12 PATIENT CASE STUDIESFile… · • Track your migraines using a program like MigrainePal (others...

12 PATIENT CASE STUDIES ……………………….…

Real patients share their experience, treatments and

advice for others to learn from.

THECASESTUDIESThesecasestudiesareself-reportedassessmentsonhowrealpeopleimprovedtheirmigraineattacks,accordingtothem.Theyarewritteninthepatient’sownwordswithminimalediting.Youmayreadpassagesofvaryingtoneofvoiceoremotionbecausetheseareliterallydifferentpeoplesharingtheirexperience. Thetreatmentsandmigrainemanagementtherapiesmentionedintheguidearenotanendorsement. Theonlysectionthathasn’tbeenwrittenbythepatientsthemselvesisthe“Commentary”sectionwhichsummarizestheinsightsfromthecasestudy.ThishasbeenwrittenbytheMigraineWorldSummitteam. CAUTIONADVISED Mentionedtreatmentshavewidelyvaryinglevelsofevidence,effectivenessandsafety.Someofthesetreatmentsmaybeharmfulorcauseserioussideeffectsiftakenbythewrongperson. Alwaysconsultyourdoctorformedicaladviceorbeforechangingyourtreatmentplan. Thisguideisforeducationalpurposesonlyandisnotareplacementforyourdoctor.Onlyyourdoctorcangiveyoupersonalmedicaladvicethattakesintoaccountyourownhealthhistory,symptomsandpotentialsideeffects.

©Copyright2018AllRightsReserved.MigraineWorldSummit.Alwaysconsultyourdoctorformedicaladvice.

HOW TO USE THIS GUIDE

ISTHISREALISTIC?These12patientcasestudiesarereal. Everyyearapercentageofpeoplewithmigraineimproveorgointoremission. It’snotgenerallyduetosomesecrettreatmentthathasbeenhiddenfromus.It’softenfrompatientsgainingabetterunderstandingtheirownconditionandputtingafewimportantself-managementprinciplesintopractice. Thankyoutoourpatientswhovolunteeredtheirpersonalinformationtohelpbenefitotherpatients. AngelaMuller BruceAlexander DanielleJones ElizabethBiddle EllenDean HelenMcConnell LeeBaas MaureenBirganMegDunleyNickySmith NicoleSoho SharwainSmith

VITAMIN&SUPPLEMENTREVIEW Anonlinesurveywasconductedofself-selectingpatientswillingtofilloutadetailedonepageformabouttheircondition. Thepatientswereaskedaseriesofquestionsincluding: •  Gender •  Ageatonset •  Durationofcondition •  Triggers(tickbox) •  Frequency •  Averagefrequencybeforeimprovement •  Averagefrequencyafterimprovement •  Keyfactorsinresults •  Treatmentstried(tickbox) •  Treatmentsfoundmostbeneficial •  Adviceyou’dgivetoothers •  Firstandlastname •  Consentformtickbox The12casestudiessharedinthisguidewereexamplesofthosewhohaveimproved.Theyarelistedinasummaryforminalphabeticalorder.


METHODOLOGY

Screenshotfromtheonlineformavailableathttp://www.blog.migrainepal.com/casestudies/

ANGELA MULLER PATIENTDETAILS Gender:Female Onset:11yearsold Duration:29years


THEMOSTIMPORTANTFACTORINIMPROVEMENT •  Knowingmytriggersandcombinationoftriggersand

avoidingormanagingthem. •  Takingmedicationorremovingtriggerearly(eg.

movingawayimmediatelyifsomeonesitsnexttomewearingstrongperfume)ratherthanwaitingtoseeifitdevelopsintoamigraine.

•  Notfeelingbad,guiltyorapologizingforavoidingtriggers.

•  UsingtheMigrainePaldiarytotrackandconfirmtriggers

ADVICEYOU’DSHAREWITHOTHERS •  TrackyourmigrainesusingaprogramlikeMigrainePal

(othersincludeMigraineBuddyorCurelator)thatpromptsyoutorecordthingsyoumaynotthinkof.

•  Thenmanageallyourtriggers,astheywillbeuniquetoyouandtorightnow(whatworkedinthepastmightnotworknow)

•  Don’tfeelbadorguiltyaboutmanagingyourtriggers

MOSTBENEFITFROM •  Dietchangesviaaneliminationdietdoneunderthe

supervisionofadietician •  Combinationoffolicacid,B12andB6 •  Topamaxwhilegettingtriggersundercontrol

TREATMENTSTRIED Amitriptyline(eg.Elavil,Endep),Aspirin,Celecoxib(eg.Celebrex),HormoneReplacementTherapy/BirthControlpills,Ibuprofen(eg.Advil,Motrin,Nurofen),Meloxicam(eg.Mobic,Movalis),Paracetamol(eg.Panadol),Propranolol(eg.Inderal),Pseudoephedrine(eg.Sudafed),Sumatriptan(eg.Imigran,Imitrex,Treximet),Topiramate(eg.Topamax),TramadolHydrochloride(eg.Tramadol),Acupuncture,AdequateHydration,Avoidfluorescentlighting,Avoidsmoke,Avoid/reducesocialactivities,Caffeine,Cardioexercise,Dietarychanges,Drinkingwater,EliminatingCaffeine,EliminatingAlcohol,EliminatingChocolate,EliminatingDairy,EliminatingGluten,EliminatingMSG,EliminatingNitrates/Nitrites,EliminatingSoy,EliminatingSulfites,EliminatingTyramine,Exercise-general,Folate,FolicAcid,Gingersupplements,Heatpack,HotShower,Hotwheatpack,Improvingposture,Ironsupplements,Magnesium,MagnesiumCitrate,Multi-vitaminBCombos,Multi-vitaminWomen,Myofascialrelease,Neck/scalpmassage,Occlusalsplint(mouthguardtoprotectagainstclenching/grinding),Passageoftime,Physiotherapy(physicaltherapy),Pilates,Probiotics,Reduce/managestress,Regularexercise,Remedialmassage,Sleep,Strengthtrainingexercise,VitaminBcomplex,VitaminB12/Cobalamin,VitaminB2/Riboflavin,VitaminB6/Pyridoxine,VitaminD3(cholecalciferol),Wearingsunglasses,Zinc

COMMENTARY •  Despiteasignificantnumberoftriggers,Angelawas

previouslyabletomanagewithonlyepisodicmigraine5daysofthemonth.

•  ThislikelywasduetoherdailymigrainepreventativetreatmentTopamax(topiramate).

•  Interestinglywhenshecombinedthiswithdietchangesandsupplementationshewasabletogetahugereductioninherattacks.

•  Abigpartofherstrategywasusingadiarytokeeparecordandbetterunderstandhercondition.

•  Anotherimportantaspectwastreatingearlyandnotfeelingbadorguiltyaboutwhatsheneededtodotoeffectivelymanagehertriggers.

•  HercombinationofsupplementsiscommonlyusedtotreatmigrainewithaurapatientswhoalsohavehighlevelsofhomocysteineandaMTHFRmutation.

MIGRAINETRIGGERS •  Sleepdisruption,changingsleepingpatternorjetlag •  Stress,includinganyformofstressincludingstrong

emotions,anxietyandpressure •  Dehydration •  Visualagitationincludingbrightsunlight,staringatthe

computerscreenfortoolong,fluorescentlights,flashinglights

•  Neckdiscomfortincludingstiffnessorpaininyourneckorupperbackareaincludingshoulders

•  Menstruation,menopauseorotherhormonalfactors •  Odors,includingincense,perfume,chemicalsmells,

cigarettesmoke,vehicleexhaust,airpollution •  Weatherincludingheatorrapidchangeintemperature

orairpressure •  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia •  Diet,includinganytriggerfoodsnotalreadycovered

abovesuchasfoodadditivesincludingnitrites(processedmeats)andMSG(monosodiumglutamate),foodcoloring,chocolate,agedcheese,redwine,beer,caffeine,citrusfruits,curedmeatssuchasbacon,hotdogs,aspartameandicecream.

•  Anyseverepainormotionsickness

MIGRAINEFREQUENCYPreviousdayspermonth:5Currentdayspermonth:1

80% reduction

BRUCE ALEXANDER PATIENTDETAILS Gender:Male Onset:25yearsold Duration:40years


THEMOSTIMPORTANTFACTORINIMPROVEMENT TakingStemetil(prochlorperazine)asasuppositoryratherthanMaxaltforacuteattack.Thishasallowedmetogetoutofrebound.OverallmanagementofavoidingtriggerscanworkonceoutofMOH(MedicationOveruseHeadache).

ADVICEYOU’DSHAREWITHOTHERS NeedtofindwayoutofMOH.Formeneededtonotusetriptansforamonthandreplacewithstemetiltogetthroughacuteattack.Thisallowedpreventativestrategiesandmedicationtowork.Ihad6monthsofveryfewmigrainesalthoughhaverelapsedrecently,probablybecausehavegoneoffpreventativemedicationcompletely.

MOSTBENEFITFROM •  Stemetilassuppository •  Physiotherapyonneck •  Avoidanceoftriggers

TREATMENTSTRIED Amitriptyline(eg.Elavil,Endep),Aspirin,Pizotifen(eg.Sandomigran),Pregabalin(eg.Lyrica),Prochlorperazine(eg.Buccastem,Stemetil),Rizatriptan(eg.Maxalt),SodiumValproate(eg.Epilim),Sumatriptan(eg.Imigran,Imitrex,Treximet),Avoidfluorescentlighting,Avoidsustainednoise,Avoid/reducesocialactivities,CoolingGelSheet(eg.Kool'n'Soothe),Dark,quietroom,Dietarychanges,EliminatingCaffeine,EliminatingAlcohol,EliminatingChocolate,EliminatingDairy,EliminatingGluten,EliminatingMSG,EliminatingNitrates/Nitrites,EliminatingSoy,EliminatingSulfites,EliminatingTyramine,Hotwheatpack,KetogenicDiet,Reducescreenbrightness,Reduce/managestress,Tinted/colouredlenses,Wearingcolouredlenses,Wearingsunglasses

COMMENTARY •  Brucelistsasignificantnumberoftriggersand

previouslyhadchronicmigraine. •  HerealizedthathewasoverusingMaxaltwhichcaused

MOH.ByweaningoffthistreatmentthenfindinganothereffectiveoptioninStemetil,andbygettingphysiotherapyonhisneckandmanaginghistriggersbetterhewasabletoimprovesignificantly.

•  Heciteshisrecentrelapseduetocomingoffhispreventativemedicationperhapsalittletooearly.



computerscreenfortoolong,fluorescentlights,flashinglight


•  Odors,includingincense,perfume,chemicalsmells,cigarettesmoke,vehicleexhaust,airpollution

•  Weatherincludingheatorrapidchangeintemperatureorairpressure

•  Caffeine •  Alcohol •  Hungerincludingskippingmeals,lowbloodsugarlevels


abovesuchasfoodadditivesincludingnitrites(processedmeats)andMSG(monosodiumglutamate),foodcoloring,chocolate,agedcheese,redwine,beer,caffeine,citrusfruits,curedmeatssuchasbacon,hotdogs,aspartameandicecream

MIGRAINEFREQUENCYPreviousdayspermonth:15Currentdayspermonth:3-15

*Upto80%reduction.

80% reduction*

DANIELLE JONES PATIENTDETAILS Gender:Female Onset:4yearsold Duration:25years


THEMOSTIMPORTANTFACTORINIMPROVEMENT •  Eightmonthstintonamitriptylinetoresetsleepand

migrainecycle.•  Correcttreatmentwhenexperiencingmigraine

symptoms.

ADVICEYOU’DSHAREWITHOTHERS Seeaneurologistwhospecializesinmigraine.Ifyoufindyourmigrainesarerelatedtooraffectingyoursleep,alsoconsiderseeingasleepspecialist.Ihadgottoapointoffearingsleepbecauseofwakingwithamigraine,andwasconstantlyexhaustedwhenIsoughthelp.Isawasleepspecialistfirstandhadsleepdisorderseliminated,thenIsawamigrainespecializingneurologist.Hedidn'ttellmetheywerejustheadaches(otherdoctorssaidthatwithoutauraImustn'tbesufferingmigraine).Heinfacttoldmethatevenmy"headaches"weremigraines,andmypainthresholdhadjustgrowntobehigh.Hekeptitverysimpleandtoldmemyconditionwasgenetic,couldmostprobablyNOTbecontrolledthroughdietchanges(oriftheyworked,itwouldonlybeshortterm)andinsteadsaidmymigrainescanbebestcontrolledthroughtherightapplicationofpharmaceuticalmedicationsandthroughlifestylechoicesfocusedonreducingstress.IusedEndepfor8monthstohelpmesleepandvirtuallyeliminatethemigraines,IthenweanedofftheEndepandthemigrainesdidn'treturn.In1yearand4monthsIhavebecomemoreincontrolofmymigrainesandnowonlyexperience1-2permonth,usuallywithmyperiod.Andwhentheyoccurtheyarenownippedinthebudveryquicklybecausewefoundtherightsumatriptanbasedtreatmentformetouse.

MOSTBENEFITFROM •  Sumatriptan,specificallyImigranFDT(normalImigran

tooktoolongtowork).•  Endeptakenfor8monthstoresetmigraineandsleep

cycle •  Massage •  Heatpacks •  Advil(ibuprofen)ononset •  Waterbasedpillow •  Yoga

TREATMENTSTRIED Amitriptyline(eg.Elavil,Endep),Aspirin(eg.Excedrin,AspoClear),CodeinePhosphate(eg.Migraleve),Diazepam(eg.Valium),Ibuprofen(eg.Advil,Motrin,Nurofen),IbuprofenCodeine(eg.NurofenPlus),Paracetamol(eg.Panadol),Paracetamol,Codeine(eg.PanadeineForte),Rizatriptan(eg.Maxalt),Sumatriptan(eg.Imigran,Imitrex,Treximet),AdequateHydration,Avoid/reducesocialactivities,Caffeine,Chiropractictreatment,Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine(eg.Coffee,Tea,Sodas),EliminatingAlcohol,EliminatingChocolate,EliminatingGluten,EliminatingMSG,Exercise-general,Glucosamine,Heatcreams,gels,balms&rubs,Heatpack,Herbalteas,Herbs&Spices,HotShower,Hotwheatpack,Icetherapy/Icepacks,Improvingposture,Ironsupplements,Magnesium,MagnesiumCitrate,Meditation/Breathingexercises,Multi-vitaminWomen,Neck/scalpmassage,Osteopathy,PaleoDiet,Reduce/managestress,Regularexercise,Relaxationtechniques,Remedialmassage,Sleep,VitaminBcomplex,WhiteWillow,Yoga

COMMENTARY •  Danielleeventuallyfoundaheadachespecialisttowork

with. •  Togethertheyfoundaneffectivepreventativethatwas

usedtobringherundercontrolover8months. •  Thiswascombinedwithlifestyleandbehavioral

changesaroundsleep,diet,exerciseandstressmanagement.

•  Shealsofoundaneffectiveacutemigrainetreatmenttohandleanyacutemigraineattacksthatbrokethrough.

MIGRAINETRIGGERS •  Sleepdisruption,changingsleepingpatternorjetlag•  Stress,includinganyformofstressincludingstrong

emotions,anxietyandpressure•  Dehydration•  Neckdiscomfortincludingstiffnessorpaininyourneck

orupperbackareaincludingshoulder•  Menstruation,menopauseorotherhormonalfactors•  Odors,includingincense,perfume,chemicalsmells,

cigarettesmoke,vehicleexhaust,airpollution •  Alcohol•  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia

MIGRAINEFREQUENCYPreviousdayspermonth:5 Currentdayspermonth:2

60% reduction

ELIZABETH BIDDLE PATIENTDETAILS Gender:Female Onset:18yearsold Duration:17years


THEMOSTIMPORTANTFACTORINIMPROVEMENT DHEtreatment

ADVICEYOU’DSHAREWITHOTHERS Knowyourtriggersandalwayshaveamigrainereliefkitwithyou.

MOSTBENEFITFROM •  Physicaltherapy •  Sumatriptan •  DHEinfusions

TREATMENTSTRIED Acetaminophen,butalbital,caffeine(eg.Fioricet),Acetaminophen,Codeine,Almotriptan(eg.Axert,Almogran),Amidrine,Amitriptyline(eg.Elavil,Endep),Aspirin,Caffeine,Orphenadrine(eg.Norgesic),Atenolol(eg.Tenormin),Celecoxib(eg.Celebrex),Cetirizine(eg.Zyrtec),Cyclobenzaprine,DihydroergotamineMesylate(eg.Dihydergot,DHE45,Divalproexsodium(eg.Depakote),Duloxetine(eg.Cymbalta),Eletriptan(eg.Replax),Gabapentin(eg.Neurotonin),GreaterOccipitalNerveBlock(Steriod/LidocaineI,Hydrocodone,Ibuprofen(eg.Advil,Motrin,Nurofen),Ketorolac(eg.Toradol),Loratadine(eg.Alavert,Claritin),Methocarbamol,Acetaminophen(eg.Robaxacet),Metoprolol(eg.Dutoprol,Betaloc,Lopressor),Mometasonenasal(eg.Nasonex),Morphine,Naproxen(eg.Anaprox,Naprosyn,Synflex),OnabotulinumtoxinA(eg.BOTOX),Ondansetron(eg.Zofran),Prednisone(eg.Rayos,Sterapred),Promethazine(eg.Pentazine,Phenergan),Propranolol(eg.Inderal),Sumatriptan(eg.Imigran,Imitrex,Treximet),Topiramate(eg.Topamax),TramadolHydrochloride(eg.Tramadol),Zolmitriptan(eg.Zomig),Zonisamide(e.g.Zonegran),Acupuncture,Avoidfluorescentlighting,Avoidsmoke,Avoidsustainednoise(eg.noisypubs),Avoid/reducesocialactivities,Cardioexercise,Cervicaltraction,Chiropractictreatment,Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine,EliminatingMSG,EliminatingNitrates/Nitrites,EliminatingSoy,EliminatingSulfites,EliminatingTyramine,Exercise-general,Feverfew,FolicAcid,Herbalteas,HotShower,Icetherapy/Icepacks,Improvingposture,Lavenderoil,Magnesium,MagnesiumCitrate,Multi-vitaminWomen,Neck/scalpmassage,PeppermintOil,Physiotherapy(physicaltherapy),Reducescreenbrightness,Reduce/managestress,Regularexercise,Relaxationtechniques,Rub/pressureTemples,Sleep,Strengthtrainingexercise,Tinted/colouredlenses,Wearingsunglasses,Yoga

COMMENTARY •  Outofallourcasestudiesnoneappeartohavetriedas

manytreatmentsorstrategiesasElizabeth. •  Fromtheextensivelistoftreatments,shefound

personallythatshehasthebestresultsfromphysicaltherapytoaddressherneck;SumatriptanorDHEinfusionstotreatheracuteattack.

•  Withthesesimpleprinciplesshehashalvedherfrequency.

•  Migrainepreventionissomethingthatshehastriedbutstillappearstobeworkingon.

MIGRAINETRIGGERS •  Sleepdisruption,changingsleepingpatternorjetlag

Stress,includinganyformofstressincludingstrongemotions,anxietyandpressure

•  Visualagitationincludingbrightsunlight,staringatthecomputerscreenfortoolong,fluorescentlights,flashinglights


•  Odors,includingincense,perfume,chemicalsmells,cigarettesmoke,vehicleexhaust,airpollution

•  Weatherincludingheatorrapidchangeintemperatureorairpressure

•  Hungerincludingskippingmeals,lowbloodsugarlevelsorhypoglycemia

•  Diet,includinganytriggerfoodsnotalreadycoveredabovesuchasfoodadditivesincludingnitrites(processedmeats)andMSG(monosodiumglutamate),foodcoloring,chocolate,agedcheese,redwine,beer,caffeine,citrusfruits,curedmeatssuchasbacon,hotdogs,aspartameandicecream


50% reduction

ELLEN DEAN PATIENTDETAILS Gender:Female Onset:16yearsold Duration:44years


THEMOSTIMPORTANTFACTORINIMPROVEMENT Exerciseandchangingdiet.

ADVICEYOU’DSHAREWITHOTHERS •  UseWiiBalanceExercise •  Changediettoincludevitaminsi.e.magnesium,B

vitaminsandzinc.

MOSTBENEFITFROM •  Exercise•  Foodscontainingmagnesium •  Lesscaffeine

TREATMENTSTRIED Propranolol(eg.Inderal),Avoidsustainednoise(eg.noisypubs),Avoid/reducesocialactivities,EveningPrimroseoil,Exercise-general,Herbalteas(eg.Dandeliontea),Lavenderoil,Magnesium,Neck/scalpmassage,Omega3,Physiotherapy(physicaltherapy),Reducescreenbrightness,Reduce/managestress,Regularexercise,Relaxationtechniques,Rub/pressureTemples,StJohnsWort,Tinted/colouredlenses(e.g.AxonOptics,Irlen),Visualeyetherapy,exercisesortraining.,Wearingsunglasses,Zinc

COMMENTARY •  Ellenhasgonefromchronicmigraineaccompaniedby

debilitatingheadpaintonoheadpaineachmonthwithVestibularmigrainesymptoms.Theseincludefeaturessuchasvertigoanddizziness.

•  Shehasreducedhercaffeineintakewhilstincreasingherintakeofvitaminrichfoodswhichincludemagnesium,Bvitaminsandzinc.

•  Thiscombinedwithregularexercisehassignificantlyreducedtheburdenofmigraineinhercase.

MIGRAINETRIGGERS •  Stress,includinganyformofstressincludingstrong



•  Neckdiscomfortincludingstiffnessorpaininyourneckorupperbackareaincludingshoulders,

•  Menstruation,menopauseorotherhormonalfactors •  Odors •  Weatherincludingheatorrapidchangeintemperature

orairpressure •  Caffeine •  Hungerincludingskippingmeals,lowbloodsugarlevels



MIGRAINEFREQUENCYPreviousdayspermonth:31Currentdayspermonth:*Noheadache,justvestibular symptoms.

n/a reduction*

HELEN McCONNELL PATIENTDETAILS Gender:Female Onset:21yearsold Duration:28years


THEMOSTIMPORTANTFACTORINIMPROVEMENT •  Learningabouthypoglycemia •  Eatingbetterandatmoretimelyintervals

ADVICEYOU’DSHAREWITHOTHERS Checkforlowbloodsugar,howevertheglucosetolerancetestfor5-6hoursisnotdonereadilyasitisthoughtunnecessary&theresultsneedtobereadcorrectlybyanexpertinthatfield.Pleaseread"VictoryoverMigraine"byProfessorRodolfoLow.

MOSTBENEFITFROM •  KetogenicDiet •  DrinkingWater •  TakingChromium •  BComplex •  Niacin •  Remedialmassage •  Regularexercise

TREATMENTSTRIED Doxylamine,Paracetamol,Codeine(eg.Mersyndol),Ergotaminetatrate(eg.Cafergot,Migril),Paracetamol(eg.Panadol),Paracetamol,Codeine(eg.PanadeineForte),Prochlorperazine(eg.Buccastem,Stemetil),Sumatriptan(eg.Imigran,Imitrex,Treximet),Avoid/reducesocialactivities,Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine(eg.Coffee,Tea,Sodas),EliminatingAlcohol,EliminatingDairy,Exercise,Feverfew,Herbalteas,Icetherapy/Icepacks,KetogenicDiet,Magnesium,Naturopathy,Niacin,Omega3,PaleoDiet,Probiotics,Reduce/managestress,Remedialmassage,Sleepingmask,Vaporinhalerstick(eg.Vicks),VitaminBcomplex,VitaminD3(cholecalciferol),Wearingsunglasses,Chromium

COMMENTARY •  Helenhashadmigraineforalmost30yearsandwas

previouslyepisodicwith6dayswithmigrainepermonth.Todaysheisdowntozerowhichisafantasticresult.

•  Sheattributesthissuccesslargelytohermanagementoffood.Notonlythroughherdietbutalsothetimingandintervalsofherfoodtoensureherbloodsugarlevelsremainrelativelylevel.

•  OtherfactorsimportanttoherimprovementweresupplementationwithBComplex,NiacinandChromiumaswellasexercise,hydrationandremedialmassage.




•  Caffeine •  Alcohol,whitewine•  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia


100% reduction

LEE BAAS PATIENTDETAILS Gender:Female Onset:13yearsold Duration:26years


THEMOSTIMPORTANTFACTORINIMPROVEMENT Iusealargewheatsackcoveringshoulders,neckandhead,sittinguprightandreappliedwhencool,untilnotneeded,itstopsthemigraineinitstracks.Italsoseemstoreduceincidentsofmigraines...itrelaxesthemuscles,Icantrackthetensionfrommyshoulders,uptherightsideofmyneckandintomyhead,besidemyear,thenrightacrossthetopofmyhead.Therearepathsyoucanfeeloftensionandterriblepain.Pressthesepathsanywhereandthepainiscruel.

ADVICEYOU’DSHAREWITHOTHERS Learntoknowtheveryearlysignsofyourmigraine,thenrespondimmediatelytowhatworksforyou,trythewheatsackmethod,I'vegonefromdaysofpresymptoms,threedaysofpain,thendaysofaftersymptomswithmajoreyedisturbancessonotbeingabletodoanything,holdingontowallsasIcan'tseeproperlyduetothepressure,to'nothing'.Ican'tusepainkillersduetoallergiesexceptParacetamol(orAcetaminophen),soI'vetriedalotofthings,thisworksforme,totally....

MOSTBENEFITFROM Hotwheatpacksreappliedastheycoolacrossshoulders,neckandbaseofskull,mustbeonbaseofskullasthisstopsthepainfromradiating.ThisSTOPSthembeforetheygetbad,nomigrainehangoversthenextdayeither...

TREATMENTSTRIED •  Paracetamol(eg.Panadol) •  Avoidsmoke •  FolicAcid •  Heatpack•  Hotwheatpack •  Magnesium •  Neck/scalpmassage •  Regularexercise •  Vaporinhalerstick(eg.Vicks) •  VitaminB12/Cobalamin•  Icannotusepainkillersduetoallergies

COMMENTARY •  Leereferstotriggerpointswhenshedescribeshowshe

useshotwheatpacksonherneckduringamigraineattack.Itissoeffectiveshefindsitstopstheattackinitstracksduetothemusclerelaxing.

•  Leealsoadvisesotherstoknowtheveryfirstsignsoftheirattacktoimmediatelyintervene.

•  Thisforherhasdramaticallyimprovedhercondition.


emotions,anxietyandpressure •  Neckdiscomfortincludingstiffnessorpaininyourneck

orupperbackareaincludingshoulders.

MIGRAINEFREQUENCYPreviousdayspermonth:5-10Currentdayspermonth:0

100% reduction

MAUREEN BIRGAN PATIENTDETAILS Gender:Female Onset:16yearsold Duration:48years


THEMOSTIMPORTANTFACTORINIMPROVEMENT Nifedipinedrug(B.P.calciumblocker)60miligramsdaily

ADVICEYOU’DSHAREWITHOTHERS Tryeverythingyouhearabout.

MOSTBENEFITFROM •  Sumatriptancuredtheheadache.•  WithnifedipineIdon'tgetthem.

TREATMENTSTRIED Acetaminophen,Codeine(eg.Tylenol3or4),Amitriptyline(eg.Elavil,Endep),Budesonidenasal(eg.RhinocortAqua),Clonidine(eg.Catapres,Dixarit),DihydroergotamineMesylate(eg.Dihydergot,DHE45,Doxylamine,Paracetamol,Codeine(eg.Mersyndol),Ergotaminetatrate(eg.Cafergot,Migril),HormoneReplacementTherapy/BirthControlpills,Methysergide(eg.Deseril),Metoclopramide(eg.Maxolon,Paramax,Pramin),Morphine,Oxycodonehydrochloride(eg.Endone),Paracetamol,Codeine(eg.PanadeineForte),Pizotifen(eg.Sandomigran),Prochlorperazine(eg.Buccastem,Stemetil),Propranolol(eg.Inderal),Sumatriptan(eg.Imigran,Imitrex,Treximet),Topiramate(eg.Topamax),TramadolHydrochloride(eg.Tramadol),Zolmitriptan(eg.Zomig),Acupunture,AlexanderTechnique,Avoidsmoke,Avoidsustainednoise(eg.noisypubs),Chiropractictreatment,Dark,quietroom,EliminatingAlcohol,EliminatingChocolate,EliminatingDairy,EliminatingGluten,EliminatingMSG,EliminatingNitrates/Nitrites,EveningPrimroseoil,Exercise-general,Feverfew,Heatcreams,gels,balms&rubs,HotShower,Icetherapy/Icepacks,Naturopathy,Neck/scalpmassage,Physiotherapy(physicaltherapy),Pilates,Probiotics,Quitcigarettesmoking,Relaxationtechniques,Rub/pressureTemples,Sleep,StJohnsWort,VitaminBcomplex,VitaminB12/Cobalamin,Wearingsunglasses

COMMENTARY •  Maureenfoundgreatsuccessfulwithasingle

treatmentdesignedtopreventmigraine. •  ShealsorespondedverywelltoSumatriptan,apopular

andeffectivetreatmentforacutemigraineattacks. •  Youcanalsoseethatithastakensometimeandmany

differenttreatmentstofindthissolution. •  Unlikeothercasestudiesshehasnotmentioneda

significantnumberoftriggersnorhasshementionedotherlifestyleorbehavioralchangesasanimportantfactorinherresult.

MIGRAINETRIGGERS •  Sleepdisruption,changingsleepingpatternorjetlag •  Alcohol,Hungerincludingskippingmeals,lowblood

sugarlevelsorhypoglycemia •  Cinema

MIGRAINEFREQUENCYPreviousdayspermonth:5+Currentdayspermonth:0

100% reduction

MEG DUNLEY PATIENTDETAILS Gender:Female Onset:13yearsold Duration:32years


THEMOSTIMPORTANTFACTORINIMPROVEMENT ChangeofmedicationplusBotoxtreatments,andavoidingtriggerswherepossible,avoidingovermedicating

ADVICEYOU’DSHAREWITHOTHERS •  Don'tusecodeine. •  AvoidPanadol. •  TakedrugsASAPattheonsetofmigraineandtakea

breakforatleast1/2hour.•  Don'tfightthemigraine-remindyourselfthatitwillgo. •  Avoidallnitratesandsulphates.•  Seekhelpfromaneurologist-butalwaysbeproactive

inyourowncare.Nobodycaresaboutyourpainreliefasmuchasyoudoanditwillprobablybeamixofdrugandalternatetherapythatworks.

MOSTBENEFITFROM Candesartan+Botoxforpreventions,ImigranandNurofenorVoltarenforrelief,Vaporinhaler(VICKS),shower,icepackonneck,washdishesinhotwater,gentlewalk,relaxationtherapy,coffee.

TREATMENTSTRIED Acetaminophen,Codeine(eg.Tylenol3or4),Aspirin,Codeinephosphate,Budesonidenasal,Candesartan(eg.Atacand),Cetirizine,Diazepam(eg.Valium),Diclofenac(e.g.Cambia,Voltaren),Doxylamine,Paracetamol,Codeine(eg.Mersyndol),HormoneReplacementTherapy/BirthControlpills,Ibuprofen,IbuprofenCodeine,Metoclopramide,Mometasonenasal(eg.Nasonex),Naproxen(eg.Anaprox,Naprosyn,Synflex),OnabotulinumtoxinA(eg.BOTOX),Paracetamol(eg.Panadol),Paracetamol,Codeine(eg.PanadeineForte),Pizotifen(eg.Sandomigran),Propranolol(eg.Inderal),Pseudoephedrine,SodiumBicarbonate,APAP,Aspirin,Anhydrouscitri,Sumatriptan,Topiramate(eg.Topamax),Zolmitriptan(eg.Zomig),Acupuncture,Aromatherapy,Avoidfluorescentlighting,Avoidsmoke,Avoidsustainednoise(eg.noisypubs),Avoid/reducesocialactivities,Caffeine,Chineseherbs,CoenzymeQ10/CoQ10,Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine,EliminatingAlcohol,EliminatingChocolate,EliminatingDairy,EliminatingMSG,EliminatingNitrates/Nitrites,EliminatingSoy,EliminatingSulfites,EliminatingTyramine,EveningPrimroseoil,Exercise-general,Feverfew,Folate,FolicAcid,Glucosamine,Heatcreams,gels,balms&rubs,Heatpack,Herbalteas,HotShower,Hotwheatpack,Icetherapy/Icepacks,Improvingposture,Lavenderoil,Magnesium,MagnesiumCitrate,Meditation/Breathingexercises,Multi-vitaminBCombos,Naturopathy,Neck/scalpmassage,Occlusalsplint,Osteopathy,Passageoftime,PeppermintOil,Pilates,Quitcigarettesmoking,Reducescreenbrightness,Reduce/managestress,Regularexercise,Relaxationtechniques,Remedialmassage,Sleep,StJohnsWort,TheFastDiet(5:2Diet,IntermittentFasting),Vaporinhalerstick,VitaminBcomplex,VitaminB12/Cobalamin,VitaminB2/Riboflavin,VitaminB6/Pyridoxine,VitaminD3(cholecalciferol),Wearingsunglasses,Yoga,Zinc

COMMENTARY •  Meghas,after30yearsofmigrainemanagedavery

impressivereductionfrom27daysto10dayspermonthwithmigraine.Thishasmovedherfromchronictoepisodicmigraine.Afantasticachievement.

•  Megadvisestoseekhelpfromaneurologistorheadachespecialistbutnottoneglectyourownroleinyourcare.

•  Shealsorevealsthatforherithasbeenacombinationofmedicinalandnaturalstrategiesandpreventativesthathavehelpedherachieveherreductioninmigrainefrequency.


emotions,anxietyandpressure •  Dehydration •  Visualagitationincludingbrightsunlight,fluorescent

lights,flashinglights •  Neckdiscomfortincludingstiffnessorpain•  Menstruation,menopauseorotherhormonalfactors •  Odors •  Weatherincludingheatorrapidchangeintemperature

orairpressure •  Caffeine •  Alcohol •  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia •  Diet,includinganytriggerfoods


63% reduction

NICKY SMITH PATIENTDETAILS Gender:Female Onset:32yearsold Duration:20years


THEMOSTIMPORTANTFACTORINIMPROVEMENT Botox

ADVICEYOU’DSHAREWITHOTHERS Oftennotonetreatmentistheanswer.Youneedtobewillingtotryarangeoftreatmentswhichwillgiveyouthemostrelief.Findingtheseandstickingtothesecanbeverydifficultandrequiresignificantlifestylechanges.Iamstillonthatjourney.

MOSTBENEFITFROM •  Relpax •  Botox •  Eliminatingalcoholandcaffeine •  Meditationandstressreduction

TREATMENTSTRIED Acetaminophen,Codeine(eg.Tylenol3or4),Amitriptyline(eg.Elavil,Endep),Aspirin,Doxylamine,Paracetamol,Codeine(eg.Mersyndol),Eletriptan(eg.Replax),HormoneReplacementTherapy/BirthControlpills,Ibuprofen(eg.Advil,Motrin,Nurofen),Indomethacin(eg.Indocin,Indocid),Mefenamicacid(eg.Ponstan),Metoclopramide(eg.Maxolon,Paramax,Pramin),OnabotulinumtoxinA(eg.BOTOX),Ondansetron(eg.Zofran),Oxycodonehydrochloride(eg.Endone),Paracetamol(eg.Panadol),Paracetamol,Codeine(eg.PanadeineForte),Propranolol(eg.Inderal),Rizatriptan(eg.Maxalt),Sumatriptan(eg.Imigran,Imitrex,Treximet),Topiramate(eg.Topamax),TramadolHydrochloride(eg.Tramadol),Zolmitriptan(eg.Zomig),Acupuncture,AdequateHydration,Avoidsustainednoise,Avoid/reducesocialactivities,Bowentherapy,Chineseherbs,CoolingGelSheet(eg.Kool'n'Soothe),Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine,EliminatingAlcohol,EliminatingChocolate,EliminatingNitrates/Nitrites,Exercise,Heatpack,Icetherapy/Icepacks,Improvingposture,Magnesium,MagnesiumCitrate,Meditation/Breathingexercises,MigraineSupportFormula,Multi-vitaminBCombos,Neck/scalpmassage,Physiotherapy(physicaltherapy),Reduce/managestress,Regularexercise,Relaxationtechniques,Remedialmassage,Sleep,Sleepingmask,VitaminBcomplex,Wearingsunglasses,Yoga,Zinc

COMMENTARY •  Nickyhasusedacombinationofmedicaland

complementarystrategiestoimprovehermigrainecondition.

•  ThisincludesBotoxtopreventmigraineandReplax(eletriptan)totreattheacutemigraineattack.

•  Throughmeditation,stressreductionandeliminatingalcoholandcaffeineshehasreducedherfrequencybyalmost40%.

•  Shemaynotberequiredtogiveupcaffeineandalcoholforever,butitiscertainlyworthconsideringtodotemporarilyforchronicmigraine.



computerscreenfortoolong,fluorescentlightsflashinglights


•  Menstruation,menopauseorotherhormonalfactors •  Weatherincludingheatorrapidchangeintemperature

orairpressure •  Caffeine •  Alcohol •  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia •  Diet,includinganytriggerfoods •  Wearinghats •  Flying


39% reduction

NICOLE SOHO PATIENTDETAILS Gender:Female Onset:27yearsold Duration:3years


THEMOSTIMPORTANTFACTORINIMPROVEMENT I'mstillgettingthemasoften,theyjustdon'tlastaslongasbefore(2-3hoursinsteadof2-3days).Ihavebeenmanagingmysleepbytryingtogettobedaroundthesametimeandwakeuparoundthesametime.ImakesureIeatevery4hoursandalwaystrytostayhydrated.

ADVICEYOU’DSHAREWITHOTHERS Keepamigrainejournalinwhicheverformyoulikeandtrackthebasics:sleeptimes,exerciseintensity,meals,menstrualcycle,lengthandintensityofmigraine,possiblestressors,treatment(drugsorover-the-counter),doctorsyou'reseeing. Removeyourselffromwhateveryouthinkisgivingyoumigraineandseeifyoufeelbetter.

MOSTBENEFITFROM •  Takingadailynap •  Caffeine •  Sleepinadarkroomuntilitbecomesmanageableand

avoidpeopleandnoisyplaces

TREATMENTSTRIED Aspirin,Duloxetine(eg.Cymbalta),Sertraline(eg.Zoloft),Sumatriptan(eg.Imigran,Imitrex,Treximet),Topiramate(eg.Topamax),Venlafaxine(eg.Effexor),Acupuncture,AdequateHydration,Avoidfluorescentlighting,Avoidsustainednoise,Avoid/reducesocialactivities,Caffeine,Chiropractictreatment,Dark,quietroom,Dietarychanges,EliminatingChocolate,EliminatingDairy,Homeopathies,Icetherapy/Icepacks,Meditation/Breathingexercises,PaleoDiet,Passageoftime,PeppermintOil,Reducescreenbrightness,Reduce/managestress,Reflexology,Regularexercise,Relaxationtechniques,Sleep,Wearingsunglasses

COMMENTARY •  Nicolehasnotreducedthenumberofdayswith

migraineeachmonthbutshehassignificantlyimprovedhermanagementofacuteattacksfrom2-3daysto2-3hoursperattack.

•  Sleepisacommonfactorthatappearsinthosewithmigraine.Sleepisanessentialfunctionthatourbrainneedstorejuvenateandfunctionnormally.Thismaybeespeciallyimportantinmigrainepatientswherethebrain‘malfunctions’duringamigraineattack.

•  Movingtoadarkquietroomandsleepareknowntobehelpfulandnaturalwaystorecovermorequicklyfromanattackformanywithmigraine.

•  Theuseofcaffeineshouldbenotedwithcaution.Takentoooftenandirregularlycanleadtoreboundheadacheormigraine.





•  Menstruation,menopauseorotherhormonalfactors •  Hungerincludingskippingmeals,lowbloodsugarlevels

orhypoglycemia

MIGRAINEFREQUENCYPreviousdayspermonth:13Currentdayspermonth:13 *Nicolehasreducedtheseverityofherattacksfrom2-3daysto2-3hours.

0% reduction*

SHARWAIN SMITH PATIENTDETAILS Gender:Female Onset:15yearsold Duration:35years


THEMOSTIMPORTANTFACTORINIMPROVEMENT •  StressReduction •  Magnesium •  Hydration

ADVICEYOU’DSHAREWITHOTHERS •  Findagoodheadachedoctor •  Keeptryingthings

MOSTBENEFITFROM •  IcePack •  Magnesium •  Rest •  Meditation

TREATMENTSTRIED Acupuncture,AdequateHydration,Avoidfluorescentlighting,Avoidsmoke,Avoid/reducesocialactivities,Caffeine,CoenzymeQ10/CoQ10,Dark,quietroom,Dietarychanges,Drinkingwater,EliminatingCaffeine,EliminatingAlcohol,EliminatingMSG,EliminatingNitrates/Nitrites,EliminatingSoy,EliminatingSulfites,Feverfew,Icetherapy/Icepacks,Magnesium,Meditation/Breathingexercises,Multi-vitaminBCombos,Neck/scalpmassage,Passageoftime,Reduce/managestress,Rub/pressureTemples,Sleep,Sleepingmask,Tinted/colouredlenses,Wearingsunglasses

COMMENTARY •  Sharwainsharessomeconcisebutfundamentaladvice

thatisimportantformostusfindagoodheadachedoctor(orspecialist)andkeeptryingthings.Itisimportanttoremembertherearemanyoptionsandmanyalternativesavailableformigraine.Differentpeoplerespondtodifferentthings.It’simportantwedonotgiveup.

•  InterestinglySharwainhasfoundthemostimportantbenefitfromnaturalalternativeslikeIcetherapy,magnesium,rest,hydrationandmeditation.Allsimple,cheapandhelpfulstrategiesformigraineprevention.




•  Neckdiscomfortincludingstiffnessorpaininyourneckorupperbackareaincludingshoulders.,

•  Menstruation,menopauseorotherhormonalfactors.,•  Odors,includingincense,perfume,chemicalsmells,

cigarettesmoke,vehicleexhaust,airpollution,Weatherincludingheatorrapidchangeintemperatureorairpressure

•  Caffeine •  Alcohol •  Hungerincludingskippingmeals,lowbloodsugarlevels




25% reduction

12 PATIENT CASE STUDIESFile… · • Track your migraines using a program like MigrainePal (others...

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Transcript of 12 PATIENT CASE STUDIESFile… · • Track your migraines using a program like MigrainePal (others...