migraines and headaches again

We had to replace Doug's ten-year-old Kindle last month, and the new one came with three free months of Kindle Unlimited, a program from Amazon that allows you to download books from a selected (huge) list for "free." I saw a book titled something along the lines of "the migraine diet," and in spite of my skepticism, I decided to see what she had to say. Which of course sent me down a rabbit hole of going from one book to another-- there are a surprising number of them out there-- trying to figure out if there were some things that might work for me. Several books referred back to a book called Heal Your Headache by David Buchholz, a professor of neurology at Johns Hopkins, originally published in 2002.

So I bought it and read it. He's part cheerleader, part snake-oil salesman, part common sense practitioner. His tone--which is of the "if you follow my plan, your headaches will be HEALED!" variety-- was a real turn off, tbh. But, on the other hand, he said some things I'd never heard before that made complete sense to me. (Other things made no sense at all.) 

I will spare you the blow-by-blow and skip ahead to this week, because one thing that seemed worth trying was inspired by his comments about "rebound" headaches. Rebound headaches are caused by the very medications you take to treat them. The idea is that you have a headache, so you take, say, two excedrin migraine, which helps for several hours, but then when it wears off, your headache comes right back (rebounds), maybe worse than it was before. 

I've known about rebound headaches forever, but I didn't think I had a problem with them until the past couple of years when I've taken so many meds (see the end of this post). The only way to get over them is to stop taking meds, which isn't exactly appealing. When am I going to stop taking meds? I have to be able to function. 

Then I made the mistake of  happened to actually look at my calendar and notice that after weeks of having company, traveling, volunteer commitments, etc-- I suddenly had two weeks with almost nothing on my calendar. Dang.

So I decided that I would do it: stop taking meds, all of them, over-the-counter and prescription, for two weeks. Fortunately for me, I was at the end of a cycle of headaches anyway--it had been two days since I'd taken my prescription meds when I started-- so the first three days were no problem. Today has been harder, but still not too bad. We'll see. 

(I did not stop my morning cup of black tea. Buchholz says caffeine should be the first thing to go, but I've had plenty of headache-free periods when I was drinking a morning cup of tea. I may try caffeine withdrawal in the future if I need it.)

After getting off meds, if I can stick with it, the next step in his plan is dealing with triggers. Migraine "triggers" are various things like chocolate or aged cheese that can result in a headache. I've known about triggers for decades, too, since they are one of the defining characteristics of migraine, but I've always thought of them as a direct response (eat the trigger food, get a migraine). In spite of numerous efforts, some focused and intentional, some half-assed, I've never been able to identify any triggers (other than wine, which I've told you about before).

But Buchholz's way of looking at triggers is a little different. He looks at everything that might cause a headache-- stress, motion sensitivity, bright lights, lack of sleep, skipping a meal, caffeine intake, alcohol, various foods, etc --  as migraine triggers. And instead of looking for a one-to-one correspondence like I have with wine (drink wine, get a migraine), he sees them like layers that pile up until you hit the point where a migraine happens.

He didn't use this analogy, but it's like your migraine threshold is a bucket, and all the individual possible triggers go in the bucket until it overflows, and then you get a migraine. So it's not just parmesan cheese (hypothetically), it's riding in the back seat of a car to get to a party, then there's loud music and smoke floating in from the patio, and then you have an appetizer with parmesan and there you go. Wine immediately overflows my bucket, but most other possible triggers aren't enough on their own to do it. 

Buchholz has a long list of food triggers that I will not reproduce here, but in addition to the usual (wine, chocolate, aged cheese), some of them surprised me. Almonds? Onions? Almonds are my main source of breakfast protein. His plan (I'm not looking at the book so this may not be exactly right) is that you spend a couple of weeks de-toxing from the meds, and then strictly avoid the foods on the list for four months. At that point, if you are consistently headache-free, you can experiment with adding some of them back in. 

I'm not doing that. Maybe because I've tried so many--so many-- elimination diets in the past. But I am willing to stop eating almonds and avoid onions for awhile, plus a few other things I've been suspicious about. 

Oddly, there are several things on the list that I already avoid, not because of headaches but because either they make my mouth itch (raw walnuts) or the taste lingers in my mouth for hours (raw onions). So it's easy to give those up.

I will report back in a few weeks. Originally I was going to have two quick items about this and then move on. As usual I have gone on and on and now I don't have time for anything more interesting. Maybe this will be helpful for someone else dealing with chronic headaches. And if you are, I wish you well in figuring them out.

Have a good weekend.