DEAR READER: Thank you for writing. I have printed your letter in the hopes that it will in fact reach those readers who need it most. However, I do have a few issues. First, cluster headaches are fairly easy to diagnose because they follow a pattern, so I am surprised to hear that your husband underwent all this treatment for something that his doctors either couldn’t diagnose or wouldn’t tell him. Second, you did not provide any dosing information. How much ginseng is your husband currently using daily?

I ask that you or any other readers familiar with this write to let me know so I can pass it on to others. Thank you.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped envelope and a $2 check or money order payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

When I was 19 years old, I developed cluster headaches that, at times, became unbearable. I presented all the classic symptoms. Our radiology office was located in a professional building, along with 40 other specialists. At the time, I became a guinea pig. I had everything from Novocain injections into my cervical nerve to histamine injections in my arm, all to no avail. I tried all the known remedies available at the time.

My agony lasted until I was about 33 years old. My episodes were predictable. Every day, they lasted from one minute to several hours, for over a period of six months. Then, just as rapidly as they appeared, they vanished for six months.

Then, as luck would have it, while reading a medical magazine, I spotted an ad from a pharmaceutical company advertising a brand new drug called Sansert, which I believe is now off the market. I asked the radiologist I worked for if he would please contact the company and ask for samples, which he did, knowing that everything else I had tried had failed.

Already in the throes of a cycle, I took the pills according to directions without success. After a period of calm between cycles, I was prepared to make another attempt. Typically, the cycle of pain would ensue and build in crescendo, until reaching its pinnacle, after which it would act in just the opposite manner until I was pain-free; usually all within a minute. Only this time, as soon as the pain started, I popped a pill and did so for one full week, after which I began to notice that the excruciating pain began to abort and then lessen, finally disappearing completely. Then I skipped a cycle, only to become disappointed when it once again returned.

After a period of remission, the pain returned. I immediately began taking the Sansert again with success. After that last bout, at age 33, until this day, I have not had another recurrence.

DEAR READER: To my understanding, Sansert is no longer available in the United States but is still available in other countries. It carries some serious side effects, and this is likely why the United States chose to remove it from the market.

Sansert is chemically similar to lysergic acid diethylamide (LSD), a well-known, potent hallucinogenic that has been purported to relieve the pain of cluster headaches and migraines. To my knowledge, no legitimate research has been done on this subject. I discourage everyone from trying LSD as a treatment because it is an illegal substance that carries stiff legal penalties, not to mention the potentially serious side effects that may last for years in some people.

I bring the similarities of these two substances up only because Sansert carries the side effects of mood changes, hallucinations, delusions and more that are also associated with LSD.

While I am happy to hear that you have success with this drug, there are safer options available. Unfortunately, Sansert has too many strikes against it for me to feel comfortable recommending it to others.

I suggest anyone suffering from cluster headaches be under the care of a neurologist familiar with the condition. Many of my readers with this problem have found relief using supplemental oxygen. Other options include the triptans (sumatriptan, zolmitriptan), local anesthetics (lidocaine, etc.), certain antihypertensives and others. Rarely, surgery may be recommended for those who don’t respond to aggressive treatment or cannot tolerate other treatments.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

The second article was from a mother about her son’s cluster headaches. I have been using essential oils for years now. Peppermint oil on the temples has been effective for migraines and cluster headaches, and also helps to relieve nasal congestion. Anyone who uses this remedy must be careful when using full-strength oils. Many people choose to dilute the oil in half with pure vegetable oil. Petroleum-based oils shouldn’t be used to dilute the essential oils because they can inhibit the effectiveness.

DEAR READER: Thank you for writing to share your experience and to offer help to my readers. Chiropractic manipulation can be beneficial for many conditions that misalign the spine, leading to pain, tingling, numbness and other unwanted symptoms.

Essential oils are primarily used for aromatherapy. They can also be beneficial in alleviating certain symptoms while providing a calming sense of being to relieve stress and help the muscles to relax.

DEAR READER: Mold growth in homes can cause a plethora of symptoms, depending on the type of mold. Most often it is associated with cold-like or allergy-like respiratory symptoms, but headaches are definitely possible.

I don’t know that your sister should have moved. There are several ways that mold can be removed from a home. If she was renting, the landlord also has a responsibility to clean up the mold. If she owned her home, she would have had to disclose this information to the purchaser because of the potential health risks.

Thank you for writing to remind me and my readers of this common problem.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

After smoking for 15 years, I finally quit when my mother passed away from lung cancer. Almost immediately after quitting smoking, my migraines came back and were so bad that I couldn’t function. With three active children, this was not an option for me, so I started smoking again, and the headaches went away.

I am scared of what my future holds if I continue to smoke, and I truly want to quit. I went to my family doctor and a neurologist. I have tried several different medications, such as antidepressants, antiseizures and migraine-specific drugs, which didn’t work. I was on a blood-pressure medication briefly that worked well for the headaches, but after a while it caused my blood pressure to drop too much, and I ended up in the hospital being monitored.

I don’t know what the connection is with smoking and migraines, but I’m guessing it involves stress. Can you offer any suggestions on what to do so that my children don’t grow up without a mother? I don’t take any medicines except an occasional over-the-counter ibuprofen or naproxen for minor aches and pains.

DEAR READER: I am not aware of any connection between smoking and migraines. However, in your instance, this is clearly the case. I cannot recommend you continue smoking in order to control the headaches. I can, however, try to offer you some advice and recommendations that you may not have tried.

First, migraines are a type of headache that can be disabling when they occur. They typically cause severe one-sided head pain, may present with a visual aura (flashing lights, blind spots, etc.) and cause sensitivity to light and/or sound. Vomiting and nausea are also common symptoms. They can run in families, and those with a family history are at higher risk of developing migraines.

Each sufferer usually has specific triggers that, when a person is exposed to them, can result in a migraine. Triggers can include hunger, fatigue, hormonal changes, certain medications, stress, head trauma, changes in environment, sensory stimuli (such as bright lights or unusual smells) and certain foods, especially those with preservatives (nitrates), MSG or aged cheeses and wines.

If possible, retreat to a quiet, comfortable place at the first sign of a migraine. Turn off the lights, apply heat or ice to your head and neck, and gently massage the painful areas. For some, taking an aspirin or other OTC pain reliever with a caffeinated beverage such as a soda or coffee can boost the pain-relieving effects of the medication. Too much caffeine, however, may worsen the pain or lead to a withdrawal headache when the caffeine intake is stopped.

Typical prescription medications include antidepressants, antiseizure drugs and migraine-specific medications such as those you have tried. For some people, certain blood-pressure medications and other cardiovascular drugs may also be beneficial. However, because you have tried this without success, I recommend one of the following alternative treatments. Be sure that you have physician approval first because not all these treatments may be appropriate for your case.

Acupuncture may provide positive results, even though it is not routinely recommended because scientific studies have failed to show strong beneficial evidence. Because you have taken the conservative, modern-medicine route, now may be the time to try this ancient therapy.

Biofeedback is a relaxation technique that utilizes special equipment to monitor and control certain physical responses. By understanding the body’s response to certain stimuli such as tension, a person may be able to learn how to control and alter those responses.

The herbs feverfew and butterbur have shown some positive results in preventing or reducing the severity of migraines. High doses of vitamin B2 may also act as a preventive. Still others have had success with coenzyme Q10.

Finally, some migraine sufferers have had success with cervical manipulation; however, there is no scientific proof that chiropractic or spinal manipulation will help migraines. This treatment also carries the risk of arterial damage that may result in stroke or death. When performed by a qualified professional with experience, this is very rare.

I suggest you return to your primary-care physician or neurologist to discuss these options.

In the meantime, you should quit smoking. Substitute over-the-counter nicotine patches or gum to reduce the severity of your migraine symptoms during this stressful period.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

Two years later, they returned once daily. His doctor did an MRI that was normal and diagnosed him with cluster headaches. He was put on heavy doses of steroids that weren’t successful.

He recently began another series. They now occur once daily between 9 p.m. and 11:30 p.m. He went to a neurologist and tried several different medications that were unsuccessful. This time frame and duration fluctuates more, and he skipped two days twice. Pain medications don’t work.

My son has done a lot of research on the Internet. However, so far the legal recommended procedures do not work for him.

Isn’t there anything to relieve the terrible pain he endures, as well as the anxiety he experiences prior to their occurrence? The pain he describes is like he would imagine having an ice pick stuck in his head in the exact same location. He also says he cannot breathe out of his nose during an attack, and his eyes water so that he cannot see. Any help or advice would be sincerely appreciated.

DEAR READER: Your son’s presentation of cluster headaches is textbook. Events may last from weeks to months, followed by periods of remission, when they may stop completely. Remission can be for a month or for several years. The duration of a single attack may be several minutes or, unfortunately, several hours. Attacks commonly occur at the same time each day. Patterns vary from person to person. Unfortunately for your son, his events occur more frequently than the norm, which is one or two annual cluster periods.

Cluster headaches may occur without prior warning. Symptoms include a stuffy or runny nose, restlessness, redness and swelling around the eye on the affected side of the face, and excessive tearing. Most people with the diagnosis avoid lying down during an attack, because the position appears to exacerbate pain.

The cause of the cluster is unknown; however, it is believed tied to an abnormality of the hypothalamus, the portion of the brain that controls many bodily functions to include the nervous and endocrine systems. Chemicals that carry impulses to the brain are thought to be involved as well. Abnormal melatonin and cortisol levels are common during events.

Unfortunately, there is no cure for cluster headaches. Once diagnosed, long-term medication will likely be prescribed. This will likely be backed with short-term medication that may prevent an attack until the long-term drug kicks in. Treatment is directed toward decreasing pain, shortening the duration of events and prevention. Over-the-counter medications are ineffective. A physician, however, might prescribe sumatriptan, commonly used for migraines, zolmitriptan nasal spray, inhaled or IV dihydroergotamine, or oxygen inhaled through a mask. Surgery can be performed only once and can have serious drawbacks.

High altitudes with reduced oxygen levels can be to blame. Avoid alcohol, tobacco smoke, cleaning solvents, oil-based paints, gasoline, heavy fumes, foods such as smoked products and some processed meats that contain nitrates, as well as medications such as nitroglycerine.

Anxiety is common with cluster headaches. Your son might benefit from speaking with a therapist or by joining a support group. He should ask his primary-care physician or neurologist for a reference.

To provide related information, I am sending you a copy of my Health Report “Headaches.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

My problem is that for the past 40 years, when I go to bed, I awaken between 2 am and 4 am because of a pounding pulse and pain on the right side of my head that extends down through the back of my neck. The pain is very intense. A few years ago I found that taking an aspirin with caffeine stops the pain within a half an hour. I still cannot get back to sleep, but I figure it’s better to lie awake pain free than to lie awake with a horrible headache. I never get headaches during the day.

I have lost track of the number of chiropractors and doctors I have seen and tests I have had done. One physician thought it might be something in my room or house. I have a big house with four bedrooms and have tried each bed and about 12 different pillows. I even went to visit some relatives in California but still had the same problem in three different location while visiting. All the tests I have had, to include a few days in a sleep clinic, have been normal.

My only relief came last spring when I tried a new supplement that contained butterbur, ginger and riboflavin. I had three glorious months without a headache but just as suddenly as they stopped, they returned. I still occasionally retry the supplement, but with no effect.

It is currently 3 am as I write this so I hope you can provide some insight or point me in the right direction.

DEAR READER:
Your situation is incredibly difficult. Upon first reading, I thought perhaps sleep apnea was the problem, but then saw that you had already been tested.

You may wish to repeat certain tests because 40 years have brought substantial change in their accuracy and sensitivity. Tests that didn’t exist 40, 30 or even 20 years ago may now be available.

You have already indicated you underwent a sleep study, but if it was more than five or ten years ago, you may wish to have another. The brain monitoring associated with many of these studies has drastically improved.

You may also benefit from a Holter monitor study because of the pounding pulse. That recording will be interpreted by a cardiologist who be able to detect any abnormal cardiac rhythms.

Another option would be to start keeping a journal of your activities. This would include mealtimes (what time and what foods were consumed), showers (and products used), exercise, and more. This could point out triggers such as an allergy to a laundry detergent, perfume, shampoo, or food. It could even show a relation to the time of last food consumption and the awakening.

I recommend you sit down and have a very frank discussion with your primary care physician. Work together to discover the cause of your head pain and pounding pulse.

Then my mother had two weeks of non-stop agonizing migraines. She had an MRI that showed an unknown type of growth in her brain causing double vision and the smelling of things that weren’t there. The growth is twice the size of a golf ball and doomed to kill her without surgery. She’s scheduled for an operation in two days.

The point of this letter is not for your help or anyone’s sympathy. It is to tell people that things aren’t always what they seem. Those readers with constant migraines should see a doctor. Don’t attempt to cover up the pain, get checked out. If pain killers don’t work, try an anti-inflammatory. And see a doctor. What’s keeping my mother pain-free isn’t pain killers. It’s medications to keep the swelling of the growth down.

Please, please print this.

DEAR READER:
You are very articulate for your age. I’m quite impressed with your knowledge and common sense view of two complex situations that never should befall a family the age of yours.

MS is a neurological disease that affects the nervous system and regulates an individual’s ability to move, speak, see, and hear. It often begins with weakness in one limb, pins-and-needles sensations, blurred vision, or difficulties with speech. It may take years for the diagnosis to be confirmed. Even then doctors do not know how symptoms will advance and whether progressive disability will result.

Patients should eat a well-balanced, nutritious diet and get adequate rest. Physical and emotional stress or fatigue should be avoided. It is critical to exercise regularly to keep muscles functioning properly. The disease is non-contagious and non-hereditary. It cannot be cured or prevented but exercise, counseling, psychotherapy, self-care, and medication can be of assistance, allowing patients to remain as independent as possible.

Headaches are not generally related to a serious condition, such as your mother experienced. In fact, only about 1% of all headaches are caused by a serious condition such as tumor, stroke or meningitis.

The classic ocular migraine often begins with a warning sign or aura, accompanied with flashing lights, colors or temporary loss of peripheral vision. Pain can occur on one or both sides of the head. Common migraines generally begin more slowly, last longer and are not preceded by an aura.

Fortunately, your mother had an MRI and the tumor was found. I hope the surgical results were extremely favorable and your family life can settle down. Let me know what happens.

To give you related information, I am sending you a copy of my Health Report “Headaches”. Other readers who would like a copy should send a self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Two years ago I started developing pains that seem to travel and throb from my sinuses to my head and from my buttocks to my legs. About a year ago I went for a physical and blood tests. The doctor told me I had probably picked up some strange virus while traveling.

In January of this year my ears started sounding muffled with a humming noise so I went to a naturopath. She told me to eliminate dairy products from my diet. The muffled humming stopped after I took her advice but these mysterious pains are still present.

The pain lasts for about two days, stops for a day or two and then comes back. I have also started losing my hair. Any advice you can give would be greatly appreciated.

DEAR READER:
I am not sure I can provide you with anything beneficial but I will try. You have not given your age, where you traveled, when the pain started in relation to your travel, your general health status, any medications you are taking, or other relevant information. I only know you are a female because you signed your letter.

The first thing that comes to mind is a possible spinal issue. Pain beginning near the buttocks that travels down the legs is often the result of pressure on the sciatic nerve. This can be due to a herniated, bulging or dried vertebral disc.

Disc herniation can also occur in the cervical spine (neck) causing your head pain. You could also have sinus headaches or an allergy. If you traveled out of the country, a virus or parasite may be to blame, but in my opinion this seems unlikely.

I urge you to return to your physician or find a new one. Explain your symptoms in detail (date of onset, travel destinations, etc.) and request testing. This should include blood work and stool samples to check for parasites and viruses as well imaging studies such as X-rays, CT scan or MRIs to check for disc problems, tumors or other lesions.

It has been two years since your symptoms began, therefore the cause is most likely benign. However, in my opinion, you need to know what is causing your pain so you can treat it properly.

While waiting for your appointment there are a few things you can do to try to narrow down the cause. You could try antihistamines for a possible allergic connection. Stretching and NSAIDs, such as ibuprofen, may help if it is a spinal issue. I also recommend that you write down anything important about your symptoms as well as everything you have tried to relieve the pain. Bring the information to the appointment. In this way you can ensure you have reported everything that may be relevant. Let me know how things turn out.

To give you related information, I am sending you copies of my Health Reports “Managing Chronic Pain” and “Headaches”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

She is a very active 44-year-old who lives and works in an office as an attorney. She takes the Excedrin whenever she has her menstrual cycle which cures her of the accompanying headaches. Is there an alternative solution?

DEAR READER:
Acetaminophen and salicylates combine to relieve pain and reduce fever. Several reports have indicated the duo may cause kidney damage or cancer of the kidneys or bladder. The side effects can occur if large doses are taken for a very long time. Taken according to recommended dosing and for short periods, these unwanted side effects are unlikely.

If your daughter takes Excedrin Migraine once a month during her menstrual cycle, she may not be overdoing at all. However, if she has headaches on a regular basis and pops a pill or two regularly, that is another story.

Migraines appear, in part, to be caused by changes in serotonin levels in the brain and intestines. When levels are high, blood vessels shrink. When levels fall, blood vessels swell, causing pain and other problems. Reasons for variations in serotonin include estrogen and blood sugar levels and certain foods. MSG, soy sauce, aspartame, excessive caffeine and beverages that contain alcohol are common migraine triggers for some individuals.

Your daughter might consider keeping a journal to determine what precedes each migraine. Stress, food and family history will come in to play here. Other than her regular cycle, she might be able to avoid situations that trigger attacks. Once the culprit is identified, she might be able to avoid it and have fewer headaches.

Pure lavender oil or clove oil has been found effective. Place a drop or two of either oil on the ends of a wet washcloth. Place the cloth in the microwave for 15-20 seconds. Remove and wrap the cloth around your neck. Aromatherapy will lessen the tension, easing a headache.

Migralief is an over-the-counter drug available in most pharmacies. The riboflavin in the product will change the color of your urine to fluorescent yellow, but this causes no physical harm.

Alternative options are available. Try suggesting them to your daughter.