DEAR DR. DONOHUE: Please say something about migraine headaches. I think that’s what I have. They come on fast, and the pain feels like something is pulsating in my head. I throw up with every headache.

Bright lights make things worse. Does all this sound like a migraine to you? Someone told me there’s always a warning before a migraine starts. I have no warning. I’ve used Tylenol, but it doesn’t do much for me. What is the treatment? Can they be prevented? – L.G.

ANSWER: Your headaches have many of the characteristics of a migraine headache. The warning mentioned to you is an aura. The aura usually precedes a migraine. It can be flashing zigzag lines, peculiar sensations – often in the hands – trouble finding the right words to speak or weakness of a group of muscles.

Only 20 percent of migraine patients have an aura, so it’s not an indispensable migraine sign. Nausea and vomiting are common migraine symptoms. Seventy percent of migraine patients have a one-sided headache that they describe as throbbing or a dull ache. It lasts from four hours to three days.

People with migraines are very sensitive to light and sound, so they seek a dark, quiet room to lie down.

Stress, overexertion, sleep deprivation and hunger can provoke a migraine. Some foods and drinks can do the same. Alcohol – especially red wine; caffeine; pickles; bananas; yogurt; avocados; aged cheeses; pickled or marinated chicken, beef or fish; salami; pastrami; bacon; pepperoni; hot dogs; and the taste enhancer monosodium glutamate are on the list of possible migraine inducers.

Medicines for treating a migraine abound. Tylenol, aspirin and drugs like ibuprofen take care of mild migraines. For more severe ones, triptans are the standard treatment.

They include Imitrex, Axert, Frova, Zomig, Amerge and Maxalt. An older medicine, ergotamine, still has a place in treatment

For migraine prevention, propranolol, verapamil and amitriptyline are prescribed if the headaches occur often and disrupt life.

The headache booklet discusses the causes and treatment of the more common kinds of headaches. 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 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: My teenage daughter twists and pulls her hair when she reads, watches TV or studies.

She has two small bald patches on her scalp. I cannot get her to stop doing this. Is this normal? – R.T.

ANSWER: It’s not normal, but it’s pretty common. It’s trichotillomania (TRICK-oh-TILL-uh-MAY-nee-uh). Some classify it as an obsessive compulsive disorder. The hair pulling quiets an inner anxiety. It’s almost an involuntary act.

If you can’t get your daughter to stop, the family doctor can recommend a therapist for her. The therapist can explain to her why she does this and how she can curtail the urge. Sometimes, medicines are prescribed for a short period.

She really does need attention. Constant hair pulling can damage the hair roots and lead to a permanent bald patch.

DEAR DR. DONOHUE: I had an examination prior to hernia surgery. I am 77. The doctor postponed the surgery because he said my EKG displayed “flat T waves.” After many other tests (I don’t want to go into them all), I was told my heart was OK, and I finally had the hernia repaired. No one has told me the meaning of flat T waves. Will you? – H.H.

ANSWER: T waves are one of the three major waves seen on an EKG. Changes in T waves are perhaps the least-reliable indication of a heart problem. Flat T waves are seen on many EKGs. Frequently, they are innocent. In some cases, the doctor has to pursue the possibility of heart trouble with further tests, as happened to you. In younger people, flat T waves often can be ignored. Forget them. You have a healthy heart.

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. Readers may also order health newsletters from www.rbmamall.com.

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