Opinion |  Ways to Get Headache Relief

About the editor:

On “Why Don’t We Have Headache Remedies?”, By Tom Zeller Jr. (Opinion Guest Essay, Sunday Review, July 25):

After all, someone sheds light on a traumatic disorder that is ruining relationships and careers, and driving you crazy and completely alone. At 47, just as I entered the prestigious Smith College School for Social Work, my migraines began.

Three years later, when my classmates and our families cheered our graduation, my heart sank. My migraines had become so common and so painful that I couldn’t imagine how I could get involved as a therapist. How could I endure other people’s emotional pain when I was in such physical pain? How could I still be a decent mother and wife?

Nine neurologists and three psychiatrists later, I got away with a suitcase full of medication and several analyzes: elementary school had been too much, gluten was the trigger, or maybe I had bipolar disorder! I cried and scolded and thought of suicide.

Ashamed, I shrank into myself and withdrew into a dark room. I also faced painful rejection from friends who didn’t like the new me and couldn’t drink and laugh anymore.

Thanks to a Houston neurologist, a headache specialist, an extremely devoted partner, and the new calcitonin gene-related peptide drugs, I was born with the semblance of life. But I remain vigilant at all times. A migraine lurks and the fear never really goes away.

Opinion interview
Questions about the Covid-19 vaccine and its introduction.

Clare Casademont
Nantucket, Mass.

About the editor:

Headaches are neurobiological, but so are stress and emotional tension and should not be dismissed.

As a doctor treating chronic pain, headaches, and back pain, I often find that focusing on a patient’s emotional stressors, childhood traumas, personality styles, etc., brings great results in pain relief.

I recently treated a 45 year old male nurse. After learning how emotions can cause and trigger migraines, she was able to learn how to manage the process through an expressive diary and brief psychotherapy. Not only is her headache gone, it’s no longer from the powerful, injectable drugs that Tom Zeller Jr. is referring to.

I consider this to be a gain for them and an enormous cost saving for society. Being open to bio-psychosocial explanation and treatment is not a weakness; it is the patient’s strength and empowerment.

David Schechter
Culver City, California.

About the editor:

I’ve suffered from cluster headaches since I was a medical student (I’m an orthopedic surgeon). I got them every two or three years, got them every other day or third for a few months, and then they went away. They were always in the same place, like an ice pick in the right eye, sometimes brutally painful – so bad that I could only walk slowly in a darkened room, not even lie down. Medicines were useless.

About 25 years ago a neurologist friend suggested oxygen, so the next cluster I got I used an oxygen tank and inhaled oxygen and in 10 minutes the headache would go away. In the past, they usually lasted two to four hours. That was great. I finally had a treatment that worked.

The last couple of times I had them they weren’t that bad and I haven’t had one in 10 years. Furious! I’m 69 now. It is common belief that migraines go away as I get older, which is the case in my case.

James Loddengaard
Palos Verdes Estates, California.

About the editor:

I am a general practitioner for headache. A little-known treatment for migraines, which I first published in the Journal of the American Medical Association in 1996, is to simply lie on your side with your head outstretched and twisted and inject a lidocaine gel into your nostril to the side of the headache (bilateral if the headache is bilateral). The procedure is known as sphenopalatal ganglion block.

While the treatment is somewhat cumbersome and less reliably effective than the usual commercial products, it is very safe, inexpensive, and when effective it is almost instantaneous. More and more headache specialists are adopting this procedure, but it is not widely accepted as it is not promoted by the pharmaceutical industry.

Morris Maizels
Everett, Wash.

About the editor:

On “Short Doses and Difficulties in Administering Them” (front page, August 2):

It is easy to find ways that vaccine delivery could be improved to almost every country in the world during a pandemic. But no one has called louder than Covax to the governments that put national interest before global, or the vaccine manufacturers who care about them.

The fact is that Covax is delivering today, albeit more slowly than we would have liked: within the first six weeks we started delivering to 100 countries, and then despite the fact that we were confronted with delivery bottlenecks due to export bans and vaccine nationalism , With dose donations, we are now on the verge of returning to our original dispensing rate. In a world without Covax, many of these countries would still be waiting for vaccines.

But yes, for the sake of humanity, we need Covax to function. If not, then the appalling global inequalities in the distribution of Covid-19 vaccines would not only be much worse, but would inevitably continue for some time – which means a continued spread of new infections and new variants.

We are pleased that the pace of deliveries has now increased. Ultimately, however, global cooperation is only as strong as it is based on partnership.

Seth Berkley
Geneva
The author is the managing director of Gavi, the vaccine alliance.