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Coping with a common malady

Head-off headaches with medication, self-awareness

June 5, 2008
By Jimmy Mincin, jmincin@altoonamirror
Nickie McIntire has been getting migraine headaches since she was a child. At 37, the problem remains a painful fixture in her life.

“I’ve been getting migraines for as long as I can remember — usually every other month, and they last for a good solid couple of weeks,” the registered nurse at Blair Medical Associates in Altoona said. “I’ve never been able to find out the specific triggers, except for certain smells like heavy perfumes or detergents. I do fine with things like food smells or spicy smells.”

McIntire’s migraines usually are signaled by what she called a “stabbing pain” behind one of her eyes.

“It’s usually one-sided, but it’s not always on the same side,” she said. “When I was a kid, (doctors) used to say it was allergies that were causing it, but that was just speculation. No one’s ever really been able to determine what causes them — we just know what triggers them.”

Today, McIntire is on a regimen of prescribed anti-migraine and anti-inflammatory medications. She thinks her lifelong battle with headaches could be a genetic condition.

“My mother gets headaches all the time,” she said. “They’re not as bad as they used to be, but she still gets them pretty frequently. My 12-year-old son was also getting them pretty frequently for a while, but a pediatric neurologist prescribed him a preventive medication, and now he doesn’t get them nearly as much — usually only when he misses a dose.”

And that’s what leads to the distinction between the two primary types of headache treatments, said McIntyre’s physician, Dr. Joseph Clark, neurologist at Altoona Regional Health System: Preventative medications taken daily to prevent the onset of headaches; and acute medications, which are used to get rid of or alleviate the headache itself.

“Headaches are the most common complaint at the doctor’s office,” he said. “Most people wonder if it’s a migraine or just a tension headache,” he said. “Most of the time, migraines occur on only one side of the head, like in Nickie’s case; are very severe and pulsating — but they don’t always have these characteristics.”

According to national health statistics, 45 million Americans have chronic, recurring headaches, he said. 30,000 of those are migraines — 70 percent of migraines are experienced by women.

“With women there often is a hormone trigger that causes migraines,” Clark said. “They often get headaches from estrogen withdrawal during the menstrual cycle.”

But there are many common headache triggers for both sexes, Clark said. He also cited sleep deprivation, oversleeping, skipping meals, computer use, allergies, flickering lights, loud noises and cigarette smoke as common triggers.

There are four types of headaches: vascular, muscle contraction (tension), traction and inflammatory, according to the National Institute of Neurological Disorders and Stroke.

The most common type of vascular headache is the migraine, usually characterized by severe pain one or both sides of the head, an upset stomach, and at times, disturbed vision.

After migraine, the most common type of vascular headache is the toxic headache produced by fever. Muscle contraction headaches appear to involve the tightening or tensing of facial and neck muscles. Traction and inflammatory headaches are symptoms of other disorders, ranging from stroke to sinus infection.

‘‘The thing that amazes me about this condition is its variability,’’ Clark said. ‘‘It’s a very individualized thing.’’

Suzanne Simons, executive director of the Chicago-based National Headache Foundation, said the main thing people need to know about any type of headache is that they are treatable.

‘‘No one has to suffer because of this condition,’’ she said. ‘‘If headaches are impeding on your quality of life, or if you find yourself taking over-the-counter medications on a daily basis, it’s time to see a doctor or neurologist.’’

Simons says habitual consumption of over-the-counter headache medicines causes what are known as ‘‘rebound headaches’’ — headaches that recur once the initial headache is gone, creating a vicious cycle of headaches.

‘‘It’s important to get the right medications from a family doctor or neurologist,’’ she said. ‘‘Headaches are a legitimate, neurological disease, and people need to recognize them as such.’’

She and Clark both recommend keeping a ‘‘headache diary’’ to track triggers and patterns.

‘‘If people can identify a triggers, then avoid them, it can reduce or eliminate the need for medications,” Clark said. ‘‘The causes are still unknown, but the triggers out there, and that’s important to know.’’

Mirror Staff Writer Jimmy Mincin is at 946-7460.

Article Photos

Mirror photo by J.D. Cavrich
Dr. Joseph Clark of Altoona Regional Health System examines a patient who has headaches.

Fact Box

Understanding triggers
n Understand your own sensitivities, be aware of external influences you cannot control like fluctuations in air pressure and weather, and your reactions to such changes.
n Be proactive in dealing with factors you can control. Avoid wearing perfume, and ask others close to you to be mindful of your sensitivity.
n Know if elements like smoke or loud noises trigger your headaches, and avoid putting yourself in these types of environments.
n Avoid loud concert music or wear ear plugs.
n Take frequent breaks when using the computer or use a non-glare screen.
n Get help. Discuss you headaches with your healthcare provider.
Source: National Headache Foundation (Chicago),

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