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CNN LARRY KING LIVE
Panel Discusses Migraines
Aired April 26, 2005 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LARRY KING, HOST: Tonight, they're excruciating, incurable. And they make millions of Americans miserable. Migraines. No ordinary headaches. How can you control the agony?
We'll talk with my wife, Shawn. Women make up the majority of migraine sufferers. Dr. Frank Lawlis, a psychologist working on alternative migraine treatments. Dr. Phil wrote the foreword to his book. Susan Olsen, the actress who played Cindy Brady on "The Brady Bunch" has suffered migraines since age 11. Lee Grant, director, producer and Oscar-winning actress, all despite dealing with devastating migraines. And Dr. Seymour Diamond, who runs America's oldest private headache clinic. They're all next on LARRY KING LIVE.
Good night -- or good evening. I'm asked to tell you before we start that you'll be hearing a lot of different headache medications mentioned during tonight's broadcast. We want you to know up front that LARRY KING LIVE is not endorsing any of the drugs, and likewise no one on the panel is being paid to endorse any of the medications that might be mentioned.
We'll get right into it. We'll start with Dr. Diamond, our M.D., director and founder of the Diamond Headache Clinic. What, Dr. Diamond in Chicago, is a migraine?
DR. SEYMOUR DIAMOND, FOUNDER/DIRECTOR, DIAMOND HEADACHE CLINIC: A migraine is a one-sided headache in most instances. It is a sick headache. People complain about nausea, vomiting with their headaches. And some people have some neurological manifestations with the headache. And it is a severe, throbbing type headache.
L. KING: Where did it get its name?
DIAMOND: It comes from the Greek "half a head." And that's how it got its name.
L. KING: Half a head?
DIAMOND: Half a head.
L. KING: And your headache clinic...
L. KING: Go ahead. I'm sorry.
DIAMOND: Go ahead.
L. KING: OK. I was going to say, in your clinic do you see a lot of it?
DIAMOND: Oh, we maybe see anywhere from 100 to 150 patients with headache a week. Not all new patients, but people coming back for repeat visits and things of that nature.
L. KING: Dr. Frank Lawlis is a clinical and research psychologist focusing on alternative methods of treating migraines and is author of the book "The ADD Answer: How to Help Your Child Now." The book has a foreword by Dr. Phil McGraw.
That's attention deficit disorder. That's not migraines, right?
DR. FRANK LAWLIS, CLINICAL & RESEARCH PSYCHOLOGIST: That's right. Correct.
L. KING: What got you interested in migraines?
LAWLIS: Well, first of all, I also ran pain clinics for about 15 years. So I've seen a lot of different kinds of headaches. And this is one of the biggest ones.
L. KING: What's the biggest problem in facing it from a clinical standpoint?
LAWLIS: Well, first of all, there's many causes. And unless you know the cause, it's hard to run down what you do about it. And so consequently, one of the biggest issues that we have is to find out, you know, what are the triggers. And it might be allergies, it might be -- it might be stress, it might be an infection. It can be the fact that you just bought a new mattress and it has formaldehyde in it. So there is a lot of different factors that just trigger these things.
L. KING: How do you find the factor?
LAWLIS: Well, this has to do with a lot of homework. And so, most of the time we do a lot of, you know, diaries, you know, like what happens with this event in your day or in your week. And then what happened with the migraine events.
L. KING: Let's talk to our patients. We'll start with my wife, because I have to start with the wife.
LAWLIS: Absolutely. Smart man.
L. KING: Shawn, by the way, is a singer as well. She has her own CD coming in early summer called "In My Own Backyard," but that's not the topic for tonight. The topic is migraines.
When did you first start getting migraines?
SHAWN KING, SINGER, LARRY'S WIFE, MIGRAINE SUFFERER: I remember the very day, it was the day my brother got married. And I put the luncheon on, the brunch. And after my part of the brunch was over with, I started losing vision in this -- like a crescent shape. And I would hold up my hand, and I couldn't tell how many fingers I was holding up. And...
L. KING: What did you think it was?
S. KING: Well, I didn't have any idea, except I mentioned it to the fellow who was sitting next to me. He said, you're about to get a migraine headache. Because he was a migraine sufferer.
L. KING: Since then you get them how frequently?
S. KING: Oh, it depends.
L. KING: Average?
S. KING: Average, boy, I can get 10 in a month. I can get one or three in a month. You've seen me go through...
L. KING: What's the longest you've ever been without one?
S. KING: Oh, gosh.
L. KING: Do you think? You ever gone three months without one?
S. KING: No.
L. KING: No. Lee Grant, when did you first get one?
LEE GRANT, ACTRESS: The first time -- and I have such sympathy for you, Shawn. The first time that I ever got it, I was directing my first movie, but it wasn't the tension. Because during the week, I didn't have a migraine. But on the weekend, when I was relaxing and when I didn't have to work, then the migraine would move in from like Friday night until Sunday night. And I realized because now I use Imitrex in order to get rid of migraines, that the migraine happens when the veins are not tightly shut. And when you're relaxed, that's when the migraine tends to move in on me.
And also hormonally, you know, it happened for me then -- that was about 1980 -- it would happen, you know, once a month, you know, for about five days.
L. KING: Do you still take the Imitrex?
GRANT: I take an Imitrex with me wherever I go. And just in case something moves in. It's a safety valve. Although...
L. KING: Does it relieve the pain right away?
GRANT: Imitrex for me relieves the pain right away. But it's not always a pleasant feeling. And I also have atrial fibrillation. You know, so that, you know, my heart goes out. And you are not supposed to take Imitrex if you have any heart problems.
L. KING: Before we ask Susan, does Imitrex work -- does anything work for you?
S. KING: So far, we're still searching. L. KING: None of the pain pills work for you?
S. KING: No. I mean, well, you've taken me to the hospital for morphine when it gets really, really bad.
L. KING: So none of the -- even the new ones?
S. KING: But you have to be really careful, because it can be a cycle where if you take too much pain medication, that can trigger another migraine.
L. KING: So the pain -- the cause -- the cure is the cause?
S. KING: Right.
LAWLIS: That's right.
L. KING: How did you start, Susan?
SUSAN OLSEN, ACTRESS: I'm just like Lee. I get the pattern that's known as letdown headache. And I miss all the wrap parties. So when a production is done, that's when my migraine sets in.
L. KING: When did it start?
OLSEN: I was 11 years old.
L. KING: On "The Brady Bunch"?
OLSEN: Yeah, we were wrapping up the fourth season. And I got sick at the party. And went home. And I thought I had the flu. And I remember my mother looking at me and saying, you know, honey, I'm afraid maybe this is one of those headaches like your dad gets. And my dad got migraines. And my dad always went to work, never missed a day of work, except for when he had a migraine. And they're horrible.
L. KING: You still get them?
OLSEN: I do. But you know, it's so much better -- knock wood. And I think part of that is they immediately started getting easier to deal with just because for me, Imitrex works. And knowing that I had something that could end the headache was such a relief. But I also get another type of migraine, which is a hemiplegic migraine.
L. KING: What is that?
OLSEN: Well, that emulates a stroke. And I've actually lost feeling on one side of my body, lost the ability to talk. And with those, it's not a real good idea to take Imitrex.
I haven't had one of those in years. And just getting involved with being a spokesperson for migraine and getting some answers has taken so much of the pressure off, that I'm not panicky about when I'll get a migraine.
L. KING: Do you know when it's coming? Like before the show tonight, you said you just finished doing photo shoots for your CD. Right? And it has been a hectic week. You worked in Atlantic City. When it comes out of it, do you feel it coming on now?
S. KING: I did just before the show, start to feel that letdown that...
L. KING: What's the feeling?
S. KING: Well, oddly enough, normally my migraines are in this upper front quadrant of my head, my right side. But today, it started on the left side. I don't know what's that about.
Dr. Lawlis, maybe you can help me figure that out? But Dr. Lawlis actually did a little exercise with me. I stop breathing when I get a migraine. Because...
L. KING: Stop breathing?
S. KING: Well, not literally stop breathing, but my breathing becomes very shallow, because it hurts so much to breathe, to -- any movement at all. So Dr. Lawlis moved me around and changed my energy.
L. KING: Let me get a break and when we come back, we'll talk about how Dr. Diamond treats it, how Dr. Lawlis treats it, more from our patients, and your calls, too. Don't go away.
L. KING: Not that it will help the sufferers, but the following people had migraine headaches throughout their lives. Thomas Jefferson, Vincent Van Gogh, Claude Monet, Virginia Woolf, Napoleon, Robert E. Lee, Sigmund Freud, Elvis Presley. Elizabeth Taylor gets them, so does Carly Simon, so does Britain's Princess Margaret, and Loretta Lynn.
How do you treat them, Dr. Diamond?
DIAMOND: Well, basically, Larry, there's four ways that we can attack a migraine problem. The first is what the person can do for themselves: keep track of their triggers, find out whether it's the bright lights, whether it's food, whether it's their menstrual period. What is -- they can do to help during the time that they're having it.
Second, is, there are reversal drugs. These are the triptans, like Imitrex and Zomeg and all these other drugs that were mentioned earlier. And these drugs reverse the migraine if they're taken early enough in the attack.
Thirdly, if people are getting frequent attacks, there are what we call prophylactic, preventive drugs.
And then, last of all, if all these things don't work, there are pain-relieving drugs. But most people can be controlled with the three other methods.
L. KING: And the pain-relieving drugs are Vicodin and stuff like that?
DIAMOND: Stuff like that, yes. But that is a last resort. We try not to get to that stage.
L. KING: Dr. Lawlis, how do you treat them?
LAWLIS: Well, first of all, again, we go back to the causes. And so, for example, if there's hormonal issues, if there's allergies, then obviously we want to find those triggers. If, obviously, if there's stress, then we want to teach a person how to, basically, manage their stress and also manage their reaction to stress. So biofeedback is...
L. KING: Bard (ph) described this as occurring after stress.
LAWLIS: Let me explain.
OLSEN: Not always.
LAWLIS: But let me explain how this happens. What happens in migraine is that your blood vessels start squeezing down. And this is the stress or it could be hormonal or whatever reason, but it starts squeezing down. And then after it squeezes down and you're having all those kinds of symptoms, then it just blows up. Your blood vessels just get huge. That's why we're having some issue in terms of, after the stress, is because then you start having this rebound effect. So, what you can teach your body to do is react to the stress by not suppressing your cardiovascular system, maybe using breathing, relaxation and other kinds of things that you can actually keep those blood vessels from squeezing down.
L. KING: Light bothers you, right?
S. KING: Light bothers me,
L. KING: You like a dark room.
S. KING: Sound bothers me.
L. KING: Sound?
S. KING: Sound.
OLSEN: All the senses.
S. KING: Movement. I mean, a breeze through the air can bother me. When I get a real bad one, when you're seeing me shake, that's when I've got a bad migraine.
L. KING: It takes a long time to come out of it, too.
S. KING: Depends on...
OLSEN: It can go days.
L. KING: Yes, it can go days, right? OLSEN: That's depressing, when you wake up on the third day...
S. KING: ...and it's still there.
L. KING: Yeah, Lee, does it cause depression?
GRANT: No. I mean, I'm depressed that I get them, but no. The thing that's so aggravating about migraine is that you don't know when it's going to come on. A lot of times -- and I'll bet that Shawn and Susan have had the same thing, that -- like the night before, you'll get a surge of energy and you'll look better than you've ever looked. And the next day, you wake up and you're just flat on your back.
But, the thing I wanted to say was, I went to Montefiore, the Montefiore Headache Clinic in the Bronx, and they sent me this list of foods that I didn't realize I was having -- you know, everybody knows about coffee and red wine and that stuff. But do they know that citrus, that ice cream, that raisins, papaya, pineapple. Pineapple can kill you, and so...
L. KING: Cause migraines?
GRANT: Yes. It causes migraine. So if, you know, if anybody would want to write away to the Montefiore Headache Clinic and get a list of the...
L. KING: One at a time. Doctor, you were going to say -- Dr. Diamond?
DIAMOND: The National Headache Foundation has a diet, and I would hope that you would list their Web site...
L. KING: Sure.
DIAMOND: ...and they can contact the National Headache, and they will gladly send anybody their diet that corresponds -- that writes them or e-mails them.
L. KING: OK, let me get a break and come back with more. We'll be right back with our panel. I'll be reintroducing them in a while, and we'll be taking your calls in a while, too. The subject is migraine headaches. Don't go away.
L. KING: Dr. Lawlis, what about Botox injections?
LAWLIS: Well, I'm not an expert in Botox, so I can't really speak to that. But I would just say that any kind of treatment like that can really have an adverse effect as well. Because I've seen, you know, people who really had caused immense kind of problems.
L. KING: You're both nodding.
OLSEN: A friend of Shawn.
L. KING: Hold on, doctor.
S. KING: I have a very close girlfriend, who over the last few years, we almost lost her because she went -- her dermatologist who was a very good friend of hers, she'd been going to him since she was 12 years old. But he told her he could solve her migraines by using Botox. And she wound up flat on her back, couldn't raise her head. And was -- had to relearn to speak and walk and talk.
L. KING: Dr. Diamond, do you recommend it?
DIAMOND: Yes. One of our many research projects at the clinic is we're doing two Botox studies at this time. And I can't say how -- because they're double blind studies, I can't tell you how the results are. But anecdotally, we have treated, because of the publicity about Botox in people, we've treated many patients with it. And anecdotally it has been helpful to some patients. And that's all I can say. We've not seen any adverse reactions. But I've read about them and heard about them, but we have not seen it at our clinic.
L. KING: Lee Grant, would you try it?
GRANT: I did, of course. You know, if it was out there, Larry, you know I tried it. And it didn't work for me. But you know, I just -- I had a father, too, like Susan, who had headaches. And my daughter, who is the mother of three and half year old twin boys, and had tremendous hormonal activity in her life also just started getting them, too. So you know, it is a family inherited thing. And...
DIAMOND: Well, certainly so. If one of your parents has it, you have about a 50 percent chance of getting it. If both, you have about a 75 percent chance.
L. KING: Susan, you ever tried Botox?
OLSEN: No, I haven't. I'm afraid of it. I've had too many -- I've had to many scares of thinking that I'm having a stroke, that to have something that paralyzing my face just doesn't appeal to me.
L. KING: You are a Botox sufferer, Dr. Lawlis?
UNIDENTIFIED FEMALE: Botox sufferer? Migraine.
LAWLIS: No. Migraine.
L. KING: Migraine, I'm sorry.
LAWLIS: I've had migraines.
Thanks for the correction. You will never be back. Good move. Correct the host. Very good move.
LAWLIS: I've had the migraine response where I have the auras and see the things and have visual blackouts, but I don't have the severe headaches we're talking about.
L. KING: You -- so you would consider yourself a migraine sufferer?
LAWLIS: Yes. Uh-huh.
L. KING: Yet -- you were -- you were nervous about the first time you had one, we were just going out. We were at Don Rickles' daughter's wedding.
S. KING: Mindy's wedding. And I didn't want you to see how ugly it was. Because, I mean, I turn green. I split. I was gone. Larry wanted me to stay and take care of me, but I didn't want you to see me. I thought it would scare you a away, because it's so severe.
L. KING: Do you want people away, Susan.
OLSEN: Absolutely. Because I'm vomiting every 10 minutes, which is very unpleasant for anybody to be around. I get very, very sick to the stomach.
L. KING: Can it kill you, doctor?
OLSEN: If you have a gun.
LAWLIS: I don't know if it can actually kill you, although you'd like to be dead.
UNIDENTIFIED FEMALE: I can't have a gun in the house.
L. KING: Dr. Diamond, it can lead to strokes, though, can't it?
DIAMOND: Yes, but not very frequently. It doesn't occur -- strokes do occur and there is a type called of migraine called hemiplegic migraine, which Susan talked about, where they do have a temporary paralysis. But in most instances long acting migraine does not cause stroke.
L. KING: Do you see any great advance coming, Dr. Diamond? Any cure?
DIAMOND: Yes. Well, not cure. But there is a great number of drugs that are highly effective. I think Susan and Lee talked about the reversal drugs, the triptan drugs, and there's prevention drugs, the beta blockers. I'm not naming any names, and the anti-convulsive. Just recently an anti-convulsive drug Topiramate or Topamax got approved. And it's been proved helpful to many, many patients. Most people who get one or two attacks a month, and they can be controlled with these reversal triptan drugs.
L. KING: Shawn, have you tried any of those prophylactically?
S. KING: We have tried it. I don't have my Topamax with me today, but...
L. KING: Has that helped?
S. KING: It may be helping. Sometimes I will get the aura and the headache just won't come.
L. KING: Does it go away, Dr. Lawlis, after a certain age? Because I've had friends who've had it and after 50 they were -- it was gone.
LAWLIS: Well, what happens a lot of times is that sometimes the stresses are removed. Sometimes, for example, you may be in a highly toxic work environment. And so for example printing -- printers or being a gas station attendant. All those have all those fumes and environmental issues. So sometimes all your triggers just disappear because you go to Florida or some place.
L. KING: Dr. Diamond, you were going to say something.
DIAMOND: When women go through the menopause and stop the fluctuation of their hormones, usually most women will get better with their headaches, if -- and they will improve. The fluctuation of hormones in any one month cycle is a big exciter of migraine.
L. KING: We'll take a break and come back and include your phone calls. I'll re-introduce the panel, too. Don't go away.
L. KING: Let's re-introduce our panel.
Here in Los Angeles, my wife Shawn King, who's CD "In my own Backyard" will be out early this summer, a migraine sufferer.
Why are you laughing?
S. KING: Because...
L. KING: Dr. Frank Lawlis, clinical and research psychologist. His focus on alternative migraine treatments not involving medication. And he's author of "The ADD Answer: How to Help Your Child" -- that's attention deficit disorder. The foreword by our friend, Dr. Phil McGraw.
Here in Los Angeles is Susan Olsen, the actress known to millions as Cindy Brady on "The Brady Bunch," migraine sufferer since age 11, formally compensated spokesperson for Magnum Migraine Awareness Group and GlaxoWellcome Pharmaceuticals.
In New York is the famed Lee Grant, director, producer and Oscar- winning actress, a migraine sufferer herself. And in Chicago is Dr. Seymour Diamond, M.D., director and founder of the Diamond Headache Clinic, executive chairman of the National Headache Foundation. Their Web site, by the way, is www.headaches.org, www.headaches.org. He's editor in chief of the magazine "Headache and Pain."
Before we go to calls, Dr. Diamond, someone asked me to ask you about someone who had a migraine and then for about an hour forgot numbers, forgot their phone number, forgot little simple things like that. Is that uncommon or common?
DIAMOND: That is a very uncommon symptom, but it does occur. I once had a pilot who was, as a patient, who was -- had his migraine and had a lapse of his knowing where he was as he was landing an airplane, which could have been a very catastrophic occurrence. And -- but it happened that the FAA thought better and had grounded him after this particular attack.
L. KING: Good idea. Indianapolis, as we go to calls, hello.
CALLER: Hello. My name is Ryan. I was just wondering, my wife and I have been married for about four years. She's been suffering from headaches ever since she was about 10, migraines. And we believe they're stress-related. And recently we've been hearing suggestions about biofeedback. I guess this question would be for the psychologist, whether or not that is a recommended treatment.
L. KING: Dr. Lawlis?
LAWLIS: Yeah. The evidence for biofeedback, especially the cardiovascular retraining, is very, very helpful. For the kind of...
L. KING: What happens with biofeedback?
LAWLIS: Well, what happens, as I explained earlier, the initiation...
L. KING: I know, but what is the biofeedback?
LAWLIS: Well, I'm going to tell you. So what happens is when you have restriction of blood vessels, it usually makes your hands cold, because there's less blood flowing through them. So you just basically connect a little thermistor here and it measures how warm or the dilation of your blood vessels, and so you basically have a monitor up here, and you train those blood vessels in your hand, and habitually in your head, to dilate when you need to dilate them.
L. KING: What's the cranium thing they did with you in Utah?
S. KING: Dr. Antwan Harris (ph) works with the bio-cranial manipulation. He told me that our skulls have 40 some odd bones in them. And he was working with my head. And after he had manipulated it, my head felt much clearer. And I had a good result.
L. KING: So you need manipulation all the time, then, though, right? S. KING: Well, you know, at that time, it worked.
L. KING: Lee, what's the longest you've gone without -- hold it, doctor. Lee, what's the longest you've gone without a migraine?
GRANT: I think the month before now, appearing on your show.
L. KING: We cured you.
GRANT: But you know, and I want to just check with Susan and Shawn. You know, I have never missed a day's work. And you know, I've worked a lot, both acting and directing. I've never missed a day's work because of migraine. And part of it is that the tension and the adrenaline, as Susan was saying, when you work, for that time, before you've been knocking your head on a rock and they say, OK, you know, pull yourself together. Action. It goes. And I've liked the work that I've done in pain or sick better than when I've been fine. It's just like something takes over.
L. KING: You do the same, Susan?
OLSEN: Yeah, I've worked through having the flu or something, and it's actually -- it's been a good focus. But like Lee, I never missed a day of work as far as entertainment goes, but I also worked in the regular world and had a regular 9-to-5 job every single day, where there wasn't a beginning and an end. So there wasn't any safety valve or ending of the project. So I would get them almost every weekend.
L. KING: Did you go on stage and sing with a migraine?
S. KING: I've done it. I've done it. I did "Hollywood Insider," that entertainment news show that I did, and they kept a bucket for me at the side of the stage.
L. KING: Athletes -- I've seen athletes...
S. KING: It is really not pretty.
L. KING: Athletes couldn't play with it. They've carried basketball players, football players into locker rooms.
S. KING: Well.
L. KING: How do you explain it?
OLSEN: She's a woman. We can deal with these things.
S. KING: We're tough. We're made of tough metal.
L. KING: Dr. Diamond, why do more women get it than men?
DIAMOND: Because of the fluctuation of their hormones. And there's a hereditary factor as well. There's certain disorders or diseases that affect men more than women. And migraine is a disease that just is more prevalent hereditarily in women. L. KING: You have a genetic background in it?
S. KING: Yeah, my folks used to get them when they were younger, but as they've gotten older, they've gotten away. But I'm getting a headache right now. It's coming back.
L. KING: What?
S. KING: It's coming back. You've got to get back to work...
L. KING: You mean your headache is coming back at this minute?
S. KING: Right now.
L. KING: Are you seeing an aura?
S. KING: I'm just -- I think it's just the lights and...
L. KING: These lights bother you?
S. KING: Yeah.
L. KING: Want to sit in the dark?
S. KING: No, I'm fine. I'll get through it.
L. KING: Toronto, hello.
CALLER: Hi, Larry.
L. KING: Hi.
CALLER: I too am a sufferer of migraines. And when it happens, it's as if I'm paralyzed on my right side. Completely. What I want to know is the doctor, speaking with the psychologist there, he talked about alternative medicine. I want to know what is the alternative to drugs?
L. KING: Well, he's already explained it. The main alternative is...
LAWLIS: Well, there's several alternatives, one of which has to do with just lifestyle. For example, a lot of people get migraines when they have some -- when they get dehydrated, for example, or if they get -- if their trigger has to do with environment or stress. So a lot of it has to do with just changing your lifestyle. And then there's the control of your body so that you -- your body doesn't react to the stress by closing down those blood vessels. And then you also have some various vitamins and nerves that seem to be helping.
L. KING: We'll take a break and we'll be back with more -- hold it, doctor. We'll be right back. Don't go away.
L. KING: We're back with our panel. Tampa, hello. CALLER: Hi, Larry. Thank you for taking my call.
L. KING: Sure.
CALLER: I have a question. I was diagnosed with migraines about seven years ago. And at the same time, I was diagnosed with hypoglycemia. And the doctor thinks that it's possible the two could be related. I wondered if there's any research or information on that.
L. KING: Dr. Diamond?
DIAMOND: No, they're not related, but when your blood sugar goes real low, you get this hypoglycemia. That's what hypoglycemia is, a low blood sugar. When that happens, it can act as a trigger. What I think is very important for any migraine sufferer is to keep a diary. They should mark down what happens when they get the headache, what preceded it, and how it affected them, whether it's food, bright lights, oversleeping. All these things can be triggers. And they should keep a diary. And you should do that about your hypoglycemic attacks and your migraine.
L. KING: You never do that, do you?
S. KING: Never keep a diary of -- no. I mean, I basically know what causes my migraines. It's stress and then it's after the event. Those are the two triggers for me.
L. KING: Well, then the cure is don't have events and don't have stress.
OLSEN: Just don't live a life. Just sit still, Shawn. Just sit still.
L. KING: It's -- the guy goes to the doctor and says every time I lift my arm, I get a pain. Don't lift your arm. Little joke.
Watertown, New Jersey. Thanks for laughing, Lee.
CALLER: Hello, yes. I'm 30 years old and I've been taking Topamax now for quite a while. And I was wondering if Dr. Diamond can tell me the highest dose that he would recommend to take. And also, I suffer from cluster headaches where it feels like spiders are actually coming out of my head, and I go to the hospital and I vomit and they gave - the last time I went, they gave me oxygen. Is that recommended? What does he think about that?
L. KING: Dr. Diamond?
DIAMOND: Okay, first of all, I wouldn't want to venture over the television to tell you what dose to take. That would be up to your individual doctor. I'm sorry. I just couldn't give that type of advice. Secondly, in cluster headache, oxygen, strangely, constricts the blood vessel. It is a vasoconstrictor. And if you're getting a cluster headache, breathing 90 to 100 percent oxygen will eliminate the cluster headache.
It's interesting that you, as a woman, gets cluster, because God repaid men for women having migraine, he gave men cluster headache. About 90 percent of cluster suffers are men.
L. KING: Now, cluster sounds worse. Cluster sounds like you're being hit with a hammer.
OLSEN: You are. It's much worse.
L. KING: It as much worse?
OLSEN: Much worse. It's the leading cause of suicide among disorders. I think it's followed by shingles, but -- because it's so intense.
L. KING: How did they get the name?
LAWLIS: I don't know how they got the -- they come in clusters. That's right.
DIAMOND: They come in groups. They come in bunches, and that's why.
L. KING: Do you ever get that?
S. KING: I was diagnosed with cluster headaches.
L. KING: You get cluster, too.
S. KING: I -- you know...
L. KING: You have every known gene in the world.
OLSEN: You're a lucky girl, aren't you?
L. KING: Lee, do you get cluster?
GRANT: No, no, no. But one of my really dear friends who is no longer with us, a guy, used to get cluster headaches. And he carried an oxygen tank with him every place that he went. And he would crawl on the floor on the bathroom floor. I mean, the pain was so excruciating. It was incredibly bad.
L. KING: I can't imagine how you people do it.
Buffalo, New York. Hello.
CALLER: Yes, my 14-year-old daughter gets severe left-sided head pain and numbness, but she doesn't get the aura, light- sensitivity and nausea. I'm just wondering, is this still a migraine? And what about acupuncture?
L. KING: Acupuncture. We'll bring that up. Dr. Diamond, is that a migraine? DIAMOND: It most certainly is a migraine. It's one-sided headache. She doesn't have to have the warning signals. Only about 25 to 30 percent of people get a warning of their migraine.
As far as acupuncture, it is -- it might help with an individual attack, but you can't go around for each attack and keep getting acupuncture. I don't think it works too well as a preventative. I did some original work back in England on it, almost 30 years ago, and have tried it in the practice, and have not found it that effective.
L. KING: Have you tried it?
S. KING: I tried it. Actually, about a month ago, I was in a very tense situation and it worked then. But today I also tried it, and it's -- you know? I went in for a treatment. And...
L. KING: You had acupuncture today?
S. KING: I had acupuncture today.
L. KING: For the headaches?
S. KING: I just -- well, actually for my breathing, but -- because I've got bronchitis. I don't have it now, but when he came to me for the acupuncture, he said, you have a very old breathing problem.
L. KING: Have you had acupuncture?
OLSEN: No, I haven't. I've always found it interesting. I think that anything that helps with your circulation in general, even something like yoga or exercise, is probably a good idea.
L. KING: We'll pick up with more calls right after this.
L. KING: We're back. Palm Beach, Florida. Hello.
CALLER: Yes, Larry. Great show.
L. KING: Thank you.
CALLER: I have a question for the doctors. I was told that I suffer from silent migraines. I get the flashing lights in my peripheral vision, and I get the aura, but I never end up with the full blown pain of a headache. I was wondering if they ever heard of that.
L. KING: Dr. Lawlis, you go first.
LAWLIS: Absolutely, because, what's happening is your cardiovascular system is shutting things down. But luckily you're not having that kind of pain.
L. KING: Just a lucky break. LAWLIS: Well, it's a lucky break, but she still has migraines.
L. KING: Dallas, hello.
DIAMOND: Can I make a comment?
L. KING: Yes, go ahead, Dallas.
I'm sorry. Hold it, Dallas. Dr. Diamond, go ahead.
DIAMOND: OK. A lot of people, as they get older, will just get the warnings and not the headache itself, and many times ophthalmologists will refer them to me -- patients who, they first go to the ophthalmologist because they're worried about it. But it's really nothing to worry about and it will go away as they get older.
L. KING: Dallas, go ahead.
CALLER: Hi, Larry. Good evening, panel. I just wanted to mention I've had migraines for 24 years, and miss an awful lot of work, and about two months ago, my doctor started me on 100 milligrams Topamex every day, and I haven't had a migraine since. I wondered if anyone on your panel has tried Topamex therapy. It really has..
L. KING: Did you try it?
S. KING: I tried it, and it had a very -- I had a bad reaction. That was the day we were in the meeting and I couldn't focus. I started crying in the middle of a meeting. And, you know, that was my lucky break.
L. KING: You had an adverse reaction. Do you take Topamax?
OLSEN: No, and actually, that was not something that was really being done when I got my first true help. And that raises a really good point. If you haven't been to the doctor and you're still suffering, every couple of years something new is being done. And you really owe it to yourself to go back.
S. KING: Right.
L. KING: Lee, have you ever had -- have you ever had taken Topamax?
GRANT: No, I don't know whether that's a brand name. I don't recognize it. But acupuncture sure did help me in the beginning.
L. KING: It did?
L. KING: Dr. Diamond, what's Topamax?
DIAMOND: It's Topiramate. It is an anti-convulsive. And we've done a lot of the original work with it at the clinic. We did several of the original research projects that got it approved by the Food and Drug Administration. And it is an effective preventative if somebody's getting three or four migraines a month. And we use it and we prescribe it. And one dose -- one can't judge. It is not going to work immediately. It takes several weeks for a preventative drug to work.
L. KING: To Columbia, South Carolina. Hello.
CALLER: Hi, Larry. This is Kathy (ph). And I just had a question. I've had migraines since I was 8. I'm now 40. And I have tried Topamax and Imitrex. I tried pretty much everything. And I have them two or three times a week. And I see my doctor more than once a month.
OLSEN: Oh, God.
CALLER: I mean, I'm on disability because of it. They just control my life. And is there anything that I haven't tried that maybe would work?
L. KING: Let's try a layman recommendation. What?
S. KING: Ice. That does help me. Put an ice pack around the back of your head. And get in the dark, lay flat. But that can -- if I catch it at the very beginning, an ice pack will...
L. KING: Like you'd like ice now?
S. KING: I would love an ice pack right now, just right around the back of my head.
L. KING: Get an ice pack.
We'll be right back with more. Don't go away. Get an ice pack.
L. KING: We're back. You got her ice? You have ice on now?
S. KING: I have ice. I feel like such a drama queen. Sorry.
L. KING: Nashville, hello.
L. KING: Hi.
CALLER: Thank you for taking my call.
L. KING: Sure.
CALLER: I've suffered from migraine headaches for about 20 years. And in the mid-'80s, I was prescribed a low dose beta blocker for these. And I have not had one since, and I'm still on them. Why hasn't something been said about this drug?
L. KING: You were told to take them, but you didn't. Dr. Diamond?
DIAMOND: I did mention beta blockers when I mentioned the preventative drug. The first one that was approved, and I did the original studies on it, was Propranarol, Inderal. But all the beta blockers do help. It is a generic drug, and it's a very good prophylactic medicine.
L. KING: Susan, are you hopeful about this? Or do you get discouraged?
OLSEN: I'm very hopeful, because I've had, you know, I've had a terrific success. I feel so lucky, especially in the face of such suffering here. And then when I hear somebody call in like that poor woman, who has a couple of them a week and she's on disability. I've been very lucky. And I think a lot of it is because I'm getting older and I'm sort of outgrowing them. And like I was saying, I've learned to deal with my stress, and I just don't care about anything anymore.
L. KING: Lee, are you optimistic?
GRANT: Well, I'm optimistic about myself. You know, I think mine are moving into a kind of different place now. But I was just wondering if Shawn, if a hot shower before that ice, you know, a little Butalbital, which people haven't talked about, you know, Butalbital, and then a hot shower before you put the ice on, you know. I just feel so bad for you, honey.
L. KING: What is Butalbital? What is Butalbital, Lee?
GRANT: It's -- well, let the doctor tell you.
L. KING: All right. Dr. Diamond, what is that?
DIAMOND: Yeah, Butalbital is a sedative. It's a barbiturate. And it's -- it can be highly habituating. And I really don't recommend it for migraine patients, because if they have very frequent migraines, they're going to get habituated to it. And it's very, very difficult to get them off.
L. KING: You can be optimistic, Dr. Lawlis?
LAWLIS: I think so.
L. KING: You are optimistic about this disease.
L. KING: Based on what?
L. KING: Hold it, doctor.
LAWLIS: For one thing, I see people who can manage their migraines on a lifetime basis, just based on their own changes in their lives, their own way of regulating their own bodies. And this is just basically a learning process. Now, I'm not saying this has worked for everybody, but I've seen some very strong improvements for people who have taken the challenges.
L. KING: Are you optimistic, Dr. Diamond?
DIAMOND: I'm very optimistic. When I first started doing headache work back in 1970, there was very few medicines available. Biofeedback was in its infancy. And it is a good treatment. But basically, a lot has been discovered.
And I can say one thing. If you're a sufferer, seek out somebody that can help you. The National Headache Foundation, you can contact them. They have a list of physicians who are interested in headache and may be interested in helping you.
L. KING: Thank you, doctor.
Are you optimistic, Shawn? Based on tonight, I would say no.
S. KING: No, I'm optimistic. I'm just going to keep trying.
L. KING: Because of your faith and your optimistic attitude?
S. KING: Well, yeah.
L. KING: You know, but you haven't had anything that has concretely helped you yet?
S. KING: No, not yet. But...
L. KING: You're hopeful.
S. KING: I work with Dr. Charles (ph) over at UCLA. Every time something new comes out, he gives me a call. So.
L. KING: And it doesn't work, and we go back.
S. KING: And we go back and we get back in the...
L. KING: Thank you all very much.
Shawn King, Dr. Frank Lawlis, Susan Olsen, Lee Grant and Dr. Seymour Diamond.
The Michael Jackson case heads into real interesting territory tomorrow night when his first -- when his previous wife testifies. We'll discuss that tomorrow night.
Right now, we'll turn the tables over to -- turn the tables? -- no, we'll turn the program -- no, we'll turn the network over to New York. What am I talking about? I got the wife here, throws you.
AARON BROWN, HOST, "NEWSNIGHT": I know. I noticed that.
L. KING: Aaron Brown is next. Yeah, have you noticed?
BROWN: I did, yeah. Listen...
KING: We're going to take her to the hospital now. I'll call you later.
BROWN: OK. Just hang in there. This is -- we've got a sequence of stories here that are perfect for you, OK? Honestly.
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