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Taking Your on Vacation FOR THOSE WHO CHOOSE TO LIVE WELL DESPITE MIGRAINE MAGAZINE Issue 02 | Fall 2017 TAKING YOUR MIGRAINE ON VACATION PLUS MIGRAINE 101 WHAT IS IT WHAT CAUSES IT HOW TO TREAT IT APRILFALL 2017 2012 CONTENTS REGULAR FEATURES 02 01 Letter from the Editor 01 Migraineur Editorial Board Profile. 2 So You Want to Take Your Migraine On a Vacation! 05 Migraine 101 09 Celebrity Migraine 05 09 SPECIAL FEATURES 11 11 Managing Your Migraine: 01 Tip of the Month 02 Treatment of the Month: Caffeine! 03 Myth of the Month 13 DOCTOR ON CALL NEXT ISSUE Copyright © John F. Rothrock, 2017. All rights reserved. No part of this publication may be reproduced, stored Sex and Migraine: “Not tonight, honey” or “Bring it on!”? in or introduced into a retrieval system or transmitted • by any means (electronic, mechanical, photocopying, • Migraine and Pregnancy recording or otherwise) without the prior written per- mission of the copyright owner or his formal designate. • “The Big 5”: What Your Doctor Doesn’t Want to Hear Migraineur Magazine • www.migraineurmagazine.com 1 LETTER FROM Migraineur Editorial Board Profile THE EDITOR Dr. Rothrock received his medical degree from the University of Virginia and completed his intern- ship and residency training in Neurology at the In this and subsequent issues we will University of Arizona. attempt to dispel the many myths that In 1983 he joined the Neurosciences faculty at surround migraine… the University of California, San Diego (UCSD), where he established and directed the UCSD Welcome to the second issue of a magazine Stroke Center and, subsequently, the UCSD Head- that is intended to both educate and ache Center. He and his UCSD colleagues assisted entertain the many millions of Americans in the development of such medications as in- who suffer from migraine. As a physician and jectable sumatriptan (Imitrex) for acute migraine fellow migraineur who has treated thousands treatment and divalproex sodium (Depakote) and of migraine patients, conducted research in topiramate (Topamax) for migraine prophylaxis. the field and assisted in the development of From 2006 to 2012 he served as professor, vice virtually every new treatment for headache chair and medical director of Neurology at the since the emergence of sumatriptan (Imitrex) University of Alabama/Birmingham (UAB). At UAB, in the late ‘80s, I have a particular allegiance Dr. Rothrock continued his clinical research in the to our readership. area of migraine, assisting in the development of onabotulinumtoxinA (BotoxA) as a treatment for Migraine is a decidedly odd malady. Although rarely life-threatening, chronic migraine. it is frequently life-altering. Migraine imposes a tremendous physical, financial and psychosocial burden upon our society, and for those of Since July 2015 he has served as professor and us afflicted it may persist, throughout most of our lives. vice chair for the department of Neurology at the George Washington University School of While common, the disorder is poorly understood both by the public Medicine. With his colleagues locally, nationally and by healthcare providers, a situation that results all too often and internationally he is working to develop new in a failure to seek medical care or medical mismanagement and treatments for migraine and other headache consequent patient frustration when such care is sought. disorders. In this and subsequent issues we will attempt to dispel the many Dr. Rothrock has been listed in America’s Top Doc- myths that surround migraine, acquaint you with the tremendous tors and Best Doctors in America in each of the strides that have been made in understanding and treating the past 15 years. He has been cited in Men’s Health disorder and, most important, offer some guidance as to how we and Women’s Health magazines as one of the 20 migraineurs may enjoy life more fully and control our headache top neurologists in America. disorder more effectively. John F. Rothrock, MD Editor in Chief Editor-in-chief: John F. Rothrock, M.D. Associate editor: Amanda Michael, M.D. Managing editor: Diane Andress-Rothrock ON THE Production editor: Bradley Bawek COVER Director of marketing: Benjamin Lankford Cynthia Andress pauses on the Design: BAWEK creative services / bawekcreative.com Shirley Lake Summit Shirley Lake Trail. She is a mother, Printing: Minuteman Press Bethesda / mmbethesda.com Squaw Valley, CA a full time student, an active Published by: Celeray Press triathlete and a migraineur. 2 Migraineur Magazine • www.migraineurmagazine.com SO YOU WANT TO TAKE YOUR MIGRAINE… ON VACATION! Follow this advice and you will increase your chances of enjoying a pleasant and headache-free vacation peaking to her physician, LM, a 35-year-old female migraineur, reports: compassionate spouse, significant other, relative or friend may find it difficult to “We live in Phoenix, and our summers extend well into October. This Fall deal gracefully with the unappealing my husband and I are planning to take two weeks off in September to go to behavior provoked by your acute migraine. S Mallorca, but instead of looking forward to our vacation I’m dreading it. We After all, you don’t have a fever. You don’t went to Paris a few years ago for what was supposed to be a second honeymoon, and look that sick. Why can’t you … go sailing; I just fell apart. I was exhausted the whole time, but I couldn’t sleep. Despite the great walk with me on the beach; stop for a food everywhere around me, I had no appetite. And my migraines went ballistic! To my poolside cocktail; have a romantic tryst in husband’s disgust, I wound up spending most of the so-called vacation in bed (alone) our room before dinner at the restaurant trying to deal with my headache and wishing I was home. He barely spoke to me on the our friends told us about? In short, why flight back to Arizona. can’t you do all those things we spent so We’ve been saving up all year for this big trip to Spain, but because of my migraine I’m much time planning to enjoy? Why are you afraid it’s just going to be a big waste of money.” ruining our vacation! Extended travel can exact a One needn’t travel thousands of miles to physical toll on anyone, but the Balearic islands of Spain; even far less long flights and a sudden ambitious vacations have the potential ENJOY A introduction to an unfamiliar to unhinge migraine. The alterations in environment may make the HEADACHE-FREE one’s usual eating, drinking and sleep- experience particularly chal- ing habits can wreak havoc, leading the lenging for the migraineur. No VACATION poor migraineur to wonder why he or she sane migraine sufferer wants didn’t opt instead to spend that hard- to experience an extended earned money on a bathroom renovation. flare-up of headache, and that such misery could occur in the Try following the advice offered here, and midst of a long-anticipated you will increase your chances of enjoy- vacation is, to say the least, ing a pleasant, headache-free vacation. discouraging. To make matters worse, the acutely suffering migraineur AIRLINE TRAVEL often must bear an additional burden: the disappointment Travel Stress: The circumstances of experienced by one’s traveling extended air travel possess a multitude companion. Especially if they of potential migraine triggers. Whatever have no personal experience the setting, migraineurs inevitably report with migraine, even the most stress to be the most common stimulus Migraineur Magazine • www.migraineurmagazine.com 3 MIGRAINE THRIVES ON that of your travel destination; as invit- at an unfamiliar medical facility can be DEHYDRATION…OVER- ing as that hotel bed may look after an frustrating and even humiliating. To do extended flight from Boston to Budapest, so bearing a statement from your regular HYDRATE WITH WATER resist the urge to give in to your weari- physician may go a long ways towards ness and climb between the sheets at lessening the hassle. for migraine activation, and events of noon. Give your hypothalamus a chance the last two decades have exponentially to recalibrate. Take your brain for a walk, amplified the stress associated with air eat dinner at a time appropriate to your travel. While there’s nothing you can do new locale and try to avoid giving in to RELAX! to eliminate this stress entirely, there are sleep until well after sunset. Don’t Overdo: Flushed with the actions you can take to reduce the inevi- Benzodiazepines (eg, clonazepam) and excitement of having shed the routine table annoyances you must endure. non-benzodiazepine sleep promoters demands of home and work, one’s natu- Try to avoid flight itineraries that involve (eg, zolpidem=Ambien)) may reduce the ral temptation is to kick off the vacation horrifically early or late departures, insomnia associated with jet lag, but with too much too soon. The beach, impossibly tight connections, “red eyes” their use can negatively affect next- ocean, lake, museums, galleries, restau- or stand-bys. When possible, minimize day physical and mental performance rants and clubs aren’t going anywhere, the need to make connections. If one of (even to the extent of causing amnesia!). and to knock yourself out of action for your flights is cancelled or so hopelessly For simple “travel fatigue”, however, as the duration of the trip by overindulg- delayed as to endanger a connection, opposed to jet lag insomnia resulting ing on your first day and night makes no look immediately to your smart phone from disruption of your circadian rhythm, sense. This is supposed to be fun . not rather than stew and fret in an endless use of a “prn” (ie, taken as needed) sleep promoter such as zolpidem, eszopi- an endurance test.
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