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Ellen Schnakenberg is a friend of this site and a writer behind many, many good articles on the subjects of migraine and chronic pain. Her latest is a piece named "Ketamine coma gives hope to chronic pain patients, but not in the US".

Here's a sniplet:

"Ketamine is being aggressively used in Germany in an unusual way-- inducing coma for an extended period of time, allowing the CNS (central nervous system) to 're-boot' in chronic pain patients. As a result, those able to afford the treatment are going overseas in an attempt to find a way to make living bearable, because the United States forbids the induction of a coma lasting longer than 2 days.

My post isn't meant to focus on Ketamine however, but instead on the practice of inducing a temporary coma or anesthesia in Migraine and chronic pain patients in desperate effort to ease their suffering."

As if it weren't interesting enough all in itself, Ellen goes on to share her personal experiences on the matter. My gentle readers, it's a must read for anyone suffering from a chronic pain. Most fascinating and thought-provoking.


link: Ketamine coma gives hope to chronic pain patients, but not in the US

John Tesh has a blog, yours truly was surprised to discover. After which yours truly was pleasantly surprised to find that Mr. Tesh talks about quite a few things that are dear to the hearts and minds of the migraine people.

Here are some sniplets:

John Tesh on Fragrance Sensitivities - "Studies also reveal that inhaling fragrances can cause circulatory changes in the brain that can trigger migraine headaches, inhibiting the ability to concentrate, dizziness and fatigue."

John Tesh on Medicine Safety - "Examine pills and packaging when you obtain a new prescription. Make sure the drug company stamp is correct and readable on the pill or tablet. Check the sticker on the pill bottle that tells you what to look for."

John Tesh on Compact Fluorescent Light (CFL) bulbs - "CFLs could cause migraine headaches. Most people are not bothered by the flickering of a fluorescent bulb, but to the migraine sufferer the flickering can cause headaches, nausea and dizziness. Since the CFLs use the same technology as fluorescents, there is major cause for concern."

Kudos to Mr. Tesh on some well-researched articles. If any of my gentle readers are fans of John Tesh, most definitely check his blog out. And if not, yours truly would try to find what Scissor Sisters have got to say on the above issues.

There's a new "hypothesis that migraines can be caused by tiny blood clots that form in the heart and travel to the brain, disrupting the blood flow and causing the typical symptoms of one-sided headache, nausea and photophobia."

It was advanced by Dr. John Chambers, a consultant cardiologist at Guy's Hospital in London, UK.

The idea is to make blood "platelets less sticky. Platelets are, after the red and white blood cells, the main constituent in blood that helps to make it clot when a blood vessel is damaged. However, if the platelets are too sticky, there is a risk of unnecessary clots forming in the blood vessels, breaking off and traveling to the lungs or the brain where they could trigger a potentially fatal stroke or embolism."

It can be achieved with clopidogrel, better known by the brand names Plavix, Clopilet and Iscover. Clopidogrel is a platelet aggregation inhibitor.

The effect of introducing an inhibitor of platelet aggregation into the blood-stream suggests that platelets may have a role in pathogenesis of migraine. It is speculated that it may be because of an effect on serotonin stores.

A larger trial on using clopidogrel as a migraine preventive is in the works.


There are, however, additional considerations for using clopidogrel in migraine treatment that need to be addressed.

Plavix, the brand name of clopidogrel, is the world's second largest-selling drug, with annual sales of $5.9 billion. If the migraine-prevention trials are a success, it could possibly be re-branded as a migraine drug with a different name and the companies making it will keep the patents on it for another 20 years. Along with the premium cost the brand-name meds enjoy over the generics.

Another problem arises when patients stop taking Plavix. A study printed in Journal of the American Medical Association (JAMA) reports a two-fold increase in death and heart attack in the 90 days after patients completed their prescribed course of clopidogrel (Plavix).

That means any migraine patient taking Plavix as a preventive will have to take it for the rest of his/her natural life. Or risk a death from a heart attack.

So, on the plus side, one could end hers/his migraine sufferings for good. On the other side one will have to keep paying for a daily doze of Plavix forever. As always, it's a give and take.

reference:

Stopping Plavix Doubles Risk of Heart Attack or Death for 90 Days, With or Without Stents

NLH Q&A Service: What is the evidence for using clopidogrel for prophylaxis in classical migraine?

Clopidogrel reduces migraine with aura after transcatheter closure of persistent foramen ovale and atrial septal defects

Clopidogrel, Plavix: wikipedia.org

Platelets, thrombocytes: wikipedia.org

Drugs trial raises hope of migraine cure

related articles: Big Pharma Going Bankrupt?

Prodrome and postdrome syndromes, taking strong painkillers or dopey pills like verapamil and topamax, not to mention the Stupid Pill - there are plenty of things that watter down migraine people's ability to concentrate.

Unfortunately for us, the universe is not standing still. There are things to do and some of them can't wait till later.

Here's a little migraine hack that should allow you to increase focus for a short period of time.

Move your hands into your field of vision, close to the object you are concentrating on. That will kick-start your brain's perception and concentrate it on that area.

It might sound simplistic but that's how our brains are wired. A recent study by Richard A. Abrams, Ph.D., professor of psychology at Washington University in St. Louis has shown that we see objects better when they are closer to our hands.

"The study demonstrates that humans more thoroughly inspect objects when their hands are near the object rather than farther away from it. This reflexive, non-conscious difference in information processing exists, they posit, because humans need to be able to analyze objects near their hands, to figure out how to handle the objects or to provide protection against them."

Simple but effective. Try it next time you load up on pills and need to read a label for counter-indications or some-such.


link: Keeping hands where you can see 'em alters perception, study finds

Benign paroxysmal positional vertigo (BPPV) is not considered a serious health risk. However, it is very uncomfortable for the sufferer and puts her or him at risk of falling or other accidents.

BPPV is an inner ear disorder that commonly causes feelings of dizziness. It's presumed to be caused by loose calcium carbonate crystals that move in the sensing tubes of the inner ear.

Research indicates that chances of developing BPPV increase with age, or if a person have a history of migraines or stroke.

Treating BPPV is actually pretty easy either by a physician or even at home by the patient him/her-self. The idea behind it is to "coax the calcium carbonate crystals out of the inner ear sensing tube where they don't belong and into another inner chamber of the ear, where the body is able to reabsorb them."

There are 3 procedures that have been developed for dealing with BPPV. The Epley and Semont Maneuvers are usually performed at the doctors office and Brandt-Daroff Maneuver for self-treatment.

The Semont Maneuver involves a procedure whereby the patient is rapidly moved from lying on one side to lying on the other. It is a brisk maneuver that is not currently favored in the United States. It is pretty difficult to perform on oneself as it does require a second person. And most likely it will trigger a migraine attack in most of my gentle readers.

However, the Epley and Brandt-Daroff Maneuvers are more gentle and can be self-administered. In home conditions they might require several repetitions before the desired effect is achieved. In some cases it could take as long as a week of those exercises but in a few cases just a single routine can be successful.

Bellow are the videos of properly executed Epley and Brandt-Daroff Maneuvers. Try to move your head gently so not to trigger a migraine.

Epley Maneuver:



Brandt-Daroff Maneuver:



It is recommended to start with Epley and follow with several days of Brandt-Daroff but sometimes a single routine of Epley Maneuver should be enough to fix the problem.

For several days while doing either Epley and/or Brandt-Daroff exercises, try to follow these guidelines:

• Sleep semi-recumbent (at about a 45 degree angle)
• Use two pillows when you sleep
• Avoid sleeping on the "bad" side
• Don't turn your head far up or far down
• During the day, try to keep your head vertical
• In general, try to stay as upright as possible

When you think that the exercises are a success, try experimenting - carefully put yourself in the position that usually makes you dizzy and see what happens. Please do be careful, make sure if you do fall, you have something soft to land on.

Only about 1% of people who get BPPV might need to see a doctor about a surgical treatment. Otherwise, my gentle readers, try the above exercises. If done properly, they might be a good addition to our health and fitness arsenal.

References:

BENIGN PAROXYSMAL POSITIONAL VERTIGO by Timothy C. Hain, MD

Benign paroxysmal positional vertigo @ wikipedia.org

A Safe and Simple Solution for Vertigo, Dr. Terry D. Fife

Topamax, Lyrica and Depakote are not going to get the 'Black Box' suicide warning on the label. The same applies to other 8 anti-epilepsy drugs that are known to increase suicide tendencies in patients who take them.

The FDA advisory panel voted 14/4 against putting the 'Black Box' on the label. The main reason cited was - "the studies didn't show a high enough risk for suicidal behavior." Apparently, doubling the risk of a suicide is not enough to put a warning on the bottle.

However, the real reason might be behind what Dr. Russell Katz, director of the division of neurology products at the FDA's Center for Drug Evaluation and Research said:

"The general view of the committee was concern that patients or physicians would not prescribe these drugs in certain circumstances where they should."

Those circumstances would be prescribing anti-epilepsy drugs off-label. For example, as a migraine preventive. And that will lead to a very substantial decline in sales for the anti-epileptics.

A study by Dr. Breslau has found that "the incidence of suicide attempts in women with migraine with aura was 5 times that of controls. In men with migraine with aura, the incidence was more than 7 times higher than that of controls."

In plain language, migraine people are 5 to 7 times are more likely to commit suicide than normals. When taking Topamax, Lyrica or Depakote these numbers would mean that migraine patients are 10 to 14 times more likely to commit suicide than people without migraines.

The tragedy of it is that Topamax, Depakote and Lyrica do work well for many migraine sufferers in preventing their migraines. On the other hand, they might kill you.

As such, my gentle readers, please do consider your options for migraine preventive medications carefully.

link: FDA Advisers Don't Back 'Black Box' Warning for Epilepsy Drugs

Using oxygen as a migraine treatment is an old idea. It's been tried periodically and time and again it was left alone as hard to implement.

This is why - in order for oxygen to abort migraine attack, the patient needs to be placed in a high-pressure oxygen chamber. The sooner it's done, the better the chances for it to work. At the first symptoms, preferably.

None of us have such technology available at home; precious few have access to it even in hospitals and treatment centers.

Taking in oxygen at normal pressure would not abort migraine headache for most of us. At best, it might get us pleasantly high.

Cluster headaches are a different matter. Breathing in pure oxygen even at normal pressure does have a good chance of aborting an attack.

On another, somewhat related note:

"Oxygen therapy might ease pain of migraine, cluster headaches" is a press release by Center for the Advancement of Health

It seems to have spawned several articles on how oxygen helps with migraines.

Yours truly would like to note that he title is misleading and plays on the hopes of migraine people. Not nice, Center for the Advancement of Health, whoever you are.

My gentle readers might be better served by reading the original meta-study by Normobaric and hyperbaric oxygen therapy for migraine and cluster headache done by The Cochrane Library. Do note that it is only a review of studies, not a study in itself.

Another such review was compiled by the U.K.'s National Library For Health.

Diana Lee is keeping on with the tradition by releasing the latest edition of Headache & Migraine Disease Blog Carnival.

This time around the topic was "How Spirituality Help Us Cope with Migraines".

Yours truly submitted Visualization Techniques for Migraines, Headaches, Pain and Increasing Breast Size.

Hardly a spirituality inspiring piece but what'cha gonna do. It's the closest we can get around here.

Rena Sherwood didn't see any problems with it and no one's complained so far.

That aside, the Carnival, as usual, has collected lots of good reads. Do check it out:

link: Headache & Migraine Disease Blog Carnival

If you, my gentle readers, are anything like yours truly, you might spend much of your time looking for your own tail. Forgetful of where you seen it last, you wonder in circles until, in turn, you forget what it was you were doing in the first place.

Migraine people are kinda like that from time to time. Something needs to be done about such situations and fast.

Enter the blueberry muffins.

Well, the blueberries, actually. It's just that blueberry muffins do seem to be the prime source of blueberries for most of us. And they taste good.

So, blueberries. They are, apparently, effective at reversing age-related deficits in memory, says study published in the science journal Free Radical Biology and Medicine.

"Blueberries are a major source of flavonoids, in particular anthocyanins and flavanols. Although the precise mechanisms by which these plant-derived molecules affect the brain are unknown, they have been shown to cross the blood brain barrier after dietary intake. It is believed that they exert their effects on learning and memory by enhancing existing neuronal (brain cell) connections, improving cellular communications and stimulating neuronal regeneration."

The conclusion was - flavonoids helps improving memory by activating signaling proteins in hippocampus, the part of the brain that controls learning and memory.

Especial improvement was made in "spatial working memory tasks". In simple words, if we eat blueberries, it might become possible to finally find our collective lost tails.

link: Getting Forgetful? Then Blueberries May Hold The Key

A study (1) was conducted to compare the retinal nerve fiber layer thickness (RNFL) in eyes of migraine patients with age-matched healthy subjects using optical coherence tomography. The paper will be soon published in The British journal of ophthalmology.

The migraine group and the control group's age was approximately between 20 and 36 years old. The migraine patients, with or without aura, were chosen according to the criteria of the Headache International Society (HIS).

RNFL average thickness in the migraine group was within normal range but, the temporal quadrant RNFL (the part of the retina closest to the temples) thickness in the migraine patients was significantly lower than that of the control group. However, there was no difference between migraineurs and controls in the superior, inferior, and nasal quadrants. No one in the migraine group was qualified as having glaucomatous damage.

In addition, there was a strong correlation between migraine severity and the thinning of RNFL.

The thinning of the the temporal quadrant of RNFL is a wear and tear that is normally accosiated with aging. This phenomena was demonstrated in a study (2) done at Kobe University Graduate School of Medicine, Japan, involving healthy subjects ranging from 16 to 84 years of age.

The temporal quadrant RNFL is responsible for peripheral vision, good night vision and seeing things that "aren't really there". As in some of the more complex migraine auras.

The most telling part of comparing the two researches is that migraine patients in the first study were relatively yuang. And yet they had the wear of the temporal quadrant RNFL usually associated with an old age.

Conclusion:

It could be speculated that since migraine patients are more light-sensitive, they have more than normal strain on their retinas. As such, the thinning of the temporal quadrant RNFL is accelerated in migraine patients.

Reference:

1. Retinal nerve fiber layer thickness measurements using optical coherence tomography in migraine patients.

2. Evaluation of the Effect of Aging on Retinal Nerve Fiber Layer Thickness Measured by Optical Coherence Tomography