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June 5, 2012 > Migraines? The Doctor Can Help

Migraines? The Doctor Can Help

Don't Suffer in Silence, Learn About Treatment and Prevention

If you suffer from migraines, you're not alone. According to the National Headache Foundation, more than 45 million people in the United States suffer from chronic, recurring headaches. Of these, 28 million - or nearly two thirds - are migraine sufferers.

"Migraine headaches affect between 12 percent and 16 percent of U.S. population," according to Vanessa Wilson, M.D., an internist who practices with Washington Township Medical Foundation. "Migraine headache pain is usually described as a dull, deep, steady pain; however, severe migraine headaches can be throbbing and volatile. Migraines typically start gradually and intensify over minutes or hours, and they're often worsened by light, constant motion, or noise."

Dr. Wilson explains that, in addition to pain, migraines usually exhibit a host of neurological symptoms that fall outside of the scope of bad headache pain. An estimated 60 to 70 percent of people with migraines will have pain only on one side of their head. In addition to increased light and noise sensitivity, other symptoms include nausea and vomiting, as well as nasal congestion and teary eyes.

"There are migraines that have what we call aura," she says. "An aura means patients have other symptoms that actually signal that a migraine is going to start even before they experience any pain - such as flashing lights or bright spots, zigzag lines, and sometimes they even smell something different.

"For some, they have numbness or tingling in hands as part of an aura, and occasionally they experience muscle weakness and a change in speech patterns."

Dr. Wilson says a number of environmental factors can bring on a migraine headache.

"We call these migraine triggers," she says. "It could be stress, worrying, menstrual periods, birth control pills, physical exertion, fatigue or lack of sleep, head trauma, as well as foods like alcohol, chocolate, coffee, NutraSweet(r), and nitrates and nitrites, which occur in preserved foods.

"Even medications can trigger migraines, including those with estrogen, as well as nitroglycerin for chest pain, and certain types of blood pressure medication like hydralazine."

Perfume, smoke, or any strong odor can also trigger a migraine. Another environmental trigger is dieting, which can cause low blood sugar. Also, skipping meals, certain altitudes, and even changes in the weather can cause these headaches.

So, what are some clues that you should talk to the doctor?

"If it's an ongoing, chronic problem, or newly onset, patients should be evaluated because there might be a trigger that can be easily removed or altered to help prevent future migraines," according to Dr. Wilson.

She adds that treatments can be given so that it doesn't become a debilitating illness, which is important, because migraines tend to be a chronic issue for sufferers.

"When migraines are mild, patients can be advised what to do to prevent them and taught about warning signs that indicate the need for urgent evaluation," she says. "Medications that can cause migraines, such as those for blood pressure, can be changed. There are a lot of things patients can do, as well as triggers that can be identified."

Simple changes like getting enough sleep and not skipping meals sometimes can be enough to improve an individual's issues with migraines. However, Dr. Wilson says, certain types of migraine headaches can be disabling and require additional measures.

"For women who experience migraines during their menstrual cycle, it's usually when the estrogen level starts to go down," she explains. "Depending on how severe the migraines are, there can be ways to help patients prevent the headache from happening.

"These migraines typically occur two days before the menstrual period and three days after, and there's usually a time that they can predict when their headache is going to happen. A pattern can be easily seen with patients who have regular cycles, and we can identify the timing."

Dr. Wilson advises patients to make a headache diary to see if they're following a certain pattern with their headaches, and if the headaches are related to the menstrual cycle, she says treatments can be geared toward that particular trigger.

Overall, when it comes to migraine headaches, she says the best advice is to seek help and make sure to address the problem before it becomes debilitating.

"It does affect your lifestyle, and if people can be aware of what to do when they feel a migraine coming on, then they can avoid getting into patterns of overusing or abuses certain medications. And again, there are medications that can trigger migraines also, so they need to be aware and treated appropriately."

When it comes to acute treatment for migraines, she says taking an over-the-counter medication like ibuprofen can be effective for some people, but it's important to talk to o the doctor about the proper dosage guidelines to manage the headache best.

"It's important to rescue yourself from the symptoms so that the migraine doesn't end up lasting for several days," she says. "Medications that work fast - called triptans - can often relieve the headache in two hours."

She adds that depending on the frequency of migraines, she can help patients prevent them through daily medication that works to decrease frequency, intensity, and duration of the headaches.

"Generally migraines are better treated if they're treated early rather than waiting until you're in bad shape and need higher doses of medications," Dr. Wilson concludes.

Your health care, your way

For more information about Washington Township Medical Foundation and its more than 60 board-certified physicians with expertise in a broad range of medical specialties - from neurosurgery to pediatrics - visit

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