Case Histories - May 1996 (2/2)

I am a 59-year-old male. When I was 21 years old, I started to have severe headaches and my doctor, who was a personal friend, performed several tests over a short period of time, including a pneumoencephlagram, angiogram of my head and an electroencephlegram. These were all studied by a neurosurgeon. There was nothing revealed to be out of order. I was diagnosed as having cluster headaches, which I suffered with annually until I was 33 years old.

I was not able to hold a job because when the headaches came, at various times of the year, I was incapacitated for weeks at a time, sometimes requiring hospitalization. I tried many different kinds of medications, including ergotamine and related medications, none of which helped. Some relief was afforded when my wife would rush me to the emergency room, where I received an injection of Demerol and Phenergan. Then we would rush home to get in bed before the medications put me under. I was terrified to go to sleep at night because I would wake up with a full blown attack, and then it was difficult for the medicine to put me down.

Eventually, the doctor presribed the medications so that my wife could give me the injections at home if I woke up with one of these. One time I woke up beating my head against the wall. Another time I put my fist through the headboard of my bed, and still another time, I tore a leather work boot in half trying to get it on so I could go to the hospital.

When I was 33 years old, my original doctor related an article to me about a medication. We tried it and I haven't had a cluster attack since. It seems that my headaches were associated with a spasming of the muscle around a nerve ganglia in the back of my head, which became worse with each episode. One year it would be one side of the head, the next year it was the other side. The medication is Dilantin (an anti-convulsant, normally associated with seizures) and Phenobarbital( an anti-spasmodic), which acted as a prophylactic. I started out with 100mg of Dilantin and 15mg of Phenobarbital four times a day for six weeks and then decreased over a period of six months to twice a day. Both medications are inexpensive. The latter costing only $4.95 for 100 pills. I have had TWENTY THREE WONDERFUL YEARS OF NO HEADACHES.

I have met many people over the years that have found relief from beta blockers, especially Tenormin. I also met a businessman in Washington state that has found relief with a betablocker and anti-convulsant combination. I hope this will encourage others to not give up and to try different approaches.

Sincerely,

---G. Gray willing@hevanet.com

It was really useful reading about other peoples headaches. I am 22 years old and I have been suffering badly from migraines for 18 months now. I had suffered infrequent migraines before this - particularly if I got very excited, before going on holiday, or going to a fair etc. The problem got worse in December 1994, when I injured my neck. I had physio on it but two months later I developed a constant headache, and would pass out with no warning. I couldn't stand any light at all and so the Doctors first reaction was that I might have meningitis. However, it wasn't and I was given anti-emetics (Stemitil) and ever increasing doses of codeine. I was also on the pill at the time - and so I came off it, It was one less tablet to take a day! At the time I was in the 3rd year at university, and my work load was very high. The university sent me home - as they felt sure that all I needed was some attention from my parents! No-one appeared to take me seriously until I collapsed at home, vomiting and extremely photophobic. I was admitted into hospital, where I had a CT scan and numerous blood tests, after 10 days they decided that I had status migrainosus - ie a prolonged state of migraine. They prescribed imipramine as a prophylactic drug, but even on the maximum dose it made no difference to the constant headache.

I went to see an osteopath, who told me that I still had problems with my neck. Acupuncture actually allowed me to sleep properly for the first time in months! I was refered to a Doctor specialising in Sports medicine - who administered two epidural injections to C1/2 under X-ray, this actually relieved the constant headache to 25% of what it had been and I felt almost human. I became a patient of the City of London Migraine Clinic. It is a wonderful place. They advised that I should try naproxen, (which didn't work) but since then have prescribed Imigran (Imitrex?) for fast relief from attacks - along with Voltoral and Domperidone (A strong painkiller and an anti-emetic - both suppositories!) I have been taking sodium volporate (an anti-convulsant) which has cut down my migraines to once a month instead of every 10 days - I still remain midly photophobic for the rest of the time but at least I can say good bye to the VERY dark glasses.

I am going to have to come of the Sodium Valporate though now as I have started to bruise very easily - even when tying my trainers! The Dr at university said 'not to worry you'll ONLY get a migraine - how can you guess that he has never had one!! I am now gradually reducing the amount of SV I am taking - and hoping that I don't trigger more frequent attacks. I can't take beta bockers because I am asthmatic - It just seems so unfair that each time i try a new 'preventer' I develop a reaction to it and so have to come of it. I graduate in July and in September I start as a maths teacher at a high school (11-18) I just hope that I can sort my life out before then. I certainly don't want to have a migraine every 10 days then. Please keep your fingers crossed.

--- Dawn D.E.Goodall@exeter.ac.uk

My migraine history began at 7 years old. (I am now 40.) My migraines seemed to continue no matter what I did. As I got older, the migraines were no more severe, but they were no longer relieved by sleep. So finally I went to the doctor and got a prescription for Imitrex. This REALLY did it for me! I have taken Imitrex for about a year now when I have a migraine, and it has always been effective in completely ending the headdache usually within minutes. (One time I had to take 2 injections a few hours apart to end the episode but in all other cases, one injection cured it.) The pills I find to be somewhat effective, but not as effective as the injection. I also might add that I have never experienced any side effects during or after an injection. You might could say it feels like a "flush" but nothing unpleasant or objectionable. I realize that Imitrex does not work for some people, but for me it was like a "miracle" drug! I would urge anyone who has migraines to at least talk to their physician about it.

I might also add in closing that for many years, I did not realize that what I had was migraines because I did not experience an "aura". Then a physician told me that in "common" migraine you do not.

Sincerely,

---Paula Wiggins, Plano, TX wiggins@fastlane.net

Dear Ronda,

I am a student of therapeutic massage and am about to graduate from Potomac Massage Training Institute in Washington, DC -- a 500-hour professional certification program. I am doing my academic case study on a client who suffers from migraines 18-24 days out of every month. She's tried everything -- she's gone to MDs, neurologists, tried all kinds of medications (Imitrex et al), food allergies, even acupuncture -- which DID help, but unfortunately became too expensive.

My client and I have been working together 4-6 weeks. I concentrate on releasing tension in her head/face, neck, shoulders, arms and back. She has had marked improvements -- ie, during the 10 days before her period when she usually has migraines every day, she has had MANY fewer. I know from my studies that massage can be very therapeutic for migraine sufferers. It reduces stress levels, opens up tight and congested tissues, flushes out toxins and metabolic wastes, improves circulation, activates the parasympathetic nervous system (= the relaxation response) and -- perhaps most importantly -- can release tension in the neck, head, shoulders and back that can restrict circulation and contribute to the headaches.

I realize that migraines are very complex and I don't mean to oversimplify the problem; but therapeutic massage may be very helpful to many of your readers. One self-help tip that has been IMMENSELY therapeutic for my client is recommended by the Upledger Institute: Put two tennis balls in a sock and lie back against them 10-15 minutes every night. Put them at the back of your head where the two thick tendons meet the skull on either side of your spine. Do not put pressure on the vertebrae! The soft, steady pressure at these points actually unhooks tension in the muscles in your neck and clear down your back. My client actually headed off a migraine at the pass by doing this one morning for 10 minutes when she first noticed the signs of a migraine coming on.

If anyone wants to e-mail me about this, I'd be glad to share whatever I know so far. It may not be a "magic bullet," but massage can be highly therapeutic. If nothing else, it helps reduce stress and puts you in touch with yourself in a way that enables you to better "hear" whatever your body is trying to tell you.

Thanks!

---Ann Thompson, Washington, DC pubpr@gprep.pvt.k12.md.us