Thursday, December 22, 2011

In which I get rid of a pain in the head

I don't think I've told you about my Medical Drama. Don't worry. It's nothing serious. Just annoying.

For years, I have had headaches. I finally went to the doctor and he called them migraines and I said, No, a migraine is when you throw up and have to be in a dark quiet room all day and he said, No it's not. He also told me there is no such thing as a sinus headache and the sineaid I had been taking for years not only did not help my headaches but probably made them worse.

He wanted me to see a neurologist but I thought $$$$$! and said, No, you fix it. It's just headaches.

He sighed, rolled his eyes, and said to quit taking so much OTC medicine because that causes rebound headaches.

When a friend at the gym suggested I try imitrex as a painkiller, I asked my doc for an RX and he gave me one.

When another friend told me about topamax, which is supposed to prevent headaches and which has the side effect of absolutely killing the appetite, I said, Sign me up.

My doc gave me the topamax, which did nothing to stop my headaches but did kill my appetite to the point that one day at work, I got dizzy as I walked up the stairs. But why? I asked myself. Then I realized that all I'd had to eat that day was half a cup of yogurt for breakfast and then three asparagus spears for lunch. The drug completely removed my desire to eat.

Within a month, I could actually see my abs, which up to now had always been covered by a fluffy Memphis Roll. All that good BBQ and corn pudding and cheese grits.

The muscles themselves were solid, as I had been exercising for a while, but I had never been able to see them before. It is possible to have muscles with a layer of fluff on top. That's what happens when you exercise + eat. I have discovered that it is not possible to exercise enough so that I can eat whatever I want. So I have made peace with my Memphis Roll.

But I had to stop the topamax because it wasn't performing the required task.

My doc sent me to an ENT for something else. The ENT did a CT scan of my head. No tumor. Then I gave up and went to the neurologist, who shook his head and told me to stop taking all the OTCs.

When I moved to [new town], my family doc refused to treat my headaches. "I don't do those," he said. "I don't know enough. You have to see a neurologist for that."

I went to the neurologist, who bills out at $800 an hour and I am not complaining about that because I would happily pay $800 never to have another headache again as long as I live.

She took a long case history, gave me a dozen photocopied pages that I glanced at and then tossed. I didn't get headaches after eating aged cheese or chocolate. I got them from glare, changes in barometric pressure, dehydration, and then sometimes just because. It was the just becauses I wanted to figure out.

We tried different preventive drugs, none of which worked to stop my headaches but all of which had lovely side effects like making my hair fall out in clumps or making me gain weight.

Primo and I visited my aunt Rita. I got an email from her the week after we left. "You weren't kidding about the hair loss!" she wrote. "I found hair all over the bathroom floor!"

I felt bad. I had cleaned the shower after I was through, but I didn't see the hair on the floor because I don't wear my glasses to shower.

I went through thousands of dollars of drugs and doctor bills. The co-pay - the CO-PAY - for the lyrica was $140. On the market, it would have cost me over $1,000.

I considered participating in a research trial where they put a little plug in your heart. There appears to be some connection between people who get migraines and people in whom that little hold between the chambers doesn't close at birth. But I decided I didn't want a tube run into my heart.

The neurologist gave up. "Try acupuncture," she suggested.

I found an acupuncturist near my house. When I got to the clinic, the clerk asked me for a urine sample. I looked around: the sign noted that I was in a drug rehab center.

"No, no urine sample," I said.

"But you have to," she stated.

"No I don't," I told her. "That's not what I'm here for."

I wanted to say, "Do I look like an addict?" but then I thought, Well maybe I do. Maybe there are addicts who aren't emaciated and have good teeth. Aren't there Hollywood addicts who go into treatment all the time in between movies where they look fabulous?

She shrugged. Whatever.

I sat and read the sheaf of papers. I had to sign a contract agreeing to keep my appointments. I rolled my eyes. Again, not an addict.

It reminded me of when I went to the dental school in Memphis for my implant. Note that's singular and at the dental school. We are not talking about implants, but an implant, as in a fake tooth to replace the tooth that had to be pulled after almost 20 years of causing me trouble, starting when half of it broke off when I was flossing.

My teeth have betrayed me my whole life. I have taken care of them, even paying for my annual cleaning and exam when I was in grad school and didn't have dental insurance, but they have done me wrong. Perhaps I don't have good teeth. Maybe that receptionist could sense how many cavities and crowns and root canals I had had. But I have good teeth in that not meth mouth way.

At the dental school, after I'd had the surgery to put donor bone in my gum, as my own bone was lacking - and I just read Stiff, which is about research on cadavers, and have a pretty good idea where that bone came from, the dental student was very insistent that I remember to return for my appointment a few months hence.

As he saw me write the appointment in my purse calendar, he looked at me: suit, heels, overall good teeth, decent haircut. "Maybe I don't need to remind you and remind you to come back," he said.

"No I don't think so," I answered.

I didn't sign the contract. I wasn't trying to kick a habit.

Not that I don't have habits to kick. I want not to reflexively, if internally, criticize misspellings when I see them online or at the grocery store. I want not to look with derision on sloppy dressers. I especially want that one, as I am in no position to criticize. It is 2:46 in the afternoon and I am still in my PJs and robe and have not even washed my face. I have, however, made a batch of homemade mustard - cross your fingers on that one - and gotten everything out to make the coffee snaps in the Joy of Cooking. Judge not lest ye, etc, etc. Plus you never know what someone's situation is. Maybe someone is staying with a sick child at the hospital and hasn't had a chance to do anything for days. You can hardly expect that person to spend an hour dressing to the max.

Or maybe that person is just lazy as sin, as I am. I go to the store in my gym clothes because the store is on my way home from the gym. It makes no sense to drive home, shower, change, and then return to the store, does it? Actually, it's because I am so environmentally sensitive. That's it.

I want to assume the best of people, not the worst, even of the people who get in the express lane at the grocery store with MORE THAN 12 ITEMS! "Can't you read?" I want to snap at them. Then I have to remind myself that sheesh! is it like you are in such a hurry that you have to get out with your cauliflower, half and half, and cilantro right now?

I looked around the clinic. I saw a man in a white lab coat hurry by me. He was wearing a yarmulke and he had those curly sidelocks. Then another man, also in a lab coat, also with a yarmulke and sidelocks. I looked at the door: a mezuzah was attached to the frame.

I glanced down at my shirt. It was rather low cut. As in, it showed the cleavage I do not have. Was this the wrong shirt to be wearing to a clinic run by orthodox Jewish men? Probably. I tugged my shirt up and my skirt down.

The acupuncturist, Seth, came to get me. He, too, was an orthodox Jew. An orthodox Jewish acupuncturist.

He waved his hand when I said I hadn't given a urine sample. "Not necessary," he said. Ha. I knew it.

Seth and I chatted. He asked me about what I ate. Here we go again, I thought. But when he told me to go a week without dairy - "Even though that's so last century," he told me - and then a week without gluten - "That's the food allergy du jour," he said and track my headaches, I thought, Well what do I have to lose?

He also told me to try yoga. Then he stuck a tiny little needle in the top of my foot and left it there for a minute. "I don't expect this to do much," he explained. "Acupuncture is not very effective for pain that is genetic in origin."

I went home and followed his instructions. A week without dairy. Which was hell as I love cheese. And half and half. And frozen custard. But I admitted to myself that it might be a fair tradeoff never to have another headache.

But the headaches didn't diminish.

I cut out the gluten. Do you know how many foods have gluten? Soy sauce has gluten! Soy sauce!

Still no change.

I returned for more poking, dressed more modestly this time. While the four needles rested in my feet and hands, we talked about Memphis, where he was going to be traveling to complete a PhD program. "Oh the barbecue!" I raved.

He looked at me. "I take my own food," he said.

"But Central BBQ is not expensive," I told him.

He shook his head. "Not kosher."

Ah! Of course.

"But Memphis has a huge Jewish population," I said. "Not one kosher BBQ restaurant?"

"I don't know," he said. "But it is a big pain in the neck to make BBQ kosher."

This was last summer. I read yesterday about a kosher BBQ restaurant there. I need to call Seth and tell him.

He pulled the needles out. I left.

And started to notice a decline in my headaches.

Which seemed crazy to me, because I don't really believe all that acupuncture stuff. Although I do have a friend who swears by it, so maybe it does work for some people. It just seemed nuts that a few little needles would stop my headaches.

What other explanation could there be? I examined the changes in my diet and behavior over the past two weeks.

One big change was it was warmer outside. We had the windows open. Could it be a weather thing? Would this be my excuse to move back south?


I had been going to yoga, which is a lot harder than I ever thought it would be. Why should I be surprised? 1. I have been bit in the ass so many times by things I have thought, Well a high-school dropout can do this so why can't I? That's how I ended up with some (note that is more than one, which shows that I am incapable of learning from experience) really bad self-inflicted haircuts. 2. Have you ever seen a yoga instructor? They are in amazing shape. AMAZING.

It was a great workout, but I discovered that the downward dog, it does not work for me. As in, when I am in that position, the blood rushes to my face and into my eye sockets and the little capillaries around my eyes burst so that it looks like I have tiny measles just across the middle of my face. As much as I sort of enjoyed the post-workout pain of yoga, I don't want to have to wear a mask in public so that people don't think my husband is shooting my eyes with buckshot or whatever you call those tiny little bullets.

Could it be the coffee? I had cut back from two cups of coffee every morning to one. It was just too warm for more than one coffee.

Caffeine? I wondered. Nah, that was too simple. Too easy. If caffeine caused headaches, surely one of the many docs I had seen over the past ten years would have suggested I stop drinking it.

But it was worth a test. I bought some decaf and switched. I stopped drinking diet Dr Pepper in the afternoon.

My headaches stopped. Completely. I went three months without a headache. I used to have two to three headaches a week. I went three months. Without one headache. Then I had a few because there were some big weather changes and because I thought, This time, I can work on my computer without closing the blinds first! I'm just going to be a second. That's not enough glare to start a headache! Only it was. But that headache was my own stupid fault. So four headaches in four months is not too shabby.

Which made me happy and made me a wee bit mad, because if it was that simple, why on earth had somebody not suggested it ten years ago? I could have saved thousands of dollars in medical and drug bills and I wouldn't have had to deal with hair fallout. Plus I wouldn't have felt crummy several days every month from the headache or from the painkillers, which sometimes work but always have their own side effects.

The moral of the story is: try cutting out caffeine before you go to the $800 an hour doctor.


  1. On the other hand, one of the things that helps to stop my migraines is caffeine. Before I moved to Imitrex, the anacin with caffeine was the only thing that helped the pain (I thought normal headaches required 6-8 pain-killers. Because what I had couldn't actually be a migraine if I didn't see colors. Or "need" to lie down, like my GS leader when she had one.)

  2. G, I have discovered the same thing. Too much caffeine causes headaches, but now that I am off it, a little bit of caffeine (coke or coffee) with an aspirin sometimes banishes them. It's a much cheaper solution than relpax and has fewer side effects.

  3. I can't believe no doctor asked about caffeine. 34 years ago, when I had migraines, that was the first question I got. Haven't had any coffee since. Good thing I like tea:).

  4. When the third one of my friends who I never saw without a cup of coffee (this was in Seattle), announced an upcoming hysterectomy for fibroids, I (very unscientifically) begged her to give up caffeine for the 6 weeks before her operation. It was just a hunch on my part, but she never got that operation and her migraines almost disappeared. Her doctor was amazed.

  5. L, I can't believe it either. There may have been something in the reams of paper the docs shoved at me, but it wasn't until the acupuncturist ordered me to eliminate certain foods from my diet that I ever really thought about it. When you have pages of stuff that suggests that aged cheese and chocolate and pickles might be causing the problem, it's hard to focus.

    Beryl, my mom's doc told her to stop with the caffeine because of fibroids in her bosom. That is odd that her doc didn't suggest that first. Your friend is lucky that you did the research!

    TwoBusy, are you suggesting I was shot in the head and didn't know about it? :)

  6. I'm a bit late coming in on this argument. For me it was the other way around. I started getting daily headaches when I had a crap job and they wouldn't go away. By accident, I realised that Coca cola was taking them away - I don't drink coffee at all because I don't like it. I still drink a daily coke to keep the headaches at bay. I wish I didn't have to because it sure isn't good for other stuff but I have a choice - headache or whatever coke does to the body. And I choose coke over the headache every time.
    I am so glad you finally found your solution but I also had some dodgy suugestions from the medical fraternity before finding this solution myself.

  7. Suzanne, my cousin drinks a Coke and takes an aspirin to get rid of his headaches. I have discovered that when I do get a headache (usually from working on the computer without my glasses - when will I learn?) that sometimes, some caffeine plus an aspirin works for me. Caffeine is an ingredient in some of the OTC migraine meds, too.

    Can you get workers' comp if your job gives you a headache?

  8. Should I tell LPC that tea has more caffeine than coffee does?

    I don't think you can get worker's comp from headaches. My job gave me asthma. Not the kind you're born with and endure as a kid; Adult Onset Stress-Induced Asthma, the kind that, once you get it, you have for life, even if you no longer have the job. The kind that can kill you, or cripple you so you're trapped on the sofa.


  9. I only just found this blog (so entertaining!) so maybe later on someone has said this. But if your eyesight is bad enough that without your prescription lenses you can't see who is wearing your stolen glasses? The migraines are your eyes telling you that this is too hard, why won't you help me?

    Try faithfully ALWAYS wearing your glasses for a couple of weeks. I will guarantee that your migraine frequency will decrease. I barely need my glasses (as I don't have a job as a knife thrower, a slight offset in my aim does not impact daily life). So I too used to neglect wearing them (glasses at home in your PJs-ridiculous). When I started wearing them regularly, the headache frequency HALVED. Which is a lot less migraines for me.

    If it doesn't help? You need a new prescription. I can always tell when I nedd a new one because the migraines (without a trigger) increase on a gradual curve.

    And in case none of the doctors was smart enough for this either --Stress is a big trigger for migraines. Huge. If you don't get them with the stress, you will get them after the stress. I always get huge migraines after a stressful event because I'm very good at the Must Be Reliable and Help Everyone During Catastrophe.

    1. Kris, I never thought about the glasses/headache connection. I will give that a try. Thank you! And thank you for reading! GD