By ZISANDA NKONKOBE
Laurens Rowles was 17 the first time she felt the crippling pain in her head which left her unable to concentrate on anything for longer than a few seconds.
The headaches soon started occurring weekly, becoming more intense each time the teenager faced the pressure of exams and never-ending school assignments. After a few months, the headaches were accompanied by vomiting, vision and hearing loss. A migraine kit from the local pharmacy, containing eight different pills to treat the different symptoms was able to assist, provided Rowles caught it early.
The situation soon became worse however, even once resulting in a hospital stay where a pain relief injection became necessary. All of this was between a number of doctors’ visits where all possible triggers and treatments were investigated.
A visit to a neurosurgeon and a CAT scan also couldn’t identify the cause.
Two years later and now a first year Bachelor of Education student at the Nelson Mandela Metropolitan University, Rowles said she knew she would have to sort the headaches out once and for all if she was to pursue any kind of further qualification post-matric.
It was then that she decided to visit The Headache Clinic in Johannesburg.
“The headaches were starting to affect my life. I couldn’t concentrate for long and I was missing a lot of class because of them. Once they hit then I couldn’t do anything.
“I was going up to Johannesburg for a water polo tournament with my mom last year and while we were there, we decided to go and check The Headache Clinic out. There I was seen by several doctors, including a neurosurgeon, who all carried out several tests to try and identify the cause.”
Rowles is one of the 12% of South Africans affected by migraines.
According to research conducted by The Headache Clinic, 18% of women and 6% of men suffer from migraines, with 2-3% of the population reporting that the problem is so severe it affects their personal relationships and they cannot work because of the pain.
Many report getting divorced or losing their jobs because of the way the chronic pain affects them.
Medical director of The Headache Clinic Dr Elliot Shevel said because headache pain originates in so many different areas and no single specialist has the know-how to diagnose them all, the clinic was born – the only multi-disciplinary clinic in the country.
Because of their multi-disciplinary approach – which places many different specialists under one roof – Rowles was seen by a host of
different doctors within a few hours.
After tests to check the amount of tension she carried in her body, Rowles said her mouth was also scanned as a means of identifying whether her teeth or the positioning of her jaw were not causing her pain.
An answer to the problem which had plagued her for years was soon discovered.
“The doctors said it was the arteries in my head causing the pain,” she said.
Rowles went under the knife the following day for an arterial ligation operation. She was also ordered to wear a mouth plate to ease the tension in her back.
“What they did is they gave me a whole lot of Botox injections around my face so my entire face was numb. Then they made incisions at the tops of my ears and the back of my head was shaved and an incision was made there for the operation. It was hard to sleep a day after the procedure because of the cuts but I’ve been fine since then.
“For the first time in years I have not had a headache. I’m living a normal life without any type of painkillers at all. The mouth plate has done wonders to ease my back tension. I have to remove it when I eat or drink and I sometimes forget to put it back in my mouth afterwards. On days that I go to bed without it, I can actually feel the pain in my neck and the slight heaviness in my back when I wake up. It’s definitely a huge help,” she said.
Despite Rowles’ treatment, Shevel said the clinic used non-drug treatments wherever possible in an effort to avoid the harmful side-effects common with headache medication, although treatment usually depends on the diagnosis and cause of pain.
According to Shevel, there is a general belief among doctors and headache specialists that headaches originate in the brain, but this is seldom the case.
“Of course one has to make sure that the brain is not involved, which is why the first part of The Headache Clinic diagnosis is a neurological examination to make sure that there is no life-threatening brain condition causing the pain, such as tumours, meningitis, or many other possible causes. Fortunately the brain is very seldom the seat of the pain, and the neurological examination is negative in the vast majority of patients.
“Once brain conditions have been ruled out, we examine the structures on the outside of the skull, and this is usually where the problem lies. Once we have determined where the pain is coming from, we can direct our treatment to that structure or those structures (often the pain comes from more than one place).
“Common causes of pain in headache and migraine sufferers are the muscles of the jaws and neck and the small arteries in the scalp. Often though, even though the pain may come from the muscles, other factors can make the muscle pain worse, and these have to be treated as well. Examples of these additional factors are impacted wisdom teeth, an uneven bite, problems with the jaw joints, and many others.”
For muscle pain, depending on the pattern of the muscle pain in each individual patient, the most common treatment used at the clinic is a plate worn on the palate.
Called a Posture Modifying Appliance, the plate works by relaxing the jaw and neck muscles to reduce muscle tension.
Shevel said other treatments for muscle pain include physiotherapy, Botox injections, trigger point therapy and magnesium supplements.
“The plate is so comfortable that the patient isn’t even aware that they have the plate in their mouth and the results in most patients are excellent. Botox injections only last for a few months and then have to be repeated. Trigger point therapy is a minor, minimally invasive surgical procedure to neutralise the trigger points. Each patient is different and the appropriate therapy has to be selected on an individual basis.
“If other factors are influencing the headaches, they must be treated as well such as wisdom teeth may need removing, the bite may have to be rectified or any other contributing cause must be treated. If the scalp arteries are causing the pain, these can be surgically closed (this is a minimally invasive procedure because these arteries are just below the skin of the scalp and have nothing to do with the brain). Fortunately the arteries that have to be closed are not necessary for the body to function normally, similar to the tonsils, appendix, and wisdom teeth.”
Shevel said headaches can be triggered by many things, including hormonal changes in the menstrual cycle, which is why more women are affected by migraines then men.
Stress, certain foods and alcohol can also act as triggers.
“Although certain foods are more liable to trigger headaches than others, it varies from patient to patient. The best way to find out if your migraines or headaches are being triggered by food is to keep a migraine diary and record everything you eat to see if the headache regularly occurs after eating certain food,” he said. — zisandan@dispatch.co.za
Headaches from hell can be cured
Laurens Rowles was 17 the first time she felt the crippling pain in her head which left her unable to concentrate on anything for longer than a few seconds.
The headaches soon started occurring weekly, becoming more intense each time the teenager faced the pressure of exams and never-ending school assignments. After a few months, the headaches were accompanied by vomiting, vision and hearing loss. A migraine kit from the local pharmacy, containing eight different pills to treat the different symptoms was able to assist, provided Rowles caught it early.
The situation soon became worse however, even once resulting in a hospital stay where a pain relief injection became necessary. All of this was between a number of doctors’ visits where all possible triggers and treatments were investigated.
A visit to a neurosurgeon and a CAT scan also couldn’t identify the cause.
Two years later and now a first year Bachelor of Education student at the Nelson Mandela Metropolitan University, Rowles said she knew she would have to sort the headaches out once and for all if she was to pursue any kind of further qualification post-matric.
It was then that she decided to visit The Headache Clinic in Johannesburg.
“The headaches were starting to affect my life. I couldn’t concentrate for long and I was missing a lot of class because of them. Once they hit then I couldn’t do anything.
“I was going up to Johannesburg for a water polo tournament with my mom last year and while we were there, we decided to go and check The Headache Clinic out. There I was seen by several doctors, including a neurosurgeon, who all carried out several tests to try and identify the cause.”
Rowles is one of the 12% of South Africans affected by migraines.
According to research conducted by The Headache Clinic, 18% of women and 6% of men suffer from migraines, with 2-3% of the population reporting that the problem is so severe it affects their personal relationships and they cannot work because of the pain.
Many report getting divorced or losing their jobs because of the way the chronic pain affects them.
Medical director of The Headache Clinic Dr Elliot Shevel said because headache pain originates in so many different areas and no single specialist has the know-how to diagnose them all, the clinic was born – the only multi-disciplinary clinic in the country.
Because of their multi-disciplinary approach – which places many different specialists under one roof – Rowles was seen by a host of
different doctors within a few hours.
After tests to check the amount of tension she carried in her body, Rowles said her mouth was also scanned as a means of identifying whether her teeth or the positioning of her jaw were not causing her pain.
An answer to the problem which had plagued her for years was soon discovered.
“The doctors said it was the arteries in my head causing the pain,” she said.
Rowles went under the knife the following day for an arterial ligation operation. She was also ordered to wear a mouth plate to ease the tension in her back.
“What they did is they gave me a whole lot of Botox injections around my face so my entire face was numb. Then they made incisions at the tops of my ears and the back of my head was shaved and an incision was made there for the operation. It was hard to sleep a day after the procedure because of the cuts but I’ve been fine since then.
“For the first time in years I have not had a headache. I’m living a normal life without any type of painkillers at all. The mouth plate has done wonders to ease my back tension. I have to remove it when I eat or drink and I sometimes forget to put it back in my mouth afterwards. On days that I go to bed without it, I can actually feel the pain in my neck and the slight heaviness in my back when I wake up. It’s definitely a huge help,” she said.
Despite Rowles’ treatment, Shevel said the clinic used non-drug treatments wherever possible in an effort to avoid the harmful side-effects common with headache medication, although treatment usually depends on the diagnosis and cause of pain.
According to Shevel, there is a general belief among doctors and headache specialists that headaches originate in the brain, but this is seldom the case.
“Of course one has to make sure that the brain is not involved, which is why the first part of The Headache Clinic diagnosis is a neurological examination to make sure that there is no life-threatening brain condition causing the pain, such as tumours, meningitis, or many other possible causes. Fortunately the brain is very seldom the seat of the pain, and the neurological examination is negative in the vast majority of patients.
“Once brain conditions have been ruled out, we examine the structures on the outside of the skull, and this is usually where the problem lies. Once we have determined where the pain is coming from, we can direct our treatment to that structure or those structures (often the pain comes from more than one place).
“Common causes of pain in headache and migraine sufferers are the muscles of the jaws and neck and the small arteries in the scalp. Often though, even though the pain may come from the muscles, other factors can make the muscle pain worse, and these have to be treated as well. Examples of these additional factors are impacted wisdom teeth, an uneven bite, problems with the jaw joints, and many others.”
For muscle pain, depending on the pattern of the muscle pain in each individual patient, the most common treatment used at the clinic is a plate worn on the palate.
Called a Posture Modifying Appliance, the plate works by relaxing the jaw and neck muscles to reduce muscle tension.
Shevel said other treatments for muscle pain include physiotherapy, Botox injections, trigger point therapy and magnesium supplements.
“The plate is so comfortable that the patient isn’t even aware that they have the plate in their mouth and the results in most patients are excellent. Botox injections only last for a few months and then have to be repeated. Trigger point therapy is a minor, minimally invasive surgical procedure to neutralise the trigger points. Each patient is different and the appropriate therapy has to be selected on an individual basis.
“If other factors are influencing the headaches, they must be treated as well such as wisdom teeth may need removing, the bite may have to be rectified or any other contributing cause must be treated. If the scalp arteries are causing the pain, these can be surgically closed (this is a minimally invasive procedure because these arteries are just below the skin of the scalp and have nothing to do with the brain). Fortunately the arteries that have to be closed are not necessary for the body to function normally, similar to the tonsils, appendix, and wisdom teeth.”
Shevel said headaches can be triggered by many things, including hormonal changes in the menstrual cycle, which is why more women are affected by migraines then men.
Stress, certain foods and alcohol can also act as triggers.
“Although certain foods are more liable to trigger headaches than others, it varies from patient to patient. The best way to find out if your migraines or headaches are being triggered by food is to keep a migraine diary and record everything you eat to see if the headache regularly occurs after eating certain food,” he said. — zisandan@dispatch.co.za
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