DEAR DR. DONOHUE: I am a 42-year-old woman who, for the past year-and-a-half, has had a headache every day. I have taken numerous medicines for them and am now on the migraine medicine Maxalt. I have to take it every day, and I take the highest recommended dose. I still have a headache. I have had many tests, including two brain scans. They were normal. What can I do? I can’t lead a life with constant pain. – R.D.

ANSWER: Your headaches could be from your medicine. Such headaches are called medication-overuse headaches. Medicine overuse is not the only cause of daily headaches, but it is a common cause. If people take headache medicines on more than 15 days of the month, the probability of medication-overuse headache looms large.

Such headaches can occur regardless of the kind of headache – migraine or tension headache. They happen with all kinds of headache medicines, including migraine medicines.

The cure is stopping the medicine. On stopping, the headaches are bound to occur, and they might be quite severe. It can take 15 days or so for them to go away. It’s not exactly a pleasant time, but the reward is freedom from headaches.

Medication-overuse headache isn’t the only kind of daily headache. You should talk to your doctor about this possibility and enlist his or her help in weaning yourself off the medicine.

The booklet on headaches deals with the more common kinds of headaches and their treatments. Readers can obtain a copy by writing: Dr. Donohue – No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have a blood pressure reading of 142/105. What is the cause of the diastolic elevation of 105? Does it require attention? – C.

ANSWER: You have an elevation of both the systolic (first number) and diastolic (second number) pressures. Systolic pressure is the pressure the heart imparts to blood as it’s ejected from the heart into arteries. Diastolic pressure is the pressure that remains in blood between heartbeats. Both numbers are important, and elevation of either one constitutes high blood pressure – hypertension. A first number of 140 or higher or a second number of 90 or higher is considered too high.

You should adopt a low-salt diet, taking in no more than 1,500 mg of sodium a day. You have to steer clear of obviously salty foods, and you shouldn’t add salt to foods. However, most of our salt comes from foods where it’s not so obvious – processed foods like luncheon meats, commercial soups, frozen dinners, and on and on. You must read labels. Upping your potassium intake brings pressure down. Potassium foods include lima beans, squash, spinach, baked potato, lentils, sweet potato, brussels sprouts, orange juice, banana, broccoli, grapefruit juice and corn. Increase your physical activity. Walking for half an hour is possible for most. Lose weight if need be. Fruits and vegetables should be the mainstays of your diet. Limit alcoholic drinks to two a day (one, for women).

If these changes don’t bring the pressure down, then medicines are the answer.

DEAR DR. DONOHUE: I would like you to forward this information to the former Marine, now a police office, who has Meniere’s disease. I am a 48-year-old woman who was diagnosed with it five years ago. I experienced severe vertigo that lasted for days. Through my investigation, I learned that Serc, a drug available in Europe and Canada, was good for it. I started taking it, and in three days all my symptoms were gone. Our government does not want us to be cured. They won’t allow Serc to be sold here. – S.

ANSWER: Serc is betahistine, a drug that has many of the actions of histamine. Betahistine was approved for sale in the U.S., but the approval was withdrawn because effectiveness studies for the drug were deemed inadequate. I am happy that you found it to be such a miraculous cure. It isn’t for everyone with Meniere’s.

I don’t believe the government is in a conspiracy to keep this and other drugs off the market.

DEAR DR. DONOHUE: Please tell me what ministrokes are, and how to deal with them. My husband, according to our doctor, has had a couple. – J.T.

ANSWER: “Ministrokes” refers to two different circulatory problems of the brain. One is transient ischemic attacks, and the other is blockage of small brain arteries.

Transient ischemic attacks – TIAs – are temporary losses of brain function due to a short interruption of blood flow to a part of the brain. A person might experience weakness of an arm or leg, have difficulty speaking or become numb in a discrete area of the body. The symptoms usually last for less than 15 minutes and can persist as long as 24 hours, but never longer. Ministrokes of this sort are often warnings that a full-blown stroke is in the offing. Doctors frequently put people who have had a ministroke on aspirin to prevent a full-blown stroke.

The other circulatory problem called a ministroke is the blockage of one or more small brain arteries. Such a blockage causes the death of a tiny section of brain. Sometimes, with one blockage, no symptoms occur. But as more small arteries become clogged, then memory deficits, clumsiness in walking and trouble using the correct word are examples of symptoms that can arise.

Both kinds of ministrokes are indications for an all-out stroke-prevention program. Blood pressure has to be maintained as close to normal as possible. Smoking must stop. Losing weight, when applicable, is important. If the person has diabetes, strict control of blood sugar is mandatory. Lowering cholesterol is important. And staying as active as possible keeps blood circulating to the brain.