DEAR DR. DONOHUE: My grandson has had severe migraine headaches since age 6. He is now 18. Two years ago, the doctor prescribed sumatriptan (Imitrex). My grandson knows a headache is about to start when he sees bright spots. He usually also throws up. Do you think a migraine condition should last for 12 years? Is sumatriptan safe? – J.S.

ANSWER: Close to 15 percent of the female population and 6 percent of the male population suffer from migraine headaches. They are severely painful, pulsating, one-sided headaches. Almost all migraine patients feel sick to their stomach when one comes on, and many throw up. Bright lights and loud sounds torment a person with a migraine. The headache lasts from four to 72 hours.

A few migraineurs, like your grandson, have an aura before the headache begins. One common kind of aura is an enlarging black spot with flashing edges. Other visual phenomena can occur.

Your grandson should look for migraine triggers. Alcohol (red wine in particular), luncheon meats like hot dogs, chocolate, aged cheeses, perfume, and too little or too much sleep can bring on these headaches. Eliminating an identified trigger greatly lessens the frequency of these headaches.

Migraine treatment reached a milestone with the arrival of triptan medicines. Sumatriptan (Imitrex) was the first one of these wonder drugs to make it to the market. They are safe medicines that have been a boon for people whose lives have been devastated by migraine headaches. Long-term use is approved, but no headache medicine should be used on a daily basis. People with heart disease or a history of stroke cannot use them because they constrict blood vessels.

Twelve years sounds like a long time to have any condition, but many migraine patients have to contend with these headaches for life.

The headache booklet gives a bird’s-eye view of the common kinds of headaches and their treatment. 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.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.



DEAR DR. DONOHUE: Will you tell me something about swine flu and the swine-flu shot? A lot of people have never heard of this or the shots. As far as I know it was a one-time event. Are all flu shots safe? I have never had one. – H.S.

ANSWER: The flu virus can sometimes jump from horses, pigs or birds to humans. In 1976, a strain of flu virus spread from pigs to humans, and there was a possibility that that strain would cause a catastrophic epidemic. The government sponsored a mass immunization program to thwart spread of this swine flu. More than 45 million people were immunized.

About a month or so after the immunization program, there was a spike in a paralyzing illness, Guillain-Barré syndrome. It occurred with slightly greater frequency in those who received the shot than in those who did not. The swine-flu shot was believed to be the reason for the increased number of cases. Most recovered from the syndrome.

Since that time, there has been no increase in Guillain-Barré with flu shots. There has also not been a threat of swine flu making a new appearance.

Flu shots are safe. The flu isn’t.

DEAR DR. DONOHUE: My 68-year-old sister has a rare form of liver cancer – hepatocellular carcinoma. They say it is not seen in this part of the country. Please explain it and what treatment there is for it. – A.G.

ANSWER: Hepatocellular liver cancer is the most common kind of liver cancer that starts out in the liver. It is not the most common kind of liver cancer if you count cancers that spread to the liver from distant sites, like the colon. Hepatocellular liver cancer is seen with greater frequency in Asia than it is in North America, and that might be due to the greater prevalence of hepatitis B and C in that region. This cancer can be a consequence to those infections. Surgeons can remove small liver cancers. Chemotherapy is used for larger ones. In some instances, liver transplant is a possible treatment.