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Disabling migraines demand attention

April 27, 2008 12:15 am

BY MARCIA ARMSTRONG

FOR THE FREE LANCE-STAR

Tracey Cox knows when she's about to have a migraine.

First comes the aura. Then an odd feeling of disconnectedness. Very soon after that, a blinding, wish-you-were-dead headache takes up residence somewhere between Cox's ear and her eye.

"I keep thinking, if I could take a stick and jab it into my eye socket, I could knock out the place where the migraines live," said Cox, who lives in Stafford County.

Although extremely painful, migraines are not uncommon. According to the National Headache Foundation, 30 million Americans experience migraines. Women are hit with the severe headaches three times as often as men. Most migraine sufferers are between the ages of 15 and 55.

In some cases, the cranium-crushers disable their victims for hours or even days, spawning such side effects as nausea, vomiting and extreme sensitivity to light and sound.

While the hit-with-a-baseball-bat kind of pain can make a migraine sufferer wonder if the condition is life-threatening, that is hardly ever the case, said Fredericksburg neurologist Paul Colopy of Neurology Associates.

"Statistics show that only a very small fraction of persons have a structural-lining abnormality, tumor or aneurysm," Colopy said.

What migraine victims do have is debilitating head pain that keeps them from working, taking care of their loved ones and enjoying life.

THE ORIGINS OF PAIN

Migraines result when the balance of adrenalin and seratonin--which regulates body temperature, mood, sleep and appetite--are out of balance, says Carol Foster, a Phoenix-based neurologist and author of "Gotta Headache? Lifestyle Changes to Help You Conquer Migraines."

Some things that can trigger an episode are:

hunger, exhaustion or dehydration

the weather

a change in routine

bright light

smells such as cigarette smoke or perfume.

Twenty-two-year-old Amanda Sale's headaches started when she was in middle school. Back then, she had no idea they were migraines.

"I thought it was a normal headache and that everyone had them," said the Spotsylvania County resident.

Exercise and Virginia's heat and humidity set off the pounding in Sale's head.

"In the summer, I get migraines every single day of the week," she said.

Cox, of Stafford, said her migraines are triggered by hormones, routinely arriving two to three days before the start of her menstrual cycle.

For Amanda Reynolds, the culprit is stress. When the Spotsylvania resident recently discovered that 700 pictures on her digital camera's memory card were erased, a killer headache immediately set in.

"The whole hour I spent trying to get them back, it got worse and worse," Reynolds said. "By the time I stood up, I was dizzy and ready to fall over."

IT RUNS IN THE FAMILY

Genetics plays a big role in who gets migraines, Colopy said.

Seven generations of Cox's family--most of them women--have suffered from severe headaches. Her daughter, 9-year-old Hannah, has had migraines for at least three years.

"She gets so pale you can practically see through her," Cox said. "Her eyes get deep-set, with big circles underneath. All she wants to do is curl up and go to sleep."

Hannah's most recent migraine was on New Year's Eve.

"She was up late, eating weird stuff," Cox said. "She woke up at 2:30, crying for me to make it stop. It rips my heart out."

"I felt like I was going to explode," Hannah said.

Cox's mother, 60-year-old Maureen Rooker, has had migraines since she was 18. One of her horrible head-pounders lasted three days. Rooker worked as a department-store sales clerk then, and had just come out of a stock room into the bright light of the sales floor.

"It was like someone hit me on the top of the head," she said. "That headache was the worst one of my life."

MEDICINE, OLD AND NEW

Twenty years ago, migraine management was limited to over-the-counter or prescription pain medications.

"The only goal was to knock yourself unconscious, and hopefully when you woke up, it was gone," Cox said.

Then came Topomax, an anti-convulsant that prevents migraines; and Imitrex, a blood-vessel constrictor that works most effectively once a headache has begun.

"Imitrex is the holy grail for migraine sufferers," Cox said. "When I'm not pregnant, I can take a dose of Imitrex and sometimes completely avoid a migraine, or reduce it almost to the level of a regular headache, with no vomiting or curling-up-in-a-ball kind of pain."

But not all migraine sufferers can use the new drugs, Colopy said.

"Each individual is different in what they respond to and tolerate," he said.

While Tylenol or Aleve might be a good first-line defense for some people, over-the-counter medications don't work on the severe migraines Reynolds, Sale and Cox suffer.

CONTROLLING THE PAIN

Acupuncture and biofeedback--a relaxation technique that helps people control muscle tension--are two non-medicinal ways to cope with migraine pain, Colopy said. Both can be effective.

"But it depends on how severe the migraine is, how transient and how frequent," Colopy said.

Though people who have never had a migraine can't begin to fathom the pain and misery of one, they can be supportive, Sale said.

"Understand that these headaches are really debilitating," she said. "When someone who has a migraine wants space, give them space. They might need an hour to sit in the dark and relieve some of the pain."

Marcia Armstrong can be reached at
Email: thisfullhouse@gmail.com.