For 26-year-old Maria Hartnett, the blinding pain of migraine headaches was a daily nightmare.
Most people suffer from an occasional headache, but for the past five years, Hartnett — a young, energetic environmental consultant — fought debilitating pain every single day. More than 45 million Americans suffer from chronic recurring headaches, according to the National Headache Foundation.
"It's just pain everywhere and then stabbing pain in the back of my head and neck," Hartnett said in a video diary she and her husband recorded for Good Morning America at their Vienna, Va., home.
There were days when Maria Hartnett could not move, or even get out of bed. The pain would force her to lie down all day in a dark room. Her husband, Jeff Hartnett, could do nothing but watch his wife suffer. During the taping of the video diary, she had to ask him to turn off the bright light of the camera.
"She's just in a lot of pain, struggling to get through another migraine," Jeff Hartnett said. "It's difficult to see your wife crying and just not being able to do the things that she could do before."
The couple recently found a neurologist who was able to help Maria Hartnett through a combination of diet changes, and eliminating medications she was taking. But it took much trial and error to get there.
Because of the migraines, Maria Hartnett had been unable to work for nine weeks, unable to make a date with her own husband and unable to take care of her 18-month-old son, Evan, by herself. She visited four different neurologists and tried more than 30 medications, but none were able to take away the agony.
But perhaps the greatest pain was the impact that her headaches had on her ability to be a mother.
"I think that is definitely the hardest part," Maria Hartnett said. "Being a mother and not being able to take care of my son has brought a whole new dimension of difficulty into living with chronic migraines." At her wit's end, Maria Hartnett met with Dr. David Buchholz, a professor at the Johns Hopkins School of Medicine, and a member of its neurology department for nearly 20 years. In private practice since 1997, he is also the author of Heal Your Headache, which teaches patients like Maria Hartnett how they can control their own migraines.
"From what I see of Maria, she's got the willingness, she's got the motivation and I expect her to succeed," Buchholz said after meeting Hartnett.
He said there really is no such thing as a "tension" or "sinus" headache, and that all headaches are migraines.
"All headaches come from the same underlying mechanism — when blood vessels swell," Buchholz said. "Control that, and you stop the headaches. Sometimes the swelling occurs in different areas, and that's why we identify, incorrectly, headaches as "tension" or "sinus" headaches."
Dump the Migraine Drugs
The first step that Buchholz asked Hartnett to take seems counterintuitive: He advised her to get rid of all of her headache medicine, which included painkillers with caffeine, decongestants and even prescription migraine medication. All of the drugs can cause "rebound" headaches if used more than a few times a month, Buchholz said.
"When your head hurts, it's because the blood vessels around it have become painfully swollen," Buchholz said. "A lot of these rebound-causing drugs constrict those blood vessels temporarily — which gives you pain relief, perhaps — but then the constricting influence wears off. These blood vessels swell with a vengeance and over time tend to swell more and more and more, being fed by these drugs." The "rebound" problem is only a problem for headache medications, not those used to treat other chronic problems such as arthritis, Buchholz added. If you are using pain relievers more than two or three times a month you should consult a doctor.
The second step in Buchholz's strategy is to limit what he calls headache triggers.
Some triggers, such as stress, weather and lack of sleep cannot be controlled, but there are plenty of triggers that headache sufferers can control, he said. Oral contraceptives can be a trigger, as can caffeine, chocolate, alcohol, MSG and unexpected foods like citrus fruit and onions. Individually, they may not do anything, but added up, enough triggers can make your headache turn "on."
No Tuna, No Bananas
After her visit to Buchholz's office, Hartnett felt better about fighting her headaches than she had in a long time.
"Nice to have some hope instead of just feeling like things are going to get worse," she said.
Armed with her new knowledge, the Hartnetts kept another video diary for GMA as Hartnett put Buchholz's approach to the test.
She raided her medicine cabinets and got rid of all the medications Buchholz said she could no longer have, and totally changed her diet.
"I have put Dr Buchholz's list up on the fridge," Maria Hartnett said in her video diary. "Both tuna packed in oil and tuna packed in water have vegetable broth and that is on the prohibited list because it potentially can have MSG."
She also learned that bananas, buttermilk, MSG, preserved deli meats and chocolate brought on headaches, so she avoids those foods too.
After a few weeks, the rewards become obvious.
"I finally feel well enough to play with Evan in the evening," Maria Hartnett said on the video diary.
Back to Work, Play
Now, nearly four months later, Maria Hartnett has been able to return to work, without having to miss too many days because of her migraines, and she is able to care for Evan almost every day.
The headaches she gets now are also not as bad as they were before, and she is able to function. She has gone as long as six to seven days without suffering from a headache, but has been unable to go any longer than that.
Most people who try Buchholz's technique need only to get rid of rebound-causing medication and reduce the foods that trigger their headaches. Some, including Hartnett, need to also go to step three, which is taking preventive medication. The medication allows patients to be exposed to more headache triggers before actually developing a headache.
Hartnett is working with Buchholz on a preventive medicine routine that will work best. In the meantime, the headaches have loosened the grip they had on her life.
"It's so much better," she said. "I'll have a good week, with no headaches at all, then the next week is tougher. But I have my life back."