Migraine…… We Can Learn To Live Happily.

 

Migraine…… We Can Learn To Live Happily.

I had a young patient today in my OPD. She came with persistent Migraine headache. Was on all types of medications including various pathies. I asked for a CT scans before prescribing any medication…. The poor girl had a brain tumour. Migraines are common especially in ladies. There are no specific tests or clinical markers, but I believe we must rule out any specific cause of headache before labelling them as MIGRAINES.

YES quite a few of you who read this are pretty familiar or are having migraines which vary from mild headaches to excruciating unbearable throbbing headaches usually on one side with nausea and or unbearable vomiting. Doctors call them as a variety of types of migraines. I am sure that does not help the sufferer. The sufferer of migraine wants relief from the unbearable pain which is possible if he starts understanding the ordeal and attending to it.  However the migraine suffers are mostly intelligent people and over a period of time do understand and come to live with terms with migraine and do not suffer much. My basic funda is in helping these people is always to spend time with them and make them understand the pathophysiology and I have great results with these friends. The cause for migraine is always different in different people.

Yes my friends, Migraine is a neurovascular headache which has definite recurrent patterns in the same individual. Most of them show sensitivity to light, sound and smell and may be accompanied by preceding aura. People getting aura have a more severe headache than the people who do not have aura. Besides any organic cause for the headache, the cluster headache and the recurrent tension headaches should also be diffentiated since the treatment for these is different.

Looking at the various ways migraine gets precipitated, you know that the physical changes like those that happen during periods and the psychosocial changes that happen in stress, I have always called this headache as a manifestation of neuropsychosociovascular stress. This analysis often helps in making this person understand and manage his problem better. I always feel this being a lifelong problem it has to be managed by the person himself, with the help of guidance from the caring doctor who has all the time in the world guide this victim of migraine

The migraine has two ways of looking at it. One is the relief when the person gets an acute attack and subsequently to prevent the next attack. Your doctor will use various medicines like the various pain killers, Triptans, Dihydroergotamine, anti-vomiting medications, Tranquillisers etc. during the acute attack. Besides this we have very successively used a number of  medications to abort the subsequent attacks so that the person lives a very comfortable life without much suffering. I would always advise, rather warn the people not to drug themselves without the supervision of their doctor.

In the management of migraine we look at the person who is prone to migraine, and this stage remains almost till the very late stage of life, all though the person learns and control them and does not suffer much later in his life. Besides this we have to look at the various precipitating factors …. like monthly periods, stress, hot sun, change in weather, oversleeping, exposure to bright light, flickering light, flickering television, loud noise, strong smell etc. In my practise I have seen a number of food substances appreciating migraine headache. These include monosodium glutamate, chocolates, cakes, artificial sweeteners, dairy products, alcohol especially red wines etc. As a young doctor I remember a very resistant case of migraine, a young nurse in our department who used to get migraine every day and nothing could stop them. As we were sitting and discussing in the ward one late evening she puts a hand in her pocket and gives me a handful of groundnuts. I enquired whether she loved the monkey nuts so much, to which she replied that she likes them so much that her day begins with a pocketful of monkey nuts which she finishes by the end of the day. At that stage I had never known that they could be the cause of her migraine. Nevertheless I requested her to stop eating the ground nuts for one month and she had no migraine. The headache went away ever since. Please look at your precipitating factors.

Besides medication the management of migraine does need a regulation in life style. Exercise, Yoga, Meditation. Progressive muscle relaxation, Botox and many such intervention will always help these persons and your doctor must encourage you to stabilise and regulate your life.

Friends Migraine as on now is not curable but we can all live a very lovely and happy life inspite of having it. We are all intelligent enough to learn to live with migraine and not suffer from it. Identify the precipitating cause and alter it. Migraine can be altered and suffering reduced.

Let us learn to live with migraine rather than suffer from it.

                                                                                                                                                                                                                                                By Dr. Digambar Naik