Follow Sharron on Twitter

Sharron's book is now available at Amazon www.amazon.com, Barnes and Noble www.barnesandnoble.com, and wherever books are sold. The book can be purchased in print form or ebook format.

Conari Press, an imprint of Red Wheel/Weiser, LLC  is the publisher of Sharron's book, Migraine: Identify Your Triggers, Break your Dependence on Medication, Take Back Your Life -  An Integrative Self-Care Plan for Wellness," released June, 2013. Follow Sharron on Twitter @murraysharron, and her page Sharron Murray, MS, RN on Facebook, for tips to help you battle your migraines and achieve wellness.

 

Tuesday
Sep242013

BRIDGING THE GAP BETWEEN EAST AND WEST: FIVE PRINCIPLES FOR MAINTAINING AND RESTORING OPTIMAL HEALTH WITH MIGRAINE

 

Eastern medicine is a naturalistic philosophy of health and medicine that looks at the interrelationship of our body, mind, and spirit. Every human being is considered unique. The patient and the doctor work together to maintain and sustain good health. The focus of the relationship is on the prevention of disease and the concept of wellness. This requires an individual to take responsibility for his/her own health and to maintain a healthy lifestyle that includes diet, exercise, and practices such as meditation to reduce the effects of stress and balance the energy centers in his/her body.

In his book "Secrets of Self-Healing" (Avery, 2008), Dr. Ni lists five principles for self-healing and wellness that provide powerful tools for maintaining and restoring optimal health. These five principles are:

  • diet and nutrition
  • herbs and supplements
  • exercise and acupressure
  • lifestyle and environment
  • mind and spirit. 

Today, in Western medicine, along with the diagnosis, treatment, and prevention of symptoms and diseases, most physicians and health care personnel acknowledge the relationship between an individual's diet, lifestyle, exercise and level of stress to his/her health. Besides medications, medical procedures, and surgeries, a variety of relaxation and behavioral treatments and therapies are part of treatment plans for a number of illnesses to promote, maintain and restore good health.

In her article "Migraine Research", Dr. Dawn C. Buse reports that people with migraine can live healthy, productive lives with an effective treatment plan that includes a proper diagnosis, medical care, and

  • acute and preventive pharmacological therapies 
  • non-pharmacological therapies such as biofeedback, relaxation training, cognitive behavioral therapy, meditation, guided visual imagery, and yoga 
  • a healthy diet
  • healthy lifestyle habits like regular sleep/wake schedules and exercise, adequate hydration, no smoking, moderate caffeine intake, and
  • trigger management.

Given this information, let's take a closer look at these principles and concepts and, from a perspective of Eastern and Western medicine, apply them to migraine disease. Keep in mind that we are individuals, who are unique in our triggers, symptoms, comorbities, and risk factors for the progression of episodic to chronic migraine, as well as risk factors for the development of numerous other diseases and disorders.

That said, there are five principles that have helped me revert from chronic migraine and medication overuse headaches (MOH) to infrequent episodic migraine. In addition, these five principles have been instrumental in maintaining and restoring my optimal overall health. They are:

  1. Diet and nutrition
  2. Herbs, supplements and medications
  3. Exercise
  4. Lifestyle habits
  5. Mind and spirit

In subsequent articles, I share each of these principles with you in more detail, along with research studies that support scientific efficacy. 

Sharron is a health and wellness author. A migraine sufferer herself, her most recent book, "Migraine Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life -An Integrative Self-Care Plan For Wellness", (2013), is a Conari Press publication.

Folow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN, and her website www.sharronmurray.com.

This article is not intended as as a substitute for medical advice. If you have specific concerns about your health or nutrition, please consult a qualified professional.

Updated, February 1, 2016

Copyright 2013, Sharron E. Murray

 

 

 

 

 

 

 

Tuesday
Sep172013

Migraine: Three Ways to Avoid Medication Overuse Headaches

Migraine, a largely inherited (genetic) neurological disease with clinical manifestations known as migraine attacks, affects the lives of millions of people worldwide (37-38 million in the United States). For many of us, the majority women, the relentless headache, a phase of the attack, can be excruciating and accompanied by debilitating bouts of nausea and vomiting.

Because our attacks often increase in frequency and severity during the very busiest years of our lives (twenties to fifties) when we are balancing our jobs, family responsibilities, and social obligations, we may inadvertently (often due to gaps in knowledge, poor response, and lack of effectiveness) overuse acute medications (over the counter or prescription) to abort attacks and manage pain, while we attempt to maintain the roles we juggle and keep up with the demands we face. This, as I found out, can lead to medication overuse headaches (MOHs), previously known as rebound headaches.

We should also be aware that we may develop MOHs because of a delay in diagnosis, or a misdiagnosis. For example, in the case of misdiagnosis, because of common symptoms like nasal and sinus congestion, clear nasal discharge and watery eyes, migraine may be misdiagnosed as "sinus" headache and the wrong treatment may be selected.

The International Classification of Headache Disorders, Third Edition  (ICHD-3) defines MOH as headache attributed to overuse of one or more medications. Diagnosis is coded according to the specific medication(s) overused. For example, triptan-overuse headache, simple analgesic -overuse headache, opioid- overuse headache and combination -analgesic overuse headache.

ICHD-3  describes MOH as "Medication-overuse headache is an interaction between a therapeutic agent used excessively and a susceptible patient". It goes on to say that about half of the people with headache on 15 or more days per month for more than 3 months, fit the diagnosis for medication-overuse headache (p. 122). Drugs implicated include:  

  • opioids = to or >10 days per month,
  • combination analgesics that contain opioids, barbiturates, and/or caffeine = to or >10 days per month,
  • simple analgesics including acetaminophen, acetylsalicylic acid, and non-steroidal anti-inflammatory drugs (NSAIDs) = to or >15 days per month, 
  • abortive drugs like ergots, and triptans. = to or >10 days per month, and 
  • multiple drugs for acute or symptomatic treatment of headache (we may not be able to give an adequate account of names or quantities) on 10 or > days per month for > 3 months.

We need to know that medication overuse (regular use on 10 or 15 days per month, for more than 3 months, depending on the medication) is considered to be a risk factor for the progression of episodic to chronic migraine. Episodic migraine (EM) refers to migraine attacks that occur with less than 15 headache days/month. Chronic migraine (CM) refers to attacks that occur with headache (tension-type-like and/or migraine-like) days more than 15 days/month for a period greater than three months, with features of migraine equal to or >8 days per month.

"Clinical evidence shows that the majority of patients with this disorder improve after discontinuation of the overused medication, as does their responsiveness to preventive treatment" (p. 122). 

In my case, unaware of the chance of MOHs, as I took more and more Imitrex to treat my attacks, I progressed to CM, with headaches every day of the month for a number of years. If you think you may be experiencing MOHs, here are some suggestions I have to help you break the cycle of overuse, prevent the progression of episodic to chronic migraine, and improve the quality of your life:

  • First, to avoid medication overuse do not exceed your recommended dose, or take the medication more often than your doctor, or the label on the container, has recommended. If a medication is not working for you, ask your doctor to switch you to one that might be more effective. If you are not on a preventive medication, ask your doctor about one. 
  • Second, if the route of administration is not working for you, ask your doctor to switch you to another one. For example, if you cannot keep the pills you swallow down, a sublingual form, nasal spray, injection, or rectal suppository may be more beneficial.
  • Third, if the frequency and severity of your migraine attacks persist no matter what, or how much, medication you ingest, you might want to do what I did when I found I couldn't keep taking Imitrex to manage my attacks and maintain the hectic lifestyle I loved: consider incorporating acupuncture or one of the other integrative therapies like biofeedback, behavioral modification (cognitive behavioral therapy), meditation, mind-body exercises such as tai chi and yoga, and/or energy healing techniques like Reike and healing touch into your treatment plan. 

These therapies can help balance our nervous systems, stabilize our serotonin levels, increase our endorphins, and thus decrease the frequency and severity of our migraine attacks. As well, because these therapies permit our bodies to relax, facilitate digestion, and allow our energy and blood to circulate freely, they can enhance the effect of the medication we take, and reduce the amount we require.    

Keep in mind, we need to have an accurate diagnosis for our headaches; our doctors should be aware of any integrative therapies or treatments we incorporate into our treatment plans, including herbs and supplements; and, we should never discontinue, or wean ourselves off, any medication without our doctors' consent. 

Keeping a daily diary is a good way to help our doctors diagnose and manage both chronic migraine and medication overuse headaches.

Reference:

International Headache Society (2018). "The International Classification of Headache Disorders" (3rd Edition). Cephalalgia. Vol. 38(1) 1-211.

Sharron Murray MS, RN is an author and coauthor CaMEO Study, "Life With Migraine". Currently, Sharron is active in the migraine community as a writer, advocate, American Migraine Foundation Partner, moderator for the American Migraine Foundation "Move Against Migraine" Facebook Group, and member of the National Headache Foundation Patient Leadership Council. 

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN 

This article is not intended as a substitute for medical advice. If you have any specific concerns about your health or nutrition, please consult a qualified health care professional.

Updated February, 2019

Copyright September, 2013 Sharron E. Murray

 

Tuesday
Sep172013

MIGRAINE AND STRESS: What is the relationship? And, why should stress management be part of our treatment programs?

Migraine is a neurological disease. Although the pathophysiology is not completely understood, research has shown it to be a complex brain disorder that involves genetics, hyperexcitable brain cells, several neuronal pathways, neurotransmitters (chemical messengers in the brain), inflammatory mediators, vascular irregularities, and environmental influences. In this article, we will take a look at the role of serotonin, define stress, discuss the stress response, examine the relationship between migraine and stress, and introduce techniques and therapies effective for stress management. 

Serotonin

Serotonin is a neurotransmitter found in the brain and in the gut. It helps regulate pain, vessel tone, peristalsis (movement of food through our gut), sleep, mood, and appetite. Along with neurotransmitters like Dopamine and Norepinephrine, Serotonin levels are believed to fluctuate during a migraine attack. Some sources indicate that people with migraine may have a low serotonergic disposition. Low levels can contribute to our headache pain, gastric stasis, nausea, vomiting, food cravings, and mood swings.

Stress

Stress is defined as the normal physical response of our bodies to any demands or changes. It is our body's way of adapting to internal or external, perceived or real challenges, termed "stressors".

The term "stress" is associated with the exertion of pressure. This pressure can be related to environmental, chemical, physical, or emotional stressors. We need to know that our body does not distinguish between these. For example, it reacts the same way whether we are overcome by toxic fumes, break a leg, having problems with our boss, are worried about mounting bills, or are anxious about a loved one.

Stress response

Acute stress

When we perceive a threat or feel "stressed" (pressured), our body activates the sympathetic branch of the autonomic nervous system (ANS) and the hypothalamic-pituitary-adrenal (HPA) axis. This causes a flood of hormones to be released including, but not limited to, epinephrine (adrenaline), norepinephrine (noradrenaline), and cortisol to fight the challenger. We know this as the "fight or flight" response, or acute phase of stress. In this phase, stress is good. It keeps us on our toes and allows us to stay focused, energetic, and alert. Levels of epinephrine, norepinephrine, and cortisol are high, giving us the energy to fight the stressor at hand. Once the emergency has passed, the levels of these hormones return to normal.

Symptoms related to acute stress include:

  • increased heart rate, blood pressure and respirations, 
  • dry mouth, 
  • sweating, 
  • cold hands and feet, 
  • facial pallor, 
  • chills, 
  • nausea and vomiting, 
  • "choked-up-feeling",
  • gastric stasis,
  • diarrhea, 
  • headache, 
  • lightheadedness,
  • rapid speech,
  • stuttering,
  • restlessness, 
  • nervousness, 
  • insomnia, 
  • anxiety, and 
  • panic attacks. 

Chronic stress

Chronic stress is not good for us. In this phase, the HPA axis may wear out and levels of epinephrine, norepinephrine, and cortisol can become depleted. When that happens, levels of dehydroepiandrosterone (DHEA), a steroid produced by the adrenal glands and used to make estrogen and testosterone start to fall and neurotransmitters like serotonin are affected. Our body's metabolism slows down and we may feel tired, fatigued, and gain weight, especially around the middle. A decrease in our sex hormones can cause hormonal imbalances and loss of our sex drive, while low levels of serotonin can contribute to emotional disturbances like anxiety and depression.

Symptoms related to chronic stress include:

  • extreme fatigue,
  • lethargy,
  • weight gain (difficulty losing weight), 
  • cold hands and feet, 
  • menstrual irregularities, 
  • loss of sex drive (libido), 
  • indigestion, 
  • heart burn, 
  • recurrent infections, 
  • rash,
  • headache, 
  • backache,
  • hypertension, 
  • hemorrhoids, 
  • varicose veins, 
  • poor concentration,
  • intense mood swings, 
  • anxiety, and 
  • depression. 

Migraine and stress

Numerous studies have shown that stress plays an important role before the onset of migraine, in the maintenance of the disorder, the frequency of our attacks, and the progression of episodic to chronic migraine. At this point, you should know that several studies have shown stress to be a trigger for migraine attacks. As well, stress is a factor that makes us more susceptible to our triggers (additive effect)

Other factors to consider in the relationship between stress and migraine include

  • the perception of stress is unique to the individual (what stresses me may not stress you),
  • some people are more sensitive to stressors than others, and
  • comorbid illnesses can affect our susceptibility. For example, I have Mitral Valve Prolapse, a condition which makes me extremely sensitive to stressors.

Keeping these things in mind, ways that stress can impact our migraine attacks include:

  • If stress is severe, prolonged, and/or frequent, it can affect our sleeping and eating patterns and make us more susceptible to triggers like fatigue and hunger.
  • Because stress can affect our estrogen levels and serotonin levels tend to fluctuate with our hormonal levels, it can exacerbate the pain of our hormonal migraines.
  • It may also contribute to new onset migraine attacks during menopause or other hormonal changes like initiation of birth control pills or pregnancy.
  • Because chronic stress can deplete our serotonin levels, it can increase the frequency, duration, and severity of our migraine attacks, and play a role in the development of chronic migraines.
  • The pain of the headache we experience during our migraine attack can itself stimulate the ANS and HPA and initiate the stress response we just discussed. This can not only exacerbate our pain, but other symptoms like nausea, vomiting, gastric stasis  (slowed peristalsis or movement of food through the gut), and mood swings including irritability, anxiety and depression. The slowed peristalsis may delay gastric emptying and affect how our oral medications are absorbed, thus delaying our pain relief.
  • The relaxation phase following an episode of stress is thought to be responsible for the migraine attack known as a "let-down" or "weekend" migraine.

Stress Management

Effective stress management is essential for those of us with migraine to help quiet our minds and calm our bodies. Behavioral, relaxation and stress management techniques, including biofeedback, meditation, guided imagery, breathing techniques, yoga, physical therapy, massage therapy, and acupuncture, have been shown to help minimize our physiological responses to stress, decrease sympathetic arousal, and stabilize our serotonin levels. Other therapies like energy-healing techniques such as Healing Touch and Reiki are thought to be helpful. These therapies have even better effects when combined with a healthy diet that is free of chemicals and preservatives, avoidance of excessive caffeine and alcohol, no smoking, and a regular sleep schedule and exercise program.

Adoption of stress management techniques has other benefits. Because these techniques and lifestyle modifications involve participation and commitment, our treatment becomes a collaborative process where we partner with our doctor or other health care professional in our care. Besides a feeling of empowerment, when we adopt a healthy lifestyle we can decrease our risk for the progression of episodic to chronic migraine, increase our chances of reverting from chronic to episodic migraine, and decrease our risk for a number of other disorders and diseases like hypertension, stroke, and diabetes.

Lastly, migraine can steal moments and events from our lives that we cannot recreate. Many of us have to give up our careers and our dreams. Feelings of loss of control and helplessness are prevalent. Stress management cannot cure our migraines but it can help us lead more full and happy lives. If you do not have a stress management program in place, you might want to consult with your doctor or other health professional about integrating one into your treatment plan.

References:

Amoils, S., M.D. & Amoils, S., M.D. (2011).  Get Well & Stay Well. Ohio:Integrative Medicine Foundation.

Buse, D. C. PhD. & Andrasik, F., PhD. (2009). Behavioral Medicine for Migraine. Neurol Clin 27, 445-465. doi:10.1016/j.ncl.2009.01.003

Hedborg, K., Anderberg, U. M., & Muhr,C. (2011). Stress in migraine: personality-dependent vulnerability, life events, and gender are of significance. Upsala Journal of Medical Sciences. August, 116(3), 187-199.   

Hamel, E. (2007). Serotonin and migraine: biology and clinical implications. Cephalalgia. Nov. 1293-300.

Sauro et al. (2009). The Stress and Migraine Interaction. Headache.: The Journal of Head and Face pain, 49 (9), 1378-1386. 

Updated February, 2018

Sharron Murray, MS, RN is a Health and Wellness author. Her most recent book, "Migraine Identify Your Triggers, Break Your Dependence on Medication, Take Back Your Life- An Integrative Self-Care Plan for Wellness" (2013), is a Conari Press publication.

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website www.sharronmurray.com 

This article is not intended as a substitute for medical advice. If you have any specific concerns about your health or nutrition, please consult a qualified health care professional. 

Copyright 2013, Sharron E. Murray

Tuesday
Sep172013

MIGRAINE: "I AM A PERSON, NOT A DIAGNOSIS"

 

"It is far more important to know what person the disease has than what disease the person has." - Hippocrates

I approach this topic from the perspective of Holistic and Eastern medicine. Both of these domains look at the relationship between the body, mind, and spirit. A person is unique, not an example of a particular disease. 

In other words, "I am a person, not a diagnosis". My name is Sharron Murray. I come to this table of migraine disease with my own platter of characteristics. They are as individual to me as my symptoms, triggers, and responses to pharmacological and non-pharmacological therapies, including integrative (complementary) strategies. 

A small percentage of us (about 2.5% in the US) progress from episodic migraine (EM) to chronic migraine (CM) each year. This progression is thought to be gradual and may occur over months or years, as our range of attack frequency and headache days increases from 0-9 days per month (low frequency EM - LFEM), to 10-14 days per month (high frequency EM - HFEM), and then to CM with greater than 15 days per month.

Risk factors have been identified that increase our chances of progression. These risk factors, are believed to be non-modifiable (those we cannot influence) and modifiable (those we can influence). In general, non-modifiable risk factors have been identified as:

  • genetic factors,
  • older age,
  • female sex,
  • Caucasian race,
  • worse socioeconomic status,
  • low education levels, and
  • head injury.

Modifiable risk factors are believed to include: 

  • medication overuse,
  • caffeine use/misuse,
  • obesity,*
  • sleep disorders like snoring and sleep apnea,
  • stressful life events,
  • depression,*
  • anxiety,*
  • chronic pain disorders*,
  • smoking, and
  • substance abuse (drugs and alcohol).

*These risk factors may be comorbid with migraine.

I consider my risk factors to be part of my platter of characteristics. I may have more, or less, than you. If I have more than you, that may make the course of my disease more troublesome and the task of preventing or reversing chronic migraine may be more difficult for me.

That said, once I identify my risk factors, I am able to work with my doctor or other health care professional to improve or eliminate the modifiable ones. In both Holistic and Eastern medicine, the doctor or other health care professional is seen as a guide to assist a person to achieve wellness. This requires me to take responsibility for my own health, and in this case take charge of my modifiable risk factors.

For example, when I taught patients about heart disease, risk factors included hypertension, elevated cholesterol, diabetes, smoking, overweight, inactive lifestyle, family history of heart disease, male sex, and older age. Things like sex, genetics and age were beyond their control. I could educate them about the factors within their control, however, whether they decided to quit smoking, lose weight, and lower their cholesterol to decrease their risk of having a heart attack was beyond my capability. On an individual basis, they were in charge of the outcome.

Multiple sources conclude that preventive treatment is essential to reduce the impact of risk factors  on our disease. Many of them suggest non-pharmacological (including integrative or complementary) therapies, combined with medication, as an effective method of treatment. Since 2001, when my migraine attacks were at their worst and my path was complicated by medication overuse, I have been an active participant in integrative treatments and strategies. Besides reverting to infrequent, episodic migraine, I have gained a feeling of empowerment.

If you have not already done so, I encourage you to make a list of your modifiable risk factors and then talk to your doctor or other health care professional about ways to improve or eliminate the most problematic. 

Healing doesn't mean the damage never existed. It means the damage no longer controls our lives." - Author Unknown.

To me, this quote means healing doesn't mean my migraine disease never existed. Until there is a cure, it will always be a part of me. However, it no longer controls my life. Hence the phrase, "I have migraine disease. It does not have me."

References:

Katsararava, Z., Buse, D.C. et al (2012). "Defining the Differences Between Episodic Migraine and Chronic Migraine." Curr Pain Headache Rep. February; 16(1): 86-92.

Manack, A., Buse, D. C., et al (2011). "Rates, predictors and consequences of remission from chronic migraine to episodic migraine." Neurology. Feb 22;76(8):711-8. doi: 10.1212/WNL.0b013e31820d8af2.

Pistoia, F., Sacco, S., and Carolei, A. (2013). "Behavioral Therapy for Chronic Migraine." Curr Pain Headache Rep.  17:304. DOI 10.1007/s11916-012-03

Sharron Murray MS, RN is an author and coauthor CaMEO Study, "Life With Migraine". Currently, Sharron is active in the migraine community as a writer, advocate, American Migraine Foundation Partner, moderator for the American Migraine Foundation "Move Against Migraine" Facebook Group, and member of the National Headache Foundation Patient Leadership Council. 

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray, MS, RN and her website www.sharronmurray.com

This article is not intended as a substitute for medical advice. If you have any specific concerns about your health or nutrition, please consult a qualified health care professional.

Updated February, 2019

Copyright 2014, Sharron E. Murray

 

 

Tuesday
Sep172013

A role for integrative (complementary) therapies in preventing the progression of episodic to chronic migraine, and remittance 

"Once you choose hope, anything's possible." -Christopher Reeve

Migraine is a complex neurological disease thought to affect our nervous systems. Although the exact cause is not known, evidence suggests we have an inherited disruption in brain function that makes our brain cells more excitable than others.

Because we have sensitive nervous systems, we are vulnerable to changes in our internal and external environments. These changes, or stimuli known as triggers, initiate the chain of events that set off our migraine attacks. It is helpful for us to know that triggers are numerous, cumulative, unique to the individual and believed to include:

  • food and beverage sensitivities (chemicals and additives),
  • magnesium deficiency,
  • loud noises,
  • flickering lights,
  • strong smells,
  • weather and barometric pressure changes,
  • hormonal fluctuations,
  • dehydration,
  • hypoglycemia (skipped meals),
  • hyperglycemia (blood sugar spikes)
  • changes in sleep patterns,
  • fatigue,
  • poor posture, and
  • stressors that, if perceived as stress, activate our bodies' stress response, which may trigger an attack. These include danger, noise, video games, cell phones, crowding, pain, infection, work pressures, loneliness, relationship problems, and emotions, including fear, worry, anger, sadness, grief, excitement (too much joy).
  • a reduction in stress (let-down stress) .

When I was diagnosed with chronic migraine and medication overuse headaches, (2001), the first and most important thing I did to reduce the frequency and severity of my migraine attacks was to identify my responsible triggers, including stressors. The next, and the most difficult thing, because I had to accept my disease and take responsibility for my health, was to manage my identified triggers and my body's response to stress (level of stress).

To manage my triggers, I changed my diet and eating habits; adopted regular sleeping patterns; avoided or took measures to minimize flickering lights, loud noises and strong smells; made sure I drank enough water to maintain hydration, and with the help of a great physical therapist, corrected my posture.

Stress management was another matter. At the time I began my path to wellness, I was familiar with biofeedback and breathing techniques. However, I did not incorporate these strategies into my daily life until I began my journey into Eastern medicine.

"The life of inner peace, being harmonious and without stress, is the easiest type of existence." -Norman Vincent Peale

There, within the philosophy of Eastern medicine, I learned about Chi, the energy force that flows through our organs and muscles and permeates every tissue and cell in our body. As well, I discovered the wonders of Yin and Yang opposite, although complementary, energies essential to all facets of life. For example, take our human body. If we get to hot, we sweat and cool down.

I equated the flow of energy to my nervous system and Yin and Yang became the sympathetic and parasympathetic branches of my autonomic nervous system. Yang (fire) was fast like the sympathetic branch, whereas  Yin (cools fire) was slow like the parasympathetic branch. Breathing took on a whole new meaning as I embraced the word "calm" on exhalation of each breath with meditation, and as I focused on controlling my heart rate and respirations with the biofeedback exercises I revisited.

As I was guided through self-awareness, I learned how to understand and express my emotions to promote healing.  For example, instead of repressing anger, I have given myself permission to tell someone, including my husband, that I am angry, irritable, or frustrated. If I am afraid or worried, I confront the cause rather than retreat inside and dwell on my inhibitions. When I am anxious, wired, or riding high on joy and enthusiasm, I use meditation to calm me down. Because I am not waking up in the middle of the night like I used to with a thousand things on my mind to torment me, I sleep better. Because I am well rested, I eat more regular and nourishing meals. Thus, I have increased my physical energy and am able to commit to health-enhancing practices like a regular exercise program.

 "The natural healing force within each of us is the greatest force in getting well." -Hippocrates

A while ago, a fellow person with migraine asked me what it was like to detox off Imitrex. I was honest in my reply. The first few weeks were tough. Worst migraines ever! At times I felt like throwing in the towel. But, something, somewhere deep inside of me, wouldn't let me. If there was a way out of this daily madness, I was going to take it.

Spurred on by the encouragement of my husband and my doctors, I adopted more practices I learned from Eastern medicine and, along with others from my familiar Western medicine, I developed and employed my wellness plan. Because, integrative (complementary, non-pharmacological) therapies take longer to work than pharmacological, change in my status did not occur overnight. Thus, I concentrated on the good days when I was free of pain and the drugged sensation and hangover effect that medication gave me wasn't around.

As time passed, my good days started to outnumber my bad days and my dependence on medication became less and less. Today, to keep my migraine attacks at bay ( I am still vulnerable and am diligent in my determination not to return to the days of chronic migraine and medication overuse headaches), I abide by the following plan: 

  • To promote healing, balance the yin-yang energy in my body, and eliminate triggers, I avoid hot and spicy foods, those with additives and preservatives, fermented foods, most dairy products, rich and creamy foods, fatty and greasy foods, and stimulants like caffeine. Except for a glass or two of white wine, I avoid alcohol.
  • To facilitate an optimal state of wellness (including, reduce my risk for cardiovascular disease as I have migraine with and without aura), I eat a well-balanced diet of organic (as much as possible) fresh vegetables and fruits, whole grains, fish, chicken, and a small amount of lean red meat, pork, cheese, and eggs.
  • To strengthen the muscles in my neck, I do the exercises I was taught by a physical therapist years ago.
  • To help prevent and/or sometimes abort, attacks, I practice breathing techniques, biofeedback exercises, and meditation. As well, I take a small dose of Verapamil daily as a preventive medication. 
  • To numb the pain of a headache and decrease the associated inflammation, I use cold gel packs and a compound keto/lido topical cream.
  • To balance my emotions and increase spirituality, I practice the self-awareness steps I learned from Eastern medicine.
  • To promote the smooth flow of energy and maintain a balanced nervous system, in addition to breathing techniques, biofeedback, meditation and regular exercise, I have acupuncture every 6-8 weeks.  These techniques and strategies also help increase my serotonin levels and endorphins, and decrease autonomic symptoms such as nausea, vomiting, gastric stasis, and nasal congestion.

 "What you can become depends upon what you can overcome." -A.D. Williams.

Today, I live a healthy and happy life with migraine disease. As I reflect on my journey, I regret that I didn't know more about triggers, the importance of stress management techniques, and the pitfalls of medication overuse before my migraines progressed from episodic to chronic.  I cannot change the past, however, I can share everything I know, and learn, to help others treat and prevent chronic migraine. 

Three scientifically proven techniques that have been shown to be as effective as medication for migraine treatment are: biofeedback (relax mind and body), cognitive behavioral therapy (helps patients understand that their thoughts and feelings influence their moods, behaviors, and ultimately their health), and relaxation therapies like meditation (ease stress). . 

Although more research is necessary to add to the body of scientifically-based evidence on the effectiveness of techniques such as acupuncture, yoga, exercise and physical therapy, these techniques and strategies have shown positive results in a number of studies. The important thing is for you to choose something that helps you keep a quiet mind and calm body (balance your energies and nervous system).  

Also, you need to know that while one therapy may work for me, it might not work for you as we are unique in our symptoms and our response to treatment. In addition, comorbid diseases or disorders can make the course of our disease more complicated and the choice and benefits of some of these therapies more limited.

Lastly, these therapies have their greatest benefits over time and when combined with a healthy diet and lifestyle, which includes avoiding identified triggers. And, remember to always check with your doctor before initiating any new therapies.

References: 

Murray, S. M.S., R.N. Migraine: Identify Your Triggers, Break Your Dependence On Medication, Take Back Your Life. San Francisco:Conari Press, 2013. 

Sharron Murray MS, RN is an author and coauthor CaMEO Study, "Life With Migraine". Currently, Sharron is active in the migraine community as a writer, advocate, American Migraine Foundation Partner, moderator for the American Migraine Foundation "Move Against Migraine" Facebook Group, and member of the National Headache Foundation Patient Leadership Council. 

Follow Sharron on twitter @murraysharron, her Facebook page: Sharron Murray MS, RN and her website www.sharronmurray

This article is not intended as a substitute for medical advice. If you have any specific concerns about your health or nutrition, please consult a qualified health care professional.

Copyright 2013, Sharron E. Murray. 

Updated February, 2019

 

 

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