Dealings with Headaches
by Michael J. Manyak, MD, FACS, MED 92
The term headache describes a myriad of problems whether they are truly medical or actually situational (like long airline check-in lines). Most headaches with a medical origin are an unwelcome nuisance…..but fortunately it rarely is a life-threatening emergency. Knowing how to prevent headaches, how to treat them before they ruin your day, and knowing when a headache is more than a headache is important for every traveler to know.
Headaches are common with three quarters of the population suffering at least one headache during any given year. Women are more likely to suffer headaches than men and three times as likely to suffer from migraine headaches.
Headaches fall into two main categories, primary and secondary. Primary headaches are the most common and are usually migraine or tension varieties but many primary headache sufferers have a combination of both types. Primary headaches are not usually a warning sign of a more dangerous condition. They certainly can be debilitating but can be very manageable and often preventable with proper knowledge and preparation.
Secondary headaches result from some other process. These often have benign causes such as a sinus infection, side effect of new medication, or relate to climate. However, headaches can also result from a more ominous event such as a stroke, a cerebral aneurysm, or a tumor. An abrupt and forceful onset of a severe headache that is often accompanied by some other sensory experience like a flash of light, temporary partial or total blindness, hearing loss, or mental confusion requires immediate emergency medical care. These secondary headaches are often called a “thunderclap” headache. In addition to a sudden, severe headache, a persistent chronic headache also requires further investigation. It may be difficult to distinguish between a primary headache and one caused by more serious conditions but anything sudden or persistent should raise concerns.
Another important but uncommon cause of headache is meningitis, an inflammation of the covering of the brain and spinal cord. Meningitis may be caused by viruses or bacteria and rarely by fungi and parasites. Symptoms develop 3 to 7 days after exposure. Meningitis presents with sudden onset of severe headache, fever, stiff neck, and often nausea, vomiting, and light sensitivity. Bacterial meningitis may present with a purplish rash. Viral meningitis resolves in 7 to 10 days without treatment. Bacterial meningitis has more severe symptoms, has a 10 to 15 percent mortality rate, may have significant side effects, and requires immediate treatment. Vaccination is recommended for travel in areas of known bacterial meningitis. When you hear about the need for a meningitis vaccination, this is referring only to the bacterial form because there is no vaccination for viral meningitis.
Many primary headache sufferers have had enough experience to have sought medical advice and to develop ways to cope with their headache. The right combinations of medicines and avoidance of headache triggers often vary for individuals.
Travelers who have frequent headaches should discuss prevention and treatment with their physicians. Some basic steps to reduce the quantity and intensity of their headaches on travel should be considered.
• Sleep deprivation or an irregular sleep schedule can contribute to headaches. Try to get at least 7 hours of sleep each night and maintain a regular sleep-wake schedule. Sleep can help thwart an emerging headache. Try using an eye mask, earplugs, and a good travel pillow to sleep better, particularly on long flights.
• Stay well hydrated to help prevent primary headaches. Water is best but caffeinated beverages can also hydrate and for some headaches caused by vascular spasm, caffeine can help relieve pain. Though caffeine does increase urine output because it is a diuretic, the idea that caffeinated beverages cause dehydration is a myth. Used in moderation, caffeinated beverages are safe and do hydrate.
• Headaches can be related to carrying heavy items for prolonged times. Travelers often carry several bags and rush from place to place. Holding unbalanced loads can exert enough tension to create muscle spasms in the shoulders, neck, and scalp and trigger a headache. Care in how you manage loads can reduce your chances of getting a headache.
• Good quality sunglasses can help prevent headaches. These have clear optics in both the central and peripheral regions. Cheap sunglasses can look cool but they are no bargain if they cause you to miss a lifetime travel experience because strong light caused your irises to go into spasm and your head is throbbing. Update your prescription if you wear prescription glasses or contacts.
• Keep analgesic medicine handy. Acetaminophen, ibuprofen, naproxen, or aspirin are common useful medications. Whatever works best for your headaches should be handy. They do no good if they are back at the hotel.
• Know your headache triggers. Pollen, alcohol, dust, animal dander, and fluorescent light can precipitate a headache in different people. If you have a trigger, then you know what you need to try to avoid it.
• If you or a travel partner has a headache accompanied by changes in vision, slurred speech, sudden muscle weakness particularly on one side, paralysis, or other unusual symptoms, you should seek immediate medical attention.
This article was published in The Explorers Journal
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