Migraine and the Future of Treatment

Hello there fellow blogettes. This week you are going to be treated to a write up of the EHMTIC (trying saying that when you have a migraine) conference.

We met at a hotel in London. I felt like I was part of a club, as we were all given a bag and some lunch (gluten and dairy free options of course, copious amounts of water, smoothie juice and decaf tea!). This gave us the chance to meet fellow sufferers and we were all swapping stories and advice. I also felt really in awe of the researchers who are so committed to helping us migraineurs. So if you ever feel alone out there because of your illness, remember these researchers who are working every day, all over the world to make things better for us. One of the researchers from California said to us "looking at you lot out there gives me strength!" He wants to help us!

I wrote copious notes, hardly any of which make sense to me now!!! SO here goes:

Migraine and Depression: research indicates that if you have migraine you are at risk of developing depression (apparently the risk increases to 50%). The talk also suggested that anyone with a chronic pain disorder (migraine, arthritis, back pain) would be at risk of developing "depressive symptoms". He also suggested that this is bi-directional ie if you have depression, you are more at risk of developing migraine. The research has not concluded whether there is a common mechanism behind depression and migraine, but recognises that they are both fluctuating disorders of the brain. In his opinion it was considered that the best treatment for people with migraine and depression was the trycyclic anti-depressants (amitryptyline, dosulepin), not SSRI's (prozac).

How your GP should care for your migraine, what NICE says: interesting facts I learnt were as follows:
1. for a bad migraine take a Triptan with an Ibuprofen or paracetamol
2. No evidence for ergotamines and cocodamol (risk of rebound greater)
3. Acupuncture has been recommended, and you can ask your doctor to have it on the NHS
4. a 400mg dose of Riboflavin (B2) is helpful

Migraine and Sleep:
Interesting facts I learnt:
1. A nap has been shown to terminate some migraines (could lead to an argument for employers to supply somewhere to sleep, as this in turn could help the migraineur to stay at work)
2. an imbalance in sleep can lead to headache (lack of restorative sleep)
3. if you do have a sleep problem, there are solutions (melatonin and light therapy) Look out for your local sleep clinic!
4. watch out for premonitory phase (yawning, irritable, craving) particularly late at night as quite often the pain of the migraine develops between 5am and 9am.
5. make sure you are getting 8 hrs minimum sleep a night. Anything less (esp 5 hrs or less) puts you at greater risk of more frequent migraines.
6. Those with migraine have a significant tendency towards circadian extremes (night owl or morning lark)

Future Treatments:

1: drugs being developed at the moment are steering away from affecting your arteries and reducing reccurence of the migraine. Good news for the over 65's who can't take the triptans, and good news for those of us who end of taking so many drugs which then in turn cause us more migraines (rebound migraine)
2: Occipital Nerve Stimulation
3: Magnetic Stimulation

The Researcher predicted that in 4 to 5 years some of this would be widely available and described it as similar to the mobile phone industry. Do you remember those huge "mobile" phones that looked like bricks? Well he said thats where we are with Magnetic and occipital nerve stimulation equipment at the moment, but in a few years time, we may be having small devices that will fit into our bags......

So if your transient receptor potential cation channel isn't working very well, I'll see you next week for Migraine Mum's next instalment. xx

The Migraine ToolKit: ways to manage your life with migraines

Migraine Mum hasn't taken a triptan drug for 12 days!!!

This is big news! Well may be it won't quite make the BBC news headlines, but I feel like I need to tell someone! I'm usually reaching for a triptan every 3 to 5 days but this last fortnight I seem to be able to rely on aspirin. I am having headpain every day now, not a migraine but a low level ache in my eyes and head/neck.

You may be wondering how or why the long term pattern of a migraine every 2-3 days has changed.......

Well to be absolutely honest, I don't know.

• The children have gone back to school and my youngest is doing 2 more sessions at nursery than last year.......more space, less stress?
• I have been trying to get more sleep (though the children have been waking me a lot over the last few weeks and I know I am very tired)
• I have reduced the amount of sugar by eating a lot less cakes, biscuits and puddings.
• May be finally the gluten and dairy free diets are paying off?
• I've resumed my pilates stretches and a small amount of exercise.
• Saw my cranial osteopath two weeks ago?

The puzzle continues. There is no one thing that is a cure. As we migraineurs know, what works for one person, doesn't for the next. But we are all like mechanics, carrying many tools in our toolkit in order to 'fix' this illness. What I firmly believe is that we can all build our own toolkits to manage our own migraines and the people around us effectively.

Here's some guidelines for building your toolkit based on The Pain Toolkit (www.paintoolkit.org)

Tool 1: accept that you have migraines...this can help with how you deal with the migraine and how you respond to it emotionally.
Tool 2: Build a support around you: friends, a good Dr, family, other migraineurs, blogs(!), join the Migraine Trust/Migraine Action
Tool 3: Pace yourself: try not to over do it on the days you feel well
Tool 4: Learn to prioritize and plan out your days. Build in relax time and fun. What brings you to life? What calms you?
Tool 5: Set yourself goals and action plans
Tool 6: Be patient with yourself (the migraine is a sign that you need to  step back and look after yourself, be kind to yourself)
Tool 7: Learn relaxation skills (you have to teach yourself to do this!)
Tool 8: Stretching exercise (pilates, yoga) and Exercise (take it steady)
Tool 9: Keep a diary and track your progress
Tool 10: Have a set back plan: who can you call for help? Let others step in when you can't manage. You don't have to be superwoman.
Tool 11: look after your body: eat healthily, drink lots of water.
Tool 12: Keep all of this up! It is a way of life and it will help you to feel you have a life...

Good Luck! Oh and by the way, I am going to the Migraine Conference in London, this Sunday the 23rd September 2012. It is a public session, so anyone can go, see www.migrainetrust.org or phone 0207 631 6970. I will no doubt be blogging about it next week.

Migraine puzzle: gluten, dairy or detox diets?!

I have a confession to make.

I went to the National Migraine Clinic in January and was on a 3 month review. I haven't been back......

I am scared. Scared of what the next step will be. The Consultant mentioned detox which involves taking yourself off all your drugs you have for migraine treatment for 6 weeks. No analgesics, no triptans, nothing. Arggh! Panic!! I cannot see how I can do this with 3 young children. There is no time that would be a good time to inflict that on myself or my family. May be a stint in the Priory would suit?

So instead, I have chosen to cut out gluten and dairy on top of all the other things I have stopped eating and drinking. It is a last ditch attempt to change the migraine brain chemistry and see if I can make a difference......if it doesn't work (which it hasn't yet) I guess I will have to take a deep breath and face my fears.....

I do feel better on the gluten and dairy free diet. I have more energy, a feeling of desire to do things and play with my children more. I feel that my mood is consistently good, not many tears at all and my stomach behaves itself better. I am getting less head pain during the day and when I am well, I feel really well.

I chatted to a friend who is a dietician. She said after 2 months you should know if there is a link. I thought "whoopee! I've been doing it for at least 2 months so I can start eating and drinking what I want again!" I started the very next day with cows milk on my gluten free cereal......within 40 mins I had a migraine........

Then on holiday I thought "well, I keep getting migraines, so I will relax and treat myself to a bit of gluten, yum". That night I had awful stomach pains, nausea, cramps in my legs and arms and joint pains. Two days later I had a 3 day migraine and felt really low and teary again.

If I am intolerant to gluten and dairy(which I think I might be), why, oh why hasn't the pattern of migraine changed?!

Migraine is like an eternally evolving puzzle which you can't seem to ever finish. I know you get migraines for many reasons, but I just hoped that diet might have been a big chunk of the solution. I'm not ready to give up yet as at the back of my migraine brain I wonder (rather simplistically I'm sure!), that may be it takes longer for the healing to get from my stomach to my head!? Another couple of months and may be then I will face my fear at the Migraine clinic..........