Heal your Headache?
April 30, 2006 4:13 AM   Subscribe

Preventing Migraines - Anyone had any success with the program described in Heal your Headache by David Buchholz?

Main components:

All headaches have the same mechanism - Migraines are the far end of a continuum. Sinus headaches, in particular, are often migraines.

1 Make sure you're not "rebounding"
Avoid caffeine, decongestants, other "vaso-active" items that can cause rebound. Be careful about how often you use meds that can cause rebound.

2 Trigger elimination diet

3 Preventative meds

The idea is that steps 1 and 2 will make the step 3 meds work better and at lower dosages.

Has anyone used this program successfully?
posted by egk to Health & Fitness (8 answers total)
Well, I don't know anything about this program, but I can tell you that the first principle that "all headaches have the same mechanism" is complete crap.

Regarding migraine headaches, the are two basic kinds: the kind everyone can get occasionally and the kind some people are stuck with for most of their lives.

Part of the problem is that people don't understand what migraines are. They are NOT headaches. A migraine episode may include a "migraine" headache but not always. And a "migraine headache" does not a migraine make.

Chronic migraine syndrome is a neurological disorder similar to epilepsy. Similar specifically in that migraine episodes are cause by screwed up electrical activity in the brain. A migraine episode (which includes such fun as visual and auditory hallucinations, light sensitivity, and more) can last from 2 hours to 2 weeks, depending on how lucky you are. The actual pain part, happens in the middle and may or may not hurt.

So the question is: do you have migraines or just chronic really really really bad headaches? Mind you: I'm not belittling any pain you may be suffering. It just helps to get the diagnoses correct. If they're just bad bad bad headache then stress and/or a food allergy is probably the problem. If it's migraines, then well, you're screwed. Welcome to the club.

That said: those first few piece of advice can be useful. If you're getting alot of them: journal. Write down everything you eat, and every headache you get. Note the correlations. Write down how much sleep you get. Not the correlation between screwing up your sleep schedule and getting the pain. As for the caffiene....that really does depend on the person. Some people are hyper sensitive to it, others (like myself) are hypersensitive to its absence. In fact, if nothing else is working and I've got the pain, a nice double shot of espresso will almost certainly take the edge off.
posted by jaded at 5:35 AM on April 30, 2006

For people with chronic vascular headaches (my neurologist categorized those under the "migraine" umbrella when he diagnosed me), caffeine actually helps, as it did in my case, precisely because it inhibits vasoconstriction.

That's why those OTC migraine relief capsules include a kick of caffeine along with the acetaminophen and aspirin.
posted by brownpau at 6:13 AM on April 30, 2006

My brother in law is following the concepts laid out in that book, and he says that he has a lot fewer migraines, and that the ones he has are less severe. YMMV.
posted by sugarfish at 10:13 AM on April 30, 2006

My fiance's neurologist put him on a program similar to the above for migraines. Eventually the problem was diagnosed as a hormonal imbalance (lack of testosterone can cause migraines in certain males, apparently for the same reason some females get migraines around the same points in their menstrual cycles every month). She took him off the diet but he's still supposed to avoid caffeine and such (it clearly doesn't help him--but he did eliminate it for some time, and that didn't seem to help, either, so he's back on it now). She's had good success with some patients narrowing down the problems--an example she gave us is that a patient figured out through the elimination program that her migraines were triggered by peanut consumption. It seems to me that this (or any program including an elimination diet) is more useful for finding out what your body can and can't take than as a lifestyle cure.

Androgel does help my fiance's migraines a great deal, for what that's worth. He has the compound problem that once the migraines were taken care of, we/he/his doctor started to realize that he had been suffering from two types of headaches the whole time--the migraine was masking/blending with the kind of headache whiplash patients sometimes get, neck pain travelling into the head. So, what Jaded said about headache mechanisms. Pressure in the sinuses != migraine != stress headaches != muscle pain headaches.

I've been suffering from migraine symptoms for a couple months now (all the time), but rarely have the headache (well, it comes and goes)--I've had visual symptoms and bad vertigo and nausea and am waiting to see a neurologist (but I have a family history of disorders with similar symptoms to migraine, which migraine medications can make worse by raising intracranial pressure). I've been working on some of the above, like cutting caffeine and other obvious triggers (having been too nauseous to eat a great deal of the time, I haven't done much with my diet, though I know anything with corn in it--particularly high-fructose corn syrup--can act as a trigger for several other problems I have, so I avoid those foods, and I try to avoid taking in much refined sugar in general), but haven't seen a major difference--but I'm not on any preventive (or reactive, except for Antivert--which is basically overgrown Dramamine) medications for the migraine, either.
posted by Cricket at 10:37 AM on April 30, 2006

I'm sitting here mouth agape thinking that somebody has described this as a "program." I hope that was you and not the author, since really it's common sense if you try to learn about headaches.
Basically, you try eliminating causes of headaches before you pile drugs on them. So if you discover something that triggers a headache and stop doing it, of course you're going to need a lower dose of preventative medication. There's nothing to lose by trying this and everything to gain.
(The rebounding thing is a good point, however - a lot of migraine meds have caffeine in them, so if you have a spell where you have a few tough headaches, and then feel better so you don't take anything, you could end up with a rebound headache which you'll interpret as another migraine starting in.)
posted by Iamtherealme at 12:14 PM on April 30, 2006

I don't agree with jaded. (I'm a board-certified neurologist with years of real-world expertise in treatment of headache. I'm also a migraineur.)

I tend to agree with what the original poster outlined above, actually, although I haven't read the book. Worth knowing:

In Europe there's no such thing as "sinus headache." Sinus headache was invented by American OTC drug companies to sell pseudoephedrine (which, non-coincidentally) treats migraines.

Also, about 20% of headaches are estimated to be caffeine withdrawal headaches. I always tell my patients, as step 1, "regularize your caffeine intake." Not "quit caffeine entirely," as most migraineurs can't tolerate this; rather, "Drink the same amount of caffeine, in the same form, at the same time every day without ever skipping a day."

This piece of advice cured about 50% of my patients, and this was in a specialty referral clinic where internists referred their patients after they'd failed to be able to control the headaches.

The other 50% of people needed my specialist advice :)
posted by ikkyu2 at 10:23 PM on April 30, 2006 [1 favorite]

I have been free of migraine for 20 years, after 7 years of agony on a almost bi-monthly basis. I looked at re-bound issues, did a wide variety of elimination tests and was subjected by a well-meaning family doctor to a variety of drugs that are now banned in the EU. Ergotamine hallucinations do not rock!
My now husband was in pre-med when we met and could not believe how much my life was affected by this condition. He insisted I try acupuncture as basically I had tried everything else. I had six sessions over six weeks and have had not had a migraine since. Of course it could be coincidental as migraines apparently can resolve but I doubt it.
posted by Wilder at 6:56 AM on May 1, 2006

Thank you for the helpful responses. They certainly covered a lot of ground. I've decided to jump in and try it.

I chose this book from the shelf because it did not have the word migraine in the title. The lists of symptoms I've seen for migraine don't seem to describe me. But according to this book's list of symptoms and plan of action, I'd been doing just about everything wrong to handle my headaches. For example, I never took a lot of meds but I didn't realize that caffeine or Sudafed counted as migraine meds. So I was taking a lot more than I thought and not really tracking everything. So I slipped into a rebound situation. I seem to be a living example of the saying that "common sense ain't common."

Since I started working on this problem several months ago, I've fixed my insomnia problem by regularizing my sleep schedule since that's one of the first things people suggest for migraines. So that's a side benefit, I guess. I've tried a lot of relaxation/stress reduction stuff although my life isn't particularly stressful by modern standards. I also went caffeine-free; I'm not a coffee or soda drinker and I never drank that much tea.

I haven't tried acupuncture because I read that it could take 8 weeks and could make things worse before it got better. Too daunting at that point, but I will consider it now. I've kept some records and so far there seems be a hormone/cyclical angle, a weather change and an airplane angle.

However, I still have headaches (much milder now) and so I was looking for the next step to try. I like the idea that this approach can help narrow down the problem further and try to avoid the meds before you have an idea of what's going on. And even if you need meds; you can keep the dosage down. Some of the migraine meds I've been reading about are amazingly expensive. I also like the idea that this could all be temporary!

The book does use the word "program" in the subtitle. I think he's trying to emphasize that you can't try A, and give it up because it didn't work, and then try B. You may need to try A AND B AND C to get results. I like the tone, it's encouraging, straightforward and clearly written with a lot of charts and illustrations. One of the "reduce your stress" books was so densely written that I tended to fall asleep. So I guess I could say that it helped too..

Now I have found out that my mother and grandfather both had "sick headaches", something I didn't know before. I did know that neither of them ate chocolate.

So maybe I had a rebound headache problem and still have an inherited migraine problem. I don't know and I don't really care too much about the underlying theory as long as I have something to try that seems to make some sense. There sure is a lot of contradictory information out there. So I wanted others opinions as to whether this approach had worked or at least seemed sensible.

And I've just found several people who are using "Heal Your Headache: The 1-2-3 Program for Taking Charge of Your Pain" at the forums at www.achenet.org. So I have plenty to work on for now. Thanks again!
posted by egk at 7:27 AM on May 5, 2006

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