How to Live with a Migraine
By Candice G. Ball
When Kim Wentz got her first migraine at age 41, she didn’t know what hit her. She woke up with the feeling that she was catching a cold or that she was in the throes of a major hangover even though she had had nothing to drink the night before.
“The headache felt like a mohawk down the centre of my head but also tons of pressure behind my eyes and nose. When they are really bad, my eyes hurt and are sensitive to light and I feel nauseous. I feel really tired, like I could sleep all day, but I can never fall asleep,” explains Wentz.
Although she has only stayed home from work four times since 2009 because of migraines, they have taken a toll on other areas of her life. “The worst part is that I don’t always notice until my husband asks, ‘What’s wrong?’ I’m walking around all grumpy because of a physical thing that on some levels I’ve grown used to.”
She’s not alone. An estimated 20 per cent of women suffer from migraines. Dr. Gregory Chernish, a medical doctor and certified acupuncturist who specializes in pain management, attributes the fact that more women seem to suffer from migraines due to hormonal fluctuations. Wentz notices her migraines get worse around ovulation and menstruation and they started with the onset of perimenopause—the changes that occur over a period of years leading up to menopause.
Dr. Chernish describes a migraine as a vascular headache, which may be thought of as a hyperreactivity of the blood vessels that supply the brain. First blood vessels supplying the brain constrict and reduce blood supply, which is known as the prodrome stage. During this stage, you may experience visual disturbances, food cravings or mood swings. The prodrome stage can happen days, hours or minutes before the onset of a migraine.
The body compensates by bringing more blood to the brain and that is what causes the throbbing, pulsating headache. A classic migraine usually involves one side of the head and it can be associated with auras or visual disturbances, nausea and debilitating pain.
The macro cause would be a genetic predisposition to migraines or a nervous system that is more responsive or sensitive to environmental stimuli. “It could be that your parents suffered from migraines or, for reasons unknown, the vascular supply to your brain is somewhat over-responsive to certain stimuli,” explains Dr. Chernish.
There are the well-known triggers: alcohol, especially red wine, chocolate, aged cheeses, aspartame, monosodium glutamate, and fermented foods to name just a few, but lifestyle triggers are trickier to manage. Dr. Chernish describes these triggers as “an unsteadiness” in lifestyle. “It could be not enough caffeine or too much caffeine, not enough exercise or too much exercise, too much stress or not enough stress.”
People who suffer from migraines are particularly sensitive to inconsistencies in lifestyle, hormonal fluctuations, diet or even changes in barometric pressure. “One of the main things that migraine sufferers can do is to keep things as consistent as possible,” says Dr. Chernish.
more women seem to suffer from migraines due to hormonal fluctuations
If you are in the throes of a migraine, your only option at that point is what Dr. Chernish calls a rescue treatment. That would include anti-inflammatory medications, triptans, painkillers and anti-nausea medications. In severe cases, a migraine sufferer may have to go to emergency for intravenous medications. Some antidepressants (especially amytriptyline), anti-convulsants and certain blood pressure medications are taken daily to prevent migraines.
Wentz has tried many different types of medications and most left her feeling like a “zombie.” She has found extra strength ibuprofen to be the most effective treatment for her migraines.
The good news is that there are many preventative measures you can take and some herbal remedies such as Butterbar and Feverfew may produce effects similar to prescription drugs. Acupuncture can also be an effective preventative treatment.
“The interesting thing about acupuncture is it is not just designed to treat the headache but to prevent the headache. So usually you’d go through a treatment schedule of weekly treatments for eight weeks and then come once or twice a month. The goal would be to prevent the headaches,” Dr. Chernish says.
The science seems to support acupuncture as an effective treatment for migraines. Dr. Chernish stresses that there is no one-treatment-fits-all. “There is not one specific migraine point. The treatment would be highly individualized. Someone who is doing your acupuncture would take into account who you are. So if you’re a woman you would want to know if the migraine occurred during the period or after the period. And what’s your period like?”
The goal would be to develop a treatment template that takes all the contributing factors into account. For instance, Dr. Chernish sees many patients with hormonal migraines. “If the cycle is irregular and associated with cramps and clots, then we would expect those cramps and clots would go away, as well as the migraine, and the cycle would become more regular.” He advocates treating the whole person, rather than just targeting the migraines.
For Wentz, one thing that always seems to help her cope with migraines is going to the gym and taking good care of her body. “I do have a better time of things when I’m eating right, abstaining from alcohol and exercising regularly. So maybe that’s my advice for sufferers —treat your body well and you’ll avoid them.”
There are other treatments such as Botox, but Dr. Chernish says the medical evidence doesn’t appear to be overly compelling. Unfortunately there’s no magic bullet for migraines. It is usually a matter of discovering your personal triggers and fine-tuning your lifestyle.