LeROY - When her chronic condition was most severe, Wendy Dooley - an active, athletic mom - needed help with her children, stopped exercising and couldn't even get out of bed.

Now, the 38-year-old rural LeRoy woman feels as if she has her life back.

Dooley suffers from migraine headaches. But taking medicine prescribed specifically for migraines combined with avoiding possible migraine triggers means that she hasn't had a migraine since July.

"In hindsight, I wish I had gone to the doctor sooner rather than suffer through it," Dooley said of her four-year battle with migraines.

Dooley is a good illustration of how crippling migraines can be because she's an active woman whose headaches ruled her life, said her neurologist, Dr. Edward Pegg of Bloomington.

Dooley has been active her entire life. The 1988 Bloomington High School graduate swam in high school.

After graduation from Purdue University in 1992, she resumed regular exercise. She walks or runs each day, plays tennis twice a week at Evergreen Racquet Club in Bloomington, and, when its cold out, uses the elliptical trainer or the treadmill in her home north of LeRoy.

Dooley, who is married to farmer Cole Dooley, had worked in health claims at State Farm Insurance Cos. in Bloomington before her children were born. Now, she focuses on Brooke, 12, a seventh-grader at LeRoy Junior High School; Bryce, 10, a fourth-grader at LeRoy Elementary School; and Will, 8, a second-grader at LeRoy Elementary.

About four years ago, she began getting migraine headaches about once a month. At first, she thought they were sinus headaches because she would get several sinus headaches a week. But it didn't take long for her to realize that the migraines were different.

Migraines were more severe and would last an entire day. The throbbing pain would worsen when she would move her head, even when she would shut her eyes.

Over-the-counter migraine medicines offered no relief.

She recalled that her mother had

migraines, starting from her late 20s until menopause.

But Dooley admitted she had been unsympathetic to people with migraines until she started getting them.

"You don't realize the pain until you have it. Having a migraine was the worst pain I ever felt.

"When I had a migraine, I couldn't get up," she said. "I couldn't lift my head up in bed without extreme, throbbing pain and nausea. I'd have to stay in bed" until the migraine passed, often for the entire day, she said.

"I couldn't do anything," she said. She couldn't exercise. She'd call her husband or family members or friends to watch the children or to pick them up from school or activities. She even had some days on family vacations when she'd have to spend the day in bed while her husband and children went out.

About two years ago, when the frequency of the migraines increased from one a month to two to three migraines a month, she decided to see Pegg.

"I was worried there was a bigger problem here," she said. In addition, "I didn't want to constantly be calling other people to help me with my family."

An MRI (magnetic resonance imaging) revealed scar tissue on the brain but Pegg told her that was from the migraines.

While Pegg couldn't pinpoint the cause of Dooley's migraines, he did note they are hereditary, and hormonal changes in women make migraines more prevalent during childbearing years.

Pegg also told Dooley about other possible migraine triggers, so she has worked to control stress, stay hydrated with water, limit salty foods and she exercises.

The first medicine he prescribed worked for awhile. Then he switched her to Imitrex, a tablet medicine that she would take when a migraine began. It worked but not for two hours.

"There were some days when I didn't know if I could last two hours," she admitted. "I thought my head would spin off."

Next, Pegg prescribed an Imitrex injection, which Dooley would administer herself in her hip when a migraine began. That would take affect after about 20 minutes and worked most of the time, she said.

About a year and a half ago, the frequency of the migraines increased to four to five a month. The Imitrex was working but those were several days a month when Dooley was not 100 percent.

Pegg prescribed medicine to prevent migraines. Dooley took one Inderal LA pill each day.

"I didn't like it," she recalled. "It made me extremely tired. I could barely get out of bed in the morning. I wanted to sleep all the time. I had no energy."

After a couple of months on that, Pegg switched Dooley to Topamax - a twice-a-day pill - in November 2006.

He warned her that as her dosages were adjusted at the beginning, she may experience some forgetfulness for awhile, forgetting how to spell some words and names for some things and people. That happened but was more of a frustration than a problem that affected her daily functioning.

The forgetfulness went away after about three months. Since she has been on Topamax, she has had only two migraines, and in those cases took another medicine, Axert, which swept away the migraines in two hours.

Her most recent migraine was last July and she thinks that episode may have been triggered by stress and by spending a lot of time in the sun without enough water.

"I'm happy with it," she said of Topamax. "I'm glad I'm taking something daily" instead of worrying about when the next migraine may hit. The medicine poses a risk to the kidneys but Dooley reduces that risk by drinking a lot of water.

Anyone living with migraines should seek help, she advised.

"It's terrible, terrible pain," Dooley said. "See a doctor and try to figure out what's causing them. Get some help. Until something like this happens, you don't realize how important your health is."

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Migraines differ from headaches

By Paul Swiech

pswiech@pantagraph.com

BLOOMINGTON - Wendy Dooley is not alone.

Migraines affect a substantial percentage of adults, especially women of childbearing years, said Dr. Edward Pegg, a Bloomington-based neurologist.

But most people don't seek help from a doctor because they don't realize there are medicines specifically for migraines.

"There are medicines available that can change your life," Pegg said.

The American Migraine Study II in 1999 found that 12.6 percent of Americans suffer from migraines, according to the 2005 book, "A Study of Migraine." About 18.2 percent of women and 6.5 percent of men get migraines.

Between puberty and menopause, nearly 30 percent of females get migraines, Pegg said.

However, 74 percent of males and 59 percent of females surveyed said they hadn't seen a doctor for their migraines, Pegg said.

That may be because some people aren't aware of medical advances. They think, as their parents did, that little can be done for their migraines.

"Their parents' generation just considered it a headache and didn't think anything could be done," Pegg said. "There were no good treatments (years ago), so we'd knock people out with pain medicine and they'd wake up without the migraine."

Some people would take over-the-counter headache medicine, which would have little to no effect on a migraine, Pegg said. Others would self-medicate by drinking caffeine, which would help some people but, for others, would make the migraine worse.

These treatments didn't help much because a migraine is different from a sinus headache or a tension headache.

A tension headache is a generalized head pain, as if you are wearing a hat that's too tight, Pegg explained. The pain is constant.

A sinus headache is head pain, generally over the sinus and behind the eyes, with sinusitis, including nasal discharge, according to "The Migraine Monitor," a publication of the University of Kentucky College of Medicine.

A migraine is severe, throbbing pain on one side of the head and is worsened by movement, said Pegg and "The Migraine Monitor." In some patients, the head pain is coupled with nausea, vomiting and an aura or visual phenomenon, including sparking lights, a hole in your vision or jagged, vibrating, geometric shapes. For some people, it appears as if they are looking through broken glass. For others, the vision is steamy.

In some patients, head pain is coupled with dizziness and a tingling sensation or numbness that appears to be marching down their arm.

"It's not a stroke because it's marching down their arm; in a stroke, it's everywhere all at once," Pegg said.

The location of the throbbing pain depends on which blood vessels are involved. Migraines are vascular headaches, meaning the blood vessels are involved, Pegg said.

In a migraine, blood vessels expand. Nerves that wrap around those blood vessels are stretched and send pain signals to the brain, Pegg said. "With every heartbeat, it's more intense," he said.

Why the blood vessels expand from time to time is unclear. Migraines are hereditary. Certain things also appear to trigger a migraine, including lack of sleep, stress, a change in the weather, some strong perfumes and certain foods, including chocolate, MSG (monosodium glutamate, an additive often found in seasonings and Chinese food), nuts, wine and cheese, Pegg said.

A major trigger is estrogen, which is why migraines are more prevalent during women's childbearing years, Pegg said.

Pegg first works with patients on identifying and controlling their migraine triggers, including getting enough sleep, managing stress and avoiding certain perfumes and foods.

When patients continue to get migraines, he prescribes medicine that may help. Medicines specific to migraines have been available for several years. The medicines work by stopping the release of chemicals that cause the blood vessels to swell, Pegg explained.

One category of prescription medicine is called abortive because those medicines are to be taken when a migraine starts and reduce the duration and severity of the migraine.

Tablets take effect after about 90 minutes. For people who don't mind giving themselves an injection in the arm or thigh, the injection abortive medicines take effect in about 20 minutes, Pegg said.

Examples are Imitrex, Maxalt-MLT and Relpax. The medicines are effective for about 80 percent of patients who try them and have few side effects, Pegg said. However, patients with coronary artery disease or uncontrolled high blood pressure can't take those medicines.

Patients who get frequent migraines - about six or more a month - may not want to wait 90 minutes or more for an abortive medicine to take effect. For those patients, Pegg prescribes a preventive migraine medicine. These tablets are to be taken once or twice a day to prevent migraines from occurring.

They include Elavil, Topamax and Depakote.

These medicines also are effective in about 80 percent of patients. But people with asthma can't take them and people with heart failure need to consult their doctor first.

Topamax is popular with women because it also can suppress appetite and promote weight loss, but there also is a rare risk of a kidney stone, Pegg said. Elavil may result in weight gain and Depakote also may increase appetite and can affect the liver, he said.

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Impact of migraines

• Migraines have a greater impact on bodily pain, vitality, social functioning, emotions and mental health than hypertension, osteoarthritis and diabetes.

• The peak prevalence of migraines is at age 40.

• Migraine sufferers miss an average of 2.2 work days each month because of migraine headaches. They work an average of 5.8 days a month with pain, leading to decreased productivity. Lost labor costs range from $5 billion to $17 billion annually.

• The typical migraine patient spends $2,558 over 18 months to treat migraines.

• Sixty-one percent of migraine patients report missing their children's activities because of migraine headaches.

SOURCES: Health Survey Scores for Migraine and Other Chronic Conditions, Headache 2001, Headache and PharmacoEconomics journals

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On the Web

Internet resources with information about migraine treatment and prevention:

• American Academy of Neurology - www.aan.com

• American Association of Family Physicians - www.aafp.org

• American Headache Society - www.ahsnet.org

• American Pain Society - www.ampainsoc.org

• National Institute of Neurological Disorders and Stroke - www.ninds.nih.gov

• National Women's Health Information Center - www.4woman.gov

• American College of Physicians/American Society of Internal Medicine - www.acponline.org

• Neurology British Columbia - www.neurobc.com

SOURCE: The Migraine Monitor (University of Kentucky College of Medicine)