HEADACHE
- Introduction ,Don't overdo the pain pills, Lie
down, Don't let the sun shine in
- Use a cold compress, Try
heat, Think pleasant
thoughts, Check for
tension.
- Quit smoking, Don't drink,
Start
a program of regular exercise,Cut down on caffeine.
- Fight the nausea first,
Rise and retire at the same time
every day.
- Keep a headache diary, Headache Resources, The National
Headache Foundation.
- Foods allowed, Foods to avoid, Recipes for Relaxation
-
- Introduction
- Headaches. We've all had them. From
the morning-after-celebrating-too-much headache to the
tough-day-at-the-office headache to the
you-might-as-well-kill-me-now-because-I'm-going-to-die-anyway
headache. Sometimes, an aspirin or other analgesic may
ease the pain; at other times, nothing short of waiting
it out seems to help. If you suffer from frequent, severe
headaches that put you out of commission several times a
month, you need to seek medical attention. Likewise, if
your headaches are associated with physical exertion,
changes in vision, or weakness, numbness, or paralysis of
the limbs, skip the urge to self-treat and see a doctor.
If you're already seeing a physician and aren't getting
relief, think about getting a referral to a headache
specialist or headache clinic. However, if you are prone
to occasional headache pain, read on. The tips that
follow can help you feel a lot better--fast.
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- Don't
overdo the pain pills.
- Although an occasional dose of an
over-the-counter analgesic may help alleviate your
headache for a few hours, taking these drugs too often
may actually worsen the pain, according to Sabiha Ali,
M.D., a neurologist at the Houston Headache Clinic in
Texas. "These drugs are OK in limited
quantities," she says, "but if you need to take
more than two doses a day, you should see a doctor."
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- Lie
down.
- Lying down and closing your eyes for half
an hour or more may be one of the best treatments for a
bad headache. For some types of headaches, such as
migraines, sleep is the only thing that seems to
interrupt the pain cycle. "The most important thing
is to recognize that the faster the patient with a severe
headache stops what they're doing and goes to bed and
rests, the faster the headache will go away," says
James R. Couch, Jr., M.D., Ph.D., professor and chairman
of the Department of Neurology at the University of
Oklahoma Health Sciences Center in Oklahoma City.
"You need to recognize when the big headache is
coming. That's the time to give up and go to bed."
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- Don't
let the sun shine in.
- Especially if your symptoms resemble those
of a migraine (such as severe pain on one side of the
head, nausea, blurred vision, and extreme sensitivity to
light), resting in a darkened room may alleviate the
pain. Bright light may also cause headaches, according to
Seymour Diamond, M.D., founder of Diamond Headache Clinic
in Chicago. "Sometimes, looking at a computer screen
may bring on a headache," he says. "Tinted
glasses may help."
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- Use
a cold compress.
- A washcloth dipped in ice-cold water and
placed over the eyes or an ice pack placed on the site of
the pain are other good ways of relieving a headache,
says Fred D. Sheftell, M.D., director and founder of The
New England Center for Headache in Stamford, Connecticut.
"Other good solutions are the 'headache hat,' which
is an ice pack that surrounds the head, and the ice
pillow, which is a frozen gel pack that is inserted into
a special pillow," he says. (These special ice packs
can be found in some pharmacies; if you don't see them at
yours, ask your pharmacist about ordering them.) Using
ice as soon as possible after the onset of the headache
will relieve the pain within 20 minutes for most people,
Sheftell adds.
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- Try
heat.
- If ice feels uncomfortable to you, or if
it doesn't help your headache, try placing a warm
washcloth over your eyes or on the site of the pain, Ali
says. She recommends leaving the compress on for half an
hour, rewarming it as necessary.
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- Think pleasant thoughts.
- Many headaches are brought on or worsened
by stress and tension, according to Couch. Learning to
handle life's difficulties in a calm way may keep the
volume down on a bad headache, he says. "Turn off
all thoughts of unpleasant, crisis-provoking
things," he says. "Think about pleasant things.
Just for the moment, try to forget about the
confrontation with the boss or the coworker. Try to relax
while you work out a strategy to cope with the
problem."
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- Check
for tension.
- Along with the preceding tip, Sheftell
recommends that patients periodically check their body
for tension throughout the day. "If you notice that
you get these headaches frequently, check the body for
signs of tension," he says. "Are your jaws set
very tightly? Are you scrunching your forehead? You want
to check to see if your fists are clenched. Also, when
you stop at a red light, are your hands gripping the
wheel very tightly?" If the answer to any of the
questions is yes--stop, relax, and take a deep breath or
two (don't go beyond a couple of deep breaths, though;
otherwise, you may begin to hyperventilate).
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- Quit
smoking.
- Smoking may bring on or worsen a headache,
Couch says, especially if you suffer from cluster
headaches--extremely painful headaches that last from 5
to 20 minutes and come in groups.
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- Don't
drink.
- Alcohol, aside from its notorious
morning-after effect, may also bring on migraines and
cluster headaches, according to Diamond. Alcoholic
beverages contain tyramine, an amino acid that may
stimulate headaches (see Extra! Extra! - "Dr.
Diamond's Antiheadache Diet" for other foods and
beverages that contain tyramine).
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- Start a program of regular
exercise.
- Regular exercise helps to release the
physical and emotional tension that may lead to
headaches, according to Ali. She recommends walking or
jogging. These and other aerobic activities, she says,
help to boost the body's production of endorphins
(natural pain-relieving substances).
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- Cut down on caffeine.
- "Caffeine can increase muscle tension
and your anxiety level," Sheftell says. "It
also creates difficulties in sleeping, which can cause
headaches." Another problem is that many people
drink several cups of coffee a day during their work week
but cut their consumption on weekends. This can lead to
weekend caffeine-withdrawal headaches, according to
Sheftell. "My advice to those people is for them to
slowly decaffeinate themselves," he says.
"Decrease your caffeine intake by one-half cup per
week. I suggest that people who are prone to headaches
cut down to the equivalent of one cup of caffeinated
coffee per day," says Sheftell. One five-ounce cup
of drip coffee contains about 150 milligrams of caffeine.
A five-ounce cup of tea brewed for three to five minutes
may contain 20 to 50 milligrams of caffeine. And cola
drinks contain about 35 to 45 milligrams of caffeine per
12-ounce serving. Sheftell also recommends checking the
caffeine content of any over-the-counter drugs in your
medicine cabinet.
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- Fight the nausea first.
- Some headaches may be accompanied by
nausea, which can make you feel even worse. What's more,
the gastric juices produced by stomach upset may hinder
the absorption of certain over-the-counter and
prescription analgesics, which may make these drugs less
effective at relieving the pain of your headache. So, by
first taking care of the nausea, the pain of the headache
may be easier to treat, says Sheftell. He says that many
of his patients have found that drinking peach juice,
apricot nectar, or flat cola has helped alleviate nausea.
Over-the-counter antinauseants such as Emetrol and
Dramamine may also be useful.
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- Rise
and retire at the same time every day.
- Going to bed and getting up at the same
time every day also helps prevent headaches, according to
Diamond. "Changes in body chemistry that occur when
you oversleep can precipitate migraines or other
headaches," he says.
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- Keep a headache diary.
- If you get frequent headaches, try to
tease out the factors that seem to be responsible, says
Sheftell. "Pick up patterns. Figure out a way to
record headaches and rate them on a zero-to-three scale
of intensity: no headache, mild headache, moderate to
severe headache, incapacitating headache. Start to look
at what foods you are eating. Women should begin tracking
their periods, as well as their use of
hormone-replacement medications or oral contraceptives.
You can show this calendar to your doctor."
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- Headache Resources
- The following associations provide support
and information for headache sufferers:The American
Council for Headache Education (ACHE). ACHE provides
patient information and referrals to headache
specialists. The organization also sends out free
informational pamphlets about headache treatment. In the
future, ACHE plans to set up patient-support groups
around the country.
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- The National Headache
Foundation
- This organization sends out free headache
information to patients and publishes a headache
newsletter. You can contact the Foundation at
1-800-843-2256.Dr. Diamond's Antiheadache Diet At Diamond
Headache Clinic in Chicago, patients are advised to eat a
diet low in tyramine, an amino acid that is known to
promote headaches, nausea, and high blood pressure in
certain individuals. People who take certain
antidepressant drugs called monoamine oxidase (MAO)
inhibitors are especially prone to accumulating high
amounts of tyramine. The following diet keeps tyramine
levels to a minimum.
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- Foods
allowed:
- Decaffeinated coffee, fruit juices, club
soda, noncola sodas. Caffeine sources to be limited to no
more than two cups per day.
- Yogurt: limit to one-half cup per
day.
- Cheese:blue, boursault, brick, Brie
types, Camembert types, cheddar, Swiss, Gouda, Roquefort,
Stilton, mozzarella, Parmesan, provolone, Romano,
Emmentaler.
- Fresh or frozen turkey, chicken, fish,
beef, lamb, veal, pork, eggs (limit three per week), tuna
fish.
- Commercial breads: white, whole wheat,
rye, French, Italian, English muffins, melba toast,
crackers, bagels. All hot and dry cereals: cream of
wheat, oatmeal, cornflakes, puffed wheat, rice, bran,
etc.
- Potatoes, sweet potatoes, rice, macaroni,
spaghetti, noodles.Vegetables, Legumes, and Seeds
- Seeds : Asparagus, string beans,
beets, carrots, spinach, pumpkin, tomatoes, squash, corn,
zucchini, broccoli, green lettuce. All except those
listed in the next paragraph.
- Prunes, apples, cherries, apricots,
peaches, pears. Citrus fruits and juices: Limit to
one-half cup per day of orange, grapefruit, tangerine,
pineapple, lemon, or lime.
- Cream soups made from list of allowed
foods, homemade broths.
- Fruits listed above, sherbets, ice cream,
cakes and cookies made without chocolate or yeast,
gelatin.
- Salt (in moderation), lemon juices, butter
or margarine, cooking oils, whipped cream; white vinegar
and commercial salad dressing in small amounts.
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- Foods
to avoid:
- Caffeine (does not contain tyramine, but
aggravates headache symptoms): coffee, tea, colas in
excess of two cups per day. Hot cocoa, all alcoholic
beverages.DairyFoods allowed: Milk: homogenized, low-fat,
or skim. Cheese: American, cottage, farmer, ricotta,
cream cheese.
- Cultured dairy, such as buttermilk, sour
cream, chocolate milk.
- Aged, canned, cured, or processed meats;
canned or aged ham; pickled herring; salted, dried fish;
chicken liver; aged game; hot dogs; fermented sausages
(no nitrates or nitrites allowed), including bologna,
salami, pepperoni, summer sausage; any meat prepared with
meat tenderizer, soy sauce, or yeast extracts (it's not
the yeast itself that's a problem, but yeast contains an
enzyme that alters an amino acid to become tyramine).
- Hot, fresh, homemade yeast breads; breads
and crackers containing cheese; fresh yeast coffee cake,
doughnuts, sourdough breads; any breads or cereals
containing chocolate or nuts.
- Pole, broad, lima, or Italian beans;
lentils; snow peas; fava, navy, or pinto beans; pea pods;
sauerkraut; garbanzo beans; onions (except as a
condiment); olives; pickles; peanuts; sunflower, sesame,
or pumpkin seeds.
- Avocados, bananas (one-half allowed per
day), figs, raisins, papaya, passion fruit, red plums.
- Canned soups, bouillon cubes, soup bases
with autolyzed yeast or monosodium glutamate (MSG)--read
labels.
- Chocolate candies, chocolate syrup, carob.
- Pizza, cheese sauce, soy sauce, monosodium
glutamate (MSG) in excessive amounts, yeast, yeast
extracts, Brewer's yeast, meat tenderizers, seasoning
salt, macaroni and cheese, beef stroganoff, cheese
blintzes, lasagna, frozen dinners, and any pickled,
preserved, or marinated foods.
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- Recipes for Relaxation
- In addition to being given an antityramine
diet (see Extra! Extra! - "Dr. Diamond's
Antiheadache Diet"), patients at Diamond's
Antiheadache Clinic in Chicago are instructed in
relaxation techniques. The following is a typical
relaxation exercise. The exercise can be memorized, or
the written instructions can be recorded on a cassette
tape. The entire exercise, which relaxes the facial area,
neck, shoulders, and upper back, takes about five
minutes. Before you begin, make sure you won't be
disturbed--close the door and take the phone off the
hook.
- 1. Settle back quietly and comfortably
into a favorite chair or sofa. Allow your muscles to
become loose and heavy.
- 2. Wrinkle up your forehead, hold it, then
smooth it out, picturing the entire forehead becoming
smoother as the relaxation increases.
- 3. Frown, creasing your eyebrows tightly,
feeling the tension. Let go of the tension, smoothing out
your forehead once more.
- 4. Close your eyes more and more tightly.
Feel the tension as you hold them shut. Relax your eyes
until they are closed gently and comfortably.
- 5. Clench your jaws and teeth together.
Feel the tension build, then let go and relax, letting
the lips part slightly. Allow yourself to feel relief in
the relaxation.
- 6. Press your tongue hard against the roof
of your mouth. Again, feel the tension, then relax.
- 7. Purse your lips together more and more
tightly, then relax. Notice the contrast between tension
and relaxation. Feel the relaxation all over your face,
forehead and scalp, eyes, jaws, lips, and tongue.
- 8. Press your head back against your
chair, concentrating on the tension in the neck. Roll
your head to the right and feel the tension shift. Repeat
to the left. Straighten your head and bring it forward,
pressing chin to chest. Finally, allow your head to
return to a comfortable position.
- 9. Shrug your shoulders up to your ears,
holding the tension, then drop. Repeat the shrug, then
move the shoulders forward and backward, feeling the
tension in your shoulders and upper back. Drop the
shoulders and relax.
- 10. Allow the relaxation to spread deep
into the shoulders, into your back. Relax your neck and
throat. Relax your jaws and face. Allow the relaxation to
take over and grow deeper and deeper. When you are ready,
slowly open your eyes.
- Fred D. Sheftell, M.D., recommends the
following relaxation exercise to his headache patients:
Lie down and relax your muscles. Place your hand on your
stomach and take a deep breath. As you inhale to the
count of five, feel your stomach rise. Allow yourself to
slowly exhale to the count of five, letting your stomach
fall. Imagine that you are breathing in relaxation and
breathing out tension. As you breath, visualize the
muscles in your head and neck as if they were scrunched
up, tense. Then, picture them becoming relaxed and
smooth, parallel to one another. Continue the deep
breathing for five minutes, then slowly open your eyes.
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