14 March 2006

Treating Migraines Without Painkillers

A very dear friend of ours emailed me the link to the story about treating migraines without painkillers. Friday, I had to go off the Topamax and Cymbalta because I am having allergy testing done tomorrow and it will interfere with the allergy test.

When I called to tell Dr. Soso's office, the kind lady at the other end of the phone told me to hold on because she had to see if I needed to be weaned off the meds. This had me concerned because John and I still want to have children. I had no idea before that I would have to be weaned off the meds. And while on the meds, I have much more fatigue, sleepiness, dizziness, loss of strength, loss of energy.

And when I talked to my car insurance, there is only about $1000 left to use on my medical expenses from getting rear ended at the stop light from 30 June 2005. The insurance lady told me that after that, everything will have to go onto my health insurance, which definitely does not seem fair considering that we have had to spend a lot of money and pain for obeying the law when the guy in the work van who did not want to stop for the red light gets off without a scratch.

According to the MRIs that Dr. Bailes gave me the readout from that Dr. Berns wrote up:

"There is diffuse cervical spondylosis present"..."At C3-C4 there is bulging and left paramedian protrusion of the disc, which thins the subarachnoid space but does not deform the cord or neural foramen. At C4-C5, there is broad-base bulging of the disc and some central protrusion without cord compression. The neural foramen show some mild bilateral stenosis."..."At C6-C7, there is bulging disc thinning the subarachnoid space without deforming the cord or neural foramen."

And according to the Emergency Department of Westmoreland Hospital on 30 June 2006:

"You have been diagnosed with a minor head injury" & "You have been diagnosed with a cervical (neck) strain."

It also says I should return to the emergency department immediately if any of the following occur (which they have and I have told doctors about, but they just get dismissed, so I have no idea what to do). Symptoms I have:
  • numbness (loss of sensation or tingling in your arms or legs (this is not an all the time thing, and I was told it could be a symptom of the Cymbalta or Topamax so not to worry about it)
  • Weakness in arms or leg (again, could be a side affect of Cymbalta or Topamax)
  • Loss of bowel or bladder control (this is the worst. It is so bad that I have to wear a pad every day and I am afraid to go walking because I fear not getting to a bathroom in time, and having a BM without being close to a bathroom is horrible)
  • Severe or increasing pain (I especially feel it in my neck and the base of my scull)
  • Fever, neck pain, change of behavior (the change of behavior can be from the meds)
  • vomiting, difficulty walking, changes in vision (these can all be affects from the meds also)

Here is the news story my friend emailed me:

Treating Migraines Without Painkillers
Biofeedback, Even Heart Surgery, Is Considered a Migraine Treatment
March 6, 2006 — - For many people, a nagging migraine means turning to an over-the-counter pain pill like acetaminophen, or, in some cases, a prescription medication like Imitrex.

But recent advances in nondrug treatments, such as biofeedback and neurofeedback, have opened more options for headache suffers. And something as seemingly unrelated as heart surgery may hold the solution for some people.

Here's a look at some nondrug alternatives to headaches.

Biofeedback: Changing Your Physiology
Biofeedback is a safe, drug-free alternative for the treatment of migraines, tension type headaches, chronic pain, sleep disorders and more. Receiving feedback from a computer, patients are trained to adjust physical features like skin temperature, muscle tension, heart rate or blood flow -- changes that can lead to decreased pain and stress.

"Biofeedback reduces the stress response and brings stability and calmness to the nervous system," said Dr. David Biondi, a neurologist and consultant in headache management at Massachusetts General Hospital. "I think it's very effective for migraines. Studies have shown that biofeedback can be just as effective as some of the preventive medications we use."

How well does it work? According to Dr. Barry Schwartz, director of the Headache Center in New Orleans, about 85 percent to 90 percent of patients with chronic headaches respond positively to biofeedback.

"Biofeedback also serves as an excellent bridge in assisting patients wean off medications," he said.

It's a method that worked for migraine patient Elizabeth Poe of New Orleans. She said she had suffered from about two migraines a week for the last 30 years. Her remedy used to be 12 tablets of ibuprofen a day, with the occasional prescription painkiller.

"After I started biofeedback, almost immediately I stopped having the headaches. Now I haven't had a headache in three years," she said. "Biofeedback got me off all the pills I was taking and taught me techniques that can help me relax and avoid headaches. I feel 1,000 percent better. "

Got a Headache? Play a Video Game.
People with migraines may also benefit from neurofeedback. Neurofeedback is similar to biofeedback, but rather than sensing skin temperature or muscle tension, it measures brain waves. Patients undergoing the treatment look like they're playing an ordinary video game, but they're not using their hands.

Instead, patients are instructed to make the computer game "go" with their brains. Painless and noninvasive electronic sensors are placed on the earlobes and scalp. As desirable brain-wave patterns increase, the video game sends Pacmanlike characters across the screen, or some other reward is given.

Undesirable brain waves cause the video game to slow down or stop. Gradually, the brain "learns" the new healthy brain wave patterns to treat the underlying condition.

Neurofeedback may take 20 to 40 sessions that run about 45 minutes each to achieve benefits, which proponents say are permanent.

Which to choose? "Neurofeedback is as effective as biofeedback for treating headaches. Patients like both equally well," Schwartz said.

But skeptics say there may be no advantage to neurofeedback over biofeedback.

"We use both the skin temperature and muscle relaxation training with good results, and feel that there is no real gain from adding neurofeedback," said Dr. Seymour Diamond, director of the Diamond Headache Clinic in Chicago.

Since popping a pill is so easy, why would patients make the effort to undergo biofeedback or neurofeedback instead?

Patient Elizabeth Poe said the benefits made it worth continuing.

"It was very motivating when I saw progress. Biofeedback has really changed my life. I don't even carry pain medication around anymore."

Heart Surgery for Migraines?
Twenty percent of the general population has a small hole between the two chambers of their heart, known as a patent foramen ovale, or PFO. The defect can increase the risk of stroke, but it usually goes unnoticed and untreated. But it's getting a second look after scientists recently discovered that patients with migraines were three times more likely to have an unrecognized PFO.

Does this mean that cardiac surgery to repair the hole could be a new treatment for migraines? Next week, researchers in England will reveal results of a large-scale study comparing migraine sufferers who undergo PFO closure with those who don't.

"It's not a curative treatment, but it can take away one potential trigger for migraine with aura,"said Biondi.

But Dr. Dawn Marcus, a neurologist at the University of Pittsburgh School of Medicine, is skeptical. While many patients have noted relief of migraine headaches after surgical closure of their PFO, she said "there are studies that show people who developed migraines or had their migraines worsen postoperatively."

What about the risks of PFO closure for the treatment of migraines?

"The way cardiologists are currently able to do reparative surgery is much better and safer than it was a few years ago," Marcus said. Previous techniques required surgically opening the rib cage, but cardiologists can now dam PFOs with an umbrellalike device that they thread up a vein from the groin to the heart.

To make a decision about how to treat migraines, Schwartz believes that patients should be told about alternative treatments for headaches -- treatments other than medications.

"People should be afforded the opportunity to make an informed decision."

Copyright © 2006 ABC News Internet Ventures

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