The 1-2-3 Play for Taking Charge of Your Pain, by David Buchholz, MD
Ranking 2 stars out of 5
A positive note about “Heal Your Headaches” is that Dr. Buchholz does make one stop and think, partly because he challenges so much of what is now considered to be basic headache and Migraine knowledge backed by significant bodies of verified and published research. In the introduction to the book, he states, “In scientific terms, my beliefs are hypotheses; potential explanations of certain cause and effect relationships.” This is a good, honest statement; one I’m glad he included in this book that has resulted in a few raised eyebrows.
Dr. Buchholz has developed a "1·2·3 Program for Taking Charge of Your Pain. It consists of three steps:
- “Avoiding the ‘Quick Fix.’ Put painkillers in their proper place: infrequent use only.”
- “Reducing Your Triggers. Eliminate headache triggers that you can readily control - mainly those that you put in your mouth and swallow.”
- “Raising Your Threshold: Consider Migraine preventive medication.”
In the plus column, Dr. Buchholz makes some well-founded points and makes some statements that need to be drilled into all physicians:
- “Regularity is key: you should sleep, eat and exercise on a regular basis. Get enough sleep each night, seven to eight hours or more, and don’t oversleep sporadically, as on weekends.”
- “Would a complete hysterectomy, including removal of the ovaries, be a good idea for menstrual headaches? No, don’t even think about it.”
- “Part of being a good doctor lies in understanding what’s on your patients’ minds - their fears and confusion, their skepticism and stubbornness (not to mention their hopes and dreams). And no doctor can do that without listening carefully to what patients are saying.”
On the other hand, I have problems with some statements in the book that are directly contradictory to large bodies of verified medical research and/or my personal experience. Here are a few examples of Dr. Buchholz’s hypotheses that are less expected:
“We all get headaches because nature has built into us a headache-generating mechanism . . . migraine . . . everyone has it.”
Comment: Scientists in Finland have identified the genetic marker for Migraine. We do not all have it.
Acetaminophen, aspirin, ibuprofen, and naproxen sodium do not cause rebound headaches.
Comment: These medications have been repeatedly demonstrated to cause rebound. I’ve experienced it myself. If you want more first-hand anecdotal evidence, just visit our forums.
Triptans must be limited to no more than two days a month to avoid rebound.
While some experts opine and some studies are showing that triptans can cause rebound, it’s generally accepted that they can safely be used two days a week before rebound becomes an issue. Again, talk to any of hundreds of triptan users in our forums.
Opioids must be limited to no more than two days a month to avoid rebound.
On this one, I’d say, “Show me the evidence.” It’s also generally accepted that opioids can safely be used two days a week before rebound becomes an issue.
Bottom Line: This is a thought-provoking book. I hope readers will approach it with what I call a “buffet” attitude - take away from it what works for you, and don’t be concerned about the rest. While I find Dr. Buchholz’s advice on identifying and avoiding trigger foods to be fairly sound, it seems that too little emphasis is placed on triggers outside our control. Some statements are so contrary to the majority of current medical evidence and my own experience that I was put off at first (especially rebound details), but was rewarded with some excellent points in other sections. Although the title is overblown, the book itself does offer some helpful hypotheses.
Teri Robert is a leading patient educator and advocate and the author of Living Well with Migraine Disease and Headaches. A co-founder of the Alliance for Headache Disorders Advocacy and the American Headache and Migraine Association, she received the National Headache Foundation’s Patient Partners Award and a Distinguished Service Award from the American Headache Society. Teri can be found on her website, and blog, Facebook, Twitter, StumbleUpon, Pinterest, LinkedIn, and Google+.