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Suffering in silence
As a migraine sufferer NICOLA MAKARITIS has struggled for years but a new pill available in Cyprus has proved to put an end to her pain
MY MIGRAINES started a short while after giving birth to my first child 26 years ago. Over the years my quest find a cure has become my ‘holy grail’ and I have tried everything alternative, from acupuncture to naturopathy, to avoid taking toxic drugs. Naturopathy did reduce them for a while, from every couple of weeks to every six weeks or so, but still, when the headaches started, I would suddenly became very sensitive to sound and light and retreat to my darkened room, lying completely still as any movement made it worse. With the sensitivity to sound came a heightened sense of smell, which often meant even a whiff of perfume could trigger vomiting. I also had an overpowering thirst for water.
The World Health Organization (WHO) lists migraine in its top 20 most debilitating conditions, because of the impact it can have on quality of life – and I can certainly vouch for that. Migraine is classed as a disease of the brain, affecting three times as many women as men. The word comes from the Greek hemicrania, meaning half the head – obviously referring to the often one-sided excruciating pain. There are two types of the condition, classical and common. Classical is when you experience flashes of light, difficulty in focusing or even blind spots – this is known as ‘aura’. Ten per cent of migraine sufferers have these symptoms. Common migraine is the headache without aura. In both cases, however, the pain is often accompanied by nausea, extreme sensitivity to loud sounds and bright light.
Although doctors don’t know the underlying causes of this complex disorder, migraine is believed to be caused by chemical changes in the brain’s nerve cells. Many factors may trigger the headache, certain foods, the hormonal swings of the menstrual cycle, alcohol or even intense stress. Quite a few people have found that their attacks come on as they emerge from an intensely stressful time. The most common triggers however, can be divided into several groups: emotional, hormonal, dietary, environmental and sleep. WHO claims that over two thirds of the world’s migraine sufferers have never sought treatment. Despite the severity of the symptoms, the majority of migraine headaches go untreated because of individual migraine sufferer’s fatalistic expectations (there’s no cure) or the holding on to old myths that see migraines merely as an inevitable response to stress. The truth is that migraines occur due to a complex interplay of genetic, environmental and neurological factors that are only now being understood.
In my case more than ten years ago salvation came knocking on the door in the form of a tiny white pill that has miraculously turned my life around. I was undergoing a course of acupuncture and my acupuncturist in Limassol, a registered GP, suggested that I also try a new medication that had just come on to the Cyprus market called Zomig. It is part of a class of medicines called tripitans. When I feel a migraine coming on I take it and it starts to work after about 40 minutes or so. My migraine is dulled and I am once again fully functional.
Now I no longer dread an attack, which used to leave me unable to even get out of bed in the morning for several days at a time. I can continue working, I can drive - I can function. The pill usually wears off after about eight hours and I take another one if the throbbing on the left side of my head starts to intensify again. I might get through the packet of three pills in one attack or one might just do the trick, it depends - as far as I know there is no rhythm or reason. The only down side is that I always feel very tired for at least 24 hours after an attack and after the effect of the pills has worn off. Without wanting to sound dramatic, those little white pills changed my life and I now no longer dread the possibility of a migraine when we plan ahead, or go abroad or even attend a small dinner party.
HOW TO COMBAT A MIGRAINE
Self Help
Self help often starts with patients trying to identify factors that trigger an attack – for example certain foods, and then eliminating or avoiding them. I experimented with a long list of supposed ‘trigger foods’ eliminating dairy, chocolate, nuts and alcohol for about a year, without success. I also gave up smoking for a while – again with no positive result. Interestingly, chocolate, once thought to be a common trigger, is now seen as an early sign of a migraine because of the craving for sweet things before an attack.
Acupuncture
Although acupuncture didn’t work for me, I do know people that have been helped a great deal. Studies in the UK have shown acupuncture, which involves the insertion of extremely fine needles into the tip of the skin at certain precise points in the body, works better than conventional treatment alone and results in fewer headaches.
Botox
The drug Botox, which is widely known as a treatment for wrinkles, is now being used by some doctors as a treatment for migraines. Some studies have reported success rates as high as 90 per cent, however, only one large double-blind study has been conducted so far. The results of the study were mixed. While a low dose of the drug was beneficial, a high dose was not. Experts do not know why the muscle-paralysing effects of Botox work in some cases and not in others, but they believe that some of the facial nerves responsible for delivering messages to the brain include pain.
Diet
Doctors have found that quite a few migraines have a food-based trigger relating to wheat, dairy, sugar or artificial preservatives. Cutting out these foods might help relieve or improve the intensity of the migraine.
Light
Researchers found that light rays trigger activity in specific brain cells within seconds of hitting the optic nerve at the back of the eye. They believe that these cells are responsible for causing the debilitating pain that light can trigger in migraine sufferers.
Even when light was removed, animal tests showed that the cells remained active until up to half an hour after.
Preventative medicine
This involves taking a pill every day to stop recurrent migraine headaches, not to be confused with taking a headache-relieving pill every day. There are different types of prevention medicines, including beta blockers, tricyclic antidepressants and anti epilepsy drugs – all of which act on the brain’s nerve cells.
The supplement coenzyme Q10 and riboflavin (which is vitamin B2) have been shown to be helpful in lowering the incidence of recurrent migraines.
