Headaches
By Maureen Robertson, RN, CNN (C)
Nurse co-ordinator of the headaches program, Calgary General Hospital, Calgary Alberta.

This information is provided by Family Health Magazine, a special publication of the Edmonton Journal.

Do headaches affect your quality of life? If the answer is yes, you are not alone. Over half of all Canadians answer yes to that question. Although headaches are seldom life-threatening, they can bring about drastic changes in a person's day-to-day existence. Relationships with family members and friends, social life, and effectiveness on the job call all suffer.

When can headaches be serious? You should see your doctor if any of the following apply to you:

• Sudden onset of a new severe headache.
• Headaches that are steadily getting worse.
• Onset of a headache with exertion, coughing, straining or sexual activity.
• Headaches associated with drowsiness, confusion, memory loss, fever, visual or speech disturbances, weakness, clumsiness or loss of balance.
• First severs headache after age 50.

The most common type of recurring headaches are: migraine, tension and cluster headaches. These are not serious or life-threatening but they can, and often do, cause severe pain.

It is important for your doctor to know everything about your headaches so that a correct diagnosis can be made. The treatment of each type is different. Before going to your doctor to discuss your headaches, you should take a few minutes to think about how you would answer some of the following questions.

• When did your headaches start?
• Did they begin following a physical injury or emotional upset?
• How often do you have headaches?
• How long do they last?
• Where is the pain located?
• Does it throb or is it a steady pain?
• Do you have any other symptoms when you get your headaches?
• Do you feel that your headaches are brought on by certain foods or weather changes?
• What do you do to get rid of your headaches? What medications have you tried?
• Does anyone else in your family suffer from recurring severe headaches?

Keep a diary of your headaches and how you have treated them. When you make an appointment to talk to your doctor about your headaches, tell the receptionist or nurse why you are coming so that enough time can be allowed for a full discussion.

Medication Induced Headaches
Another type of headache is Medication Induced Headache (MIH) which is all too common. A person with MIH has daily or almost daily headaches that they treat with medication. What they are actually doing is not getting rid of the headache but causing it. These headaches can be mild to severe. They may be present on waking in the morning. They can be associated with poor sleeping, nausea, memory problems, difficulty with concentration, restlessness and irritability.

This could be your problem if you take medication for headaches more than three days a week and you have found you need to increase the amount of medication that you take without getting much relief. Doctors recommend that patients not treat mild headaches with medication at all. You should use medication, if needed, only for moderate or severe headaches. Your headache diary can help you and your doctor decide if MIH is a problem for you.

Headaches in Children
When children complain of headaches, parents are always concerned that it might be a sign of something serious. Between five to 10 per cent of children get migraine headaches. In fact, 10 per cent of all migraine sufferers are children under age 15. The highest incidence of migraine in males is between age 10 and 14 while in women it is age 20 to 24 years of age. In children, diet seems to be an important trigger.

The tendency for headaches can be inherited. Parents should consider that their child may have migraine if one or both parents also get migraine headaches. The best way to treat migraine headaches in children is with regular sleep routines of adequate length and mild medications, plus following the measures listed at the end of this page and offering whatever comfort you can to your children.

Migraine Headaches
The cause of migraine is very complex and involves many brain chemicals, inflammation and irritation of blood vessels in the covering of the brain and the brain itself. About 18 per cent of women and six per cent of men are affected by migraine headaches. A family history is very common.

There are many triggers for migraine headaches. Sometimes people are more likely to experience migraine headaches at work. It has been stated that migraine cost Corporate Canada $487 million per year. This is through shared drug costs, decreased productivity and absenteeism. Jobs are precious in today's bottom-line economy. Take the time to identify possible headache triggers in your office such as bright lights, computer screens and glare from venetian blinds. Even chairs that do not promote good posture maybe a trigger.

Treatment of Headaches
Once it has been decided which type of headaches you have, you should consider the following approaches.

• General - eliminate triggers you can control. See end of page for ways to prevent some of the triggers causing you a headache. Exercise regularly and eat regularly. Keep up-to-date on what is known.
• Comfort Measures - see end of page for a list of comfort measure that will work for many types of headaches, and remember to get enough sleep every day.
• Medications - there are two basic types of medication: some to prevent headaches and others to treat headaches. When you already have a headache there are, of course, pain killers and muscle relaxants. For migraine headaches, there are a number of medications specially designed for their treatment. You should consult your doctor to decide which medications would be most appropriate for you.
  Medication that can prevent headaches (this applies particularly to migraine) is taken daily whether you have a headache or not. This is another topic best handled through a discussion with your family doctor.
• Resources - there are more resources for headaches sufferers than you might realize. Of course there is your family doctor and the possibility of referral to a neurologist who specializes in the diagnosis and treatment of headaches. There are a number of support group as well. The Migraine Foundation is a very useful source of educational information for migraine sufferers. Your family doctor will often be able to direct you to other local support groups in your community.

Headache Prevention Measures:

• Make sure you keep a supply of any medications you require with you at all times.
• Use sunglasses whenever you are in bright light.
• Take breaks outside - fresh air helps compensate for poorly ventilated buildings.
• Avoid sports that require head down positioning.
• Watch for and avoid possible food triggers, especially red wine and chocolate.

Headache Comfort Measures:

• Change into loose clothing.
• Try ear plugs or cotton balls in your ear to dull outside noises.
• Elevate your head when lying down (foam pillow wedge). It decreases the throbbing.
• Lie down in a quiet, dark environment.
• Apply cold (or hot for some people) compress to forehead.
• Practice relaxation exercises or visualization technique.
• Learn how to massage your temples to ease the pain.

This information is provided by Family Health Magazine, a special publication of the Edmonton Journal and distributed by your neighborhood Canadian Safeway Pharmacy.

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