Headstrong

Marcy Lowe of St. Louis usually works a 60-hour week as a public relations executive. No wonder she looked forward to seven sunny days in Jamaica this winter. But two hours after she plopped herself into a beach chair, she was struck with a blinding, excruciating headache. Sound familiar?

“Many migraines occur on weekends or while people are on vacation,” says Glen Solomon, MD, a headache specialist at the Cleveland Clinic Foundation in Cleveland, Ohio. “Adrenaline is produced when the body is stressed, and it helps protect blood vessels against migraines. You’re more prone to an attack when you have a drop in adrenaline levels.”

As Marcy and other sufferers know, a migraine is no ordinary headache. The pain often affects one side of the head and is frequently accompanied by nausea, visual distortions, and sensitivity to light, noise, or odors. It can last anywhere from five minutes to several days. An estimated 28 million Americans suffer annually from migraines. Children as young as two can get them, but they are most common among those ages 15 to 50.

Of course, avoiding vacations, working weekends, and increasing stress aren’t the antidotes. Instead, try taking the following steps to reduce the likelihood of an attack during your precious time off:

1. Don’t alter your biological clock. Try to rise and retire at the same time every day. If you sleep more or less at night, or even nap, increased levels of serotonin, a brain chemical, cause blood vessels to constrict. As serotonin levels drop, the blood vessels dilate, pressing on nerve endings and creating inflammation and pain.

2. Don’t suddenly cut back on caffeine. “The withdrawal you’ll experience when you drop your intake could trigger a migraine,” says Sherry Siegel, MD, a neurologist in Greenwich, Connecticut.

3. Eat regularly – but watch what you put in your mouth. Missed meals can produce migraines. Also, avoid headache-triggering foods like nuts, aged cheese, and red wine. Other culprits: aged, dried, fermented, salted, smoked, or pickled products; MSG (monosodium glutamate often found in Chinese food); frozen dinners; self-basting turkeys; instant gravy; processed and canned foods and soups; artificial sweeteners; and bananas and raisins.

4. Tune in to the environment. Barometric pressure changes can produce a migraine. “You can take one or two over-the-counter (OTC) pain relievers an hour or two before a storm, if, of course, you can predict the weather,” says Lawrence Robbins, MD, Founding Director of the Robbins Headache Clinic in Northbrook, Illinois. Chemical insecticides, gasoline fumes, perfume, and chemicals in cigarette and cigar smoke can also be a problem – obviously avoid them whenever possible.

5. Don’t alter your exercise regimen. You can get a migraine by exercising too strenuously. Doctors recommend that you spread out your workout plan over your vacation rather than exerting yourself suddenly. Take it easy!

6. Regulate your hormone levels. Some 60 percent of female migraine sufferers report attacks just before, during, or right after menstruation, according to the National Headache Foundation (www.headaches.org or 888-643-5552). “These headaches are the toughest to treat,” says Dr. Robbins. Before your trip, discuss estrogen therapies to prevent migraines with your physician – research suggests that this might be effective. (Warning: Don’t take estrogen if you have relatives with breast or endometrial cancers.)

7. Don’t overdo OTC pain-relieving medicine: These drugs can cause “rebound”
headaches if taken too often and over a long period of time. You shouldn’t take OTC painkillers more than two to three days a week, cautions Dr. Robbins.

8. Consider an herbal or vitamin cure. Some suffers swear that feverfew curtails migraines if taken regularly. This leaf helps maintain normal blood vessel tone. The recommended dose is two tablets(380 mg each) per day. (Warning: Pregnant women and those with compromised immune systems should not take it. Adverse affects include mouth sores and bleeding.) Magnesium supplements may also work since some studies show that people who get migraines have lower levels of this mineral in their brains. The recommended dose is 250 mg once or twice a day if you’re taking magnesium oxide. Another option is Vitamin B2(riboflavin), which calms the overactive serotonin receptors and helps decrease the severity of headaches. The recommended dose is 400 mg a day. Be aware, though, that the long-term side effects are not known.

9. Bring in the “big guns.” Before you go away, talk to your doctor about prescription medicine. Beta and calcium channel blockers, for instance, may prevent migraines from occurring. There are also drugs on the market that can stop a headache once it starts, as well as medicines that relieve symptoms like nausea and vomiting.

With so many treatment options available today, there’s no need to suffer like Marcy did. “It’s all about balance,” says Dr. Siegel. Prepare yourself before your vacation, and then, as she puts it, “ease into relaxation.”