Headache guru gets diagnosis right

I have suffered with "the Monster" for more than 20 years. That's what I call my excruciating headaches. It took five years to get a decent diagnosis.

I'd inject [migraine treatment] Imitrex, and the pain would leave eventually. I'd rather not take Imitrex unless there is no other choice.

One day, I'd had seven attacks. I called my doctor and said unless I could get help, today would be my last. I sent the same message to the Headache Clinic in Jefferson Hospital in Philadelphia. They took me seriously. The next day I had an appointment with Dr. Stephen Silberstein, the chief headache guru.

I was diagnosed with cluster headaches and prescribed verapamil for prevention and oxygen with a rebreather mask for treatment.

Amazingly, the first time I used the oxygen, the headache was gone in several minutes. That was 10 years ago. This has now become nothing more than a nuisance that occasionally wakes me up at night.

Your story really points out the importance of a correct diagnosis. Patients and doctors need to work together to get that right so the proper treatment can be found.

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When medicine directions say "take with food," do I take it before I eat anything, at mid-meal or following the meal?

Unless there are instructions to the contrary (such as "take 30 minutes before eating"), a drug to be taken with food can be taken at any point in the meal. The idea is to reduce stomach irritation and, for some drugs, improve absorption.

Joe Graedon is a pharmacologist and Teresa Graedon is an expert in medical anthropology and nutrition. www.peoplespharmacy.com