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GETTING MIGRAINE: HEREDITY, MIGRAINOUS PERSONALITY

admin — Thu, 07 Jul 2011 15:32:23 +0000

Heredity There is no doubt that migraine is a familial disorder. Estimates of how frequently it runs in families will depend on how widely the term ‘family’ is extended. Even restricted to close (first-degree) relatives such as parents, siblings and children, it is still over 50 per cent more common within than outside the family. Indeed, a positive family history of migraine is further evidence that a headache sufferer has migraine.The precise way in which migraine is inherited is not as simple as, for example, the inheritance of blood groups. Nor is it scientific to say that headaches are inherited, but only the tendency to have certain types of headaches.Other familial disorders, such as allergy and epilepsy, have been said to be commoner in migrainous families but there is no scientific proof of this.
The migrainous personalitySince the eighteenth century, doctors have thought that it was the ‘upper’ strata of society that suffered more from migraine. In those days it would only have been the better-off that could have afforded doctors’ fees. Recent scientific studies indicate that migraine attacks occur in all ranks, irrespective of intelligence. The reason why the myth has persisted for two centuries is because of the biased selection of patients that doctors see; there is no doubt that only a minority of migraine sufferers go to their doctor. These groups are more likely to be those with more money, time, or intelligence. This applies to other ‘complainers’ and not simply migraine sufferers.It has also been thought that hard-working, conscientious perfectionists are more likely to suffer from migraine, a subjective view that migrainous doctors find hard to dispute. The objective studies that have been done do not confirm that one type of personality is more prone than others and show that migraine occurs just as frequently in people who are neither obsessional nor compulsive.There is no doubt that some migraine sufferers are aggressive, demanding, and distrustful. An explanation for this could well be that any person suffering from repeated headaches is likely to become ‘neurotic’ or depressed. It can be difficult to decide whether these characteristics are the result or the cause of migraine.
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PAIN WITHOUT A CAUSE: ORPHAN PAINS

admin — Tue, 07 Jun 2011 15:26:47 +0000

There are many pains whose cause is not known. If a diligent search has been made in the periphery and no cause is found, we have seen that clinicians act as though there was only one alternative. They blame faulty thinking, which, for many classical-thinking doctors, is the same as saying that there is no cause and even no disease. They ignore a century’s work on disorders of the spinal cord and brainstem and target the mind. The mind for them is foreign territory owned by the patient. Because they believe that the mind is governed by free will, they are saying that the patient has invented the pain for some devious purpose. A mountain of hogwash has been written about patients inventing pain for some symbolic purpose or as a method of manipulating other people. These are the doctors who repeat again and again to a Second World War amputee in pain that there is nothing wrong with him and that it is all in his head.

Of all the hundreds of patients I have seen, there was only one I believed had a ‘symbolic’ pain, by which I mean that the patient uses the word ‘pain’ to represent some other urgent need. Bill Noordenbos, a neurosurgeon in Amsterdam and the kindest, gentlest doctor I have known, introduced me to a Dutch woman with one arm amputated. She complained of a burning pain in her phantom hand but she went on to say that only one finger was burning. Neither of us had ever heard a patient describe so localized a pain so we went on to explore the details.

She had been driving her car on a hot summer day with her arm out of the window. A car driving from the opposite direction scraped along the side of her car and sliced off her arm. That evening, her husband came to see her in hospital and told her that he had no use for a one-armed wife and was leaving her. On further questioning of this poor woman, she said that her pain came from her wedding ring, which was burning her finger. She was given intensive counselling so that she came to see the loss of her arm as a tragedy but the loss of her husband as long overdue. The pain in her hand went away.

A dramatic example of an incorrect search for the location of the cause of pain is seen in patients with a damaged spinal cord who report pain in the numb part of their bodies.

Some patients who have their spinal cord cut across develop a deep, severe pain located in the completely anaesthetized part of their body. There are some twenty cases in the literature in which surgeons have believed that some pain-producing nerve impulses must be travelling through their useless spinal cord and that the pain-producing nerves originate in the damaged spinal cord. They have therefore opened up the spinal cord above the area of damage and have removed completely some segments of the remaining cord. The operation has no effect on the pain and should never be done. This is a truly central pain. Some cells that have lost their normal input have reacted in an attempt to recreate their former role by raising their excitability and beginning to fire steadily. No one knows where these cells are because we do not yet have the diagnostic tools to locate them. Vigorous research is in progress to find these cells and, perhaps even more importantly, to understand the chemistry of their excitability, explaining what makes them run wild.

I have mocked the search for the cause of pain which jumps from a peripheral cause straight to cognitive processes, as though the only function for the massive, complex, intervening nervous system was simply a mechanical relay. Of course, that is not to say that cognitive processes play no role in pain. All of us have sources of aches and pains that fail to capture our attention when we are busy and happy and yet can dominate us when we are down, lonely and miserable. The last chapters of this book will integrate sources of pain into the vast repertoire of possible reactions that are the nature of us and our brains. This chapter has attacked simplistic solutions that propose that, if an appropriate cause for pain cannot be detected in peripheral tissue, then the pain must be an invention of the mind. There are alternative solutions to the problem of pain without a detectable peripheral cause. Diagnostic methods are not yet good enough to detect all disorders, particularly in nerves and soft tissue. Increased sensitivity of nerve cells in spinal cord and brainstem can produce ‘false’ signals but present diagnostic methods do not yet permit the detection of such abnormal activity.

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MENSTRUAL CYCLE-CREATURE COMFORTS: HAIR AND SKIN

admin — Wed, 29 Apr 2009 08:20:56 +0000

Greasy hair is a problem at period time too. I’m not going to advise you to wash your hair every day, although I know many girls do. It’s a good idea to keep it clean, but if you subject it to a daily dose of hot water, you could be forcing it to produce even more grease than it would anyway. So my advice would be to cut down the shampooing to once or twice a week and then to make sure that you wash in warm rather than hot water and that the final rise is a cold one.

Skin-If you suffer from spots, boils or styes, then obviously you must keep your skin as clean as possible. It’s probably better to use cotton wool pads than a flannel, which can spread the infection. Failing cotton wool, you can clean your face very efficiently with pure soap and water and your fingertips.

Fingertip massage while you wash, in fact. Some people prefer to use a gentle cream rather than soap. Be specially careful how you clean your eyes: the gentlest make-up remover and a separate cotton wool pad for each eye. Skin irritation can be provoked by some anti-perspirants or deodorants, or even highly perfumed talcum powder. If you get skin irritation in your armpits it makes good sense not to shave when you’re low and to avoid anti-perspirants and deodorants altogether. Stick to baby powder. In other words, treat your skin with great tenderness when it’s vulnerable.

Sadly, the one skin trouble that won’t respond to a careful diet and scrupulous cleanliness is acne, probably the most distressing of all the infections you’re likely to suffer at period time. Acne is in a class by itself, as sufferers know. The trouble is that when your body first starts producing sex hormones it doesn’t always get the balance right. So some people produce more grease than they need and their pores get clogged with it. Cleanliness will help it not to get any worse but it won’t cure it. Only time will do that, which isn’t much help to you if you’re already suffering from all those spots and blackheads, or if your skin has already been scarred by them. Fortunately the amount of grease you produce will be inhibited by better supplies of oestrogen and many girls who go on the Pill report that one of its pleasant side-effects is that it clears up their acne.

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