reader mail You ask . We answer .
Tired of searching the Internet for answers ? It ’ s time to learn from those in the know . In every issue of Head Wise , our experts respond to reader-submitted questions about migraine and headache disorders .
BREATH OF FRESH AIR
My father has a variety of medical conditions , including Parkinson ’ s disease and diabetes . He has severe headaches almost every day . His doctors continue to prescribe more and more medications , which are not working . He has had every test imaginable to rule out any serious medical issue that may be causing the headaches . He has tried acupuncture and Botox ® , which provide minor temporary relief .
I have read many articles on oxygen offering relief for chronic headache pain . For some reason none of his many doctors are willing to even attempt this therapy . They just continue to prescribe more medications and , as you can imagine , he is using many medications already . Do you have any recommendations on how to convince any of his doctors to try oxygen treatments ? My father ’ s headaches are completely debilitating . He often can ’ t even hold his head up . — Debra K .
I ’ m sorry to hear that your father is having so many health issues . Extensive testing does not usually lead to headache control , unless it reveals an abnormality on MRI scanning , a carotid ultrasound or a blood test known as an erythrocyte sedimentation rate ( sed rate ). If he is on many painkillers , he will continue to have headaches , overshadowed by medication overuse headaches ( formerly called “ rebound ” headaches ). According to the International Headache Society , medication overuse headaches occur when a migraineur is taking combination analgesics ( e . g ., Excedrin ® ) or narcotics for 10 or more days per month , for more than three months . Medication overuse headaches can also be caused by the use of simple analgesics ( e . g ., Tylenol ® ) for 15 or more days per month . Even Botox will not help people with medication overuse headaches .
Episodic use of oxygen has been very helpful in cluster headaches but not of much value in other headache types . You need to begin with a proper diagnosis before considering treatment plans . If outpatient treatment fails , inpatient headache care is a viable option .
It sounds like you are looking for a rational approach to your father ’ s debilitating headaches , and I strongly recommend that he see a board-certified headache specialist . His other illnesses may have an impact on medication choices , so a careful history and physical examination will be very important , as well as a careful assessment of other factors such as sleep apnea , depression and other conditions that might worsen a headache condition .
— Edmund Messina , MD , Michigan Headache Clinic , East Lansing , Mich .
The National Headache Foundation has a list of headache specialists who may be of help . See www . headaches . org or call 888-NHF-5552 .
6 HEAD WISE | Volume 2 , Issue 2 • 2012