Migraine headaches are a harsh affliction for millions of Americans, many of whom suffer needlessly because they go undiagnosed or receive the wrong diagnosis.
Fairly effective prescription drugs have been available since the 1990s, but up to half of the 30 million migraine sufferers in the United States take over-the-counter painkillers, gut it out and sometimes miss work, said Dr. Stephen Landy, a migraine expert at the University of Tennessee Health Science Center.
A small study of migraine-suffering employees of Bryan Medical Center in Lincoln found that the use of appropriate medications and other strategies, such as exercise and massage, diminished the severity and frequency of migraines. Of 28 participants in the study, 24 had less frequent headaches and 23 experienced less severe headaches.
“There's a stigma against migraine headaches because you can't see them on a CT scan or an MRI,” said Nancy Waltman, a Lincoln-based University of Nebraska Medical Center nursing professor who helps oversee the employee headache clinic at Bryan.
The Lincoln hospital provides the once-a-week clinic because migraines affect productivity.
“There's a lot of denial and there's a lot of 'Well, I'll just power through it' kind of attitude,” said Catherine Parker, manager for employee health services at Bryan. “In health care, we've got to have people on top of their game.”
Landy, who helped produce a major report on migraines in 2009, said employee absences because of migraines and days of low productivity when employees suck it up and keep working lead to billions of dollars in lost productivity.
He called migraines “a public health care nightmare.” Getting professional care is important because medications are available that diminish pain in many patients.
Molly Tate, a retired college instructor, has had migraines most of her life, but they worsened about 15 years ago.
Her doctors eventually prescribed a drug called Treximet, the brand name for one of several migraine-fighting drugs. If she takes it soon enough, she can tamp down the migraine.
“You have to get it when it starts,” she said of the pain.
Tate, a 60-year-old Omahan, figures that her migraine condition is genetic. Her grandmother, uncle and dad suffered from severe headaches. Her father would go into a dark room and wrap a woman's nylon stocking tightly around his head to apply pressure and squeeze the pain. Her relatives didn't have effective medications, she said.
If she doesn't get to her medicine in time, the pain thumps at the back of her head.
“It renders you immobile, and you're almost crying,” she said. “You can't read. You just have to go lay down.”
Landy defined migraine as “episodic disabling headaches” and said there's a spectrum of migraines that behave in various ways. Twelve percent of people have them, he said, and women are three times more likely to suffer from them than men.
Medical providers sometimes misdiagnose migraines as tension headaches or sinus headaches, Landy said. In the past, doctors expected migraines to affect only one side of the head and to come with light and sound sensitivity.
Landy said that over the past 10 to 15 years, though, doctors have realized that migraines may include runny noses and runny eyes, and may cause pain on both sides of the head as well as in the neck.
“They don't necessarily follow that classic sort of pattern,” Jenkins said.
Georgia Lopez is a frustrated migraine patient. Medications help Lopez temporarily or not at all. Her migraines worsened recently, and a physician shot a “nerve block” injection into the back of her head.
That has helped for the time being, Lopez, 27, said.
She estimated that she has 60 migraines a year and lately she has missed her work as a billing representative once a week or more.
“The severity is to where I can't function,” she said. “I'm down. I'm out.” She goes into a dark room and tries to sleep.
“I've tried everything,” she said. “I go see a masseuse once a month. That kind of helps.”
A dentist is fitting her with a mouthguard to stop her from grinding her teeth at night. She is considering acupuncture. Although she has been diagnosed as having migraines, the mother of three worries about what her next visit to the neurologist might turn up.
“I'm really scared,” she said.
The World Health Organization considers headaches so troublesome that it began a Global Campaign Against Headache in 2004 to raise awareness and improve the quality of care. The WHO said lack of knowledge among medical providers is a problem, but poor awareness extends to the public, too.
“The low consultation rates in developed countries may indicate that many sufferers are unaware that effective treatments exist,” the organization wrote. “Fifty percent of people with headache are estimated to be self-treating.”
Lindsey Rai Ehlers, a fundraiser for an Omaha nonprofit organization, has chosen not to get prescription migraine medication. Ehlers, 32, doesn't want to pump those drugs into her body.
Ehlers said her migraines, which occur two or three times a year, begin with kaleidoscope-like colors in one eye. “And then the headache comes,” she said.
Her eyes tear up. She takes an over-the-counter painkiller, turns off all the lights and lies down. She occasionally misses work because of migraines, which her mother had, too.
They are debilitating, she said, but not a frequent enough problem to force her to go a doctor and get prescription medication. If they worsen, she said, she'll go.
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