16 Facts About Migraines

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Unless you suffer from migraines yourself, you may think that having a migraine means having a really bad headache. But debilitating head pain is only one part of the medical condition called migraine disorder. Other common symptoms are nausea, dizziness, fatigue, sensitivity to light and sound, and even temporary blindness. The symptoms and causes of migraine look different in different patients, and researchers are only now beginning to understand what the condition is and how to treat it. Here are some of the most enlightening facts we know about migraine disorder.

1. IT'S THE THIRD MOST COMMON DISEASE IN THE WORLD.

Even if you don’t suffer from migraine, chances are you know someone who does: The disorder affects 14.7 percent of the population, or one in seven people, around the world. In the U.S. alone, roughly 39 million people are affected by the condition. Chronic migraine (experiencing at least 15 headache days per month over a three-month period, with over half being migraines) is more rare, impacting about 2 percent of the world population.

2. WOMEN SUFFER MORE THAN MEN.

Of the one billion people on Earth who have migraine disorder, three-fourths are women. Medical experts suspect this has to do with the cyclical nature of female hormones. According to research presented earlier in 2018, NHE1, the protein that regulates the transfer of protons and sodium ions across cell membranes, is a crucial component of migraine headaches. NHE1 production likely fluctuates a lot more in women than in men. When scientists looked at the brains of lab rats, they found that NHE1 levels were lowest when estrogen was at its peak. In general, female rats also had four times the amount of NHE1 in their brains as males. If the same holds true for people, that could explain why women are not only more likely to suffer migraines in the first place, but why they experience them more frequently and more intensely, and have more difficulty responding to treatment.

3. MIGRAINE TRIGGERS VARY WIDELY.

For doctors and sufferers, migraine triggers can be a source of confusion. They vary from patient to patient and often come from unexpected sources that have no relation to each other. Stress, too much or too little sleep, dehydration, alcohol, and caffeine are some of the most common triggers. Some people get migraines after eating specific foods, like cheese, and others are sensitive to changes in weather conditions like barometric pressure. Some people manage their migraines by pinpointing and avoiding triggers.

4. FOR SOME, AURAS ARE A WARNING THAT A MIGRAINE IS COMING.

Before the nausea, dizziness, and splitting head pain begin, auras warn some people that a migraine is on its way. Less than 25 percent [PDF] of migraine sufferers experience distorted senses, such as numbness or tingling in the hands or face, or blotches of light or darkness disrupting their vision. Auras usually occur 10 to 30 minutes before the migraine develops and last from five minutes to one hour.

5. SYMPTOMS CAN INCLUDE TEMPORARY BLINDNESS …

Unlike migraine with aura, retinal migraine is limited to one eye. Symptoms range from seeing twinkling stars to partial or complete loss of vision. The same eye is almost always affected, and the person typically regains their sight after 10 to 20 minutes.

6. … AND LOSS OF LIMB FUNCTION.

One of the rarest, and scariest, subtypes of migraine is hemiplegic migraine. People with this variant can experience weakness, numbness, tingling, or loss of motor function in parts of one half of their body, including their arm, leg, or face. Though sensations usually dissipate within 24 hours, they can last anywhere from one hour to several days. Sometimes they’re accompanied by typical migraine symptoms, such as head pain, but they can also occur on their own.

7. KIDS GET MIGRAINES TOO.

Migraine isn’t just a problem for adults—up to 10 percent of all school-aged kids are affected by the disorder, with reported cases coming from children as young as 18 months. According to the documentary Out of My Head (2018), migraine is the third most common reason for child emergency room visits. The symptoms of migraine in kids are similar to what’s seen in older patients: They may experience intense head pain, sick feelings, distorted vision, and sensitivity to sound and light. The major differences are that child migraines often develop suddenly and are shorter than they are in adults. In children, it’s not uncommon for the nausea and abdominal pain to feel worse than the actual headaches. Just as some sufferers don’t experience their first episodes until after puberty, some children with migraine grow out of it. According to one study, migraine symptoms disappeared completely in 23 percent of former child sufferers by age 25.

8. MIGRAINE MAY BE HEREDITARY.

For most people with migraine disorder, it runs in the family. Anywhere from 80 to 90 percent of migraine sufferers report having at least one family member who has it as well. If one parent has migraine, there’s a 50 percent chance their child will eventually have to live with migraine—and that risk shoots up to 75 percent when both parents have the condition.

9. MANY VETERANS RETURN HOME WITH MIGRAINES.

Genetics isn’t the only factor that contributes to someone’s chance of having migraine disorder. One study found that after a 12-month deployment in Iraq, 36 percent of veterans exhibited symptoms of migraine. The cause often stems from head or neck trauma sustained from explosions, falls, or other accidents during their service. While post-traumatic migraine goes away in most patients within a few months, in some cases it can develop into a chronic condition.

10. MIGRAINE IS LINKED TO THE "SECOND BRAIN" IN YOUR GUT.

In addition to the part of our nervous system that responds to outside stimuli, humans have an enteric nervous system: the part responsible for regulating digestion. Some medical experts believe that migraine is closely tied to this “second brain.” People with migraine are twice as likely to have IBS as people with tension headaches. Abdominal migraine, where the pain is concentrated in the stomach rather than the head, is one form the condition takes. It's most often seen in children, but it can affect adults as well.

11. DESPITE THE HIGH COST OF MIGRAINE DISORDER, RESEARCH IS UNDERFUNDED.

In 2017, the National Institutes of Health invested $22 million in migraine research. Asthma research received $286 million, breast cancer $689 million, and diabetes $1.1 billion.

12. THE DISORDER COSTS US UP TO $13 BILLION ANNUALLY.

Though migraine isn't life-threatening like these other conditions, it is widespread enough to have a negative impact on society as a whole. Workers with migraine often end up taking a lot of time off from their jobs, which can cost their employers. According to Out of My Head, it’s estimated that 113 million work days are missed annually due to migraine, adding up a to $13 billion loss.

13. MIGRAINE MAY HAVE INSPIRED PARTS OF ALICE IN WONDERLAND …

In the famous children’s book, Alice drinks a liquid that makes her grow many times her size and eats a cookie that shrinks her to tiny proportions. Migraine sufferers may recognize themselves in these passages. Possible symptoms of the disorder include micropsia and macropsia, or perceiving objects to be much smaller or larger than they really are. Some theorize that Alice in Wonderland author Lewis Carroll suffered migraines and wrote his experiences into his story. The book’s connection to migraine is so famous that today the related symptoms are commonly known as Alice in Wonderland Syndrome.

14. … AND PLAGUED A FOUNDING FATHER.

Another famous person from history who likely suffered from migraines was Thomas Jefferson. His symptoms could last for weeks and often appeared during stressful times in his life. There was even an episode that coincided with one of the most important nights of his political career. One night in June 1790, he invited Federalist Alexander Hamilton and Republican James Madison to his home for a dinner party in the hopes of getting his peers to agree on a location for the new U.S. capital. Despite dealing with lingering head pain from a migraine, he successfully brokered the compromise that landed the capital at its current spot on the Potomac River between Maryland and Virginia. In return, Madison agreed that he would not block Hamilton's plan for the federal government to take on state war debt, thus helping establish the young nation's credit.

15. MIGRAINE IS LINKED TO DEPRESSION.

In the U.S., up to 40 percent of people with migraine also have depression. Risk of anxiety, bipolar disorder, and panic disorder are also higher in migraine sufferers. Researchers are still figuring out the connections between mental illness and migraine. While the anticipation of painful symptoms can cause depression and anxiety in some people, experts believe that mental illness is often more than just an effect of living with migraine. The production of the brain chemical serotonin is involved in both migraine and depression. That’s why tricyclic antidepressants designed to increase serotonin levels are sometimes prescribed to treat migraine.

16. A NEW SHOT CAN TREAT MIGRAINE.

Many migraine therapies from the past few decades have been the result of trial and error. Medications designed to treat other conditions, such as antidepressants, epilepsy medicine, and botox, have all been prescribed to migraine sufferers, with mixed results. Earlier in 2018, the first-ever shot made to treat migraines specifically secured FDA approval. The shot, which blocks a peptide linked to migraine, is taken once a month and can improve symptoms or completely eliminate them in some cases. Before the new injection came along, the only other migraine-specific medications patients had to choose from were triptans, which stimulate the neurotransmitter serotonin. They can't prevent migraine, but they can help dampen symptoms by reducing inflammation and constricting blood flow. According to Out of My Head, triptans were first approved more than two decades ago—so new medication options are long overdue.

8 Enlightening Facts About Dr. Ruth Westheimer

Rachel Murray, Getty Images for Hulu
Rachel Murray, Getty Images for Hulu

For decades, sex therapist Dr. Ruth Westheimer has used television, radio, the written word, and the internet to speak frankly on topics relating to human sexuality, turning what were once controversial topics into healthy, everyday conversations.

At age 90, Westheimer shows no signs of slowing down. As a new documentary, Ask Dr. Ruth, gears up for release on Hulu this spring, we thought we’d take a look at Westheimer’s colorful history as an advisor, author, and resistance sniper.

1. The Nazis devastated her childhood.

Dr. Ruth was born Karola Ruth Siegel on June 4, 1928 in Wiesenfeld, Germany, the only child of Julius and Irma Siegel. When Ruth was just five years old, the advancing Nazi party terrorized her neighborhood and seized her father in 1938, presumably to shuttle him to a concentration camp. One year later, Karola—who eventually began using her middle name and took on the last name Westheimer with her second marriage in 1961—was sent to a school in Switzerland for her own protection. She later learned that her parents had both been killed during the Holocaust, possibly at Auschwitz.

2. She shocked classmates with her knowledge of taboo topics.

Westheimer has never been bashful about the workings of human sexuality. While working as a maid at an all-girls school in Switzerland, she made classmates and teachers gasp with her frank talk about menstruation and other topics that were rarely spoken of in casual terms.

3. She trained as a sniper for Jewish resistance fighters in Palestine.

Following the end of World War II, Westheimer left Switzerland for Israel, and later Palestine. She became a Zionist and joined the Haganah, an underground network of Jewish resistance fighters. Westheimer carried a weapon and trained as both a scout and sniper, learning how to throw hand grenades and shoot firearms. Though she never saw direct action, the tension and skirmishes could lapse into violence, and in 1948, Westheimer suffered a serious injury to her foot owing to a bomb blast. The injury convinced her to move into the comparatively less dangerous field of academia.

4. A lecture ignited her career.

 Dr. Ruth Westheimer participates in the annual Charity Day hosted by Cantor Fitzgerald and BGC at Cantor Fitzgerald on September 11, 2015 in New York City.
Robin Marchant, Getty Images for Cantor Fitzgerald

In 1950, Westheimer married an Israeli soldier and the two relocated to Paris, where she studied psychology at the Sorbonne. Though the couple divorced in 1955, Westheimer's education continued into 1959, when she graduated with a master’s degree in sociology from the New School in New York City. (She received a doctorate in education from Columbia University in 1970.) After meeting and marrying Manfred Westheimer, a Jewish refugee, in 1961, Westheimer became an American citizen.

By the late 1960s, she was working at Planned Parenthood, where she excelled at having honest conversations about uncomfortable topics. Eventually, Westheimer found herself giving a lecture to New York-area broadcasters about airing programming with information about safe sex. Radio station WYNY offered her a show, Sexually Speaking, that soon blossomed into a hit, going from 15 minutes to two hours weekly. By 1983, 250,000 people were listening to Westheimer talk about contraception and intimacy.

5. People told her to lose her accent.

Westheimer’s distinctive accent has led some to declare her “Grandma Freud.” But early on, she was given advice to take speech lessons and make an effort to lose her accent. Westheimer declined, and considers herself fortunate to have done so. “It helped me greatly, because when people turned on the radio, they knew it was me,” she told the Harvard Business Review in 2016.

6. She’s not concerned about her height, either.

In addition to her voice, Westheimer became easily recognizable due to her diminutive stature. (She’s four feet, seven inches tall.) When she was younger, Westheimer worried her height might not be appealing. Later, she realized it was an asset. “On the contrary, I was lucky to be so small, because when I was studying at the Sorbonne, there was very little space in the auditoriums and I could always find a good-looking guy to put me up on a windowsill,” she told the HBR.

7. She advises people not to take huge penises seriously.

Westheimer doesn’t frown upon pornography; in 2018, she told the Times of Israel that viewers can “learn something from it.” But she does note the importance of separating fantasy from reality. “People have to use their own judgment in knowing that in any of the sexually explicit movies, the genitalia that is shown—how should I say this? No regular person is endowed like that.”

8. She lectures on cruise ships.

Westheimer uses every available medium—radio, television, the internet, and even graphic novels—to share her thoughts and advice about human sexuality. Sometimes, that means going out to sea. The therapist books cruise ship appearances where she offers presentations to guests on how best to manage their sex lives. Westheimer often insists the crew participate and will regularly request that the captain read some of the questions.

“The last time, the captain was British, very tall, and had to say ‘orgasm’ and ‘erection,’” she told The New York Times in 2018. “Never did they think they would hear the captain talk about the things we were talking about.” Of course, that’s long been Westheimer’s objective—to make the taboo seem tame.

10 Things You Should Know About Asthma

iStock.com/Wojciech Kozielczyk
iStock.com/Wojciech Kozielczyk

To anyone with asthma, the feeling of an attack is unmistakable. Patients have compared an asthma attack's feeling of breathlessness, caused by inflammation in the lungs and airways, to being smothered by a pillow or having an elephant sit on their chest. Medical experts have already figured out some aspects of asthma, like how to diagnose and treat it, but other components, like what causes asthma and how to cure it, remain unclear. From the triggers people encounter at work to the connection to allergies, here are some facts about asthma symptoms and treatments you should know.

1. Asthma attacks are related to allergies.

The physical process that occurs when someone has a sneezing fit during pollen season is similar to what happens during an asthma attack. But while the former causes discomfort, the latter produces potentially life-threatening symptoms. When people with allergies are exposed to an allergen like pollen, they produce antibodies that bind to that allergen. This signals the body to release the chemicals that cause allergic symptoms. In most people, the symptoms are limited to the head, such as a runny nose or watery eyes, but in people with asthma, they're felt in the lungs. If the lungs are inflamed, the airways that carry air swell up and fill with mucus, constricting airflow and causing common asthma symptoms like coughing, wheezing, and shortness of breath. Such asthma attacks can be fatal when patients can’t get enough air to their lungs.

2. Asthma is the most prevalent chronic disease among children.

Asthma is common, affecting 25 million in the U.S. alone, and of those patients, about 7 million are children. Most people with the disease develop it during childhood. Asthma is the most prevalent chronic illness among kids, and each year, students miss 13.8 million school days because of it.

3. Asthma may be inherited.

Doctors aren’t entirely sure what causes asthma, but they know it sometimes runs in families. A 2010 study found that people with one parent with the condition were nearly twice as likely to have it themselves, and people with a parent and a grandparent with asthma were four times more likely to develop it. Because asthma is connected to allergies, a genetic disposition toward allergies, known as atopy, may explain some inherited asthma cases.

4. Asthma is surprisingly easy to diagnose.

One of the simplest ways to diagnose asthma is through a lung function test. If a patient is reporting asthma symptoms (coughing, chest tightness, a feeling of not getting enough air), their doctor may check the strength of their exhalations before and after having them use an inhaler. If their breathing improves with the medicine, they likely have asthma. An X-ray of the patient’s chest can also be used to reach an asthma diagnosis.

5. Kids who grow up around germs are less likely to have asthma.

A person’s environment early in life may also play a role in whether or not they develop asthma. People who grew up in rural areas, around animals, and in large families are less likely to have asthma than those who did not. One possible explanation is the hygiene hypothesis: According to this theory, kids who were exposed to germs and pathogens while their immune systems were developing are better equipped to deal with allergens, while kids who were sheltered from germs may be more likely to have an exaggerated (and in the case of asthma, potentially deadly) immune response to harmless substances. The hygiene hypothesis hasn’t been proven, however, and it’s definitely not an excuse to expose children to infections in an attempt to strengthen them against asthma attacks in the future.

6. Asthma triggers are everywhere.

To manage their symptoms, doctors tell asthma patients to limit exposure to their triggers when possible. Common asthma triggers include irritants and allergens like dust, tobacco smoke, car exhaust, mold, pet dander, and smoke from burning wood. Triggers that don’t come from the environment, like colds, sinus infections, acid reflux, and hyperventilation brought on by stress, can be even harder to avoid.

7. There's one asthma trigger patients shouldn't avoid.

Physical activity causes fast breathing, which can provoke asthma attacks in some people with the condition. There’s even a type of asthma called exercise-induced bronchoconstriction that specifically describes people who suffer from these kinds of attacks. But the risks of living a sedentary lifestyle outweigh those of exercising carefully, even with asthma. Instead of cutting out cardio altogether, doctors work with patients to come up with an exercise plan that’s safe for them. This might include warming up and using an inhaler before working out, practicing cool-down activities afterward, and wearing scarves or masks to limit exposure to irritants that may also trigger asthma symptoms.

8. There are two types of asthma treatments.

Long-term controllers and quick-relievers are the two types of medications used to treat asthma. Immediate medicines like short-acting beta agonists and anticholinergics relax muscles in the airways when flare-ups occur, and they’re typically administered directly to the lungs with an inhaler. Long-term medications help keep asthma symptoms under control over time are taken as often as once a day, regardless of whether symptoms are present. They include inhaled long-acting beta agonists and corticosteroids, biologic injections, and theophylline and leukotriene modifier pills and liquids. All of these medications suppress asthma symptoms by either relaxing muscles, reducing swelling, or preventing inflammation in the airways.

9. Asthma can be an occupational hazard.

Occupational asthma develops when a patient’s triggers come from their work environment. According to the National Institutes of Health, wood dust, grain dust, animal dander, fungi, and various chemicals are some of the most common asthma triggers that patients encounter in the workplace. Bakers, farmers, laboratory workers, millers, and woodworkers predisposed to asthma are all at higher risk.

10. There's no cure for asthma, but symptoms can lessen over time.

Though asthma is treatable, there’s no cure for the chronic illness. Some people, however, do appear to grow out of the condition after suffering from it as kids. It’s possible for asthma symptoms to become less severe and go into remission as patients get older, but once someone is diagnosed with asthma, the risk of an episode never goes away completely. Changes in hormone levels are a factor that could possibly bring asthma symptoms back in patients who haven’t experienced an attack in years.

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