DEAR DR. DONOHUE: I have had headaches since I was 12. I am now 32. I hear people talk about their migraine headaches and wonder if I might have them. What makes a headache a migraine headache? I take aspirin for my headaches. It helps, but not all that much. Are there special medicines for migraines? — K.D.

ANSWER: Yes, there are special migraine medicines, so it is important to determine if your headaches are true migraine headaches.

Some of the distinguishing attributes of migraines are the following: They begin before age 40. More women have them than men. The headache starts out with minor pain but often progresses to intense and incapacitating pain. The word used to describe it is “throbbing.” Nausea and vomiting frequently accompany it. In a little more than half of migraine patients, the headache is on one side only. Bright lights and noise intensify the pain. Sufferers try to find a dark, quiet room where they can lie down until the headache goes, and that can take four to 72 hours.

Migraine sufferers can identify triggers that bring on their headaches. Stress, missing a meal, too much or too little sleep, menstrual periods, bright lights, certain odors like cigarette smoke or perfume and fatigue are some of the things that start a migraine. Alcohol — beer and red wine in particular — chocolate, some cheeses and cured meats like hot dogs, sausage and bacon are triggers for some.

Aspirin, Tylenol, Midrin and naproxen alleviate mild migraines. Cafergot is a migraine standby. A group of newer drugs are especially good for migraine sufferers. Seven of them are available. Some names are Imitrex, Maxalt and Zomig. Imitrex comes as a nasal spray and as an injection, administered like insulin. Zomig also comes as a nasal spray. This is a godsend for those who become sick to the stomach along with the headache.

Not all migraine headaches produce all the signs and symptoms I mentioned, but if you have more than two of these characteristic symptoms, it’s a good bet that you suffer from migraines.

The booklet on headaches describes the common kinds and their treatment. 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: Many of my friends take aspirin for the prevention of a heart attack or stroke. I decided I should join them. Is this a wise move? — K.H.

ANSWER: Aspirin and similar drugs are the rule for prevention of heart attacks and certain strokes. The aspirin dose in greatest use is 81 mg — low-dose aspirin. Three different regimens for the prevention of stroke are acceptable: Plavix, aspirin or aspirin combined with sustained-release dipyridamole. The aspirin-dipyridamole combination comes in one tablet called Aggrenox. Note that these are for prevention of second heart attacks and strokes.

For the prevention of a first heart attack or stroke, patients should consult their doctor, who will evaluate each patient’s risk. Based on that particular patient’s risks, the doctor will recommend a regimen that’s appropriate. It’s not a good idea to self-medicate with any medicine.

DEAR DR. DONOHUE: I had a breast lump removed two years ago. After the removal, I had radiation. Everything has been going fine, except for a breast infection I got last month. Were the treatments responsible? — A.D.

ANSWER: Surgery and radiation could have caused changes in the breast that made it more susceptible to an infection. But neither was the actual cause of it.

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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