned additives and processed foods.
    •    Eating on time. Missing meals or fasting is a primary dietary trigger. Many of us skip our first meal of the day—breakfast. While our body is prepared to provide fuel while sleeping, not eating a meal soon after awakening can put added stress to ensure a steady supply of energy. Alternatively, we may start a restrictive diet or prepare for a fasting blood test or medical procedure. On a daily basis, make sure to eat a nutritious breakfast, lunch, and dinner, on time. And, too, if hungry, or if you suffer from migraines, consider a late-night nutritious, protein, whole-grain, or fiber-filled snack before going to bed. Some ideas include hummus, avocado, cheese, Greek yogurt, milk and a piece of fruit, or peanut butter.
    •    Alcohol Drinks (AD). Studies show that ADs provoke migraine attacks in about one-third of migraine sufferers (it is also a major contributor to other types of headaches). And, red wine is the principal trigger. While the mechanism is not completely understood, it has been shown that alcohol can increase blood flow to the brain, cause inflammation, and release certain chemicals—all of which are seen during a migraine attack. If you suffer from migraines, looking to curb or abstain from alcohol should be considered and discussed with your healthcare provider.  
    •    Technology. Many of us spend considerable time in front of a computer at home or work, or with smart phones. The bright light, need to focus our eyes, concentration required, and neck and shoulder positioning and strain can trigger a migraine attack. Make sure that you use anti-glare screens, take regular breaks, sit ergonomically (e.g., feet flat on the floor, roll shoulders back and keep ears directly over them so our head is not tilted forward).
 
Research and new technology is helping us uncover the mystery of migraines – leading to a number of treatments that include non-prescription and prescription  ways to ease the symptoms of a migraine. If you are a sufferer, talk with your doctor to determine the best approach for you.


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