Ten years ago my daughter began suffering from chronic headaches. That means for the past 10 years, 24 hours a day, 7 days a week, she has had a headache. This constant state of gnawing pain is only occasionally interrupted by something even worse, a debilitating migraine. When the migraines come, it’s hard for her to function at all. Instead she is relegated to lying down in a silent, dark room until the pain, nausea and heightened sensitivity subsides.
We’ve tried everything including pharmaceuticals, massage therapy, yoga, meditation, Eastern herbal remedies, glasses, TMJ mouth pieces, acupuncture, and even Indian tongue reading. Although her current medications brought the chronic pain down from a 7 to a 3, they don’t come without side effects.
Years ago one of our neurologists suggested a book called “Heal Your Headache: The 1-2-3 Program for Taking Control of Your Pain” by David Buchholz, M.D. He’d said one of his patients had a similar experience to my daughter’s, where nothing but powerful meds helped, and she hated what they were doing to her. She followed the program and within 8 weeks was experiencing whole days without any pain at all. She was able to wean herself off the meds and although she still gets the occasional headache, she now knows a) what triggered it and b) how to control it. Back then, I read the book and created a one page summary of what it proposes. The problem is, the program requires incredible discipline for anyone to follow it, but particularly for a teenager. My daughter rejected it.
Fast forward to a few weeks ago, when during a business meeting with a local investor, I noticed that she asked the waiter whether a certain dish had aged cheese in it. I’d never heard anyone ask that question, but aged cheeses are a known trigger for migraines according to the Buchholz book. I asked her if she suffered from headaches and for most of the remainder of the meal we spoke about her chronic headaches, how she conquered them, my daughter’s experience, etc. Turns out, she is the woman who had followed the Buchholz program, cured herself and brought the book to our neurologist’s attention.
I ran home to tell my wife and called my daughter at college. She was of course lying in bed in the middle of the day, fighting through yet another powerful migraine. The news was encouraging and she decided then and there that she was ready to do whatever it took to overcome this. She wanted to take medical leave from college and focus solely on taking control of her life, to get rid of the medications and rediscover the woman hidden beneath them. I flew out immediately to pack her up and bring her home.
My new friend, “the investor”, agreed to meet us for lunch to explain what we should expect from the program and how it changed her life. We left that meeting inspired.
My part in the plan is to learn all I can about the program, the science behind it, set expectations, work with the neurologist to make for a smooth transition and most of all, coach her through this.
WHAT IS THE PROGRAM
Step 1: Avoid Quick Fixes That Cause Rebound. This means she has to stop taking all the medications migraine sufferers turn to at the moment of peak pain. She cannot take decongestants, caffeine, excedrin, fiorinal or tylenol with codeine.
Step 2: Reduce Triggers
Dietary Triggers include caffeine, chocolate, MSG, nuts, vinegar, citrus fruits, dried/preserved fruits, ripened fruits, onions, fresh bread, aspartame, miso and alcohol although white wine and vodka are tolerated in small quantities.
Non-Dietary Triggers include perfumes, smoke, bright lights, dehydration, stress, sleep deprivation and hormonal birth control.
Step 3: Raise Threshold with Preventive Medications (if necessary)
The idea is that headaches are a function of 2 things; the accumulation of triggers relative to the threshold of a particular person. The triggers listed above are triggers for everyone, but for chronic headache and migraine sufferers, the threshold is much lower than for most of us.
Today is Day 1 of the program.
Below is the full list of “Things to Avoid”
CAFFEINECoffee, tea, iced tea and cola. Even decaf coffee and tea which contain other chemical triggers. Try caffeine free herb tea without citrus and other trigger flavors.CHOCOLATEWhite chocolate (no cocoa) is okMONOSODIUM GLUTAMATE (MSG)Chinese & other restaurant food;soups and boullions;Accent & seasoned salt,flavored, salty snacks;croutons and bread crumbs;ready-to-eat meals;cheap buffets;veggie burgers;protein concentrates;low fat, low calorie foods.Look for these words and those that sound like them…Hydrolyzed protein(including vegetable/soy/plant/rice protein)Yeast extract and autolyzed yeastNatural flavors/flavoringsBroth, stock or bouillonSoy protein concentrate/isolateTextured proteinWhey proteinProtein-fortified itemsMalt extractMalted barleyMaltodextrinCarrageenanKombu (seaweed extract)Sodium or calium caseinateGlutamic acidGelatinFermented or cultured itemsUltra-pasteurized itemsEnzyme-modified itemsBe suspicious of “natural flavors (or flavorings)”CHEESE AND OTHER DAIRY PRODUCTSThe more aged, the worse.Beware cheese-containing foods including pizza.Yogurt (including frozen), sour cream and buttermilk are also triggers.Cheeses that are ok: ricotta, cream cheese, and good quality American cheese.NUTSAvoid all kinds, as well as nut butters. Peanuts and peanut butter. Seeds are okay.ALCOHOL and VINEGAREspecially red wine, champagne and dark or heavy drinks. Vodka is best tolerated in limited quantities. Too much alcohol at once leads to accumulation of acetaldehydes, a trigger.Clear, ideally distilled, vinegar is allowable.Don’t overdo condiments made with vinegar incl ketchup, mustard and mayonnaise.CERTAIN FRUITS AND JUICESCitrus fruits incl oranges, grapefruits, lemons, limes, tangerines, clementines and pineapples & their juices. Bananas, raspberries, red plums, papayas, passion fruit, figs, dates and avocados.Raisins and other dried fruits if preserved with sulfites.Fruits in general accumulate tyramine as they ripen, choose young, fresh fruits whenever possible.CERTAIN VEGETABLES, ESPECIALLY ONIONSPlus sauerkraut, pea pods, and certain beans (broad Italian, lima, fava, navy and lentils).Allowed: leeks, scallions, shallots, spring onions and garlic.FRESH YEAST RISEN BAKED GOODSLess than one day old; homemade (or restaurant-baked) breads, especially sour dough, as well as bagels, donuts, pizza dough, soft pretzels and coffee cake.ASPARTAME (NUTRASWEET)Saccharin (Sweet n Low)OTHERSCultured Soy (Miso)Fermented Soy (Tempeh)Soy Sauce containing MSGHormonal birth controlRegularity is key: you should sleep, eat and exercise on a regular basis. Get enough sleep each night, seven to eight hours or more, and don’t oversleep sporadically, as on weekends. Skipping meals is a common trigger for migraine. Stay on schedule for three meals a day, no more than six to eight hours apart. Snack in between if you wish—but only on nonrestricted items!Exercise also enhances endorphin production in the brain and is a natural way to help raise your migraine threshold, which otherwise requires preventive medication. Aim for a half-hour or more of aerobic exercise three to four times a week.