Thursday, November 29, 2012

Why the Holidays can Trigger Migraines

This article discusses why migraines can result from extra stress resulting from the holidays.

People who suffer from migraine headaches face additional triggers during the holiday season.

"During the holidays, people's sleep/wake cycles are often skewed," said Dr. Karen Lauze, a neurologist at Portsmouth Regional Hospital. "They do not get enough sleep. Traveling through different time zones and the stress of travel can trigger a headache."

And there is the convergence of family members.

"If there are family conflicts," Lauze said, "it can make a difference, although both good and bad stress can trigger a migraine. Excitement, as much as bad stress can be a factor. Then you add in a lot of bright lights, flashing camera bulbs and noises and all your triggers are thrown into play."

Food can also be a trigger, Lauze said, along with red wine, spirits, certain cheeses, chocolate and nuts, as well as foods containing MSG.

"Butternut squash contains a great deal of MSG," she said. "Skipping lunch, altering the timing of food is another. Weather, a change in barometric pressure is a big trigger. Even flying, while the cabin is theoretically pressurized, changes your system. If there is only one trigger, the person may be OK. Add two or more and a migraine is likely."
People who are aware of their susceptibility can take steps to try to prevent migraines. Lauze said they can take increased levels of their prescribed medication, under the advice of their doctor. They can also try to assure they get enough sleep and avoid foods they know are triggers.
"If you are traveling to see family and can afford it, it might be better to pay the extra money for a hotel room," Lauze said. That way, you can retreat to the quiet when family wants to stay up all night. Plan ahead. Maybe use biofeedback meditation and relaxation techniques. We do offer that training here at the hospital."
It takes time to relieve painful symptoms of a migraine. Lauze said medications like Aleve or Imitrex can help. Caffeine has been known to help some people although she cautions that too much can increase anxiety, and make the pain worse.
There are medications that can be prescribed to decrease the frequency of attacks. Healthy lifestyle changes can also reduce the number and severity of migraines. Avoiding the activities, foods or situations that have triggered migraines in the past is one of the best prevention tools. Don't smoke. Estrogen-based medications, such as birth control pills or hormone replacement therapy, may need to be reduced or replaced with other methods.
Lauze said she considers biofeedback techniques and other alternative therapies such as acupuncture and chiropractors as long-term solutions. But, she said they can be used to lessen the severity and frequency of migraine headaches.
Craig Shannon, a Portsmouth based chiropractor, said he treats many patients who suffer from migraines.
"We can't cure migraines but we can lower the triggers," Shannon said. "By adjusting the cervical area (neck) we can remove pinched nerve areas to allow for freer blood circulation and that does help a lot. Think of a garden hose. Step on it and it is blocked. Take your foot off and the water flows again. We see fast results in our patients and I think it's neat to see them come here after trying a lot of other things and finding relief."
Dr. Christopher Santini, a chiropractor in York, Maine, agrees. He said he works to improve proper motion and posture. He also looks at his patient's lifestyle.
"We do nutritional counseling because certain foods or the chemicals in them are factors," Santini said. "If we can figure out when they get the headaches and what they were doing at its onset, we can often help them avoid a future migraine once their body is in proper alignment."
Carie Bernard, a licensed acupuncturist who works with Santini, said she approaches the pain itself.
"Where there is pain, there is an imbalance," Bernard said. "There is a loss of energy and things are not flowing as they should. I do a complete intake. I observe the whole person, take their pulse and look at their tongue. It is not a one size fits all medicine. I need to find out where their blockage is and treat it. Ten people may present in ten different ways."
Portsmouth acupuncturist Bridget Lewis Holzer said once you figure out the trigger, fine needles are used on the proper points to treat the condition. Magnets are used effectively on young children. She said location of the points for the needles varies with the triggers that are responsible.
Adam Learner of Family Acupuncture and Wellness of Portsmouth said acupuncture can provide both immediate relief and can be used as a long term therapy for prevention.
"If it's a chronic problem, they might come weekly at first," Learner said.
"Eventually, they might come once a month, for maintenance of their condition. It varies with the individual. Acupuncture is on of the best treatments for migraine headaches. We treat a fair number of patients here and finding the underlying cause is the key to successful treatment."
Learner added wheat and dairy products to the list of food triggers. He said he puts his patients on a "challenge diet" in order to ferret out their triggers.
The bottom line is that, with care, holiday stress does not have to be the source of a migraine headache, Lauze said.
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