Dr. David R. Coddon, director of the headache clinic at New York City’s Mount Sinai Medical Center, has won an international reputation for his pioneering work in the treatment of headaches.
Q. Dr. Coddon, are certain people more susceptible to headaches than others?
A. Generally, no. Probably everyone, at one time or another, ahs a headache of some kin – and more than 20 million people a year in this country have headaches severe enough to require medical help.
Q. is the number of headache sufferers increasing?
A. I think so. Environmental stress is unquestionably a major factor.
Q. what does environmental stress have to do with headaches?
A. There’s environmental stress in every dealing with other people and situations – at work, at home, everywhere. Yet paradoxically, it is when stress stops that headaches hit many individuals. The hard-working, hard-driving individual rarely complains about a headache. It’s when he relaxes that the headache comes. There is the week-end headache, the headache that occurs after sexual intercourse, or during and after vigorous sports, such as tennis.
Q. Why should relaxing bring on a headache?
A. Because, in my opinion, the vast majority of headaches are probably due to alterations in the blood flow. That’s different from blood pressure. Let me explain:
The head contains the body’s greatest number of pain-sensitive nerve endings and chemical transmitter. It also has the greatest amount of blood flow. This happens to everyone, but not everyone has severe headaches.
Q. What’s second?
A. Migraine. At least 10 to 20 percent of the world’s population is afflicted. Migraine is a genetic, or hereditary, illness. Four out of five sufferers had a parent who also suffered. Migraine usually starts early in life, frequently in childhood; it is also significantly more prevalent in women than in men.
Q. What does a migraine headache feel like?
A. The attack can be on either side, beginning in the eye and radiating to the back of the head. The pain is throbbing and increases in severity. The patient is usually very sensitive to light and/or sound, may get nauseated and vomit, will want to go into a dark room and lie down. The headache typically can last from several hours to three days, after which most patients will tell you, “Feel all washed out.”
Q. What starts migraines? Why do they stop?
A. There are hormonal factors involved, but we don’t know exactly how they work. In 90 percent of women sufferers, migraine attacks stop completely during pregnancy, and then return after the pregnancy is completed. Migraines also get is completed. Migraines also get worse after a woman has a hysterectomy. The tendency in both sexes is for migraines to decrease or disappear completely by the time the patient is in his 50s to 60s.
Q. What are some other serious types of headaches?
A. One very painful kind, predominant in men, is the “cluster headache.” It’s called that because a person can get it every day for three weeks or three months, and then it stops. It almost always involves the region of one eye. The pain lasts from 15 minutes to about an hour and is associated with redness of the eye and a dripping nose. It may be excruciating.
Q. People often complain about getting headaches from eyestrain. Is that really a common cause?
A. No. Eyestrain – or bunching up of the frontal muscles – is a very unusual cause of headaches.
Q. Can foods cause headaches?
A. Yes. Foods high in the amino acid tyramine can cause so-called “dietary migraine.” Tyramine is found especially in cheese, nuts, pork and fish.
Q. Does drinking too much cause headaches?
A. Yes. But a more common cause is mixing drinks. If you have couple of martinis, you may be all right. But if you have a couple of martinis and then some red wine or some beer, I can almost guarantee you a headache. Champagne will produce a headache in almost anybody. There’s something chemical about the fermentation process that affects the nervous system.
Here’s a therapeutic tip: If you have had a few drinks and you take three aspirin (or compounds containing aspirin) before you go to bed, you may very well wake up the next day without a headache.
Q. Do headaches become less frequent as you get older?
A. Generally, yes. Headaches are far more common among younger people,. But older people do get headaches for a variety of reasons. And when you get headaches in the age group of, say, above 60, you begin to think of other kinds of illnesses that could be causing them: glaucoma, cervical arthritis, diabetes, others.
Q. Broadly speaking, how dangerous are headaches? You can live with them, can’t you?
A. You certainly can live with them, but it depends on your definition of living. If you have seen any of your friends in the throes of an acute migraine, cluster headache or any kind of severe headache, you know that these people look terribly sick – they are terribly sick.
Q. At what point should a person suffering from headaches consult a physician?
A. I suspect many people try to live with their headaches for a long time before they go to a doctor. This may be okay, but it could be dangerous, too. People should seek medical help if a headache persists, grows worse, changes, is a new kind never experienced before, or is associated with other symptoms. Also, I regard persistent, disabling headaches in children as more ominous than in adults. For one thing, I must consider the possibility of a tumor. Nobody knows your child as well as you do. If he complains of a fever or headache, or he suddenly isn’t doing well in school – if he just isn’t himself – it would be wise to have him examined.
Q. When you say “if a headache persists,” what do you mean?
A. I mean that if a severe headache persists for more than a day, or if a person’s headache is of such intensity that it interferes with his activities, he should seek medical advice.
Q. What treatments do you recommend for headaches?
A. Aspirin is the drug of choice for common headaches. But even with aspirin you must be careful. Taking too much can cause gastrointestinal bleeding and other serious complications. The use of buffered aspirin or an antacid can reduce these hazards.
Q. Is it dangerous to take drugs for headaches?
A. Yes. Drugs can be abused. If you respond to a certain type of medication and you are fearful of getting a headache, you might take the drug to ward off the attack. The danger: Many of these medications are habit-forming and addicting-ergot preparations, for example. Patients with chronic headaches should not be treated with narcotic analgesics such as morphine, Demerol, codeine and so forth. Too many doctors prescribe these drugs.
Q. Does acupuncture help headaches?
A. No. the results have been extremely poor. Nor does hypnosis appear to be very beneficial – or psychotherapy, in most cases.
Q. What are the chief goals of headache research today?
A. Our main goal is to understand as much as possible about the basic mechanisms of headache production – the mechanism of blood flow and the whole neurovascular network. Also, how can you artificially produce headaches? Is it possible to develop an anti-serum? Why does a cluster headache turn on and off? That’s the direction. When we have more of this basic information, we’ll be better able to prevent headaches – and treat them more effectively when they do occur.
Who Owns the Free-Enterprise System?
Do the big corporations own it? NO
Does the government own it? NO
Do the bureaucrats own it? NO
Do the rich own it? NO
Okay. Who owns it?
Here’s who: Farmers, businessmen, professionals, government employes, corporate employes, members of labor unions and all owners of corporate and government securities. In short, everybody owns the free-enterprise system. So, since we all own it, let’s stop trying to beat it to death. Instead, let’s treat it with the respect it deserves.