My (Awesome) Visit with the TMJ Specialist

My neurologist recommended me to a TMJ specialist because I clench my jaw and grind my teeth at night. The specialist was at an oral surgery clinic that is part of a larger hospital; it wasn't at the actual hospital but it was on the campus. Check out the spectacular building!

 

I was just as impressed with the doctor as I was the building - ok, more. I started with x-rays and after just a few minutes, the doctor brought them in and she clearly explained what everything was and said that everything looked normal. Then she did a physical exam and that's when she noticed the wear on my teeth, popping, and tenderness. She said that my TMJ isn't acute but it still could be causing some - probably not all, but some - of my headaches.

Here's our battle plan:

• Take Aleve twice a day (morning & night)
• Do a moist heat massage on the jaw and temporal areas once a day
• Diet modification (GREEEAAAAAT....)
• No gum, chewy candy
• No bagels, pizza crust, tough meats (cut meats into small pieces)
• Reduce sweets
• No big bites: cut apples, sandwiches, carrots, etc. into pieces
• Mouth guard

I've done all but the last one. I'm waiting on my insurance to approve the mouth guard, and if/once approved, I'll wear it 24/7. After 60 days I can stop the Aleve, then after a while I'll be able to stop the other steps and will eventually decrease the amount of time I wear the mouth guard until I'm wearing it nights only.

I love that I don't have any new drugs to take (I was afraid I'd have to try a muscle relaxer which I tried for grinding/clenching in the past), and I'm also happy that while the doctor didn't promise complete relief from my headaches, she thinks the frequency will reduce. And she has seen plenty of headache patients, so she knows what she's talking about. I mean, just look at that gorgeous building she works in! :)

Double Book Review: elimination diet

As a Valentine's present to my readers (sorry, not very romantic) I'm doing a double book review, with lots of pictures!

First, a much-talked-about book in the headache world, "Heal Your Headaches: The 1-2-3 Program for Taking Charge of Your Pain" by David Buchholz, M.D. This book outlines a three-part plan: (1) Avoid rebound-causing medications, (2) Reduce your triggers, particularly foods that commonly trigger migraines, and (3) Try preventive medication if the first two steps aren't working.

This is the book I've been using to guide my elimination diet. It says to try the diet for four months, which I'm hoping to do, although it's a big challenge...then again, so are headaches! I've pretty much completed the first step, although I still take one or two Butalbitals a month (If I remember correctly, I'm supposed to get down to zero for a while and then add to once or twice a month if needed). The elimination diet is going ok, and the book brings up an interesting point about preventive meds. Dr. Buchholz claims that they won't work as well unless you're doing the elimination diet along with taking the meds. This is why I've decided to try them again - I don't want to take anything I've tried before though, because I know about the bad side effects, so I started a new one (which I mentioned in my previous post).

The only negative about the book was I felt like I was being talked down to at times, but the author also talks down toward other doctors who are getting it wrong. It may be my own sensitivity, and I wouldn't let that stop you from reading this book.

The second book I'd like to review is "Migraine-Free Cooking!" by Heidi Gunderson.

 

This book uses "Heal Your Headache" as a guideline for recipes. I'm being a little stricter than these two books for now by avoiding tomatoes and pork, which are not-as-common migraine triggers, but I may add those back soon. I'm waiting to see a reduction in headaches, and so far that hasn't happened (it can take a while, I've heard).

Instead of writing a lengthy review of Heidi's book, I thought I'd let my pictures of a few of her recipes that I've tried speak for themselves. Enjoy! :) 

Garlic Butter Shrimp

 

Barbecue Chicken Sandwiches

  

Hummus

 

Blue-Strawberry Smoothie

 

Brown Sugar Chicken

 

Seasoned Salmon

New medication: Zonisamide (Zonegran)

I saw my neurologist today and told her I was willing to try another preventative medication. Although I've tried several - I'd guess at least 20 - and tend to have the horrible side effects, I had 27 headaches last month, which is completely ridiculous. Also, a book I read (I WILL do a review soon, I promise) said that preventatives sometimes won't work unless you're doing an elimination diet at the same time. So, I'm trying Zonisamide (brand name Zonegran), a seizure medication. Has anyone ever tried this for headaches - if so, please comment and share your experience! Also I'm weaning off the Ropinirole.

I have to admit that I've cheated on my elimination diet. I went on a ski trip the other weekend and ate some common migraine trigger foods. Of course I've had daily headaches so I didn't notice a difference. Plus I was on Aleve all weekend because skiing (and falling) makes you sore!!! But I will take it more seriously moving forward.

Me & my hot husband in our dorky ski gear

Finally I'd like to thank Emily (WinnyNinny PooPoo) for mentioning my blog in the post below. I encourage you to check it out and share your thoughts!

Does Anyone Really Know What Causes Migraines?

MRI Results

Thanks to the electronic health portal of my unnamed health center, I've received my MRI results with notes online. My official results:

1. Normal brain MRI
2. Incidental congenital failure of segmentation anomaly and C7-T1, otherwise normal cervical spine.

From a past X-ray at a chiropractic office, I already knew about #2. Basically two of my neck discs are missing the thing that goes between them. Can't remember the technical terms, but I've received chiropractic treatments and physical therapy and neither helped.

Most everyone told me I wouldn't want anything to show up in the brain MRI, but I really did. I want an answer - a reason for my pain. I can't begin to explain the mixed emotions I'm feeling right now, but most of all I'm disappointed.

MRI and other fun things

My MRI last week was interesting. Upon arriving to a top-notch hospital, I was completely thrown off when I discovered that the MRI was going to take place in the PARKING LOT in mobile units connected by wooden covered walkways. I went in one trailer for check-in, another to get the IV thing put in (so they could easily add the contrast) and another for the actual MRI. I thought it would take hours to do the neck and brain scan, with and without contrast, but it only took a little more than an hour. I also thought I'd have trouble holding still, but it wasn't bad at all. The hardest part was not falling asleep, because I tend to jerk when I wake up and didn't think that would work out to well.

I called Monday about my results and found out I had to fax an authorization form, which I did right away, so I'm still in waiting mode right now. Of course I'll write about my results, good or bad, as soon as I find out anything.

Since I haven't mentioned things I'm trying other than the elimination diet in a while, I thought I'd do a quick recap.

Meds: The only med I'm taking is Ropinirole for restless leg syndrome (which I don't think I have, but my neuro wanted me to try it due to my sleep study results). I hate it because it wakes me up at night and makes me feel like I'm going to throw up. I haven't yet, but every time I'm sure I'm going to. I take iron every so often, but other than that and some topical acne creams I'm not on anything else, which is nice. When I have headaches, I take 2 Aleves and pray that they work (they generally don't). If they're bad enough, I have Butalbital/Fioricet, and if they're unbearable I have Toradol, but I'm trying to stop relying on those.

Therapy: I'm also still seeing a therapist for stress and pain management. It's not expensive with my insurance, and it's awesome to have someone to talk to because I feel like I overburden my husband and mom with my problems.

Diet: The elimination diet is getting discouraging, not because it's hard to do (although it is) but because I'm having no relief in my headaches. I'm convinced they're hormone-related, but my hope is that I can still have fewer headaches by doing the diet, but I'm slowly losing that hope. Also, I've gotten sick three times this month, and the symptoms have been similar to my MSG symptoms (trust me, you don't want me to elaborate) but I, of course, didn't eat MSG. This diet might be making me aware of foods my stomach is sensitive to, so I've been writing them down.

Exercise: I'm still working out; maybe not four times a week but at least three most weeks.

I wish I had better results to share, but all my efforts don't seem to be getting me anywhere. I'm considering making some (additional) life changes to cut down my stress levels, but I'd rather not get into that now. Next month I meet with my neuro again and a TMJ specialist. Always something to look forward to. :\

Food Elimination Diet Update

Just wanted to give an update on my elimination diet. I started January 1 with a rice-only diet and lasted about four days; then I added in foods that don't typically trigger migraines. However, I still decided to completely cut out dairy and tomatoes in addition to more common trigger foods. And I cut all my vitamins/minerals except an occasional iron pill here and there. My diet guidelines are two books that I'll review in a future post.

The good news is I'm losing some of my tummy fat and have had one or two days without headaches (but I had a killer migraine last week and had to miss a day of work). Also I'm not eating out (except for once) so that's saving money; although I'm buying more produce and organic meats which are pricey.

I'm planning to do the diet through the month and reassess at that time, depending on how my headaches are doing.

P.S. - my first MRI is scheduled for Thursday, assuming my insurance approves it this time (see my comments to this post for details if interested). Very excited! :)

Have a great week everybody!

New Book: Migraine Heroes

Alexandra, co-founder of CureTogether, sent me a new book called Migraine Heroes to review.

CureTogether.org is a Web site that helps people anonymously track and compare health data, to better understand their bodies, make more informed treatment decisions and contribute data to research. It started in July 2008 with three conditions: vulvodynia, endometriosis, and migraine. It has since expanded to more than 280 conditions and 150,000 data points submitted by members.

From the book: Migraine Heroes presents stories and data from 271 people who gathered at CureTogether.org to share their experiences. Anyone living with Migraine is a hero. By sharing knowledge, we can help ease the pain of Migraine.

I thought the book would be only personal stories, but that's just the beginning. This book has tons of statistics from its members on their migraine symptoms, treatments, etc. and shares some comments after the statistics. While there were a few misspellings (from user-submitted information), overall this is a good book with a lot of ideas of things to try to treat migraines as well as resource links at the end.

If you'd like to purchase the book, please click this link or the link below. Under full disclosure, 20% of sales from this link will go to me. (No pressure to buy whatsoever!)

Migraine Heroes

A new guide to treating Migraine, based on the experience of 271 people who've been there.

Get Your Copy

Rice diet - I am insane.

As I write this blog post, I'm SO hungry. A little background: I decided to do a two-week rice diet, nothing but white rice (no flavorings or seasonings, not even salt) and water for breakfast, lunch and dinner. I ran it by two neurologists to make sure it was safe, and they said it may not take a full two weeks, but I should be fine. I'm doing this as an easy way to eliminate migraine triggers - there are so many that it's easier to only eat rice, in my opinion. Or so I thought.

I went to Costco and got a ginormous bag of rice; then I made a big batch. I'm on day three of my rice diet. Brushing my teeth is the highlight of my day because my taste buds actually get some flavor (toothpaste)! The rice tastes so plain, I'm actually craving foods I don't even like. Since it's rice enriched with iron, my burps taste like metal. (You're welcome for sharing.) I thought after doing a gluten-free diet that this would be a piece of cake (ooh cake, yum...), but it's hard always being hungry but not wanting more rice!

I'm also frustrated because I'm still getting bad headaches/migraines so now I'm thinking maybe food doesn't trigger them after all. So I've decided to redo my plan a little. First I'm going to finish my rice, so I'll do the diet another one to two days. I'm doing a lot of research to find out what foods I can and can't eat (book review coming soon) and I'm going to start adding in some foods that are NOT known to trigger migraines.  Then I'll add in common migraine triggers, one per week.

Since it's a new year, and last year sucked on so many levels, I wanted to share my resolutions. I generally do not make resolutions because I always thought they were pointless, but I want 2010 to be awesome. So here goes:

• Eat healthier. I'm considering going completely organic, but I think that's a little too ambitious (and expensive). But I'm going to try to eat as fresh as possible. I got a food processor for Christmas so I'm hoping that will make it more fun to chop veggies!
• Exercise at least four times a week. A typical resolution, I know. I drove by a gym the other day and it was PACKED. Lucky for me I have a gym in my condo's clubhouse, and it's hardly ever in use, so I have no excuse. Even when I have head pain, I'm planning to at least walk for 20 minutes.
• Read through the Bible. Not really headache-related, but my Bible study group at church is doing it and I'm actually really excited about it because even though I'm a P.K. (preacher's kid), I can't say that I've read every word in the Bible.
• Don't stress! Work gives me a lot of stress. Not because it's all that stressful, but because there are always articles to write, projects to manage, deadlines looming, etc. and I think about them constantly, even when I'm not working. I need to find a way to leave work at work and enjoy my free time.

P.S. - here's one resource on the migraine diet if you want to try it. The food lists are not all-inclusive based on other things I've read, so I'd do additional research, but it's a good way to get started. Note that I have never visited the clinic it's from, but a friend shared the link with me. Also note that I'm not sponsoring the rice company from the picture in any way!

Book Review: Living Well with Migraine Disease and Headaches

I'll be completely honest...a lot of people recommended I read Living Well with Migraine Disease and Headaches by patient advocate Teri Robert, but I was hesitant because of the title. I don't want to "live well" with pain - I want it to go away!

After reading the book though, I too am joining the fans who recommend it. It's different from other books I've read by doctors who simply go through the types of headaches and a few drug treatment options. This book includes that information but also gives personal stories, including Teri's, and educates you on terminology and our legal rights as patients. Some of the personal stories are extremely sad, but you need to read them to know that the worse thing that can happen - stroke for example - can and has happened, so it's important to have that knowledge and be aware of what's going on with your own body.

Everyone who suffers from chronic headaches and migraines, or "Migraine disease" as Teri calls it, should read this book.

-------------

A quick update: My MRI was canceled because the MRI office couldn't get in touch with my neurologist for a signature which was required by insurance. I spoke with my neuro's assistant and she said that wasn't the case; my neuro had to speak with a doctor on my insurance's medical board and wasn't able to get in touch with them in time. I'm going to guess that my insurance is holding things up so that I'll have to wait until January for my MRI, which means I pay my full $500 deductible because it starts over in 2010. Ugh.

I'm starting my rice and water diet January 1 (please don't try to convince me not to do it, unless you're a nutritionist), so I'll keep everyone posted on how it goes. I'm also headed to the library to pick up another book to help me do the elimination diet, so I'll have another book review coming soon.

Happy New Year, everybody!

Webinar Notes - Avoiding Holiday Headaches

I attended the holiday headaches webinar by the National Headache Foundation and I wanted to share my notes. A big thank you to Dr. Sylvia Lucas, the NHF and Merck & Co. (for sponsoring).

How to manage holiday headaches/migraines:

• Identify your triggers (environmental, diet, stress, sleep, etc.) using a headache diary.

• Avoid triggers you know, plus common triggers (sometimes it takes a combination of triggers to bring on a migraine).

• Avoid disrupting normal sleeping and waking patterns – make sleep your #1 priority.

• Social engagements expose you to smoke and perfume – get fresh air or try to move to an area that’s relatively clear. If you can’t get away, try breathing through a scarf (during a play for example).

• If you must drink alcohol, alternate between alcoholic and nonalcoholic beverages, mix drinks with other fruit/vegetable juices, drink slowly, and avoid red wine.

• Don’t skip meals; if unable to follow a normal eating schedule, at least have snacks – always keep snacks on hand (not salty though because they can lead to dehydration). Good options are fruit, peanut butter for protein, crackers, and nutrition bars (Kashi, Luna, etc.). For bars, check for those with the lowest sugar and highest protein.

• Avoid ripe cheeses, processed meats and chocolate.

• Schedule personal time to give yourself a break.

• Traveling tips: plan in advance, be prepared for lines/long waits/traffic, and pack migraine meds.

• Rest, exercise, ice/heat, massage, biofeedback.

From the Q&A session:

- Are there programs to help cover cost of migraine medications? See drug company Web sites for programs, coupons.
- What are ergotamine derivates? Cafergot, DHE, etc. – older than triptans but highly effective. Can cause nausea and the caffeine can cause trouble sleeping.DHE-45 is a good rescue drug (injectable).
- (One of my ?s) If I do a two-week rice diet, slowly adding foods back, is that healthy? It shouldn't cause harm but you may not need to do it a full two weeks. It's better to do it under a nutritionist's guidance.
- Can neck/shoulder tension cause migraine? 75% of migraine sufferers have neck/shoulder pain so it can be part of a migraine – many people think muscle tension is causing the migraine but that’s not the case.
- Can stress cause migraine? Headaches in stressful occurrences can be triggered by adrenaline/nervous system changes.

Hope these notes aren't too scattered or out of context.

I'm going to take a short break from all things computer, including this blog, so I want to go ahead and wish everyone a Merry Christmas!!!