Managing Migraines

East Oregonian | Nov. 27, 2012 1:20 p.m. | Updated: Nov. 27, 2012 9:20 p.m.

Contributed By:

Phil Wright

Daily Astorian

Angela Ellis, 18, of Pendleton, has suffered horrible headaches since the birth of her daughter almost two years ago. The attacks last hours, she said, force her to seek darkness and cause a deep throbbing pain in her head.

“You know how a person’s heart goes ‘boom, boom, boom?’ That’s what it feels like,” she said.

The attacks interfere with her efforts to raise her daughter and complete her high school education, she said. The over-the-counter ibuprofen she takes does not do much to alleviate the siege on her brain.

“I just fight through the pain, I guess, and my mom helps me out a lot,” she said.

Though Ellis hasn’t been able to see a doctor to confirm what causes her attacks, she described some some classic symptoms for migraines. Christina Peterson is a neurologist in private practice for 26 years and the medical director of the Oregon Headache Clinic, Clackamas.

“Migraines are a neurological disease and not just a bad headache,” she said, and have at least two of these symptoms:

•throbbing or pulsating pain that usually settles into one side of the head;

•attacks that lasts four to 72 hours;

•routine physical activity, such as climbing stairs or bending over, makes the pain worse

•moderate to severe pain intensity.

Migraines also have one of the following symptoms: avoidance of light (photophobia), sound, or even smell, nausea or loss of appetite.

About 15-20 percent of migraine sufferers see an “aura,” Peterson said, which can look like shimmering zigzag lines or a prismatic rainbow of lights. About 20 percent, she said, experience a prodrome, or warning signs a migraine is coming. Those can include goose bumps, cravings for certain foods, even increased urination, Peterson said, but the warning is not always reliable. The prodrome can come eight hours before an attack or just 30 minutes before, Peterson said, and the period can vary from attack to attack.

Migraines are genetic, Peterson said, and passed down through families. Interviews of migraine sufferers going back three generations show as many as 90 percent of the family have a history of the headaches, she said. Genetic researchers in the last few years have identified candidate genes for causing migraines and last year identified genes on the X chromosome. Woman have two X chromosomes, and Peterson said three times more women suffer migraines than men.

“We’re still looking for genes, we’re not done with that,” she said. “We don’t yet know how many genes are involved or how many kinds of headaches there will be.”

Peggy Ruiz, 51, of Pendleton, is an assistant in the life skills room at Pendleton High School. Ruiz said she was in her early 20s when a doctor diagnosed her with migraines, which made her life miserable for years. She tried medications to block attacks, but nothing worked.

“Nothing was helping,” she said. “This sounds horrible, but I was about to ready to chop my head off and be done with it. I just could not function.”

But by 2004 she had four children, Ruiz said, including twin toddlers, so she had to find a way to function. Her doctor recommended a physical therapist who claimed success helping migraine sufferers. Ruiz said she was skeptical but desperate for relief.

The program lasted several weeks and included multiple sessions per week of electro therapy to the back of her neck, deep tissue massage, listening to a relaxation tape, exercises to stretch her neck muscles, an insert for her pillow for added support to her head and neck and and posture exercises.

The regime “sounded absolutely bizarre,” she said, but it helped. Ruiz said she follows the routine to this day and remains migraine free.

“I don’t ever want to go back to having to take all those drugs,” she said.

Before any migraine sufferer tries drugs, Peterson said they need to focus on what triggers an attack. Certain foods, skipping meals, not sleeping enough, sleeping too much and consuming caffeine are only a few of the triggers people have reported, Peterson said. Some have visual triggers, including movies in a theater or seeing alternating light and shadow, such as along a street with trees.

Controlling triggers is a must, the doctor said, but obviously some are beyond control. Changes in barometric pressure from storms can trigger attacks, she said, and it is also common for women to experience migraines with hormonal changes, such as a first pregnancy or menopause.

“We can’t stop biology, then we get to the next set of treatment — using medication to curb an attack,” Peterson said.

Certain drugs block or lesson the severity of an attack when users take it at the onset of a migraine. There is also daily medication for people who have four or more migraines a month or have particularly debilitating attacks. But Peterson warned that overuse of medication is a serious problem when treating headaches. Taking too much or taking it for too many days, she said, can cause headaches.

Ellis said she hopes she she can find some help soon. She is learning to live with the attacks, which she said happen multiple times a week. But she doesn’t want to live with them at all.

Peterson has more information about migraines at her website: www.migrainesurvival.com .

Contact Phil Wright at pwright@eastoregonian.com or 541-966-0833.

This story originally appeared in East Oregonian.


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