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*****= An all-time favorite
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****Heal Your Headache

The 1-2-3 Program for Taking Charge of Your Pain

by David Buchholz, M.D.

Reviewed October 1, 2004.
Workman Publishing, New York, 2002.  246 pages.
Available at Sembach Library (616.8491 BUC).

I thought I’d read all there is to know about headaches.  I saw this new book at the library and glanced through it, sure it contained the same information I’d read many times.  The first thing that caught my eye was something I’d never seen mentioned in any medical book before—“Eustachian Tube Dysfunction.”

For pretty much as long as I can remember, I usually have a feeling of stuffiness in my ears, with popping noises.  In high school, a specialist said that my head had five more years to grow, and I would eventually grow out of it.  This was a clever diagnosis, since by the time he was proved completely wrong, I didn’t live near that doctor any more.

David Buchholz explains that the eustachian tubes are lined with mucous membranes, and migraine can cause the blood vessels in these mucous membranes to swell, thus blocking the eustachian tubes.  The down side to this information is that he says that decongestants and antibiotics won’t work to clear them.  (Of course, I’ve been taking decongestants and knew they didn’t work, but I clung to the notion that antibiotics helped temporarily at the times I could talk a doctor into prescribing them.)  This adds up, since I’ve gotten frequent migraines since at least fourth grade.  Since I’ve had numerous doctors act as if I’m crazy with this complaint, that one page increased my respect for David Buchholz.  I checked out the book.

Recently I’ve had a few friends talk about getting headaches worse than they’ve ever had before.  This makes sense, since headaches in women tend to get worse before menopause and better after.  I’m afraid that’s the time of life we’re reaching.  I’m strongly recommending this book to these friends and to anyone else who gets headaches at all frequently.

“Heal Your Headache” explains the mechanism behind migraines better than I’ve seen it presented in any other book.  It also clearly explains triggers and thresholds, showing how getting a headache depends on how many triggers are present as well as how high your threshold is.  He explains the wide range of symptoms that can be present and even explains why headaches are so often one-sided.

I expected the usual explanation of migraine versus tension-type headaches, but this author believes that all headaches are caused by the same mechanism.  Since that has always seemed true in my case, it makes sense to me.  He claims that his program will help all types of headaches (except of course secondary headaches caused by something like a tumor, which usually make themselves known through other symptoms as well).  Therefore this book is good reading for anyone who gets headaches, even if you never thought of yourself as having migraines.

Step 1 of the program is stopping Quick Fixes.  In this chapter, Buchholz explains rebound headaches and why those Quick Fixes can hurt you more than they help.  Although I understood about rebound headaches and remember back to the days when I took 8 or 9 Excedrin a day, I had never realized that Sudafed and many other decongestants also cause rebound headaches.  (Even though I had wondered about the way I tended to get a headache when Sudafed wore off.)

The second step is to reduce your triggers.  He focuses on dietary triggers, providing a list of foods that people with migraine should avoid.  At first I was a bit skeptical, not wanting to disrupt my eating so much.  Then I noticed that I avoid most of the foods on the list already, since I knew that they can cause headaches for me.  However, there were some notable exceptions.  I knew that low blood sugar can give me a headache, so I had started eating yogurt for snacks, and was disappointed that I was getting headaches in late morning anyway.  Then I saw yogurt on the list of foods that can trigger migraine, and it made more sense.  A few others I hadn’t realized were dangerous are citrus fruits, onions, and fresh-baked breads.

The third step of the program, if it is necessary, is to try preventative medication.  He lists medications that have proven helpful.  These work by raising your threshold.

Now, I have to say that while the information in this book is fantastic, and I have little doubt that the 1-2-3 program would work, I find it just a tad brutal.  He recommends cutting off all quick fix medications cold turkey at first, then implementing the diet, including cutting out caffeine cold turkey, and only after that working on finding a preventative.

I am counting myself fortunate that I have recently found a preventative that works beautifully for me.  (Interestingly, it’s Neurontin (Gabapentin), a drug that he dismisses as a fad.)  This is after finding that most other preventatives on his list had unacceptable side effects.  (I once thought that Inderal worked beautifully and used it for two years.  With the help of a rheumatologist, I finally figured out that it was giving me drug-induced lupus.  I was pretty leery of preventative medications after that, yet I was taking Naproxen Sodium (Aleve) pretty much every day.)

Neurontin has dramatically decreased my headaches, and I’ve also dramatically decreased the amount of Aleve I’m taking.  So, for me, having a preventative that I trust is going to help me reduce the quick fix medication and dietary triggers.

You could argue that I might not need a preventative if I took the other steps first, but with all my decades of headaches, I’m afraid I don’t believe that.  I can always try reducing the preventative if my headaches get even less frequent.

At first, I was also skeptical of his demand that headache sufferers completely eliminate caffeine and never add it back.  I have eliminated caffeine for months at a time in the past.  I know that it does affect my headaches.  However, I reasoned that no caffeine didn’t eliminate the headaches completely and did take away a tool I could use against them.  (Caffeine’s main problem is its rebound effect.)

However, he has enough good information here and enough case studies to convince me to try the first two steps of his program after all.  With a preventative that I’m completely impressed with to help me, I’m going to try eliminating caffeine and the other suspect foods he lists.  It’s certainly worth a try.

If you get headaches more than once or twice a year, the $13.95 price of this book is a tiny price to pay for the information and advice it provides.

Copyright © 2004 Sondra Eklund.  All rights reserved.

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