Modern people's life rhythm is tense, and headache is a warning signal that the brain can't bear the pressure load, among which migraine is the most common headache in the help-seeking clinic. Shi Jingsen, a neurologist who specializes in treating headaches, said that some patients take painkillers as soon as they have migraine, which leads to drug addiction or aggravation of pain after taking medicine. In fact, migraine can be prevented, thus reducing the frequency of attacks and excessive dependence on painkillers.
Migraine is like an alarm clock! "5432 1" How many items did you encounter?
Headache is a common symptom in daily life. For many people, this sounds like a wake-up call at any time, causing great physical and mental stress. Some people call it "migraine" because they always have a unilateral headache. Dr. Shi Jingsen said that "migraine" actually has many characteristics, and one side is only one of them. According to statistics, 1/3 people have bilateral pain. At present, there is a simple formula "543,265,438+0" for the diagnosis of migraine for readers' reference.
5: Headache more than 5 times.
If you don't take painkillers, the headache will last for more than 4 hours.
Generally, the headache will relieve itself within 3 days (72 hours).
2. Have two of the following four characteristics: unilateral, pulsating pain, moderate or severe pain (pain level is 0- 10, with at least 4 points), and daily activities will aggravate headaches or avoid such activities (such as walking or climbing stairs).
1: Combine the following: nausea, vomiting, fear of light and noise.
Dr. Shi Jingsen reminded that when you suspect that you have a migraine attack, you should go to the neurology department first to rule out other reasons. In addition to stress migraine, some people are sensitive to light, and there are also some cardiotonic agents, such as antihypertensive drugs or coronary artery dilators (sublingual nitroglycerin). Chocolate, cheese, red wine, monosodium glutamate and other foods may induce migraine. Because there are more than 100 causes of migraine, you can write your own headache diary to record the frequency, intensity and possible inducing factors of migraine for doctors' reference.
Dependence on "cold syrup" has great side effects, and it is easy to become addicted without knowing it.
Many migraine sufferers will have some prodromal symptoms before the attack, and may feel particularly tired after waking up, similar to cold symptoms. Some people think that they have a cold, and they will buy cold syrup on the market. These drugs can relieve headaches because they contain opium, caffeine and painkillers. Although drinking a bottle for the first time is effective, it is easy to use it frequently or increase the dose later, and long-term overdose is also easy to cause drug dependence.
Dr. Shi met Miss Lin (a pseudonym) with a successful career in the clinic. Because I have a headache every day, I buy commercial painkillers every time I have an attack. She is addicted to drugs, and taking any painkillers is ineffective. After taking painkillers, it is even more painful. For example, Miss Lin can't work without taking painkillers, and the number of headaches per month exceeds 15, which is consistent with the diagnosis of drug overuse headache. Because the treatment effect in the outpatient clinic is not good, Dr. Shi suggested that Miss Lin be hospitalized for drug withdrawal treatment. At first, I had a rebound headache and kept vomiting because of withdrawal symptoms. After adding some antiemetic drugs and migraine preventive drugs, my discomfort was relieved and the number of headaches was greatly reduced after a few days. About two weeks later, I was discharged from the hospital. Miss Lin recalled that when I had a headache, I wanted to "hit the wall" and felt that "life is not as good as death". Now she seems to be a whole person reset, and her life starts again, more energetic.
draw
▲ Dr. Shi Jingsen, Department of Neurology, Kaohsiung Rongzong
Migraine can be prevented, reduce the number of attacks, and no longer rely on painkillers.
Through prevention, patients can no longer suffer from migraine. At present, there are four kinds of oral drugs to prevent migraine: antiepileptic drugs, beta blockers, calcium antagonists and antidepressants. Doctors can give them according to their symptoms. For example, people who are depressed can be prevented by antidepressants. In addition, topiramate, an antiepileptic drug, can effectively reduce the number and frequency of headaches and lose weight, killing two birds with one stone. Botox for injection has certain effect on preventing chronic migraine. If you meet the requirements of medical insurance payment, there is no need to pay at your own expense.
Recently, there are also monoclonal antibodies against newly injected drugs, such as calcitonin gene-related peptide (CGRP), 1 ~ 3 months, which can effectively reduce the occurrence of migraine in patients. These preventive drugs are relatively safe, and their main mechanism is to reduce brain sensitivity or increase the threshold of migraine. Although they have side effects such as drowsiness and dizziness, it is recommended to take them in small doses or before going to bed to reduce discomfort. After taking preventive drugs for three to four months, we can evaluate the frequency of patients' attacks. When the number of headaches is reduced and the intensity is weakened to achieve the expected goal, we can consider reducing or stopping preventive drugs and taking painkillers occasionally during the headache attack.
Doctors who live in peace with migraine: they must be psychologically prepared for a long-term war of resistance.
In fact, migraine attacks are related to physical fitness. Dr. Shi observed that many migraine patients are anxious, pursuing perfection and full of sense of responsibility. Many of them have successful careers, or play an important role in families and groups, but they are also easy to put too much pressure on themselves to produce negative emotions, leading to physical and mental overload.
He reminded us that "headache is actually a stress warning signal" and "our brains are overwhelmed and need to rest. If we still refuse to rest, we will be forced to stop immediately and have a good rest through severe headache and constant vomiting. Learn to coexist peacefully with migraine. Besides commonly used preventive and acute analgesic drugs, you can also use meditation, acupuncture, hot compress and aromatic essential oil. Take the medicine according to the doctor's advice, try to relax and don't rush to take the medicine. I believe you can overcome migraine and enjoy a happy life.
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