DEAR DR. DONOHUE: Since age 16 (I am 32 now), I have had incredibly harsh headaches. I practically live on aspirin. These headaches are destroying my life. Please help. – S.S.

The big three in the headache world – even the daily headache world – are migraine, tension and cluster headaches.

Migraines are one-sided affairs. When one of these headaches strikes, people often become sensitive to light and sound, are nauseated and seek a quiet, dark room to get some relief.

Tension headaches produce a dull pain often described as a band encircling the head and squeezing it like a vise. They last from 30 minutes to a week. Maybe you have this kind of headache.

Cluster headaches are located around one eye, come on suddenly and often while sleeping, and are of such intensity that the person jumps out of bed and paces through the house. You don’t have cluster headaches.

There is a fourth kind of headache called rebound headache. It comes from overuse of headache medicines. People up the dose and frequency of medicine only to find it not working. They continue escalating medicine use. Overuse of medicine can deplete brain serotonin stores. Serotonin is an important brain chemical messenger. Its depletion can lead to a headache.

In honesty, I don’t know the cause of your headaches. You need a hands-on examination by a doctor. In your case, it might be best to start with a neurologist, the headache specialist. If the headaches are rebound headaches, stopping the medicine can stop the headaches.

Information on the kinds of and treatments for headaches can be found in the headache pamphlet. Readers can order a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My husband worries me. He wakes from a sound sleep, gets up holding his head and complains of a terrible headache. He’s only 27, and he refuses to see a doctor. This has happened three times in the past week. – J.I.

Your husband must see a doctor. New and repeated headaches of great intensity can be alarms sounding a warning that catastrophes are in the making unless prompt intervention takes place.

Or, your husband might be having cluster headaches. He’s the right age, and what you say fits their description. They are one-sided headaches and are often centered behind the eye.

The next time it happens, get up and look at his eyes. If the eye on the side of the headache is bloodshot and watering, that is more evidence for cluster headaches. The nostril on the same side might drip.

Cluster headaches earned the name by coming in bunches (clusters) for weeks or months and then disappearing for months to years.

Breathing pure oxygen from an oxygen tank can often end these headaches. Sumatriptan, a medicine used for migraine headaches, also works for cluster headaches. So does ergotamine, another migraine remedy. It comes in a form that is placed under the tongue for quick action. (It comes in other forms, too.)

Medicines can also be used to prevent cluster headaches. Lithium, Calan and Inderal are examples.

DEAR DR. DONOHUE: Twice in the past year I have gotten out of bed to empty my bladder and have fainted. What’s going on? – R.M.

This might be micturition syncope. “Micturition” is a medical word for urination, and “syncope” is one for fainting. Sometimes emptying the bladder sets off a reflex slowing of the heart that, in turn, deprives the brain of its usual blood supply. A faint occurs. Tell your doctor about this. There are more ominous explanations for such a phenomenon, such as abnormal heartbeats.

DEAR DR. DONOHUE: I know some women are going to say they envy me, but they shouldn’t. My breasts are far too large. Toward evening, my upper back is in agony. No bra offers reliable support. What can I do to shrink them? Can any medicine or herb do it? Sign me “Anxious for an Answer.”

You are so signed.

No medicine or food can shrink breasts that are too large. A surgeon, however, can remove excessive breast tissue and remodel the breast’s contour.

This is a legitimate and necessary operation for many women. Check with your insurer to see if your policy covers the surgery. It should. This is not cosmetic surgery. It’s a procedure done routinely.

DEAR DR. DONOHUE: What is a branchial cleft cyst? My daughter tells me that my newly born grandson has one. I have asked around, and no one has heard of it. I am concerned. Is this something that will bother the boy for the rest of his life? – S.P.

“Branchial” refers to neck sites; it’s different from “bronchial,” which refers to the lungs. Branchial clefts are slits in the neck region of a maturing embryo. Ordinarily they close completely as development progresses. If one or more does not close, the baby has a cystlike defect in its neck. It is not disfiguring, and it is nothing that should concern you.

These cysts can become infected. For that reason, they are routinely removed, and the surgery is not difficult or dangerous.

DEAR DR. DONOHUE: Please explain what a “lesion” is. I had the scope exam last month, the exam where the scope is passed down your throat to the stomach. My doctor says I have a lesion, and he put me on Nexium. – R.T.

“Lesion” is one of doctors’ favorite words. It’s the equivalent of “thing” or “whatchamacallit.” A pimple is a lesion. A tumor is a lesion. Any wound or injury is a lesion.

For you I would guess it stands for irritation of the lower esophagus, the swallowing tube, due to an upsplashing of gastric acid from the stomach. It’s what most people call heartburn.

I’m making this deduction from the medicine you are taking. It stops the production of stomach acid.

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