The Keeler Migrane Method Q&A

Most of us have suffered from them at one time or another - a mind-numbing pain, or a sharp one right between the eyes, or the throbbing of your occipital lobe – the dreaded migrane. Some of us are lucky enough only to have had one or two. Others have them with extreme regularity.

Either way,  a migraine can turn any good day sour very quickly.

Dr Robert Cowan, who with team of specialists  at the Keeler Center for the Study of Headaches, has conducted some of the most cutting-edge research in the field.  From the research as come a  book The Keeler Migrane Method, a step-by-step guide to individualized migrane management.

Find out what he has to say about migranes and migrane management with this informative Q&A:

It seems like migraine treatments are like diets. What works for one person doesn’t always work for the next. Why is that?

If we approach migraine treatments like we do diets, they will work about as well as diets do – which for most people, is not too well. To use that metaphor, we lose weight when we understand why we are overeating and underexercising. If I am not eating ice cream, cutting it out of my diet won’t help my weight problem. If chocolate is not one of my triggers, eliminating it won’t help my headaches. No two people have exactly the same weight issues. Neither do migraineurs have the same trigger issues. But once you understand WHY you have a particular health issue, you can begin to work on minimizing it’s impact on your life. That is what we do in the Keeler Method. It is not another ‘treatment plan’ but rather a tool to understand why you get headaches and what you can do to minimize their impact on your life.

We are always hearing about triggers for headache. What triggers headaches and does everyone have the same triggers?  Why is it that triggers don’t cause headaches in non-migraine sufferers?

A trigger is some external (like a change in barometric pressure or bright lights) or internal (like a change in estrogen or other hormone levels) stimulus that contributes to creating a headache. Not only do different people have different triggers, but most triggers are not absolute. Most are PARTIAL triggers, meaning that they only lead to headache when combined with other partial triggers. Given the right combination of triggers, anyone can get a migraine. But migraineurs are more susceptible, have a lower threshold, for triggering a migraine.

Lots of people talk about sinus headaches and tension headaches. How are they different from migraines?

People talk about sinus headaches because the pain seems to be in their sinuses, but unless there is other evidence of infection like nasal discharge and fever, the pain is not coming FROM the sinuses but going TO them through the trigeminal nerve – the nerve that is part of migraine. The problem is in the trigeminal nerve (migraine) not in the sinuses. Millions of people have unnecessary sinus surgery because this simple anatomy is so often misunderstood. The story with tension headache is slightly more complicated, but similar. The nerves that go to the muscles of the head and neck run very close to the trigeminal nerve pathways, so migraine can cause the muscles to tense up and tense muscles can irritate the trigeminal nerve and lead to headache. Bottom line: most headaches are migraine, not tension or sinus. Treat the headache as a migraine and nine times out of ten it will get better.

I understand that you use both western medicine and non-traditional or alternative treatments in your clinic. Is it difficult to walk the line between the two? Do you find that one approach is better than the other?

A lot of the distinctions between various approaches to health care are artificial. Medicines that are prescription and medicines that are sold over the counter or in health food stores are still medicines. Similarly, there are good MD’s and MD who…aren’t. Same is true for chiropractors, acupuncturists, physical therapists and so forth. I am trained in western medicine and that is my expertise, but I have tried to learn enough about other approaches to allow me to seek out practitioners and modalities that can help my patients. No two patients are alike and no two treatment plans are alike. There is no one-size-fits-all.  I see my job as providing my patients with enough information and options for them to effectively manage their headaches, and then we help them implement that plan, modify it when necessary, and monitor for effectiveness.

This may seem like a strange question but do you have any idea as to why people get headaches? And why only certain people get headaches?

This is one of my favorite topics, one I have lectured on and written extensively. Pain is how we know when we are under attack. If you can’t feel pain, you tend not to survive. But clearly, different people have different “thresholds” for pain, and are more sensitive to assaults from the environment. Migraineurs are at one end of this spectrum – very sensitive to environmental changes. So in one sense, migraineurs can be thought of as the sentinels of the species – more attuned to potential environmental risks than the general population.

What kind of feedback have you gotten from migraine sufferers since the book has been published?

On a personal level, it has been amazing. My patients, migraine blogs, and my colleagues have been so positive and appreciative that I am left speechless (an odd state for me). E-mails from as far as Australia, South Africa and England and New York have come in asking for local practitioners of the Keeler Method. The most frequent comment has been “Why hasn’t anyone explained this before?”. People also seem to like the humor in the book and that it is non-judgmental. On a professional level, people have told me it has changed the way they see their headaches and how they manage them. That is huge. It is why I wrote the book. It makes the whole project worth it.

You can find out more about The Keeler Migrane Method here