Reddit mentions of The Mysterious Mind: How to Use Ancient Wisdom and Modern Science to Heal Your Headaches and Reclaim Your Health

Note, I'm listening while working, so these won't be by any means all-encompassing.

David Dodick, Director of Headache Program, The Mayo Clinic

It's not your fault.

Repeat.

It is not your fault.

There are numerous (40+) genes that have been tied to it. He calls the heritable condition a hyper-responsive brain (as opposed to hyper-sensitive). It is a combination of biology + environment.

• Phases of attack:
  
  Premonitory/prodrome: Roughly 3/4 of patients (possibly more that don't realize it). It's not in the blood vessel, or the nerves, it begins in the brain. This gives us an interesting window for treatment, especially considering the total time of attack when we consider from start of prodrome to end of postdrome. Take care not to mistake prodromal symptoms with triggers (food cravings/scent are common).
  
  Aura: Spreading electro-chemical event in the surface/cortex of the brain. 2-3mm/minute. Typically starts in occipital cortex, which explains the visual disturbance. Sensory aura possible depending on where that moves. Language, motor, brainstem auras all fall under the category.
  
  Pain/headache phase: Usually begins with mild pain but usually progresses to moderate-severe. This window of progression varies. Nausea usually here, but can land anywhere and run all the way through postdromal phase. Aura can also start after pain begins or come back after pain phase.
  
  Postdrome/hangover: How long before you feel 'back to normal'? If you can't function, you can't function, and that's just as important as being unable to do so because of pain.
  
  
  
• Why are triggers so cumulative? Because of how responsive your brain is at any given time based on other factors, including other triggers, stress level, fatigue, etc.
  
  
• Visual disturbance- at least 1/2 of patients without aura will have something wrong w/their vision during attack. Blurry, can't see as clearly, not as crisp, etc.
  
  
• Where you experience pain doesn't necessarily reflect where the pathology lies. Examples: TMJ, sinus issues, neck, etc. Migraine refers pain all over the head and neck. That being said, if you're susceptible to migraine attack, other pathologies (sinus, TMJ, etc.), may leave you more likely to see more migraine attacks.
  
  
• Ayurveda/TCM - may have real biology behind them. If patients are finding things that help them, maybe we need to go back to the lab and find out. He does however say to his patients, 'Let's stick with what we know. Let's stick with what we know to be safe.' He has had patients who have had serious complications from homeopathic products. This is important. We need to be sure that what we put in our bodies is safe. Is there a rationale? Are there safety concerns?
  
  
  
  Move Against Migraine Foundation
  
  American Migraine Foundation
  
  Headache on the Hill
  
  American Headache Society
  
  
  Dr. Trupti Gokani, Neurologist & Author, The Mysterious Mind
  
  Interesting to me that she talks about ayurvedic medicine after the comments above. :)
  
  The number of nerves in the nervous system vs the enteric nervous system is about even- when you include the rest of the GI, there are more. You can cut the connection b/w gut and brain and both will continue to function.
  
  Migraine physiology in the gut: Liver (detox- cleanses, breaks down toxins, etc) and gallbladder (breaks down fats) are often overburdened in the effort to break down an excess of food, fats, bad fats, bad emotions. Toxins build up. If you don't have enough bile to buffer your stomach acid. Too much food, too much toxin, not enough bile to buffer the acid. About 50% of migraine patients have some sort of reflux system.
  
  Gastroparesis starts w/the gut being unable to keep up. Then... we don't have enough enzymes to break down the food.
  
  If we're not managing the stressors (food, overall stress, etc), the pain will get worse and the gut will get involved. When it turns off, you may be ok in that moment, w/o lifestyle changes to strengthen the system (as Eastern medicine tells us), the pain will come back.
  
  So... her focus is on addressing the underlying causes that stress the system.
  
  You need a healthy gut. Good poop! Regular poop (yoga and ayurveda are ALL ABOUT THE POOP!). Without help (coffee, laxative). Lack of gas, bloat, constipation, diarrhea. Are you having symptoms? Are you able to have an appetite/hunger signal?
  
  GABA - a neurotransmitter believed to play a role in migraine and affects the gut bacteria. If we eat while stressed, the vagus nerve will kick us into fight or flight and move blood away from the digestive system. Gaba is the inhibitory neurotrx that is released in rest & digest mode. Your gut bacteria like to snack on gaba. Nomz. And it's manufactured by the bacteria in the gut, consumed by bacteria in the gut, and its mfr is triggered by the vagus nerve.
  
  100 TRILLION bacteria in your gut. 10x more bacteria than human cells.
  
  Why isn't there research on this? It's complicated. The gut is complicated. Your'd think your neuro crazy if they asked you about poop. The enteric nervous system (the small intestine has 100 million neurons- as many as in the spine) - it's a powerful system and one we should be paying attention to. It may be doing more to signal well being in certain circumstances. We're becoming more aware and beginning to pay attention (95% of serotonin is produced in the gut) - there's now a field of science- neurogastroenterology- looking at the gut & brain. Most docs aren't trained in this, so studies haven't yet been done.
  
  How can this (ayurvedic medicine) help? Understand your gut type so you can use ayurvedic medicine - digestive enzymes, food, ancient herbals, tea, so you can dose it based on your gut flora, symptoms, headache, etc. She's doing it in her practice but would like to see the studies done, as well as studies regarding how your emotions impact your digestion. Her book does get into research re: the 3 dosha types. She discusses the dosha types, headache types, and what you can do for them.
  
  Go to bed by 10. Make lunch your biggest meal. Make sure you're setting up time to sit and be aware every day- even just 2 minutes to be quiet and mindful.
  
  Food as medicine. Spices (usually cooling- cilantro, cumin, fennel). Supplements/nutrients (magnesium, CoQ10, B2). Start the day with a warm beverage.
  
  Medications that impact gut health: NSAIDs and steroids damage the microbiome- the bugs and the prostaglandin layer (the place your bugs call home). For triptans she recommends non-oral delivery.
  
  The Mysterious Mind: How to Use Ancient Wisdom and Modern Science to Heal Your Headaches and Reclaim Your Health
  
  Trupti Gokani, MD
  
  Deepak Chopra – Ayurvedic
  
  Triggers session:
  
  18% accuracy in determining triggers
  
  only 2 of hundreds had greater than 75% accuracy
  
  
• Common triggers
  The profile used to be menstruation, neck pain, stress, etc.
  
  In the study referenced, what they found that NO ONE IN THE STUDY had the average trigger profile. Many had derivatives and combinations, but no one checked all the boxes for the 'average'. Even those of us that have been at it for years aren't very good at this.
  
  My takeaway - looking at a common list and assuming you should cut them all out is probably a LOT of unneeded pain.
  
  We have a bias for making positive associations vs. negative. If nothing happens, we don't remember the dozens of times we've been exposed to a 'trigger' and have been just fine. Just the one when we were.
  
  One person's potential triggers are another's potential protectors (alcohol, coffee, travel all examples).
  
  'Risk factors' encompass both triggers and protectors in his context. Other things are termed 'no association' factors.
  
  Migraine severity modifiers! These have nothing to do w/whether you will get a migraine, but do have an impact on whether it will be more or less severe.
  
  He also discusses the Curelator app, which has the benefit of some pretty well tested algorithms behind it to help with flagging triggers, protectors, and no association. They are testing the algorithms for the severity modifiers and hope to have that out soon. It's 3 months of tracking to get the maps, and the app, if you don't have a neuro in the coupon program, is $50. Most of us wouldn't drop $50 on any number of other things regarding our migraines, so while it's expensive for an app, if it were, say, a computer program, etc., the expectation would be different (and the program would be harder to use). I've contacted my doc already and if they're not participating in the program I'll be buying the app.
  
  Curelator.com
  
  RTI International
  
  Cincinnati Children's Hospital
  
  Curelator Facebook Page