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The Drain of Migrainenurse week

migraine sufferer

By Mary Ann Hellinghausen

Illustrations by Malcolm Garris/PhotoDisc

March 6, 1998

   

The Super Bowl was on low volume in the background as Michael Coleman worked at his headquarters for a migraine awareness group. When he heard that Denver Broncos running back Terrell Davis was leaving the football field because of a migraine, "we immediately perked up our ears‹we couldnąt believe they were talking about migraine at the Super Bowl on network TV," he said.

Davis's ability to abort his migraine and gain 93 yards in the second half of the game was a mixed blessing, however, for those who advocate better awareness of migraines. "It opened dialogue and you canąt beat that," said Coleman, executive director of MAGNUM, or Migraine Awareness Group: A National Understanding for Migraineurs, based in Alexandria, Virginia.

But Coleman is worried that the incident left the misimpression that a severe migraine sufferer could rebound quickly and go on to excel in a football game. Davis gets migraine attacks only a few times a year and does not have a severe form of the disease, Coleman said.

Unrealistic recovery

Davis was able to bounce back quickly because he aborted the migraine before it turned acute by using a new nasal spray, Migranol, enhanced with oxygen, said Coleman, who discussed Davisą situation with the head of the Broncosą medical staff.

"He did not play during an acute migraine," Coleman said. "People need to understand that when attacks occur more than three times a month, the sufferer most likely will not be able to function well in a work environment. Theyąre at a severe disadvantage."

About 75 percent of the estimated 26 million Americans who suffer from migraines are women. Migraines are believed to be caused by certain events or substances that trigger an imbalance of naturally occurring chemicals in the brain, causing the blood vessels in the head to expand. Hormonal changes are believed to be one reason migraines are more prevalent in women.

Migraine symptoms can include severe pain on one side of the head, throbbing or pounding pain, pain that disrupts normal activity or is aggravated by activity, nausea, and sensitivity to light and sound. Food triggers can include aspartame, red wine, cured meats, and citrus fruits.

Easing the pain

Research shows that two-thirds of people who have problem headaches donąt see a physician for treatment, said Marjorie Winters, RN, director of research and education at the Michigan Head Pain and Neurological Institute in Ann Arbor, Mich. "Because so few treatment alternatives were available, the healthcare community didnąt have a lot of answers for them," she said.

In recent years, however, new medications have been developed to specifically treat migraine pain. Imitrex (sumatriptan succinate), the first medication specifically formulated for migraine treatment, has been available since 1993 and Imitrex Nasal Spray became available last year. Amerge is another new treatment that has proved more effective at relieving acute migraine pain over longer periods.

The new medications can cost as much as $13 a tablet, and migraine sufferers shouldnąt necessarily forsake older, cheaper medications if they are effective, said Neal Raskin, MD, professor of neurology at the University of California, San Francisco and past president of the American Association for the Study of Headache (AASH).

"The word has gotten out that old is bad and new is good," Raskin said, noting that many older medications still have a 60 percent success rate. Even over-the-counter medication such as Excedrin can be effective for mild to moderate migraines, he said.

Ninan T. Mathew, MD, director of the Houston Headache Clinic and a past president of the AASH, said 80 percent of migraines can be managed today with preventive medicines and lifestyle changes such as diet, exercise, and relaxation techniques.

© Nurse Week & Health Week Magazines 1998

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