the headache post (part two)
Hi there! I'm back to tell you about this book that seems to help me: Heal Your Headache, The 1-2-3 Program for Taking Charge of Your Pain by David Buchholz, M.D.
Please, please don't take any of this as me preaching to you. I am simply sharing this theory because it seems to work... for me. Everyone must make their own decisions and conclusions when dealing with any health issue. Right? Right.
This is a simplified explanation of this particular neurologist's approach to migraine control. It isn't easy, and it involves drastically altering your diet for at least awhile. If your headaches are currently manageable and you are feeling good about how you deal with them, I'm so glad. If not and (like me) you're reaching a point that they are honestly negatively affecting your life, at least give this book a look-through. I checked mine out from the library, but ended up buying a copy.
First, his basic theory of migraines:
He feels that all headaches, with very few rare exceptions, are the same. Headaches occur when the blood vessels in your brain inflame and cause pain and a myriad of other symptoms. Things like tension and sinus irritation can cause the migraine process to begin; they are not a kind of headache on their own. Everyone has certain triggers that may start this process- some of us more triggers than others. Also some of us have a lower tolerance level for the amount of triggers we can handle before something tells our brains to fully activate the migraine process, leading to, as I called it, A Bad One.
Ding, ding, ding! That was it! That was the key for me, why I liked his approach. I have always told doctors that no matter what kind of headache it was- a slight hangover, tension related, allergies- if I let it go on too long, it would become a migraine! Could they all be migraines to start with?! Finally. Someone backed up my theory. And so I read on.
Step #1: Avoid quick fixes.
The reason coffee and Excedrin make headaches go away is that caffeine constricts your blood vessels thus reducing the inflammation and pain. Of course we use caffeine to manage our pain. It works really well. Triptans like Maxalt (my miracle drug) and Imitrex are powerful vasoconstrictors and in a complicated way trick your brain into shrinking the blood vessels quickly. Ahhhh... relief in minutes. There are several other drugs in this section, but these are the ones that I use.
BUT you see, there is a problem with these drugs. They can cause rebound headaches. Your blood vessels overcompensate after the drug wears off and can, over time and use of the drug, make your headaches worse. (Drastically oversimplified- he explains this all very well.) This, I think, is where I'd been trapped for several months. I'd gotten myself into a nasty rebound cycle and couldn't get out.
Coffee is also a double edged sword- not only is caffeine a drug that can cause some dependency, coffee and tea also contain some other substances that can be migraine triggers. I'd drink the coffee because I needed it to stave off a headache, and then it actually caused me more headaches. Oy.
Step #2: Reduce Your Triggers
This is the doozy. So again, simplifying his theory. Everyone has triggers they cannot control like weather changes, hormonal fluctuations, odors, unavoidable stress, etc. But add to those very common medication and dietary triggers and we can quickly find ourselves in that fully activated migraine state. Ouch.
I know, I know. This is the tough one. He gives you a list of the most common trigger foods and recommends removing them all for a few months to see if you really feel a difference. The lists in his book are very detailed and specific. Here's the short version:
Caffeine, caffeine, caffeine (coffee, tea, soda)
Chocolate
MSG (this one is SUPER tricky and what makes this diet most difficult for me)
Processed meats (often full of MSG and nitrates)
Cheese and dairy products (milk, cream, ice cream, ricotta, cream cheese are ok.)
Nuts (seeds are ok.)
Alcohol and vinegar (except white vinegars)
Certain fruits and their juices (citrus, pineapple, raspberries, fruits dried with sulfites)
Certain veggies especially onions (certain beans are out. green onions, shallots, leeks and garlic are ok.)
Fresh yeast risen breads (they need to be a day old. this is a weird one.)
Aspartame (NutraSweet)
Any others you suspect affect you.
You take these items out of your diet as best you can, trying hard not to drive those around you crazy, for a few months and hopefully see some dramatic improvement. You probably won't have to keep them ALL out for good- he explains how to liberalize the diet later on.
This brings us to where I am in the plan. I've been on the diet for six weeks. At first it was REALLY. HARD. It's easier now. It sounds like a lot, but you get used to it fast. Eating out is still difficult, but I'm navigating that as best I can.
This diet is helping greatly. I am hoping it's not onions that bother me- that one makes it hard to eat out as does MSG. I thought I'd miss chocolate terribly, but I don't. Same with cheese. I do miss coffee and I'm hoping down the line I'll be able to handle a cup of decaf. I'd also like to be able to enjoy a vodka tonic now and then on the patio this summer. Could I live on this diet forever? Absolutely. Do I think I'll be able to reintroduce a few items? Of course.
And that's the thing about this diet. It is a TOOL, not a life sentence. If you start cheating too much, and the headaches start to creep back in, you can pull out the tool and tighten it back up. I'm also thinking at some point I'll be able to judge a few of my uncontrollable triggers better and decide if a little cheat is doable now and then.
Step #3: Raise your tolerance
Certain preventative medications can raise your tolerance for your particular triggers. Dr. Buccholz lists many good and proven options and I've discussed one with my doctor. (It's a tricyclic antidepressant.) He wrote me a prescription and I'm waiting. I was hoping with the diet and a little more exercise, I could avoid that step all together. My headaches are better, but they certainly aren't gone. But I have to say for the first time in a long time, I feel in control. I'm not just waiting for these headaches to happen.
I've been pondering the medication. If I could raise my tolerance just a little, so that a cocktail on the patio or a piece of chocolate cake at a party didn't throw me into a tailspin, wouldn't it be worth a try? If it improved my enjoyment of life? Surely. I'm trying to stay open minded. I'll make a decision in the next couple of weeks.
. . . . . . . . . . .
So there you go. That's it in a (big) nutshell. Like I said before, this is a "last resort" sort of plan. The diet is a pain in the butt. Yes. But it's helping. If you're feeling at your last straw, go to the library and find it. You never know.
And finally I'm done. I'll hush about it now. : )
Wishing for many headache-free days for us all.
Comments
That book was my salvation also. I had daily migraines for years until about a decade ago I stopped (decaf) coffee for another reason (heart fibrillations). After a month or more of killer withdrawal headaches, the daily migraines lessened dramatically, to weekly migraines.
About a year ago I was getting lots of migraines again and in desperation read that same book. After a period of experimentation I learned that my primary triggers are caffeine of any kind, namely chocolate. Nuts, beans, onions, citrus are okay for me--thank goodness! Treat it like an allergy elimination diet, where you figure out which are okay for you and which are not. If I start to be more headachey than usual (or if it's weather/barometric pressure change season, which lowers my tolerance levels), I try to cut down on all triggers. Good luck!
Posted by: Fellow Migraineur | March 29, 2010 4:59 PM
I'm always leery of medications too but I remember when I finally got on some for PPD I was thinking, why did I wait? I;m glad that you are seeing some results.
Posted by: Mama Urchin | March 29, 2010 5:05 PM
It's really interesting to read these posts, not only because you're writing pretty clearly about your own health, but also because I can recognise my own bodily tendencies in what you're saying. I KNOW if I have even a half a glass of wine (but not other alcohol) that I will wake up with a terrible headache which, if I let it go on, will be incapacitating. I've found that getting cool, fresh air right away helps with that, as well as food and water right away. Obviously that's just in my case. But what you write about triggers, and tolerance for triggers, is really interesting. I'm glad you're feeling better and even more so that you feel like you have some control over your health. Lacking that is very hard. Take care.
Posted by: eireann | March 29, 2010 5:28 PM
I'm sure feeling in control is HUGE.
glad you're having positive results thus far - will pass this on to some family members who suffer from migraines often.
Posted by: kirsten | March 29, 2010 5:32 PM
have great pain guy, can get you in, btw his wife is neurologist, if you want to drive, call me s
Posted by: suz | March 29, 2010 7:38 PM
This is great information. If my headaches come back, I'm going to have to get this book. Thank you for sharing!
Posted by: Stacy | March 29, 2010 8:26 PM
again, i am so happy that this is working for you! i know that i often suffer the after effects of otc pain meds by making the headache re-occur so i have cut them out unless absolutely necessary. and i completely agree about all headaches are headaches, some just are waaaaaaay worse than others. thanks for your thoughtful posts, alicia. i hope that you have continued success!
Posted by: erin | March 29, 2010 8:42 PM
I think it's awesome you are taking control of this issue and not just throwing drugs at it. I'm not opposed to a good Excederian pill but I don't think it's the answer.
I've noticed aspertane, splenda and msg give me a headache too. I've also discovered regular chiro visits help me a LOT.
Very interesting post!
Posted by: Flipfloppingmamma | March 29, 2010 9:43 PM
So glad you are finding something that is working for you! It can be so frustrating to not have any answers and certainly to have to wait months for a doctor's visit is quite depressing in itself.
I got my first migraine 3 years ago - it was a doozy, lasting months on end and only tapered off as we increased the antidepressant (which works for me). I noticed someone else mentioning chiro visits - I have included massage therapy.
Here's to having headache free days!
Posted by: kimberly | March 30, 2010 12:42 AM
i have already passed this link on to a friend, i hope you don't mind. i am so proud of you for really working so hard at this. avoiding that "quick fix".
Posted by: heidi | March 30, 2010 11:12 AM
Incredible information. Thanks so much for sharing! And I'm so glad your headaches are getting better.
Posted by: tracy | March 30, 2010 11:26 AM
alicia! thank you SO MUCH for posting this. i've suffered from migraines pretty much since i was a little kid and even though they are mostly under control now, i am still dependent on excedrin fairly often (thankfully i've never ended up in the hospital, or had to take prescription meds- imitrex never worked for me). i'm so glad you've found something that's improving your life and putting you in control of your body and health. it's such a good feeling. i'm definitely going to look into this!
Posted by: julia | March 30, 2010 1:33 PM
hmm
i suffer badly from migraines and i don't even know where to begin with triggers.
i can wake up with them.
some days they build and i can feel them coming on.
thanks for sharing this info. i need to check out the book!
Posted by: Amanda {Mocking Bird} | March 31, 2010 2:43 AM
These 2 posts are very interesting. I have had a few migraines, but nothing like you describe, which must be horrendous. I did read of medical trials involving botox, taking place at an American university, to resolve migraines.
Posted by: Claire | April 1, 2010 4:24 AM
Wow. This sounds really interesting and I'm definitely going to check this book out. My headache situation sounds quite a lot like yours and I have really been trying to do something about it lately (visiting a naturopath, getting massage therapy). Thank you!
Posted by: Isabelle | April 1, 2010 9:08 AM
I'm so sorry about your headaches but very happy you found this book and that it's helping. I may recommend it to a friend who suffers terribly from migraines!
Posted by: Leslie | April 2, 2010 9:51 PM
I tried the same book. Found that the full diet didn't make a difference, but avoiding aged cheeses (which I was already doing) does make a huge difference. Cheeses that seem ok: cream cheese, cottage cheese, paneer, mozzarella, chevre, mizithra. Parmesan I can't even have a pinch of. Good luck with figuring out what does and does not help. Chiro seems to be helping right now.
Posted by: Terra | April 3, 2010 10:29 PM
i completely agree about all headaches are headaches, some just are waaaaaaay worse than others. thanks for your thoughtful posts, alicia. i hope that you have continued success!
Posted by: Baby Bedding | April 4, 2010 5:56 AM
This sounds really interesting and I'm definitely going to check this book out. My headache situation sounds quite a lot like yours and I have really been trying to do something about it lately (visiting a naturopath, getting massage therapy). Thank you!
Posted by: grow taller for idiots | April 6, 2010 9:04 PM
I can't even begin to thank you enough for this post. I too suffer from headaches and migraines. How you describe "A Bad One" is spot on to what I experience. No one in my life experiences migraines like I do, and it's so hard to describe and/or appreciate what it's like unless you do. It's nice to know I'm not crazy. :) I am definitely getting this book. Might even just buy it on Kindle tonight. Thank you!!!!!
Posted by: Denise | April 8, 2010 7:59 PM
Hi there, a reader of mine just sent me your post -- I just read his book last night, and I'm putting myself on the program today, so your info is REALLY good to hear. Thank you for posting. I so appreciate knowing you're feeling more in control.
Posted by: Rachael | April 14, 2010 4:05 PM
I have had migraines since puberty and only within the last 3 years have found that dairy is my main trigger. But I am also allergic to sulphites, so have omitted that too.
Thanks so much for posting about this - I think many people don't make connections about diet and their state of being - and how everyone is made up differently.
Posted by: Laura | May 4, 2010 4:43 AM
Thanks for this information but I'd like to know how you stopped the rebound effect first? I've been doing all the right things diet-wise, but the rebound headaches require a triptan and then cause another headache and on it goes. please email me or comment. Thanks
Posted by: Shari | September 8, 2010 10:13 AM