An apple a day, an aspirin a day, a slog a day, an ACE a day keeps a doctor at bay is hopefully what your doctor is preaching.
An orgasm(serotonin factory/sumaptrin) a day in the case of migraine may soon be the new instructions manual in a few months time or be in contempt of Hippocratic oaths of today?
Medicine has taught us that migraine is prognostically benign. It should be as much a reprieve to diagnose migraine off your differential as is GORD in a patient being investigated for coronary artery thrombosis or heart attack for the intellectually challenged majority.
In my setting I frequently have to see a young lady post normal lumbar puncture and brain scan if it it’s Christmas. (You don’t get a scan in KZN unless your surname is Shabir, drive a blue lights car or happen to be a prisoner) after a headache workup.
The patient’s headache usually is worse by then as the post LP headache has complicated the picture, and everybody's nerves are on the edge with names being flung around with ‘f’ adjectives ad lib.
To find out then that the original headache was a migraine is a champagne moment. We take a collective sigh of relieve, doctor patient and relatives in unison and go home with our proton pump blockers, sumaptrin or analgesics prescription depending on the case.
New evidence from NEJM seems to contradict our dictum though. Women with migraine have been found to be at a higher risk for strokes. Migraine sufferers have been found to have a thicker cortex on MRI. This is post stratification for smoking and use of oral contraceptives. Migraine sufferers, me included will testify to the worsening trigger sensitive points to the extent that I can’t go to church no more. (Something had to go, and the singing and drumming in church has triggered mine every time)
‘Grounded for life’ comedy is mistaken; you don’t get rid of kids that easy. I still have all mine, sticky as super glue including the 29yrs old. Our forgiving God will understand the choices I had.
If the pathophysiology of migraine has to be the mainstay of how we treat it, then serotonin will play more than just a cursory role in disease processes in the brain, including plain aggression. We don't all have Harley's, therefore one can possibly understand the higher rate of alternative and cheaper forms of serotonin pump use.
I will not want to simply a complex picture with science. The serotonins are different, and even similar serotonins acting on different parts of the brain will effect different outcomes. The day we can prescribe a specific neurotransmitter to a migraine sufferer on the edge and get a drum slinging commercial church fanatic on the other side are close though.
We may have an orgasm tablet for all to enjoy without need for sex. We may save even the catholic nuns of tomorrow from life time suffering. In the meantime orgasm might be the only outlet for many.
My wife may yet find out I am a fanatic Christian after all the accusations of addiction being thrown my way.
If you want to throw the cat in the mix, add an aldosterone a day, as recent studies show in CCF. Whether any man will knowingly accept chemical castration is another debate.
If biochemistry and physiology of beauty and health are the elements of every mix, then results are assured