Easing the burden of migraine headaches
It starts in the jaw most times, and shoots through her skull to the base of the neck. The pain is intense. Janelle Janzen says it feels like somebody is pounding on her head with a hammer. The single mother of two girls has suffered from migraine headaches f or nearly 20 years. While she has learned how to manage her symptoms, the condition can make it difficult to get through the day.
“It is very different from a regular headache,” she ex
plains. “You can’t just take a Tylenol and lay down for 20 minutes and have it go away. Nausea comes with it, so you can start vomiting. There is vision impairment.”
The 47- year old used to work for an oil-and-gas company in Calgary. Now, due to the downturn in that industry in Alberta, she is juggling a number of part- time jobs. The headaches remain a persistent challenge as she works to balance a hectic schedule, pay the bills and care for her children. She feels the strain of having migraines is aggravated because the condition can be difficult for others to see, and to understand.
“People don’ t see t he physical pain, they don’t see you in a cast,” Janzen says. “They don’t see any bruises on you and they say, ‘ Oh she is fine.’ They can’t really quite get it. Nobody gets it until they have it.”
An estimated 2.7 million Canadians have been diagnosed with migraine; however, the government of Canada points out that the number of sufferers who go untreated likely means the incidence in Canada is even higher, pointing out that an estimated 14 per cent of the global population suffers from migraine at some point in their lives.
Dr. Christine Lay is a neurologist and director of the Centre for Headache at Women’s College Hospital in Toronto. She emphasizes that migraines are not your everyday stress headaches. They develop as part of a complex neurological condi- tion that involves multiple areas of the brain. Chronic migraines, she notes, are recognized as a leading cause of disability.
“Individuals suffering from chronic migraines may not be able to go to work or they may have reduced productivity,” Dr. Lay says. “The pain and the suffering presents a huge burden on the individual, so it is an incredibly disabling condition.”
Janzen began to experience migraines after moving from Edmonton to Calgary, a city which sits at a higher elevation. At one point, she was having between 23 to 28 migraine episodes a month. She believes her headaches are often triggered by severe weather, especially blizzards and high winds.
A heightened sensitivity to changes in temperature and barometric pressure are common among people who experience migraines, known as migraineurs. Dr. Lay says many of her patients are also more aware of sights, sounds, and smells.
“Migraine seems to be more common, or at least as common now as it was centuries ago,” Dr. Lay says, noting it is considered one of the world’s oldest ailments, first identified as far back as 3000 BCE. Some of our ancestors, she adds, may have developed a hypersensitive nervous system for protection and survival. “They are going to smell smoke before they get trapped in a fire. If you could sense a bad weather storm coming, you got your family to safety.”
As a teenager and in medical school, Dr. Lay experienced bad headaches which, at the time, were misunderstood by her doctors. Later, while studying neurology, she was able to diagnose those headache episodes as migraines. In her practice as a headache specialist, she treats patients who are seeking help managing a range of symptoms. She has come to understand that not all migraine headaches look alike.
“Sometimes, the headache is throbbing and sometimes, it is one- sided. But that is not an absolute,” she says. “Nearly 50 per cent of my patients have a pressure headache rather than a throbbing headache. Close to half of them will say the headache is not one-sided.”
Dr. Lay prescribes “a triangle of treatment” that includes medication to prevent attacks, therapies to turn off an attack and lifestyle management. She recommends migraineurs eat well, get enough sleep, stay hydrated and watch their caffeine intake.
Now in treatment with a specialist, Janzen has found her migraines have diminished significantly. She has about a dozen headaches a month on average, and they are less intense. The therapies her doctor has recommended are helping her achieve a better quality of life. The pain of migraine remains, but these days the burden of her condition is significantly lighter.