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 Annual 2007

Annual 2007


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Myths and Realities

    Carol Bartlett has tried just about every remedy available to cure or curtail the severe migraine headaches that began 14 years ago when she hit menopause. The list is long and varied, including acupuncture, Chinese herbs, Tai Chi, stress management classes, chiropractors,
hormone treatment and yoga.

    “I really liked some of these, but everyone is different and responds differently. These things just didn’t work for me, and they had no effect on my headaches,” she says.

    What has been successful for the Walnut Creek resident is a combination of both preventive, or prophylactic, and abortive therapies and medications that keep her headaches in check. She has worked with Walnut Creek-based neurologist, Dr. Michael Stein, to treat her chronic condition and remains active with the East Bay Headache Support Group based at John Muir Medical Center.

    “I feel a lot better now than I did 14 years ago. I have a lot more knowledge,” she says. In the support group, she has found people who understand and seek more information, too. “It’s good to talk to people who don’t dismiss you when you tell them you have a headache.”

    Migraines, or primary headaches, affect 26 million Americans—one in five people in this country—and women are three times more likely to suffer such pain. Primary headaches are their own disorder. In other words, they are not caused by another underlying medical condition, a disease, an infection, an event, head trauma or injury.

    There are many myths about migraines, because their causes are uncertain, explains Stein. For example, that sinus headache you repeatedly get in your forehead or your cheeks or that severe tension headache in the back of your head may not be what you think it is. It could very well be a migraine.

    Stein describes two “flavors” of migraines—migraines with an aura and migraines without an aura. An aura acts as a warning to the onset of a migraine. “It’s a visual sign, often like a flashbulb going off or a shimmering in the eyes. It clears up in about 30 seconds, and then the headache begins,” Stein says. Approximately one in five migraine sufferers experience an aura before their headaches.

    The next aspect in diagnosing migraines is determining the level of pain. “We rate pain in terms of intensity on a three-level scale—mild, moderate and severe,” Stein says. According to this scale, the pain of a mild headache does not interfere with daily activity; the pain of a moderate headache slightly interferes with activity; and the pain of a severe headache is incapacitating.

    While these diagnostic tools and benchmarks might be daunting for some patients, Stein has a clear message: There is hope. “There are things to do, treatments, abortive measures to prevent and manage headaches. This does not have to be their fate.” ✚ Edit Module