On the recommendation of a board member here, sorry but I can’t remember who lol, I bought this book and read it cover to cover last night. I am SO glad that I did. For the first time since this condition hit me, I don’t feel like I am completely victim to it and out of control. The doctor explains the mechanisms of migraines, the theories involved in its developement, and the wide array of symptoms it can cause. He also says that doctors who diagnose migraine “variants” are simply trying to get away from the conventional view of migraine with looking obvious lol. He says “migraine is migraine”. MAV, Tension headaches, sinus headaches, even regular headaches,…all migraine! And the symptoms produced depend on the site of the blood vessel dilation or constriction. If blood vessels to the eyes or inner ear are constricted, you get a feeling of fullness in the ears, sensivitiy to loud noises, sensitivity to bright light, dizziness, and so on. If the blood vessels in the head, neck or face are dilated, you can get the pounding headaches, facial pain, neck stiffness, and so on. It was very interesting to read about the mechanisms involved. Even though he fully admits that nobody really knows the full ins and outs of migraine, it doesn’t matter. His program, according to him, works!! There are 3 steps involved:
-
Eliminate “quick fixes” such as exedrin, immitrex, and other drugs that cause blood vessel constriction initially and immediately, but cause “rebound” to occur. In other words, once the blood vessels are constricted, and the drugs wear off, the dilation comes back with avengence, often worse than before the med. This creates a viscous cycle which also makes the person resistant to preventative migraine meds.
-
Step 2 involves cutting out all dietary triggers. MSG, caffeine, and certain amino acids are the culprits because they inflame blood vessels further, which contributes to what he calls the overall migraine “threshold”. He says that every human on the planet has a built in migraine threshold. As long as you are under the threshold, you do not experience symptoms. But once your “triggers” put you over this edge, you experience symptoms. Triggers can be stress, anxiety, depression, MSG, caffeine, certain amino acids, pressure changes with weather patterns, perfumes/chemicals, loud noises, bright lights, flashing lights, etc. Certain triggers are hard to avoid, but the dietary ones are completely under our control. He doesn’t seem to be such a proponent of stress/anxiety elimination since he feels that’s largely not possible, and doesn’t like the benzos and other anxiety drugs, but says that if you can reduce your stress load, this will reduce your trigger load, which will lower you below the threshold, and symptoms will go away. Anxiety, crying, depression, and stress, are often the triggers that put people over the edge, but aren’t necessarily the ones mostly responsible. It’s an overall “trigger load” that contributes to migraine. Once all dietary triggers are gone, and rebound meds are stopped, it could take 2 months to lower the trigger level.
-
However, if this fails to lower the trigger load enough to bring you under the threshold, migraine preventatives can be used to RAISE your threshold, and reduce or eliminate symptoms. He goes through all the drugs, which ones are best to use for specific situations for each person, the dosages needed, even how to properly give the medicine its trial. He says a lot of meds fail not because the med doesn’t work, but because too high a starting dose is used, people stop meds due to initial side effects that often discipate with use, and because they are still using rebound drugs and have many triggers still afecting them. For example, the trycycline anti-depressants such as notriptyline, which is his favorite TAD due to the low amount of side-effects and sedation, is good for people who are already depressed, have anxiety, and insomnia. Verapamil is good for people already with high blood pressure, Depakote is good for people who are manic-depressive and have seizures or seizure-like activity in their brains, and on and on he goes. VERY informative.
He also goes through the many mis-diagnosis’s that people are often given, which are really nothing more than migraine. He also says that although you can be symptom-free for life, if you maintain yourself below your migraine threshold, symptoms can and will return when you exceed your threshold. He says this happens for a variety of reasons. He even gave exmaples of how people claimed to be doing well on a med, and then suddenly, after a few months, it stopped working. He says that often times, it’s not that the med stopped working. It’s that other triggers raised your trigger level above your threshold, even while on the medication. The medications are not a “cure-all”, or a guarantee to stop migraine. They are a tool to artificially raise your threshold, nothing more. Therefore, there is NO migraine “cure”, as all human beings have migraine mechanisms. However, some people just have incredibly high thresholds. Some poeple have very low thresholds. The key is to get your threshold higher than your trigger level.
Personally, I am getting RIGHT ON this program. I have already eliminated everying he says,…I am still taking my xanax when needed, but will most likely wean off that when I start notriptyline, which seems like the drug for me since I am depressed, have anxiety, and trouble sleeping. My brain-mapping shows seizure-like activity in my brain, so if this drug doesn’t work, depakote is my next choice if the doctor’s agree. I have also ordered, for what it’s worth, lucinda bassette’s “stress and anxiety” program for anxiety and depression. I might not be able to avoid stress and anxiety, but I can reduce my REACTION to it, which WILL lower my threshold. I am excited, as for the first time, I feel like there is something I can proactively DO about this, and that I am not simply a victim who is at the mercy of this thing. I am going to win!!! One way or another. It’s going to take time, and I know that. But I am in this for the long haul!!!
He also has a great idea, which I will mention here…he says exercise and sex are unfortunately triggers. However, he says one way to avoid the migraine sysmptoms of exercise/sex is to take a high dose (but safe) of ibprofen (up to 800mg) 30 minutes to 1 hour before exercise, and then again 4 hours later. This can abort the symptoms of increased dilation or constriction which causes our dizziness and other symptoms. I plan on giving it a try to see what happens.
Anyway, for me, this is quite exciting. If you have nothing good to say about the program, I would honestly prefer that you just not respond. I’m not interested in hearing how this has not worked for someone else. My guess is, if it didn’t work, you either continued to set off “triggers” you were unaware of, despite your use of meds, which kept you in your cycle of migraine. No offense to anyone, obviously, because I respect each and every one of you for the hardships you have all indured with this, and being only 3 months into this, I am very new, so I don’t know what it’s like to do this for the long haul. But to me, one thing is clear now…negativity will accomplish nothing, even when symptoms are at its worst, which for me, seems like the case right now. But even then, I am trying to look beyond this, and consider the likely possibility that I can get control of this because ultimately, it is ME who DOES have the control, not the migraine. When someone asks me what I have, for now on, I will be saying “migraine”, not MAV. That’s just me. That’s just my outlook on it. If your blood vessels are inflamed, dilated or constricted in only certain areas, you may not fit the profile of traditional migraine, but the cause is exactly the same. I believe that now. I look forward to getting control of this. And honestly, I’m not sure if I am going to start the preventative meds right now, or wait an additional 2 months on the diet/stress/anxiety reduction to see what happens. But the prescription is filled, and I have it just in case. I will be talking to my doctor about that until I am able to get into Johns’ Hopkins to see their headache guy. At least now, I am armed with powerful information I didn’t have before.
My only concern, is the impact of certain designer supplements on this condition, mainly the effects of Vitamin K (which I need for osteoporosis), grape seed extract (which is supposed to affect blood vessels to some capacity), and the effects of calcium/magnesium. He actually recommends a multivitamin, but warns against herbs, as they act as drugs as well. That’s all I have
Rich