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Blogs by Dr. Carol Nelson

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Dr. Carol Nelson - May 31, 2024- 2 minute read

Common Question about Headaches

Question:

“I am so frustrated! I have severe headaches, so why is the MRI/CT of my brain normal?’

 

The answer:

Any imaging of the brain, CT or MRI, is simply a picture of your brain. A fantastic picture of a remarkable organ, but still just a picture. This image says nothing about how the brain is functioning.

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The cause of migraine pain is complex, but in short it is from changes in several neurotransmitters (chemicals in the brain). This neurotransmitter change cannot be seen in a picture. The chemicals change throughout the day as a normal part of brain functioning, so drawing blood to check neurotransmitter levels is not helpful, or even available. The diagnosis of migraine is made by a thorough history and neurologic examination.

Dr. Carol Nelson - April 24, 2024- 3 minute read

Migraine Triggers

If you google migraine triggers (please don’t), you will see that migraines can be triggered by an impossible array of factors, many of which are hard to avoid. I have narrowed the list down to those I see most commonly.

 

Nitrates from hotdogs, bacon, ham, pepperoni, prepackaged lunch meats, etc

Aspartame (NutraSweet), common in diet soda

Too much caffeine or a sudden decrease in caffeine use

Change in sleep schedule

Change in eating schedule

Barometric pressure changes

Hormonal changes, specifically estrogen and thyroid

Stress

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I get asked about caffeine frequently. How is this on the list of triggers, yet it is in several migraine medications, and I notice that a cup of coffee or caffeinated soda helps my headache?

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The answer is that it is the amount and frequency of caffeine that is the problem. If you use caffeine in small amounts a few days per week, you are fine. If you use large amounts daily, you can trigger a headache. However, all people do not have the same sensitivity to caffeine. For example, my Danish grandparents never complained of headaches, yet coffee and an occasional small glass of water were all I ever saw them drink. If I have more than 2 cups of coffee in a day, I will wake up with a headache the next morning. Only you will be able to determine your appropriate amount. I can say, that in my 30 years of experience treating headaches, the most common threshold is 2 cups of coffee or 2-3 cans of caffeinated soda.

Dr. Carol Nelson - September 19, 2023 - 4 minute read

What is a Migraine?

Headache pain is a universal disorder that has been described since the beginning of recorded
history.


Claudius Galen (A.D. 131 to 201) was a leader in Roman medicine. Galen used the term
“hemicrania” to describe headache pain, but more specifically to describe migraine pain. This
term literally translates to “half of the head”. The term evolved from “hemicrania” to
“hemigranea” to “migrainea” to “migraine”.


There are many different headache types, and the specific diagnosis will determine the
appropriate work up and treatment plan. If your headaches are new, changing and/or affecting
your quality of life, you may benefit from seeing a neurologist.


A migraine type headache is a recurring disorder that is moderate to severe in intensity. It is a
throbbing, unilateral pain and it is aggravated by physical exertion. This exertion can be as
minimal as walking or bending over to tie your shoes. The pain is associated with nausea,
vomiting, light sensitivity and/or sound sensitivity. They are less commonly associated with an
aura, which can be visual, sensory (tingling), dizziness or weakness.


If this description sounds like what you are experiencing, I would love to see you and come up
with your individualized treatment plan.

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