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How to head off a headache.

Lisa Kaaki

David Buchholz has helped thousands of people heal their headache. He is among the first to challenge many of the popular beliefs about headache diagnosis and its treatment. The author challenges us to think differently about headaches. Ultimately, 'Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain' is about control, it teaches us how to take charge of our headaches. Ninety percent of people admit to having headaches. We get headaches because nature has built into us a headache-generating mechanism. This mechanism known as migraine causes swelling and inflammation of blood vessels around the head and it is commonly accompanied by nausea, vomiting, sensitivity to bright light and noise, diarrhea, constipation, flushing or pallor of the skin, sweating, chills and even fever. Two factors play a role in the activation of the migraine mechanism. One is the trigger level and the second is the threshold which is largely genetically determined. If you come from a family susceptible to migraines you might most likely have low thresholds whereas most people who do not suffer from headache problems have higher thresholds and therefore fewer and milder headaches. Certain foods, stress, noise, light, barometric pressure changes, and sleep deprivation can trigger a migraine. When the sum of these triggers exceeds your threshold, the migraine mechanism will be activated and you will feel the symptoms. For example, you might one day eat more chocolate than you should and get away with it. But a few days later, the weather is stormy, you are seated near someone wearing a heavy perfume, and you just eat one piece of chocolate then you are suddenly hit with a splitting headache. "The greater your trigger load, the more likely you'll get a headache and the worse it will be. The key to controlling your headaches and other migraine symptoms is simple: "Keep your trigger level below your threshold." As the mechanism which causes the headache proceeds, neuropeptides are released from nerve endings. These so-called neurotransmitters cause blood vessels around the head to become swollen and inflamed which in turn generate pain around the head, face or neck. A migraine makes your brain act and feel more sensitive so that even the pulsation of blood vessels which are normally hardly perceptible are felt instead as throbbing and pounding pain as if your heart is beating in your head. Migraine can strike from early childhood through old age and the onset of the symptoms happens earlier rather than later. Toddlers and children are mostly unable to communicate their suffering therefore it is very likely that children's headaches are misdiagnosed as "psychosomatic" or incorrectly attributed to a "sinus" problem or "eyestrain". The core of the book is Dr. Buchholz's three-step approach which teaches you that headache control is not only possible but also largely in your own hands. When you rely too frequently on painkillers, you make your headache problem worse and more difficult to control. Step one tells us how painkillers can be used appropriately so that they don't make your headache worse. According to Dr. Buchholz, painkillers may be taken only if the need arises infrequently, and if the treatment is safe and effective. This amounts to taking a safe and effective medication at most twice a month for severe headaches and not more than two days a week for milder headaches. If your headaches happen more frequently, or your painkillers are causing in fact the headaches to reappear; you should focus on preventing your headaches. The treatment for mild headaches can be efficient especially if you take a high dosage as early as possible. However, the medication used for such a purpose is not totally safe. Acetaminophen can cause liver damage as for aspirin, ibuprofen and naproxen, they may cause stomach irritation or kidney problems particularly if you are suffering from high-blood pressure or diabetes. "When headaches occur, it can be helpful to eat something, to try to relax, in a dark, quiet room or go to sleep, to apply ice, heat or gentle pressure, to be massaged, to do neck stretches or to exercise. If you find any of those measures helpful, do whatever works for you as soon as possible after a headache starts." For infrequent severe headaches, triptans are the most effective treatment but these drugs must be taken no more than two days a month or they will lead to rebound. Overcoming your dependence on quick fixes and controlling your headaches requires long-range perspective. Rebound is the biggest problem with quick fixes and the greatest potential impediment to headache control. The recurrence of headaches develops over weeks, months, and years. The rebound syndrome not only increases headache frequency but also fosters drug resistance and you eventually find yourself less responsive to a quick fix that used to work well. Ideally, the rebound effect should be avoided by limiting the use of rebound-causing medication in order to become responsive to preventive treatment. Elimination of rebound is potentially the hardest but also the most important step toward controlling your headaches. This brings us to Step 2 of Dr. Buchholz's program which consists in reducing your migraine trigger level. There are a number of migraine triggers which you should be aware of. The list includes changes in the weather, hormonal fluctuations, sensory stimuli such as perfumes, smoke, bright lights and cleaning products, physical exertion, sleep deprivation and stress. It is interesting to know that these unavoidable triggers generally do not reach above your threshold and do not give you a headache; the avoidable triggers mostly consist of food, beverages and medications. There are several reasons why headache sufferers do not pay attention to the food they consume and the reason is the delay in hours from the time an item is eaten until its impact is felt. Sometimes certain food products react within minutes and this is the case with caffeine. Yes, caffeine has a paradoxical effect that makes it appear helpful for headaches. Beverages containing caffeine such as coffee, tea, iced tea and colas tend to provide temporary relief by constricting the blood vessels and this explains why caffeine is present in certain medicine such as Excedrin, Fiorinal and Fioricet for example. The problem, however, is that as soon as the caffeine's constricting effect wears off, the blood vessel start swelling again. This is the reason why people suffer from headaches when they do not have their usual caffeine dosage first thing in the morning or when they try to reduce their caffeine intake. You can begin to take control of your headaches by eliminating each and every one of those potential triggers from your diet. Strict compliance is required. The better you follow the diet, the more likely you are to achieve headache control. Dr. Buchhholtz's diet is tough since it concentrates on what you cannot eat and drink rather than on what you can. The exhaustive list includes chocolate, processed meat and fish, cheese, the more aged, the worse and yoghurt. Cottage cheese, ricotta cheese and cream cheese are permissible. Nuts are forbidden along with citrus fruit, pineapple, dates, avocados, raspberries and red plums and dried vegetable such as lima, fava beans and lentils. You should also avoid aspartame until you can safely reintroduce gradually the forbidden food items. You must also stop taking nonessential medication such as diet pills and herbal stimulants. However, some medications which are listed as triggers cannot be stopped because they are being taken for serious medical conditions such as heart problems. But people suffering from asthma for example can find alternative treatments that can be as effective without triggering migraine. If despite having followed step one and step two you feel you are still at the mercy of your headaches, you can implement the third step which enables you to take an effective preventive medication every day. These medications in fact raise the threshold for migraine. You have to be patient and under a doctor's supervision, you must keep on trying different types of medication at a low dosage until you find one that works for you. This book helps you understand the complex mechanism of migraine and gives you practical advice to control your headaches. "Heal Your Headache "is a must read for anyone suffering from migraine. - Email: [email protected]

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Publication:Arab News (Jeddah, Saudi Arabia)
Date:Feb 10, 2016
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