Migraine pain hits one in four households
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| Dr. Richard R. Helm |
Dr. Helm, who is board certified in headache medicine, outlined common myths, how to diagnose migraines and the most effective treatments at Community Regional Medical Center on Sept. 26. Nearly 100 Community Medical Centers staff and residents from UCSF Fresno Medical Education Program attended.
Dr. Helm stressed that migraine is a biological disorder – much like asthma or diabetes – that debilitates people, keeping them from work, school and regular activities. Although it can start during childhood, it generally starts in early adulthood and peaks during people’s most productive years, age 30 to 60.
Migraines sometimes are confused with other types of headaches and they’re difficult to define – even by the people who suffer them. “It’s sort of like pornography,” joked Dr. Helm. “You may know it when you see it, but you may not be able to describe it.”
The International Headache Society has defined migraines as:
- Having at least five headache attacks
- Lasting 4 to 72 hours
- Having pain that increases with exertion
- Having at least one of the following symptoms: nausea and/or vomiting; light, odor and/or sound sensitivity; pain severe enough to interfere with daily activities
Dr. Helm said his patients report their migraines are triggered by monthly hormonal changes, alcohol, flickering lights, stress, changes in sleep habits, certain foods and weather changes. “Chocolate is not a trigger,” he said, to chuckles and light applause. “Migraine causes a craving for chocolate, though.”
He continued, “People who sleep in only on weekends get migraines more often. And when your stress level changes, that affects it too. I always get migraines when I go on vacation.”
Dr. Helm told the hospital staff that sometimes migraines take on the same symptoms as strokes. “But it’s not a lack of blood flow to the brain,” he explained. “It’s really the opposite.” So while stroke sufferers may report numbness or vision problems, migraine sufferers will have numbness or tingling that moves from one body part to another and they will see flashes and zig-zag lines rather than fuzziness or blackness.
He said there are many drugs on the market that work to abort migraines and the most effective are Triptans, often given with drugs for nausea. But oxygen will work to stop cluster headaches. Dr. Helm listed several ways to prevent headaches, including beta blockers and calcium-channel blockers used for high blood pressure, anti-depressants, anti-convulsants, bio-feedback relaxation techniques, vitamins such as magnesium and riboflavin and botox injections.
Botox studies are just being lauched. Dr. Helm said he’s not sure why it works but it does. Patients are paying $800 for multiple injections that give them up to three months of relief from migraines, he said. Insurance doesn’t pay for the treatment yet.
This story was reported by Erin Kennedy. She can be reached at ekennedy@communitymedical.org.