MIGRAINE – HOLISTIC APPROACH TO A COMMON DISTRESSING HEADACHE

MIGRAINE – HOLISTIC APPROACH TO A COMMON DISTRESSING HEADACHE

Migraine is a form of headache. The word Migraine is a corrupted form of the word ‘hemicrania’, which meant one sided headaches. Therefore it is usually thought of as one sided headaches. Migraine is a primary headache disorder characterized by recurrent headaches that are moderate to severe. Typically, the headaches affect one half of the head, are pulsating in nature, and last from two to 72 hours. At times, the pain is one sided or may involve the whole head. It is often wrongly thought that all migraine headaches are one sided. It is often so but this does not in any way mean that Migraine headaches are always one sided. Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell. The pain is generally made worse by physical activity. Up to one third of people have an aura as typically a short period of visual disturbance which signals that the headache will soon occur. Occasionally, an aura can occur with little or no headache following it.

Etiology

The exact cause of migraines is not known. Changes in neurotransmitter levels within the brain are thought to play a role.

Trigger factors - Many factors have been identified as migraine triggers.

The normal hormone fluctuations which occur with regular menstrual cycles may predispose some women to experience migraine headaches.

Some types of oral contraceptives (birth control pills) can trigger migraines.

Various foods such as: Red wines, Aged cheeses, Preservatives used in smoked meats (nitrates), Monosodium glutamate, Artificial sweeteners, Chocolate, Dairy products, Alcohol beverages, Oversleeping, Stress, Exposure to strong stimuli such as bright lights, loud noises, or strong smells.

Changes in barometric pressure have been described as leading to migraine headaches.

Another common trigger is staying hungry more than usual. If the eating routine of a patient is disturbed, it can cause migraine. Not every individual who has migraines will experience a headache when exposed to these triggers. If a person is unsure what his or her specific triggers might be, maintaining a headache diary can be beneficial to identify those individual factors which lead to migraine.

Clinical Manifestations

The most common clinical symptoms of migraine are severe, often "pounding," pain, usually on one side of the head, Nausea and/or vomiting, Sensitivity to light, Sensitivity to sound and Eye pain.

The International Headache Society defines episodic migraine as being unilateral, pulsing discomfort of moderate-to-severe intensity, which is aggravated by physical activity and associated with nausea and/or vomiting as well as photophobia and/or phonophobia. A migraine headache typically lasts for several hours up to several days.

Many patients describe their headache as a one-sided, pounding type of pain, with symptoms of nausea and sensitivity to light, sound, or smells (known as photophobia, phonophobia, and osmophobia). In some cases, the discomfort may be bilateral. The pain of a migraine is often graded as moderate to severe in intensity. Physical activity or exertion (walking up stairs, rushing to catch a bus or train) will worsen the symptoms.

Up to one-third of patients with migraines experience an aura, or a specific neurologic symptom, before their headache begins. Frequently, the aura is a visual disturbance described as a temporary blind spot which obscures part of the visual field. Flashing lights in one or both eyes, sometimes surrounding a blind spot, have also been described. Other symptoms, including numbness or weakness along one side, or speech disturbances, occur rarely.

Some people describe their visual symptoms of loss of vision, which lasts for less than an hour, and may or may not be associated with head pain once the vision returns, as an ocular migraine. These symptoms are also known as retinal migraine, and may be associated with symptoms similar to those described as an aura, such as blind spots, complete loss of vision in one eye, or flashing lights. If a patient experiences these symptoms regularly, evaluation to exclude a primary retinal problem is needed.

Eye pain which is different from sensitivity to light is not a common component of migraine. If eye pain is a persistent symptom, or if eye pain is present and accompanied by blurred vision or loss of vision, then prompt evaluation is recommended.

Types of Migraine

·        Migraine without aura, or "common migraine", involves migraine headaches that are not accompanied by an aura.

·        Migraine with aura, or "classic migraine", usually involves migraine headaches accompanied by an aura. Less commonly, an aura can occur without a headache, or with a nonmigraine headache.

·        Two other varieties are familial hemiplegic migraine and sporadic hemiplegic migraine, in which a person has migraines with aura and with accompanying motor weakness. If a close relative has had the same condition, it is called "familial", otherwise it is called "sporadic".

·        Another variety is basilar type migraine, where a headache and aura are accompanied by difficulty speaking, world spinning, ringing in ears, or a number of other brainstem related symptoms, but not motor weakness. This type was initially believed to be due to spasms of the basilar artery, the artery that supplies the brainstem.

·        Childhood periodic syndromes that are commonly precursors of migraine include cyclical vomiting (occasional intense periods of vomiting), abdominal migraine (abdominal pain, usually accompanied by nausea), and benign paroxysmal vertigo of childhood (occasional attacks of vertigo).

·        Retinal migraine involves migraine headaches accompanied by visual disturbances or even temporary blindness in one eye

Diagnosis

The diagnosis of a migraine is based on signs and symptoms.  Neuroimaging tests are not necessary to diagnose migraine, but may be used to find other causes of headaches in those whose examination and history do not confirm a migraine diagnosis. It is believed that a substantial number of people with the condition remain undiagnosed.

The diagnosis of migraine without aura, according to the International Headache Society, can be made according to the following criteria, the "5, 4, 3, 2, 1 criteria":

·        Five or more attacks—for migraine with aura, two attacks are sufficient for diagnosis.

·        Four hours to three days in duration

·        Two or more of the following:

·        Unilateral (affecting half the head); Pulsating; Moderate or severe pain intensity; Worsened by or causing avoidance of routine physical activity

·        One or more of the following: Nausea and/or vomiting; Sensitivity to both light (photophobia) and sound (phonophobia)

·        If someone experiences two of the following: photophobia, nausea, or inability to work or study for a day, the diagnosis is more likely.

·        In those with four out of five of the following: pulsating headache, duration of 4–72 hours, pain on one side of the head, nausea, or symptoms that interfere with the person's life, the probability that this is a migraine is 92%. In those with fewer than three of these symptoms the probability is 17%.

Prevention

Preventive treatments of migraines include medications, nutritional supplements, lifestyle alterations, and surgery. Prevention is recommended in those who have headaches more than two days a week, cannot tolerate the medications used to treat acute attacks, or those with severe attacks that are not easily controlled.

The goal is to reduce the frequency, painfulness, and/or duration of migraines, and to increase the effectiveness of abortive therapy. Another reason for prevention is to avoid medication overuse headache. This is a common problem and can result in chronic daily headache.

MANAGEMENT

Home Managements

• Apple Cider Vinegar - Being a nutritional powerhouse, apple cider vinegar helps reduce migraines. Apple cider vinegar also offers health benefits like aiding detoxification,controlling blood sugar, regulating high blood pressure, reducing bone pain, promoting weightloss and relieving constipation.Add one tablespoon of organic apple cider vinegar to a glass of water. Mix in one tablespoon of honey. Drink this daily to prevent as well as treat migraines. If you are not used to taking apple cider vinegar, start by taking one teaspoon and gradually increase the amount. During migraine attacks or when you feel them coming on, you can take two or three tablespoons.
• Ice Pack - Using an ice pack is perhaps the most popular home remedy to get rid of tension as well as migraine headaches. It has a numbing effect that alleviates pain. Wrap a few ice cubes in a clean towel and place it on your temples, forehead and/or the back of your neck for 10 to 15 minutes. Repeat as needed. You can also try alternating hot and cold compresses for about 15 minutes, as needed. For better results, add lavender and/or peppermint essential oils to the water for the compress.
• Peppermint - The anti-inflammatory property of peppermint helps soothe the nerves. Plus, it has an antispasmodic and calming effect. A study published in the International Journal of Neuroscience in 2008 found that the fragrance of this herb induces the feeling associated with headache relief. Simply drink peppermint tea sweetened with honey. Repeat as needed. You can also massage each of your temples with one drop of peppermint essential oil or a combination of peppermint and lavender oils. Leave it on for at least 20 to 30 minutes. Do this a few times a day until you get relief.
• Cayenne Pepper - Cayenne pepper is a great home remedy for migraines because it stimulates circulation and improves blood flow. Plus, it contains capsaicin, a compound that works as a natural painkiller. Mix onehalf to one teaspoon of cayenne pepper in a cup of warm water.Optionally, add some lemon juice and honey to improve the taste as well as health benefits.Drink this as needed.
• Chamomile - Chamomile has antiinflammatory, antispasmodic, and soothing properties that help relieve migraines. Regularly drinking chamomile tea can also help prevent the problem. When dealing with migraines, you’ll get best results using German chamomile. Steep two to three teaspoons of dried chamomile flowers in a cup of hot water for a few minutes. You can also add some lemon juice and honey. Strain and drink this tea three or four times a day for relief from migraine symptoms. Alternatively, prepare an herbal tea by steeping equal quantities of chamomile, horehound and meadowsweet in a cup of hot water for at least five minutes. Strain and drink it. Repeat as needed.
• Ginger –  a study published in Phytotherapy Research indicates that ginger may prove effective in the treatment of common migraines. It blocks prostaglandins, which are chemicals that promote muscle contractions, impact hormones and regulate inflammation in blood vessels in the brain. Most nonsteroidal anti-inflammatory drugs (NSAIDs), too, work by reducing the production of these chemicals. Drink ginger tea a few times throughout the day until you get relief. Make sure to drink it at the onset of your headache.  Simply chewing on a piece of raw ginger root will also help treat the problem and relieve symptoms like nausea and digestive distress.

HOMOEOPATHIC MANAGEMENT

Homoeopathic philosophy does not favour the use of temporary painkillers or short cuts for the treatment of migraine or for that matter any disease. Homoeopathy tries

to go deep down into the cause of the problem and completely eradicate the tendency of a patient to have these migraine headaches now and then. That is why it takes some time for the medicines to show results. They do not have a short term or temporary effect like the allopathic painkillers. On the contrary, homoeopathic medicines have long term effects and work to completely cure the migraine problem. After a couple of months of homoeopathic treatment for migraine headaches, patients are pleasantly surprised to experience a completely pain free or headache free life. This is the beauty of Homoeopathy. Homoeopathy has been found to be very successful in treating migraine and medicines are perfectly safe. These natural homoeopathic remedies do not have any side effects at all. Safety of the medicines is a major issue when you are to give any medicine to your child. Therefore it is of utmost importance that the medicines should be completely safe. Homoeopathic remedies are known to be perfectly safe and have been tried by millions of patients all over the world over the last 2 centuries.

Indicated Remedies	Indications
Belladonna	one of the most frequently used medicines for migraine headaches. Throbbing is the great keynote, but violent shooting pains in the head, driving the patient almost wild, are scarcely less characteristic. The patient cannot lie down, must sit up, nor can he bear light, a draft of air, noise or jarring; this last is most characteristic. The location of the ache is mostly in the frontal region or right side, flushed face, dilated pupils accompany.
Glonine	When the headache is congestive in nature, Glonoine is very suitable homeopathic medicine for migraine with congestive headaches. There is a rush of blood to the head. Heat and redness of the face and head is seen. Pain is usually throbbing in character. There is a feeling of shocks in the head and this is in sync with the pulse. This headache is aggravated by going out in the sun or heat in any other form. The patient cannot tolerate any warmth around the head. He feels better from uncovering the head
Natrum Mur	It is very commonly used for migraine that arises from any mental grief or stress. It is also good for anaemic headaches. Such headaches are often seen in young girls. There is temporary blindness with the headaches. The pain is as if there are thousands of small hammers beating inside the head. The pain increases during the day and is better after sunset. Paleness of the face accompanies the headache. The pain may be triggered by eyestrain.
Sanguinaria	It is a very commonly used medicine for right sided migraines. The pain often starts in the back of the head ie the occiput and settles into the right eye. There is distention of the veins of the head and the temporal region. The headaches are periodic in nature and occur on every seventh day. One gets relief from lying down and from sleeping.
Spigelia	It is very useful remedy for migraine headaches that occur on the left side. In this medicine the pain settles over the left eye. There is a feeling as if there is a tight band around the head. The pain is aggravated by touch or motion.
Nux vomica.	headache from the excessive use of alcohol, the morning “big head,” tobacco, coffee, headache from digestive troubles, constipation, and specially auto-“intoxication” and hepatic insufficiency. These are all common causes of the Nux vomica headache. It suits the gouty and haemorrhoidal, which makes up four-fifths of all migraines. The ache is situated over one or the other eye, usually the left, or else in the occiput. It is apt to being in the morning with giddiness on first rising, and last all day until night, and is accompanied with sour taste or perhaps nausea and violent retching. The dull, wooden, bursting feeling of the head following a debauch is most characteristic of Nux vomica.
Iris versicolor	it is especially a remedy for gastric or bilious headaches. Blurring of the sight may be preceded by drowsiness and the head begins to ache as soon as the blurring disappears. The pains are mostly located over the eyes in the supra-orbital ridges, usually in one side at a time, mostly the right. The dental nerves are frequently affected. The pains are throbbing or sharp, and when at their acme vomiting occurs, which is apt to be copious, bitter or sour. Especially characteristic is vomiting of matters so sour that the teeth are set on edge. The headache of Iris is aggravated by violent motion, cold air and coughing; moderate exercise in the open air relieves. In sick headache with continuous nausea it is one of our most useful remedies
Gelsemium	headache commencing with blindness, and especially is it a remedy for headaches due to eye strain. The ache commences in the occiput or nape of the neck, comes up over the head settles in the eye. There is a feeling as if a band were about the head, the patient is dull and apathetic, and there is great soreness in the eye when moving them. Occipital headaches, which are dull and dragging.
Onosmodiu	dull aching extending down back of neck or over on one side, generally the left; there is a strained stiff sensation in the corresponding eye.
Cocculus	the ache occurs in the lower part of the occiput and extends to the nape, and it is intense and nearly always associated with vertigo there is constant nausea. Causes of headache may be mentioned riding in the cars and a carriage. A peculiar symptom of the sensation as if the occiput were opening and shutting.

BEDWETTING

BEDWETTING – HOLISTIC APPROACH TO A COMMON CHILDHOOD PROBLEM

Bedwetting is also known as night time incontinence or nocturnal enuresis. Generally, bedwetting before age 7 isn't a concern. At this age, your child may still be developing night time bladder control. Most children wet the bed occasionally or even nightly during the potty training years. Bedwetting in children is often simply a result of immaturity. The age at which children become able to control their bladders during sleep is variable. Bladder control is a complex process that involves coordinated action of the muscles, nerves, spinal cord and brain. Wetting the bed can be upsetting, especially for an older child. Child may feel bad and be embarrassed. Can help them by being loving and supportive. Try not to get upset or punish child for wetting the bed.

Parents must realize that enuresis is involuntary. The child who wets the bed needs parental support and reassurance. Most children simply outgrow bedwetting with a rate of resolution of the issue of about 15% per year.

The prevalence of childhood primary enuresis is: 5 years old 16%, 6 years old 13%, 7 years old 10%, 8 years old 7%, 10 years old 5%, 12-14 years old 2% - 3%, over 15 years old 1%- 2%.

Types of Bedwetting

There are 2 types of bedwetting: primary and secondary. Primary means bedwetting that has been ongoing since early childhood without a break. A child with primary bedwetting has never been dry at night for any significant length of time. Secondary bedwetting is bedwetting that starts up after the child has been dry at night for a significant period of time, at least 6 months.

Causes:

Primary Bedwetting: The cause is likely due to one or a combination of the following:

The child cannot yet hold urine for the entire night. The child does not waken when his or her bladder is full. The child produces a large amount of urine during the evening and night hours. The child has poor daytime toilet habits. Many children habitually ignore the urge to urinate and put off urinating as long as they possibly can. Parents usually are familiar with the leg crossing, face straining, squirming, squatting, and groin holding that children use to hold back urine.

Secondary bedwetting can be a sign of an underlying medical or emotional problem. The child with secondary bedwetting is much more likely to have other symptoms, such as daytime wetting.

No one knows for sure what causes bedwetting, but various factors may play a role:

Small bladder. Child's bladder may not be developed enough to hold urine produced during the night. Inability to recognize a full bladder. If the nerves that control the bladder are slow to mature, a full bladder may not wake your child — especially if your child is a deep sleeper.

Hormone imbalance. During childhood, some kids don't produce enough antidiuretic hormone (ADH) to slow night time urine production.

Stress. Stressful events — such as becoming a big brother or sister, starting a new school, or sleeping away from home — may trigger bedwetting.

Urinary tract infection. This infection can make it difficult for child to control urination. Signs and symptoms may include bedwetting, daytime accidents, frequent urination, red or pink urine, and pain during urination.

Sleep apnea. Sometimes bedwetting is a sign of obstructive sleep apnea, a condition in which the child's breathing is interrupted during sleep — often due to inflamed or enlarged tonsils or adenoids. Other signs and symptoms may include snoring, frequent ear and sinus infections, sore throat, or daytime drowsiness.

Diabetes mellitus. For a child who's usually dry at night, bedwetting may be the first sign of diabetes. Other signs and symptoms may include passing large amounts of urine at once, increased thirst, fatigue and weight loss in spite of a good appetite.

Chronic constipation. The same muscles are used to control urine and stool elimination. When constipation is long term, these muscles can become dysfunctional and contribute to bedwetting at night.

Structural problem in the urinary tract or nervous system. Rarely, bedwetting is related to a defect in the child's neurological system or urinary system.

Inherited cause - Bedwetting does tend to run in families. Many children who wet the bed have a parent who did too. Most of these children stop bedwetting on their own at about the same age their parent did.

Clinical Manifestations

Bedwetting is involuntary urination while asleep after the age at which staying dry at night can be reasonably expected. Most kids are fully toilet trained by age 5, but there's really no target date for developing complete bladder control. Between the ages of 5 and 7, bedwetting remains a problem for some children. After 7 years of age, a small number of children still wet the bed.

Most children outgrow bedwetting on their own — but some need a little help. In other cases, bedwetting may be a sign of an underlying condition that needs medical attention.

Bedwetting needs more attention when child still wets the bed after age 7, child starts to wet the bed after a few months or more of being dry at night & Bedwetting is accompanied by painful urination, unusual thirst, pink or red urine, hard stools, or snoring

Diagnosis:

Child will need a physical exam. Depending on the circumstances, physician may recommend: Urine tests to check for signs of an infection or diabetes, Xrays or other imaging tests of the kidneys or bladder, if suspects a structural problem with child's urinary tract or another health concern., Other types of tests or assessments, if other health issues are suspected

Complications:

Although frustrating, bedwetting without a physical cause doesn't pose any health risks. However, bedwetting can create some issues for child, including:

·        Guilt and embarrassment, which can lead to low self esteem

·        Loss of opportunities for social activities, such as sleep overs others home and camp

·        Rashes on the child's bottom and genital area — especially if child sleeps in wet underwear

MANAGEMENT

Home Managements:

Making some changes at home may help for children’s like:

·        Anxiety and stress tend to make bedwetting worse. So, instead of blaming or punishing child, treat child with love and support to relieve their embarrassment.

·        Encourage child to empty the bladder just before going to the bed.

·        Install night-lights and make sure that child has easy access to the bathroom at night.

·        Offer simple reinforcements or rewards when there are dry night.

·        Encourage child to drink more fluids during morning and afternoon but limit fluid intake in the evening.

·        Avoid caffeinated beverages, even hot chocolate, as caffeine stimulates the bladder.

·        Treat constipation. Urine control and stool elimination use the same muscles. With chronic constipation, these muscles become dysfunctional and contribute to bedwetting.

·        Use waterproof sheets to protect the mattress.

·        You can also use a bedwetting alarm.

Home remedies

Bedwetting is not a problem that can be solved in a day or two. Be patient and allow these remedies time to work.

·        Cinnamon. It is believed that this spice keeps the body warm. Have your child chew a piece of cinnamon stick thoroughly once a day. You can also combine sugar and cinnamon powder and then sprinkle it on buttered toast. Give this toast to child for breakfast.

·        Indian Gooseberry also known as amla, is an excellent Ayurvedic remedy for bedwetting. Crush and deseed two Indian gooseberries. Add one tablespoon of honey and a pinch of turmeric. Give one tablespoon of this mixture to your child every morning. Another option is to give your child one teaspoon of the pulp of Indian gooseberry mixed with a pinch of black pepper powder.

·        Olive oil Massage- For an easy treatment to cure bedwetting, you can use olive oil. Simply heat some olive oil and when it is comfortably warm, rub it over your child’s lower abdomen and then massage the area gently for several minutes. Follow this remedy daily until you are satisfied with the results.

·        Cranberry juice is good for the bladder and urinary tract. Although most liquids should be avoided soon before bed, you can give your child a cup of fresh cranberry juice one hour before going to bed. Repeat this process daily for at least a few weeks. If bedwetting is due to urinary infection, give your child one-half cup of cranberry juice three times a day.

·        Walnuts and Raisins can also be used to reduce the frequency of bedwetting. Many children will enjoy this as a tasty snack. Give your child two walnuts and five raisins before going to bed. Repeat this remedy for at least a few weeks or until you see positive results.

·        Bladder Exercises help stretch the muscle that controls the release of urine from the bladder and increase bladder capacity. Muscle-strengthening and bladder-stretching exercises are considered good for bladder control.

·        Honey - Many children like the sweet taste of honey, making this an easy remedy to try. Simply give your child one teaspoon of raw honey before bed. You can also give your child a spoonful of raw honey mixed in milk for breakfast.

·        Apple Cider Vinegar helps balance the body’s pH and reduce acid levels which may be contributing to the problem. It will also aids detoxification and treat constipation. Stir two teaspoons of apple cider vinegar in a glass of water. Optionally, add a little raw honey.

·        Mustard Seeds can be of great help to those suffering from urinary tract infections. Stir one-half teaspoon of dry mustard seed powder in a cup of warm milk. Give this drink to your child at night one hour before going to bed.

·        Jaggery has a heating effect on the body. When the body remains warm from inside, the problem of bedwetting vanishes soon. Each morning give your child a small piece of jaggery along with a cup of warm milk.

HOMOEOPATHIC MANAGEMENT

Homoeopathy has been found to be very successful in treating bedwetting and medicines are perfectly safe. These natural homoeopathic remedies do not have any side effects at all. Safety of the medicines is a major issue when you are to give any medicine to your child. Therefore it is of utmost importance that the medicines should be completely safe. Homoeopathic remedies are known to be perfectly safe and have been tried by millions of patients all over the world over the last 2 centuries.

The aim of Homoeopathy is to strengthen the nervous system of the body. This allows the child to gain control over the urinary bladder. The same child who had been urinating in the bed for years is able to keep the bed dry within a matter of a couple of weeks. Homoeopathy offers the best way of treating bedwetting. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. Please consult a qualified homoeopath before taking any homoeopathic remedy.

Indicated Remedies	Indications
Equisetum	One of the most common remedies for nocturnal enuresis and mainly used on a child that wets the bed during dreams or nightmares. Equisetum treats other forms of urinary incontinence such as passing water without any cause, with involuntary stools, or with clear light-coloured without feeling any relief. It can also be used on a child having the constant urge to urinate.
Argentum Nitricum	It can be used to treat bed wetting problems of a child who feels anxious about upcoming events (exams, performances, etc). The homoeopathic treatment’s principle is “like cures like” or simply put, the very substance that causes the same symptoms as a serious disease is taken to treat or prevent that disease.
Belladonna	it can be used to treat bed wetting children, specifically those who have frequent and profuse urination after midnight toward the morning. In addition, Belladonna is also effective in treating nocturnal enuresis caused by illness or bladder infection.
Sulphur	Usage is suggested for a nocturnal enuresis sufferer who loves sweets and spices and who wets the bed past the first half of the night. Sulphur can also be used on a warm-blooded bedwetter who sleeps with his feet sticking out of the covers or if the child has vivid dreams.
Causticum	It is recommended for a bedwetting child who is a light and uneasy sleeper. The homeopathic remedy can also be used for a patient who unintentionally passes water when he laughs, sneezes or coughs.
Sepia	Aside from bed wetting, Sepia can also be used as homeopathic treatment for kidney problems. It is recommended by most homeopaths to treat female children with nocturnal enuresis, especially if they wet the bed on the first part of the night or if they love dancing and any vigorous activities.
Kreosote	the child is so deep asleep that it is difficult to waken him. The urine is offensive in odor. The child even has dreams of urinating. Even during the daytime, the child finds it difficult to exercise control over the urinary bladder and has to run when feels the urge to urinate.
Cina	The child is irritable and rubs the nose. The urine is turbid and white, which turns milky on standing. Increased appetite is another prominent symptom that indicates Cina.