Thirty-one year old Gene, a mechanical engineer, comes home from work at least thrice a week with a throbbing pain at the back of his head. He says, “All I want is to lie down until it’s gone because I also feel dizzy and nauseous. It actually affects my family because I don’t get to spend a lot of time with them”. Gene adds that his “headache” lasts about 4 hours and sometimes, even till dawn.
Gene is suffering from migraine and he is not alone. Migraine affects 38 million Americans, according to an article by the Migraine Awareness Group: A National Understanding for Migraineurs (M.A.G.N.U.M), a non-profit health care public education organization aiming to bring awareness to migraine.
Unfortunately, migraine, despite having been identified for over a century, remains one of the most misunderstood health conditions in the world. “There is no condition of such magnitude that is as shrouded in myth, misinformation, and mistreatment as is this condition [Migraine], and there are few conditions which are as disabling during the acute attack”, said Dr. Joel R. Saper, Director of the Michigan Head-Pain & Neurological Institute.
True enough, there abound a lot of wrong beliefs about migraine today, mostly diffused by media. Gene is no exception. When talking to him, I was quick to catch some of his statements which reflect these misconceptions. Such inaccuracies are dangerous as they hinder him and other misinformed migraineurs (migraine suffers) from properly treating their condition.
Below are some of Gene’s false assumptions along with the facts that debunk them. By knowing what is true about migraine, you are then able to correctly deal with migraine for your self, family and friends.
“It’s just a headache.”
Migraine is a disease and headache is just one of its manifestations. Although the real cause of migraine is yet to be fully known, it is widely accepted that it results when abnormally excitable neurons cause arteries in the brain to dilate. This dilation stretches the nerve fibers that coil around the affected arteries. These nerve fibers then release chemicals that cause inflammation and pain which Gene felt as a headache.
An ordinary headache is brief; a migraine lasts 4 to 72 hours. Unlike usual headaches, migraine also comes with other symptoms such as nausea and dizziness as Gene reported. Others experience vomiting, diarrhea, cold extremities, and sensitivity to light and sound .This is because migraine affects the sympathetic nervous system (SNS) or that part of our nervous system responsible for our “fight or flight response”. Activation of the SNS initiates a cascade of events that leads to the said symptoms.
“I thought it’s migraine only if I see an aura”
Auras are unusual sensations such as seeing flashing colored lights, zig zag lines, and blind spots as well as feeling pins and needles on the hands and parts of the face. Auras are usually experienced before migraine attacks. Gene however is wrong because not all migraines come with aura. In fact, with a ration of 2:1, there are more migraines occurring without aura than those with it.
Examples of Visual Aura:
“I thought only women get migraines.”
Although 75 percent of adult patients are women, anyone can have migraine – men, elderly, teenagers, children and even babies. Women are more susceptible simply because a decrease in estrogen, a female hormone, is linked with migraine. Hormonal imbalances and therefore migraine happen in women before and during menstruation, in the first three months of pregnancy, and when taking oral contraceptives.
“I’m just stressed.”
It should be noted that stress (physical and emotional) does not cause or trigger migraine; it just makes us vulnerable to it. In fact, the International Headache Society moved “stress” from their list of triggers to its list of exacerbating factors.
While exacerbating factors increase susceptibility to migraine or its triggers, migraine triggers, on the other hand, are those that actually start off the chain reaction that results to migraine. According to M.A.G.N.U.M, migraine triggers are physiological other than psychological. People vary in their triggers but mostly have combinations. These include weather, menstrual cycles, diet (foods containing caffeine, aspartame, and monosodium glutamate, chocolate, citrus, cheese, etc.) and environmental factors (bright and flickering lights, strong smell, and loud noise).
For every migraineur like Gene, it is important to recognize stress as an exacerbating factor but at the same time identify his real triggers. This way, he can seek ways to minimize stress and avoid triggers, if controllable, making migraine prevention more effective.
Some doctors focusing on “stress or even depression” as a migraine cause also prescribe unnecessary medications which don’t cure the migrain and may even make it worse.
“It’s not inherited.”
Researches since the mid-90’s showed that migraine is hereditary. In studies involving twins, it was derived that their genes influence their predisposition to migraines by 60 to 65%. A group of research physicians also found out that a person with one parent suffering from migraine has 50% possibility of having migraine too. The Australian genetic research team at Grithiths University in Sydney also discovered three genes linked to migraine. In 2010, another genetic defect associated with migraine was further detected. To date, four gene mutations are believed to cause susceptibility to migraine.
Migraine being genetic-based proves that it is a genuine medical disorder. Furthermore, genetic studies on migraine will help find a real cure for migraine which still remains elusive today.
“It won’t kill me.”
It can. Blood vessels dilating from migraine can rupture and might lead to stroke, blindness, coma, and possibly, death. MAGNUM even claimed that “more people died of Migrainous Stroke last year than were murdered with handguns”. Based on a report by the New England Journal of Medicine, 27% of strokes suffered by persons under age 45 are caused by migraine. The Mayo clinic also stated that migraine is linked to 25% of all cerebral infarction cases. In addition, after evaluating 14 studies in the US and Canada, the British Medical Journal recently published that migraineurs are 2.2 times more likely to suffer stroke than those not afflicted with migraine.
If a migraineur won’t die of his condition, the World Health Organization (WHO) says that he may be disabled by it. As such, WHO included migraine as one of the top 20 causes of disability that prevents long healthy life. Not surprisingly, there is a documented huge amount of labor time and productivity losses due to migraine. In the US, a position paper signed by the American Academy of Pain Medicine stated that workers complaining of head ache miss 150 million work days per year or 1,200 million work hours annually. The cost of this to businesses and the health care sector ranges from $5 to $17 billion every year.
A lot more valuable is the time migraineurs fail to spend with their families due to their condition.
Indeed, migraine is a disease that shouldn’t be taken lightly. These days, migraine treatments are focused on medications both abortive and preventive. However, frequent use of these drugs may have unpleasant side effects including medication overuse headache (MOH) characterized by rebound headaches that are more frequent and severe.
If migraines are mild to moderate, it is still best to prevent migraine attacks by keeping track of migraine triggers, preferably by having a migraine diary, and avoid them as much as possible. A healthy lifestyle including a balanced diet, regular exercise, and relaxation time is definitely helpful.
If you don’t have migraine but have a loved one that suffers from it, don’t dismiss his condition by saying, “It’s just stress”. Instead, tell him you understand and offer to do anything that could help him such as turning the TV or radio off, dimming the lights, keeping him away from intense odors and other nice things.