Health Care

If you suffer from chronic migraine headaches, it’s almost impossible to explain to a headache-free person exactly what this devastating condition feels like. Like hearing thunder in the distance and knowing a storm is approaching, you feel the pre-morbid signs of the impending onslaught.

Your vision may change; you may see spots or brief flashes of light called “auras,” you might feel nauseous, and you may become sensitive to light and noise. Although you feel no head pain yet, you know what’s coming; the migraine headache that grinds forward like a crushing force until you’re incapacitated by intense head pain, severe nausea, and your need to be in a dark, silent room.

You feel helpless to stop the migraine’s onslaught, but you know it’s useless. It will come, no matter what you do, and it will stay with you for up to three misery-filled days until it finally relents and your body succeeds in fighting it off. In the meantime, you can’t eat or sleep, you dare not even move lest it cause increased pain. You can’t go to work, you can’t do household chores or care for your children. You’d like to weep, but that would just make the pain worse so you remain as silent as you can. No lights, no noise, nothing.

Then you slowly emerge from the migraine headache feeling as if you’ve been beaten to a bloody pulp. You eventually regain normal functioning, but there is always the fear of “next time,” because you know there will be a next time, especially if you are female, pre-menstrual or menopausal, and have a family history of migraine headaches.

Migraines are often so misunderstood and under-diagnosed, that many view them as female bids for attention or pity or even a symptom of mental illness such as chronic depression. You give up trying to describe just what a migraine headache feels like because unless you’ve walked that walk, you can’t possibly empathize with the suffering they cause.

What’s the Difference Between Then and Now?

A lot! We now know what causes migraine headaches: heredity, certain foods like red wine and aged cheese, PMS, menopause, too little sleep, to name a few. The actual mechanism of the migraine headache is the constriction and then relaxing/engorging of blood vessels in a part of the brain, usually over one eye.

Once the cause of the headache was known, the treatment of this condition made great strides. To medical researchers, the answer was simple; to eliminate the pain of engorged blood vessels, we need a medication that’s called a “vaso-constrictor,” which constricts, or tightens, these blood vessels that are the culprit in causing the migraine headache. The first of the vaso-constrictors was obvious and unassuming: caffeine!

A natural vaso-constrictor of the highest order, right there on grocery store shelves in the form of coffee, tea, chocolate, and pure caffeine tablets like No-Doze and Vivarin. It was as simple as that; take a pain-killing drug like aspirin, combine it with acetaminophen (Tylenol), throw in a little caffeine, and Voila! Along came Excedrin!

Migraine headache sufferers rejoiced. Well, some of them did, anyway. But for many more who did not tolerate caffeine’s side effects of feeling jittery, this wasn’t a solution and they continued to live in pain. Finally, a decade ago, a safe, effective and easy solution to just about everybody’s migraine came to pass. This was sumatriptan, brand name Imitrex. This was the first of the “triptan” drugs that provided complete relief from migraines within about an hour’s time.

In the 90s, Imitrex was only available as an injection; migraine headache sufferers learned to use an auto-injector that they carried with them at all times to stop the headache before it got going full-force. Some sufferers balked at self-injection, and the first five minutes of an Imitrex injection caused some very strange, tingly bodily sensations. But the triptan drug worked.

Modern medicine moved on, and gave the world Imitrex in pill form to many sufferers’ relief. This drug paved the way for other triptan drugs; the “big three” being Imitrex, rizatriptan (Maxalt) and elatriptan (Relpax). They’re all triptan drugs, made by different drug companies, but their mechanism to relieve migraine headaches is the same vaso-constriction that proved effective for some with caffeine.

They work quickly, at the first sign of a migraine such as an “aura.” Gone is the nausea, the sensitivity to light and sound, the throbbing, relentless pain. If you feel a migraine coming on, you can begin to feel relief within about thirty minutes; with an additional dose, your pain can be relieved completely. No missed work, no missed family time – you have your life back!