I wish I had something exhilarating to say about the diet experiment, but I don't. The simplest truth is that I've been to the ER once on the no-wheat no-tyramine diet, and I'm in day one of another pretty bad one right now. Today I decided to let the tyramines back in. Despite not feeling abstention made a significant difference I'm still going to go through the motions and finish the whole thing out.
Research shows skin pain sensitivity increases with migraines. Why don't they just ask me?
Actually, honestly, I thought it was obvious. Just like the light and sound and smell sensitivity...sensation just gets more painful when a migraine's on. I thought it was all accepted truth. Hell, I thought light and sound sensitivity were just normal headache stuff. It wasn't until I started paying special attention that I learnt that they were part of what defined a migraine.
But yes--if you didn't know--steer clear of the skin of a migraine sufferer. Do not brush their hair. Especially if they're female or fat or depressed.
Two out of three ain't bad.
Showing posts with label dietary triggers. Show all posts
Showing posts with label dietary triggers. Show all posts
23 April, 2008
28 March, 2008
The Tyramine Principle
It would be hard to avoid something like tyramine in your diet without understanding what it is. Otherwise it's hard to predict where it might show up, and you're left bound to whatever was on the last "allowed foods" list you read.
This page on a low-tyramine diet is very helpful in that regard. I like patterns better than rote memorisation.
Tyramine is a natural substance formed from the breakdown of protein as food ages.
Der! My migraine specialist had said that avoiding tyramine would involve a more European-style diet, shopping and cooking right away. Until reading that page I thought he was referring to avoiding prepared foods with preservatives. Sure, those too, but tyramine levels can increase in my own home--just having them around for a while can have that effect.
Fermentation. Fermentation is the devil. I'm not avoiding soy sauce because of the soy, but because of the fermentation. So soy milk may be back on the list. Good to know, especially since I intend to limit dairy.
Any protein food, improperly stored or handled, can form pressor amines through protein breakdown. Chicken and beef liver, liver pate, and game generally contain high amine levels due to frequent mishandling. Game is often allowed to partially decompose as part of its preparation.
There's so much reading to be done. I'll never finish.
This page on a low-tyramine diet is very helpful in that regard. I like patterns better than rote memorisation.
Tyramine is a natural substance formed from the breakdown of protein as food ages.
Der! My migraine specialist had said that avoiding tyramine would involve a more European-style diet, shopping and cooking right away. Until reading that page I thought he was referring to avoiding prepared foods with preservatives. Sure, those too, but tyramine levels can increase in my own home--just having them around for a while can have that effect.
Fermentation. Fermentation is the devil. I'm not avoiding soy sauce because of the soy, but because of the fermentation. So soy milk may be back on the list. Good to know, especially since I intend to limit dairy.
Any protein food, improperly stored or handled, can form pressor amines through protein breakdown. Chicken and beef liver, liver pate, and game generally contain high amine levels due to frequent mishandling. Game is often allowed to partially decompose as part of its preparation.
There's so much reading to be done. I'll never finish.
24 March, 2008
Diet Plan
Had another appointment with the specialist today. He's been stonewalled in his attempt to get me anaesthetised either as an in- or an out-patient, so he's going try and get me a referral to Cedars Sinai.
He's out of medicine, he says.
I brought up dietary mods, and he agrees that tyramine and wheat are a good place to start, although wheat is difficult. I don't doubt that for a second. The idea is to quit as much as possible for three or four weeks, and if it has made a difference, start introducing foods slowly back in and see what makes the needle wiggle.
I figure wheat will be the first thing back in, if I don't snap horribly beforehand. His tyramine recommendations are from the National Headache Foundation, and look...oh, I don't know what's doable and what's not. His summary of the whole thing is that I'll be eating European-style--fresh food, freshly cooked. It would be great if it were just that simple.
Here's what I can have:
* fresh meat, poultry, eggs.
* a fairly generous range of foods dairy-wise, but I don't think I'll take advantage of that. Since I can get protein from meat, I won't lean on cheese for it instead.
* most vegetables and fruit
It also seems to be limiting my chocolate and molasses and licorice consumption. Honestly, putting chocolate in that sentence makes it seem so much less appealing I could even give that up for a heartbeat or two.
I figure that in the first day or so of the juice cleanse I'll do a long slow Wholefoods/Trader Joe's shopping excursion and lay out a plan for a few weeks of healthy eats, and work out how often I'll need to be shopping to sustain this lifestyle.
He's out of medicine, he says.
I brought up dietary mods, and he agrees that tyramine and wheat are a good place to start, although wheat is difficult. I don't doubt that for a second. The idea is to quit as much as possible for three or four weeks, and if it has made a difference, start introducing foods slowly back in and see what makes the needle wiggle.
I figure wheat will be the first thing back in, if I don't snap horribly beforehand. His tyramine recommendations are from the National Headache Foundation, and look...oh, I don't know what's doable and what's not. His summary of the whole thing is that I'll be eating European-style--fresh food, freshly cooked. It would be great if it were just that simple.
Here's what I can have:
* fresh meat, poultry, eggs.
* a fairly generous range of foods dairy-wise, but I don't think I'll take advantage of that. Since I can get protein from meat, I won't lean on cheese for it instead.
* most vegetables and fruit
It also seems to be limiting my chocolate and molasses and licorice consumption. Honestly, putting chocolate in that sentence makes it seem so much less appealing I could even give that up for a heartbeat or two.
I figure that in the first day or so of the juice cleanse I'll do a long slow Wholefoods/Trader Joe's shopping excursion and lay out a plan for a few weeks of healthy eats, and work out how often I'll need to be shopping to sustain this lifestyle.
21 March, 2008
Potential toxin #1: Tyramine
http://en.wikipedia.org/wiki/Tyramine
My specialist mentioned that one of the few medications left untried was something tied into adrenaline, but that would require dietary modification because I would run the risk of ending up with either too much adrenaline in my system, or too much adrenaline precursor. From reading the Wikipedia entry on tyramine I wonder if it's related. I'm pretty sure he also mentioned MAOI inhibitors.
In humans, if monoamine metabolism is compromised by the use of monoamine oxidase inhibitors (MAOIs) and foods high in tyramine are ingested, a hypertensive crisis can result as tyramine can cause the release of stored monoamines, such as dopamine, norepinephrine, epinephrine.
The entry goes on to say there are no conclusive links between tyramine and migraines, but, well, conclusive isn't helping much is it? So this is a possible avenue of deprivation to explore:
Foods containing considerable amounts of tyramine include meats that are potentially spoiled or pickled, aged, smoked, fermented, or marinated (some fish, poultry, and beef), most pork (except cured ham), chocolate, alcoholic beverages, and fermented foods such as most cheeses (except ricotta, cottage cheese, cream cheese), sour cream, yogurt, shrimp paste, soy sauce, soy bean condiments, teriyaki sauce, tofu, tempeh, miso soup, sauerkraut, broad (fava) beans, green bean pods, Italian flat (Romano) beans, Chinese (Snow) pea pods, avocados, bananas, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast, and an array of Cacti.
I just have to find out what would be left over, especially when it comes to proteins--poultry, beef, some fish, and most pork? What's left? As is, it doesn't look sustainable for too long. If the reduced diet is stressful, after all, the whole effort will be counterproductive.
My specialist mentioned that one of the few medications left untried was something tied into adrenaline, but that would require dietary modification because I would run the risk of ending up with either too much adrenaline in my system, or too much adrenaline precursor. From reading the Wikipedia entry on tyramine I wonder if it's related. I'm pretty sure he also mentioned MAOI inhibitors.
In humans, if monoamine metabolism is compromised by the use of monoamine oxidase inhibitors (MAOIs) and foods high in tyramine are ingested, a hypertensive crisis can result as tyramine can cause the release of stored monoamines, such as dopamine, norepinephrine, epinephrine.
The entry goes on to say there are no conclusive links between tyramine and migraines, but, well, conclusive isn't helping much is it? So this is a possible avenue of deprivation to explore:
Foods containing considerable amounts of tyramine include meats that are potentially spoiled or pickled, aged, smoked, fermented, or marinated (some fish, poultry, and beef), most pork (except cured ham), chocolate, alcoholic beverages, and fermented foods such as most cheeses (except ricotta, cottage cheese, cream cheese), sour cream, yogurt, shrimp paste, soy sauce, soy bean condiments, teriyaki sauce, tofu, tempeh, miso soup, sauerkraut, broad (fava) beans, green bean pods, Italian flat (Romano) beans, Chinese (Snow) pea pods, avocados, bananas, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast, and an array of Cacti.
I just have to find out what would be left over, especially when it comes to proteins--poultry, beef, some fish, and most pork? What's left? As is, it doesn't look sustainable for too long. If the reduced diet is stressful, after all, the whole effort will be counterproductive.
There are foods that are already and clearly on my no fly list, since my sensitivity is dramatic and swift.
Aspartame: I want to say all artificial sweeteners, but that doesn't make sense--it's probably just that I dislike Splenda. I avoid them mostly anyway because of the slippery mouth feel and unpleasant aftertaste, but now I even avoid most chewing gum, since ten minutes of chewing can start the pain.
Nitrites: This is another one I discovered by myself. Suddenly pepperoni pizzas were no longer palatable. I studiously avoid all sausage with nitrites in them, and limit my bacon intake--it's good that I live in a large enough market that I can find breakfast meats light on the preservatives.
Mint: Not always, but sometimes. And when it does, it sends me over hard. Often it's mint and sweet, which is why I don't chew gum anymore, and why I've switched to weirdo toothpaste.
These are the biggies--the ones where I still have the taste in my mouth when the pain sets in. They are the easy ones, since I don't miss them. Feeling them trigger pain makes them no longer tasty. I have some misty technical sadness at the loss of pepperoni, but I can't look at a slice of the pizza with hunger anymore.
The next part of the investigation will be much more complicated.
Aspartame: I want to say all artificial sweeteners, but that doesn't make sense--it's probably just that I dislike Splenda. I avoid them mostly anyway because of the slippery mouth feel and unpleasant aftertaste, but now I even avoid most chewing gum, since ten minutes of chewing can start the pain.
Nitrites: This is another one I discovered by myself. Suddenly pepperoni pizzas were no longer palatable. I studiously avoid all sausage with nitrites in them, and limit my bacon intake--it's good that I live in a large enough market that I can find breakfast meats light on the preservatives.
Mint: Not always, but sometimes. And when it does, it sends me over hard. Often it's mint and sweet, which is why I don't chew gum anymore, and why I've switched to weirdo toothpaste.
These are the biggies--the ones where I still have the taste in my mouth when the pain sets in. They are the easy ones, since I don't miss them. Feeling them trigger pain makes them no longer tasty. I have some misty technical sadness at the loss of pepperoni, but I can't look at a slice of the pizza with hunger anymore.
The next part of the investigation will be much more complicated.
20 March, 2008
29 February, 2008
Finger licking good
I think I'm going to attack diet.
It might seem weird that it's only coming up now, but it's not, really. I've made adjustments to my diet but they weren't arcane in any way, or requiring of any detective work to suss out. I can get a migraine from the Nutrasweet in a stick of gum before it loses its flavour, or be sunk by the nitrites in a sausage before finishing the dog. Nice and simple, easily avoided.
What if there's more? In stuff I mind giving up, or which is kinda hard to ignore?
So I'm going to go terribly LA and do a cleanse, and then embark upon a couple weeks of a restricted diet and see what happens.
Thing is, my last cleanse had me incredibly pissy and migrainey by day 2...I have to make sure I'm not running that risk again. So I'll probably opt for something embarassingly chi-chi and expensive in terms of a cleanse, and then buy out half of Wholefoods for my restricted diet afterwards.
As for restrictions--where to start? Wheat, I think. Let me see if I can do without that a while.
It might seem weird that it's only coming up now, but it's not, really. I've made adjustments to my diet but they weren't arcane in any way, or requiring of any detective work to suss out. I can get a migraine from the Nutrasweet in a stick of gum before it loses its flavour, or be sunk by the nitrites in a sausage before finishing the dog. Nice and simple, easily avoided.
What if there's more? In stuff I mind giving up, or which is kinda hard to ignore?
So I'm going to go terribly LA and do a cleanse, and then embark upon a couple weeks of a restricted diet and see what happens.
Thing is, my last cleanse had me incredibly pissy and migrainey by day 2...I have to make sure I'm not running that risk again. So I'll probably opt for something embarassingly chi-chi and expensive in terms of a cleanse, and then buy out half of Wholefoods for my restricted diet afterwards.
As for restrictions--where to start? Wheat, I think. Let me see if I can do without that a while.
12 July, 2007
Alternatives
I've embarked upon a number of searches to find ways to manage my migraines other than medication.
Acupuncture: I still do this, once a week when I feel up to the drive on a Saturday morning. It kills a migraine dead, plus I like my acupuncturist a great deal (he's a fellow krav student). I have no idea if it has any lasting effect, but a short term effect stronger than meds? I'm all about that.
Biofeedback: I probably gave up on these sessions too soon. I admit I balk very quickly when a doctor's front desk people give me grief, but still. I got to the point where I could increase the blood flow to my extremities mostly on demand, and that could help alleviate migraines if done really early on. I still use that now. The problem with the other stuff was that I can't tell the difference without the monitoring equipment. I mean, I managed to do it, but only because I could tell by reading what was working and what wasn't. The memory of the effort wasn't enough for me to be able to duplicate it when unwired.
Pain management: This is totally apart from migraine meds. I've had two things--nerve blocks (2 of the 3 worked really well), and trigger point injections (oddly, the ones given to me by my pain management guy worked less well than the ones from one specific ER doc, or my primary care physician).
Dietary modification: I have some really obvious triggers. Artificial sweeteners and nitrites are pretty much guaranteed to cause a migraine. All the migraine specialists I spoke to said to keep avoiding what I could tell was a problem and to ignore anything more subtle. However people more into dietary mods keep telling me it's gluten or it's yeast or some other thing that would stop me from eating bread. I admit, I'm not that open-minded about giving those things a shot. It's not that I think the solution to the migraine problem needs to be easy--just that I don't know I have the energy to stick to anything that's not. My ER escort, as noted earlier, thinks that more salt=fewer migraines. He enjoyed forcing me to finish my bacon last night. Does that still count as sadism, if it's for my own good? Well, it probably doesn't count as sadism because I got a chocolate cupcake for my troubles. Still, pretty close. (side note: bacon's nitrites have never sparked a migraine, but most other meats will give me the whammy)
Physical therapy: This is either good or bad. On a delicate day like yesterday, they can't really touch me without triggering a migraine. I quit my last PT guy for a number of reasons, but even if I hadn't I was going to make sure he stopped working my neck. The pain bounces right up into a migraine, and he provoked at least one sick day before I bolted. The current PT people--well, I get a light massage, some ultrasound, heat, ice, and electrical stimulation, and then they watch me do my daily exercise. The best thing about them is that I get no grief for last-minute cancellations. My life has to be as cancellation-friendly as possible, sadly.
Psychotherapy: This is pissing me off. This post became more urgent because of the call I just took. I decided to go to a therapist to get coping mechanisms for my response to migraines. The guy decided he wanted to cure them. Admirable, but not the point. Not my point, anyway. I saw him 4 or 5 times, and was never able to get him back on the track *I* thought I needed. So, with the impending hospitalisation, I cancelled my upcoming appointments via phone message, telling him that I'd re-evaluate my direction after the DHE infusion. The bit where he calls me a couple days later to ask me to go over my intentions at least twice? Not endearing him to me. The bit where he tells me that my neuro and migraine guru want me to see a therapist? Not convincing me to make that therapist *him*. I hate being nagged, and he's nowhere near enough to me to get away with it.
Botox: Boy, did I hate this. I lost the ability to furrow my brows. And that's a key part of my teaching style. But seriously--it made no impact whatsoever on the frequency or severity of my migraines, and even the partial paralysis (didn't affect the lower half of my forehead) wore off pretty quickly. Figures, doesn't it? My body killed that toxin right dead.
Acupuncture: I still do this, once a week when I feel up to the drive on a Saturday morning. It kills a migraine dead, plus I like my acupuncturist a great deal (he's a fellow krav student). I have no idea if it has any lasting effect, but a short term effect stronger than meds? I'm all about that.
Biofeedback: I probably gave up on these sessions too soon. I admit I balk very quickly when a doctor's front desk people give me grief, but still. I got to the point where I could increase the blood flow to my extremities mostly on demand, and that could help alleviate migraines if done really early on. I still use that now. The problem with the other stuff was that I can't tell the difference without the monitoring equipment. I mean, I managed to do it, but only because I could tell by reading what was working and what wasn't. The memory of the effort wasn't enough for me to be able to duplicate it when unwired.
Pain management: This is totally apart from migraine meds. I've had two things--nerve blocks (2 of the 3 worked really well), and trigger point injections (oddly, the ones given to me by my pain management guy worked less well than the ones from one specific ER doc, or my primary care physician).
Dietary modification: I have some really obvious triggers. Artificial sweeteners and nitrites are pretty much guaranteed to cause a migraine. All the migraine specialists I spoke to said to keep avoiding what I could tell was a problem and to ignore anything more subtle. However people more into dietary mods keep telling me it's gluten or it's yeast or some other thing that would stop me from eating bread. I admit, I'm not that open-minded about giving those things a shot. It's not that I think the solution to the migraine problem needs to be easy--just that I don't know I have the energy to stick to anything that's not. My ER escort, as noted earlier, thinks that more salt=fewer migraines. He enjoyed forcing me to finish my bacon last night. Does that still count as sadism, if it's for my own good? Well, it probably doesn't count as sadism because I got a chocolate cupcake for my troubles. Still, pretty close. (side note: bacon's nitrites have never sparked a migraine, but most other meats will give me the whammy)
Physical therapy: This is either good or bad. On a delicate day like yesterday, they can't really touch me without triggering a migraine. I quit my last PT guy for a number of reasons, but even if I hadn't I was going to make sure he stopped working my neck. The pain bounces right up into a migraine, and he provoked at least one sick day before I bolted. The current PT people--well, I get a light massage, some ultrasound, heat, ice, and electrical stimulation, and then they watch me do my daily exercise. The best thing about them is that I get no grief for last-minute cancellations. My life has to be as cancellation-friendly as possible, sadly.
Psychotherapy: This is pissing me off. This post became more urgent because of the call I just took. I decided to go to a therapist to get coping mechanisms for my response to migraines. The guy decided he wanted to cure them. Admirable, but not the point. Not my point, anyway. I saw him 4 or 5 times, and was never able to get him back on the track *I* thought I needed. So, with the impending hospitalisation, I cancelled my upcoming appointments via phone message, telling him that I'd re-evaluate my direction after the DHE infusion. The bit where he calls me a couple days later to ask me to go over my intentions at least twice? Not endearing him to me. The bit where he tells me that my neuro and migraine guru want me to see a therapist? Not convincing me to make that therapist *him*. I hate being nagged, and he's nowhere near enough to me to get away with it.
Botox: Boy, did I hate this. I lost the ability to furrow my brows. And that's a key part of my teaching style. But seriously--it made no impact whatsoever on the frequency or severity of my migraines, and even the partial paralysis (didn't affect the lower half of my forehead) wore off pretty quickly. Figures, doesn't it? My body killed that toxin right dead.
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