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‘tis the season for pins and needles
‘Tis the Season for Pins and Needles
CHRISTIAN COTRONEO, TORONTO STAR, DECEMBER 2006
e thermometer is taking its seasonal swan dive, shoppers are milling in malls, festive lights are a-twinkling — andin the heads of millions of Canadians, a time bomb is a ticking. Migraine suﬀerers seem to be especially vulnerableduring the holidays.
“People are out and they’re partying or they’re kind of living it up and indulging more than they might at othertimes of the year,” says Brendan Cleary, and acupuncturist who founded the Ontario Migraine Clinic inGeorgetown, Ontario.
Cleary cites changes in behaviour — from our sleep schedules, to the time we spend trawling shopping centres tothe diﬀerent foods we eat — as key factors in the onset of migraine.
One trigger at this time of year is the leaﬂess trees of winter combined with unobstructed sunlight. “You’re drivinghome in rush hour,” one expert says. “You’ve got naked tree branches and the sun on your horizon line…it’s like astrobe. You get a migraine.”
Although Cleary sees many of those triggers at Christmas, business at his acupuncture practice remains steadythroughout the year — at 450 patients per week.
e Ontario Migraine Clinic is among North America’s well-known clinics for migraine suﬀerers, drawing patientsfrom as far away as Afghanistan. But the practice of inserting needles at speciﬁc points in the body stems fromancient times in China, where it is still widely practiced. In the West, acupuncture is ﬁnding increasing acceptanceat medical schools, including the venerable May Clinic in Minnesota. But only in recent years has acupuncturebeen examined as a treatment for migraines, which aﬀect nearly one in ﬁve Canadians.
ough considered the humdinger of all headaches, a migraine is actually deﬁned by several symptoms, includinga one-sided headache and nausea. Perhaps most intriguing is the presence of what’s called an aura, aﬀecting one in10 suﬀerers.
“People will have blindness,” Cleary says. “Almost like if you held up a dinner plate in front of you at arm’s length,it’s like a black hole in their vision. So if they were looking at you, they couldn’t see your head. ey could seeeverything else.”
During a migraine, he explains the surface of the brain experiences a kind of short circuit. “at wave of shortcircuiting mover really slow across the brain. If it happens to cross the part of the brain that is related to vision,people get that aura.”
Woman suﬀerers vastly out-number men, since one of the chief triggers is the menstrual cycle. at explains whythe gender division among suﬀerers is about equal until puberty. Ali Sauer, 32, a PhD student at York University,was watching a movie four years ago when her ﬁrst migraine hit.
“My family kind of went nuts. I has so much pain,” she says, “I had no idea what was going on.” She went to thehospital, but, she says, “I actually had to leave because I couldn’t stay under the ﬂuorescent lights and the noise.”Now, when she gets a migraine, “Laying in the dark in complete silence and trying to sleep… is always the bestthing.”
Eventually, as Sauer’s attacks became daily, she was prescribed a battery of medications, but the headaches alwayscame back.
Last September, she paid a visit to Cleary’s clinic. Aer 33 acupuncture treatments, she now goes as long as a weekand a half without any migraines, “which is unbelievable for me,” Sauer says. Another beneﬁt, she adds, is thattaking medication also helps. “When I came here, no medication relieved me of a migraine at all.”
Cleary’s patients undergo 40 to 50 sessions on average, each costing $75; Sauer still has many more treatments togo. But her biggest headache these days, she says, is the frequent commute to Georgetown.
Despite the success of patients like Sauer, not everyone is convinced of acupuncture’s beneﬁts. “People go andinitially get a kind of positive (feeling),” says Michael John Coleman, executive director and founder of MigraineAwareness Group: A National Understanding for Migraineurs, called MAGNUM, in Alexandria, Va.
“I think it’s almost a euphoric phase, a placebo eﬀect.”
Founded in 1993 as a grass-roots organization, MAGNUM is now federally recognized as a non-governmentalorganization in the U.S. e organization has helped develop models and guidelines for migraine treatment— andcollected thousands of anecdotes from people undergoing various treatments, including acupuncture.
“We’ve had lots of people go for acupuncture treatment and not been happy,” says Coleman.
Indeed, Coleman, a lifelong migraine suﬀerer, has tried acupuncture treatment himself, and went for several trials.
He stopped not because he was cured, he says, but because he wasn’t.
“I know everything you can know about a migraine and I still battle it.”
Dr. James Wright, managing director of erapeutics Initiative, an independent agency funded by BritishColumbia, says that acupuncture has “…been claimed (to help) everything.”
But ultimately, Wright says, migraine eludes not only a cure, but a deﬁnition. Some experts, like Coleman, call it adisease. Others, like Wright don’t.
“I don’t think you can call something a disease unless you understand the path of physiological mechanisms,”Wright says. “And I don’t think we do, so I would say we don’t’ know enough to understand whether it is.”
Babylonians were bemoaning the personal plague that is migraine as early as 3,000 B.C. Since then, humans haveexperimented with a battery of herbal and pharmaceutical treatments, including current migraine mainstaysImitrex and Zomig, as well as nonmedicinal treatments.
At Rush University medical Centre in Chicago, researchers are experimenting with electrical stimulation of nervesin the neck at the base of the patient’s head. Migraineurs also learn the art of prevention.
Meanwhile, even those who may be skeptical of acupuncture are willing to give it a fair test.
e technique has gained support from German researchers who found acupuncture a “highly eﬀective method” oftreatment in a 2004 study.
But Dr. Dieter Melchart, one of the researchers working on the project at the Centre for Complimentary MedicineResearch in Munich, challenges Cleary’s claims of a nearly 96 per cent success rate.
e study found it eﬀective on a little more than half of 300 patients tested — still a substantial number, he adds, fora condition that still has no cure.
In the study, co-authored by Klaus Linde, patients were given false, or sham, acupuncture that did not pierce therequired points in the skin.
“Even the placebo acupuncture was highly eﬀective,” Melchart says.
“If you insert a needle into the skin you have a lot of non-speciﬁc eﬀects. It doesn’t have to do something even withan acupuncture point. You always get eﬀects.”
One of those eﬀects may be merely to raise expectations, which in turn, raises the chances of success.
Also, unlike the pharmaceuticals administered during drug trials, acupuncture is considered an invasiveprocedure, which in turn, says Melenchart, “always has high placebo eﬀects and high expectation. It’s not only aphysiological eﬀect.”
e burning question remains: Why would it work?
“We really do not know,” Melenchart says. “In science we can’t answer this question right now. It is eﬀective. Youcan observe this eﬀect. But you don’t know why.”
A RETINA CONSULTANTS Mark D. J. Greve* Brad J. Hinz* BSc, MD, FRCSC, Matthew T.S Tennant* MD, FRCSC, ABO Chad F. Baker* BSc, MD, FRCSC Riz Somani* Research AMD Diabetes University of Alberta Clinical & Surgical Tele-ophthalmology Advanced Medical & Surgical Management of Retinal and Vitreous 4 -1801 Fax (780) 448-1809 www.a
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