[HN Gopher] Pioneering work that has changed our understanding o...
       ___________________________________________________________________
        
       Pioneering work that has changed our understanding of migraines
        
       Author : robaato
       Score  : 138 points
       Date   : 2021-10-09 14:33 UTC (2 days ago)
        
 (HTM) web link (www.theguardian.com)
 (TXT) w3m dump (www.theguardian.com)
        
       | noyeastguy wrote:
       | I used to get aura-style migraines. After following a yeast and
       | wheat free diet my migraines went away. I started on the diet
       | based on a small study as a way to suppress hidradenitis
       | suppurativa symptoms. I've now been on this diet for 7 years and
       | have not had a single migraine. It's clear to me that the cause
       | of migraines are inflammation, in my case caused by innate
       | immunity (with a failure to down regulate) to fungi and 1,3, 1,6
       | beta glucans.
        
         | berdon wrote:
         | I get aural migraines from Niacin and MSG. Most wheat based
         | flour is enriched with Niacin. You might look into seeing if
         | Niacin is your trigger and be able to eat wheat/yeast again.
        
           | MarkMarine wrote:
           | I actually got an aural migraine while reading the article,
           | and I had a pizza last night which is a rarity (my wife is
           | gluten intolerant and I mostly follow her diet.)
           | 
           | Now I'm curious about this, thank you for posting this.
        
         | halfmatthalfcat wrote:
         | My mother has had the same journey. She's had migrations for as
         | long as I can remember and recently removed lectins from her
         | diet. Haven't had a migraine since, it's actually amazing.
        
       | cpncrunch wrote:
       | Terrible article, saying that a stress explanation means the
       | patient is crazy, and that we now know something biological is
       | going on. Ever heard of stress hormones? Adrenaline? Cortisol? Of
       | course stress is biological.
       | 
       | This article just discusses one small piece of the puzzle, but
       | the evidence shows that stress is still a major trigger for many
       | patients.
       | 
       | My wife used to have almost weekly migraines every weekend, but
       | hasn't had one in years now after moving out of a stressful job.
        
         | aksss wrote:
         | Stress levels (emotional, physical, both at once) are also
         | known triggers for flare-ups of autoimmune disorders (MS,
         | lupus, etc). These disorders will readily obviate high stress
         | levels, and people with AI disorders learn quickly that
         | managing stress is often their best weapon for managing the
         | disease.
         | 
         | Even without these disorders, your body is still having to cope
         | with and dispose of these conditions _somehow_. Often this is a
         | crescendo of getting through the week (thanks adrenaline), and
         | suffering massive headaches on Friday night /Sat morning. Not
         | surprising to me that chronic high stress manifested as
         | horrible headaches with your wife, essentially forcing her to
         | shut down for repairs - usually this means crawling into a dark
         | room and staying there until the pain stops. I imagine that far
         | more unseen/unfelt damage was happening that was more easily
         | ignored on a daily basis (blood pressure and chronic
         | inflammation for instance).
         | 
         | Unchecked inflammatory responses, particularly chronic
         | inflammation for months, is highly damaging to the body, even
         | if the effects aren't noticed in real time.
         | 
         | I suppose what I'm trying to say is that yes, chronic high
         | stress sucks, is very unhealthy, and its evident effects are
         | manifested in odd ways which our bodies are are less capable of
         | papering over as we get older.
         | 
         | If someone out there reading this is suffering from chronic
         | headaches, or feels hung-over occasionally even when they have
         | no excuse for it, destress your life systemically - meaning
         | don't just try meditating, but change jobs like above comment
         | said. Structurally remove the elements that are driving your
         | body into such a condition, because it will only get worse as
         | the effects compound and your body ages.
        
       | Indy9000 wrote:
       | That whole article could have been just two sentences.
        
         | d4rkp4ttern wrote:
         | Wish we could use one of those "social highlighting/annotation"
         | apps so people identify key highlights to make it easier for
         | others to find the key points.
        
         | gumoro wrote:
         | I recommend the 6th paragraph (4 sentences) in this article:
         | https://newsroom.ucla.edu/dept/faculty/peter-goadsby-migrain...
        
         | carlmr wrote:
         | I blame schools for teaching kids to reach word limits, instead
         | of how to express themselves concisely.
         | 
         | A prime example of Goodhart's law, or just finding an easy to
         | check proxy for writing quality.
         | 
         | Of course another reason is that modern journalis has to
         | include at least two paragraphs of enticing fluff so that
         | readers buy the subscription.
        
           | toyg wrote:
           | _> schools [...] subscription_
           | 
           | None of that. Journalists simply want to feel like they are
           | novelists, because, deep down, that's what most of them
           | really wanted to be.
        
           | lelandfe wrote:
           | On the web, content length is also typically seen as an SEO
           | signal. Whether that's a direct signal or just keyword
           | stuffing, who knows.
        
           | dorkwood wrote:
           | They can also fit more ads into a longer article. That's
           | arguably the most important thing.
        
           | magicalhippo wrote:
           | My SO had that problem with word limits at school. She would
           | write 5 pages for a 300 word assignment, it was almost like a
           | brain dump.
           | 
           | At college I helped her with her assignments after she was
           | done writing. I didn't know her topic but just reordering
           | sentences, deleting redundant ones and shortening others.
           | 
           | I started doing this after she failed an assignment and she
           | asked for help. After we were done "post-processing" it, she
           | got a B on it. We hadn't touched any of her technical points,
           | just improved the language.
           | 
           | I now help my sister through something similar. She has the
           | opposite. She'll write 300 words for a 1000 word assignment.
           | Again I know nothing of her subject, but I'll do a similar
           | post-processing. In the process I'll notice there are some
           | gaps in her arguments perhaps, or things that aren't as
           | fleshed out.
           | 
           | So I ask her about it and almost always she can tell me lots
           | about the subject from the books and articles she's read as
           | part of the curriculum. So I tell her to write it down, and
           | after going through the assignment we're suddenly in the
           | position where we have to trim some stuff.
           | 
           | I used to think word limits were somewhat silly, but now I
           | see how they can help focus the unfocused or help tease out
           | the knowledge. Both my SO and my sister improved over time,
           | requiring much less help after a while.
           | 
           | Of course left to their own devices, it would likely be very
           | difficult for them. So there's that.
           | 
           | Incidentally, language was never my favorite subject and I
           | didn't do particularly well. However studying math helped me
           | a lot with writing non-fiction, where things like consistent
           | logical arguments matter.
        
             | tcbawo wrote:
             | The ability to tell an engaging and concise story without
             | gaps is a difficult skill. I imagine it can be required
             | through practice and attention. I have noticed a certain
             | deficit in this regard with my own family and I would love
             | to hear what techniques or exercises might help.
        
             | saalweachter wrote:
             | Do you think there is any problem with teachers setting
             | word limits appropriately?
             | 
             | I could imagine novice teachers who haven't attempted the
             | exercise themselves being off considerably -- over or under
             | -- on the number of words needed to complete an assignment.
        
               | magicalhippo wrote:
               | So far I haven't seen much of that. There has been a few
               | times were I told them to ask the teacher about
               | clarification of the word count, like how bad would it be
               | if we had 1300 instead of 1000. Sometimes the teacher
               | would say OK if it was relevant stuff.
               | 
               | I can't recall any instance where either of them got a
               | low grade for not fulfilling the assignment due to very
               | limited word count. If you have 200 words it's impossible
               | to go into deep details, that's just how it is.
               | 
               | Of course in those cases we often would have to do
               | multiple passes to cut fluff, focus the arguments by
               | cutting out details, find a word which might replace
               | three others etc. We'd typically start with maybe 4-600
               | the words and work our way down to 200.
               | 
               | Of course as a teacher, if you just failed your entire
               | class, maybe you need to look at yourself and the
               | assignment you gave rather than the students.
               | 
               | I had one instance of that at high school. When handing
               | back the assignments he loudly proclaimed "Well done, you
               | did by far the best in class" as he handed me my
               | assignment. I looked down and saw a D- on the paper.
               | 
               | The following class the teacher explained what he was
               | looking for, and we would explain what we had learned
               | earlier and he then filled in the gaps.
        
           | marcos100 wrote:
           | > I blame schools for teaching kids to reach word limits,
           | instead of how to express themselves concisely.
           | 
           | I thought the same in the past. But I think it's a good idea
           | to enforce word limits to make them think more about the
           | subject and to practice writing longer and complex texts.
           | 
           | The problem is that the teachers just impose a limit without
           | explaining and then it just looks like some bullshit metric.
           | 
           | I think modern journalism is more about SEO and getting
           | attention, not word limits imposed when we were in school (if
           | you hate word limits, then you probably dind't continue
           | writing longer texts)
        
         | dougSF70 wrote:
         | Come on, it wouldn't be an article then.
        
       | rcgs wrote:
       | What a meandering read.
        
       | julbook wrote:
       | This is not related to migraines, but I have a friend that
       | triggers his allergy with a sneeze. Once he sneezes, he'll have a
       | runny nose for the whole day.
        
       | everybodyknows wrote:
       | Chronic migraine sufferer here, male -- symptoms now well under
       | control. Hope this may be useful to someone. Triggers in my case
       | are almost entirely chemical, with a delay of ~18 hours from
       | ingestion to aura. The list:
       | 
       | - MSG
       | 
       | - sodium nitrate or nitrite
       | 
       | - celery powder (added by makers of sausage and jerky to dodge
       | disclosure of sodium nitrate/nitride)
       | 
       | - aspartame
       | 
       | - many fermented foods: yogurt, cheese, ...
       | 
       | - raw onions, garlic
       | 
       | - red grapes, red wine
        
       | WaitWaitWha wrote:
       | Article gives me an attack.
       | 
       | List of commercial anti-GCRP meds. https://www.drugs.com/drug-
       | class/cgrp-inhibitors.html
        
       | codeulike wrote:
       | Anecdata: a close friend has suffered from terrible migraines for
       | years. Triptans such as Sumatriptan/zolmatriptan helped, if taken
       | with anti-sickness meds, but they were needing to take them too
       | often and getting dependency headaches from them.
       | 
       | Over the years they tried many things which didn't really help,
       | or seemed to help but then didn't, or were inconclusivbe.
       | 
       | About a year ago they started on Ajovy (fremanezumab), a CGRP
       | inhibitor. Its been like magic. A simple injection every month
       | (you can do it yourself - they courier them over and you keep
       | them in the fridge) and barely any migraines. Sometimes one or
       | two towards the end of the month when the next jab is due. And no
       | real side effects as far as can be told.
       | 
       | Its unusual to come accross a medicine that works so well for
       | something as intractable as migraines.
       | 
       | UK specific: Originally they were paying for the Ajovy after
       | getting prescribed it by the brilliant National Migraine Center
       | (https://www.nationalmigrainecentre.org.uk/) - its expensive. But
       | after it was shown to work managed to get it on the NHS via a
       | referral to a specialist.
        
         | the_d3f4ult wrote:
         | These types of discoveries are becoming more and more common
         | with the explosion of novel biologics.
        
           | amatic wrote:
           | What are novel biologics?
        
             | datameta wrote:
             | Medication that is past what is considered "large molecule"
             | and in the size and complexity ballpark of proteins. These
             | need to be injected as opposed to taken orally as they're
             | too large to enter the bloodstream otherwise. There is a
             | whole search space out there for medication of this class
             | and we're only just getting started. It's (loosely) like
             | finding out what is possible with a 100MB program vs a 50KB
             | one.
        
               | dm3 wrote:
               | This is very interesting. Are there any books you'd
               | recommend on the topic which would explain the directions
               | pharmaceutical science is heading towards to a layman?
        
               | datameta wrote:
               | I'm not currently aware of a book on the subject, but
               | would also like to read a compilation of the cutting
               | edge. I am relaying what I know from tangentially
               | following advances my peers participate in filtered
               | through my former chemistry+bioinformatics background.
               | 
               | Here is some more info on considerations to be had for
               | near-future breakthroughs in the oral administration
               | route. The key is in preserving the biologic structure
               | long enough for it to reach the intestine where, in
               | contrast to the stomach, it would be able to enter the
               | bloodstream with the aid of agents that enhance
               | permeability. https://otd.harvard.edu/explore-
               | innovation/technologies/oral...
               | 
               | Edit: The field of cheminformatics is currently utilizing
               | machine learning to help discover novel drugs in the
               | various search spaces, such as that of kinase inhibitors.
               | They have the ability to function in a multi-target
               | regime. That is, there exist drugs that can be effective
               | for several pathologies.
        
         | ortusdux wrote:
         | A friend's insurance would not continue to cover their
         | preferred 'as needed' migraine medication until they tried
         | Ajovy. Both doctor and patient were unhappy with the
         | requirement, but damn if that shot didn't remove the existence
         | of migraines from their life completely.
        
           | Apofis wrote:
           | Very interesting case of an insurance company also being a
           | healthcare provider.
        
         | GordonS wrote:
         | This almost mirrors my own experience, only difference is I
         | take erenumab instead of fremanezumab - it really has been a
         | godsend!
        
         | dmd wrote:
         | Yep! I've been keeping a migraine diary since 1998. For twenty
         | years I averaged 12-15 migraines a month, where I define a
         | "recordable" migraine as one that stops me from doing anything
         | other than taking care of the migraine for more than an hour.
         | 
         | In 2018 I started Aimovig (later switching to Emgality). I now
         | average between 0 and 1 migraine a month.
        
       | hdjjhhvvhga wrote:
       | What you are looking for is here:
       | 
       | https://en.wikipedia.org/wiki/Calcitonin_gene-related_peptid...
       | 
       | So what's the catch?
       | 
       | 1. These drugs are relatively recent (approved within the last 3
       | years).
       | 
       | 2. It's not a pill but injection (although you can be trained to
       | give it to yourself), once a month on average.
       | 
       | 3. The medicine is relatively expensive (EUR500 per injection).
       | So unless your country subsidizes one of these or you can afford
       | such amount once a month, you will probably look for alternative
       | treatments for now.
        
         | auslegung wrote:
         | What I'm looking at here https://migraine.com/clinical/cgrp-
         | gepants lists only 2 drugs and they're both pill form. I've
         | done Aimovig which is a self injection but iiuc it's a
         | different class from the gepants CGPR drugs.
        
         | mhd wrote:
         | Either one of the existing ones or the new IV version can also
         | be taken as a "combined package" for a few months. But
         | honestly, the injection is the least of the worries. You don't
         | have to pull something up in a syringe, you get a complete
         | injector from the pharmacy. Aim it at your thigh, push the
         | button, no big chances of doing it wrong. Hurts like hell, I'm
         | told.
         | 
         | But those monoclonal antibodies aren't really wonder drugs.
         | Sure, they help a lot of people, but for others they don't or
         | at least they don't do it for a long time. It's a better,
         | dedicated medication than just using pain medication or anti-
         | depressants off-label, but we're far from every migraine
         | sufferer finally getting a totally reliable off-switch.
        
         | codingdave wrote:
         | When Imitrex (another migraine med) was new, it was an
         | expensive injection, too. They got it to pill form later, and
         | it got cheaper. These things take time. It isn't ideal, but it
         | how it works.
        
         | GordonS wrote:
         | I suffer from chronic headaches and debilitating migraines. I
         | was having several migraines a week - I was able to mostly stop
         | those that started during the day using sumatriptan, but I
         | frequently had migraines start during the night whole sleeping
         | too, which mean that as soon as I woke up, I'd end up lying in
         | the dark, unable to move and wishing I was dead. The pain
         | really is that bad.
         | 
         | I started erenumab (a CGRP antagonist, brand name Aimovig)
         | around 8 months ago, and it's been _absolutely amazing_! I 've
         | went from having several migraines a week to almost none, and
         | never while sleeping.
         | 
         | It really is expensive though - here in the UK it costs the NHS
         | PS386 per injection pen! As a result, I had to fight with my
         | neurologist for over a year to let me have it.
         | 
         | Doing subq injections yourself sounds daunting, but it's not so
         | bad once you've done it a couple of times. Apart from...
         | 
         | ...as an aside, the Aimovig branded injector pen is _shit_ - it
         | hurts like absolute hell, and somehow always seems to cut me,
         | like it  "slides" before the needle goes in. I've done subq
         | injections with a regular needle before, as well as using
         | another kind of pre-filled injector pen for a different
         | medication, and they were so much better!
        
       | mchusma wrote:
       | Frequent migraine sufferer, so very interested in content.
       | Horrible article, but I did search for articles on CGRP
       | treatments and may give them a try.
        
       | abhijat wrote:
       | As someone who used to suffer from visual auras (which ranged
       | from a few minutes to 15 minutes at most) due to migraine, a
       | persistent aura which does not go away sounds truly horrible.
        
         | halfmatthalfcat wrote:
         | I also get auras but thankfully it's the worst part of my
         | migraine cycle (actual headache is a 3/10). Probably get one a
         | month. I occasionally get pre-drome symptoms a couple days to a
         | week out. It's a minor inconvenience for 30-45 minutes but they
         | seem pretty benign (also verified by a neurologist).
        
         | snegu wrote:
         | Yes, I had no idea that was possible! I have had a total of 5
         | silent migraines (aura but no headache) in my life, and each
         | time was terrifying.
         | 
         | What's worse is that my current doctor says there's no way to
         | know if my last one was a TIA or migraine (all my research
         | shows otherwise) and now wants me to start on baby aspirin. So
         | yeah, every time I have an aura I'm convinced it's a stroke.
        
         | vanderZwan wrote:
         | I would lose the right half of my vision, except not like
         | anyone here (without similar experiences) is probably imagining
         | it right now: it was not like my right eye stopped working, no,
         | _the part of my brain that processes visual information would
         | deny the existence of the right half of my vision_ and replace
         | it with a reaction-diffusion lookalike aura. Split precisely
         | down the middle, doesn 't matter which eye. Even freakier, if I
         | were to look at someone's face, my eyes would refuse to turn
         | and show me the missing half of said face on the "left" side of
         | my remaining vision. Similarly I could no longer read words or
         | sentences because they were cut off and my eyes refused to do
         | the normal reading saccades.
         | 
         | It was then that I first learned that my conscious is only a
         | small part of my mind, and not in direct control of everything.
         | 
         | If I would have been stuck with that mode of perception
         | permanently I would have gone crazy.
        
           | Apofis wrote:
           | > It was then that I first learned that my conscious is only
           | a small part of my mind, and not in direct control of
           | everything.
           | 
           | We're made up of disparate systems that our conscience pilots
           | essentially, even our mental faculties are disparate systems.
           | This can sometimes make it hard to recognize when one of
           | these systems is under-performing or worse-yet failing.
        
           | coldcode wrote:
           | I know exactly what you describe, I had migraines for many
           | decades; oddly enough now that I am older I still get the
           | aura, but the headache itself is barely a Tylenol.
           | 
           | I also had cluster headaches one summer in college; now those
           | are truly the worst pain in the world. Imagine an electric
           | drill going through your head for 15 minutes once a day, then
           | vanishing.
        
           | 555watch wrote:
           | > It was then that I first learned that my conscious is only
           | a small part of my mind, and not in direct control of
           | everything.
           | 
           | That's probably the craziest takeaway from these. In my
           | experience, losing half the vision + the middle part was the
           | most often one. However, the craziest attack was when I
           | temporarily lost the control of speech. The mind and thoughts
           | were there, but nothing verbally said made sense when
           | listening to myself. I'm so glad that taking a nap was enough
           | to resolve that...
        
           | lostlogin wrote:
           | > If I would have been stuck with that mode of perception
           | permanently I would have gone crazy.
           | 
           | I get some sort of hearing perception change and vertigo to
           | the point of vomiting. However the devastating pain makes any
           | examination of the strange hearing changes near impossible.
           | 
           | Anyone who has these last any significant duration has my
           | sympathy.
        
           | miguelrochefort wrote:
           | This exactly describes an experience I had recently. I ended
           | up in ER thinking it was a stroke. Nobody ever mentioned
           | migraines or auras.
        
           | SavantIdiot wrote:
           | > the part of my brain that processes visual information
           | would deny the existence of the right half of my vision
           | 
           | YES. I get the scintillating scatoma but also a new thing,
           | that I call "the folded magazine page": it looks as if
           | someone folded out the middle of a magazine page and I have
           | to turn my head left & right rapidly to construct the rest of
           | the image.
           | 
           | My brain is like: nope, not gonna show you the middle strip,
           | just gonna cut-and-paste the left and right thirds together
           | in the middle.
        
         | jtwigg wrote:
         | I also suffer these though I've learnt to pick up on them
         | before they happen so I can pull over or step away from the
         | computer. This started when I was a teenager and has gotten
         | better since my mid twenties (30 now). I've only had 2 attacks
         | this year, though they have both been in August. I find taking
         | a nap helps. I don't get a headache but I do eventually lose
         | 99% of my vision.
        
         | SavantIdiot wrote:
         | Heya, me too. A few times a year, 30-40 minutes. More
         | frequently as I get older. Are you on anything for them?
        
           | abhijat wrote:
           | Hi, no, right now I'm not on any medication for them. At the
           | time I had them frequently (a few years ago) I was diagnosed
           | with very low vitamin b-12 and given shots for it which
           | seemed to help a lot with the frequency.
           | 
           | I also gave up alcohol gradually around the same time and the
           | episodes gradually subsided after that (I had noticed that
           | the migraines were pretty bad after drinking). I do not know
           | if the two were related or not.
           | 
           | Hope you get better.
        
         | culopatin wrote:
         | Hey here too. The first time it happened to me I was in high
         | school and my professor thought I was lying when I told her I
         | could no longer see my periphery. I had a dentist appointment
         | after school and I had to take the bus. By the time I got on
         | the bus, I could only see through a tiny window so I had a hard
         | time finding the handles to hold on to. I was lucky and my
         | dentist was working with a massage therapist when I got there
         | and the lady was nice enough to give me a massage where my head
         | meet the neck and that seemed to start undoing the effects.
         | Within an hour my vision started getting better.
         | 
         | Over time I started learning the patterns of my migraines and
         | I've avoided the auras for 10 years. Biggest impacts for me are
         | staying hydrated, not starving myself and avoiding prolonged
         | sun exposure (as in 3hs under the sun in summer)
        
           | JKCalhoun wrote:
           | Thank god for the internet. I too would (infrequently still
           | do) lose my periphery. (I called it tunnel-vision when I was
           | a teenager ... close enough.) No one I talked to knew what I
           | was talking about.
        
           | positr0n wrote:
           | Woah is sun exposure a trigger all by itself? I almost always
           | get a headache if I've been outside all day, but I always
           | assumed it was a second order effect like being outside makes
           | it harder to get enough liquids so I was dehydrated. Or heat
           | stroke.
        
             | culopatin wrote:
             | I think it's just like what you described. I love the sun
             | and I love being outside, but after a long day out at the
             | beach or racetrack I feel drained and I always have a
             | headache that can end up in migraine easily if I don't cool
             | off and over hydrate
        
             | ars wrote:
             | Bright light of the sun can trigger a migraine, at least in
             | me and some other people I know. It's not dehydration, it's
             | the bright light itself.
             | 
             | I found shade 5 sunglasses that are essentially lightweight
             | welding glasses they have been amazing. Unlike most
             | sunglasses they are _actually_ dark.
        
           | tw04 wrote:
           | Same, too much caffeine and being dehydrated are a trigger,
           | too many nights of not enough sleep as well. It's annoying
           | they've gotten more frequent as I've gotten older.
           | 
           | The first time it happened a doctor recommended Excedrin
           | (HAH!), fortunately I had already suspected caffeine so I
           | skipped that advice and hammered water and laid in bed for a
           | couple hours instead.
        
             | culopatin wrote:
             | I avoid acetaminophen altogether. i had a terrible terrible
             | morning because of it. I guess my liver wasn't doing great
             | which caused a migraine and I added acetaminophen to the
             | mix. 3hs of incapacitating pain followed by 6hs of
             | recovery:m. A wasted day.
             | 
             | Ibuprofen or naproxen for me. Caffeine is risky but present
             | in my day to day, I just have to take double the water even
             | if i know I'm just going to pee it out.
             | 
             | Any energy drink messes me up BAD
        
           | abhijat wrote:
           | Mine started with a very weird feeling that something was off
           | in my vision (usually triggered while working on a screen). I
           | would notice after a while that a tiny portion of my vision
           | was going missing and then the shimmering would begin and
           | spread out.
           | 
           | I've also not had auras for several years though I do get
           | headaches still. I had extremely low vitamin b-12 levels and
           | I think the auras disappeared after I took shots for b-12.
        
         | Daub wrote:
         | Some interesting work on the visionary writings of the 12th
         | century Abbess Hildegard of Bingham. Her visions are now being
         | understood as manifestations of migraines. I believe Oliver
         | Saks was the first to understand them in this way.
         | 
         | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4103393/
        
       | tmnstr85 wrote:
       | When I was 9, I remember grabbing a handful of mini-M&M's from an
       | information table at UCBerkley and we jumped in our rental van to
       | start the family vacation out to the Grand Canyon. About 15
       | minutes later I couldn't see due to an aura. That was the
       | beginning of my migraines.
       | 
       | In the spring of 2008, my dad go remarried to a Chocolatier - we
       | don't talk a lot.
       | 
       | It wasn't until I was 26 that I found out about triptans. I had
       | endured years of avoiding chocolate and racing to find the
       | darkest room possible any time I felt so much as a tinge of an
       | aura.
       | 
       | Today, any time we leave the house, I've got triptans and a
       | bottle of Aleve ready to go. Thankfully I'm down to about 2 per
       | year. This science is necessary and this article does a good job
       | of highlighting how and why this topic has been glossed over for
       | decades.
       | 
       | The picture gets even more complicated now that I have kids. both
       | female and one with a traumatic brain injury as a result of
       | bacterial meningitis at birth. I can barely comprehend about how
       | she interprets the world on a daily basis. If she has migraines
       | on top of that, I will be so thankful there are a wider set of
       | options today than ever before.
       | 
       | Goadsby deserves to be celebrated!
        
       | newbamboo wrote:
       | Many migraines are not migraines but stem (no pun intended) from
       | spinal cord problems that chiropractors can easily treat. Doctors
       | hate this fact and will gladly put people on meds or tell them to
       | change their lifestyle or their career rather than tell them to
       | visit a chiropractor. Doctors are not immune from the effects of
       | ego and hubris.
        
         | jonny_eh wrote:
         | > from spinal cord problems that chiropractors can easily treat
         | 
         | Please no. Chiropractors are mostly pseudo-scientific pretend-
         | doctors that should be allowed anywhere near a nervous system.
         | They are not "back doctors".
         | 
         | In 2021 they're a huge source of anti-vaccine misinformation.
         | 
         | https://simonsingh.net/media/articles/alternative-medicine/b...
         | 
         | https://www.health.harvard.edu/heart-health/chiropractic-nec...
         | 
         | > Doctors hate this fact and will gladly put people on meds or
         | tell them to change their lifestyle
         | 
         | Hating on doctors is no reason to go see a quack.
        
         | techrat wrote:
         | > Doctors are not immune from the effects of ego and hubris.
         | 
         | And that's why you recommend someone who isn't a doctor at all
         | for issues with the body?
         | 
         | Sounds like ego and hubris to me: "I can fix things that I've
         | never studied like actual Medical Doctors have simply by
         | twisting someone's back suddenly!"
         | 
         | No thanks.
        
       | 01acheru wrote:
       | I suffer from migraines and that article could have been
       | interesting, but I cannot stand those ten page long storytelling
       | articles anymore
        
         | codeulike wrote:
         | There's actually very little in the article about the
         | 'pioneering work' and how it happened, what the breakthroughs
         | were etc
         | 
         | Edit: although to be fair, the gist of it is that migraine has
         | only recently started to be taken seriously due to a kind of
         | medical sexism, so it's not so much a scientific breakthrough
         | as a social one
        
           | starkd wrote:
           | I can recall reading articles making that claim going back at
           | least thirty years now, claiming they need to take a fresh
           | look because it has not been taken seriously. It's just a
           | pitch for more research dollars. There's likely no one cause
           | for the illness. Migraines can due to wide number of things.
        
             | [deleted]
        
         | acjohnson55 wrote:
         | I was also taken aback by that. I think the headline set
         | expectations poorly.
        
         | rocketbop wrote:
         | I found the same when I came across the article a couple of
         | days ago. There was no real revelations, but the doctor in
         | question has worked on some new medications which work better
         | than previous medications and are now coming on stream.
        
         | neals wrote:
         | Yes I agree, these articles give me a headache.
        
         | nelox wrote:
         | If you would rather listen, Peter Goadsby was featured in this
         | BBC Discovery podcast about his pioneering research on
         | migraine: https://www.bbc.co.uk/programmes/w3ct1m7t
        
           | noneeeed wrote:
           | That was a great episode of Jim Al-Khalili's "The Life
           | Scientific" which is worth listening to.
           | 
           | It's an excellent series for anyone interested in science and
           | engineering, he does a great job of showing just how varied
           | science is, and also how varied the routes into science can
           | be. Many of his interviewees end up in their specialisms
           | thoough often very circuitous routes.
        
         | billfruit wrote:
         | Yes, this is so tedious a practice, where everything needs to
         | spun out into 10/20 pages of storytelling, and cliffhangers
         | etc.
         | 
         | Low information density articles are such a drain on all of us.
        
           | munificent wrote:
           | Some readers consider the human interest part "information"
           | too.
        
         | civilized wrote:
         | I give them about 2-3 paragraphs and if they haven't said
         | anything yet, I assume they never will and close the window.
        
           | specialist wrote:
           | Totally. Hidden topic sentences. Now I just skip preambles.
           | 
           | The Wadsworth Constant for text.
        
       | wombatmobile wrote:
       | If you don't want to wade through the preamble in the article,
       | search for "calcitonin" and start at that paragraph.
        
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