A long week

People said I have emaciated. If they went through half of what I  have, they might not survive it.

I barely sleep at night. In fact,  I *don’t* sleep at night. I tried sleeping with catarrh medicines pff. I bought sleeping tablets, nada. The boy advised I take 3 of the pills, I took 5 instead.


I took a friend abi acquaintance to my special corner, so we will smoke some weed. We arrived there and the place had changed. There were lights everywhere. The way lights shone on our faces, we became scared to get caught by Nigerian police. Make we no spend Eid Mubarak in prison.

My companion gave me two rolls to take home. The hallucinations that came afterwards. In just smoking half of a stick. I couldn’t sleep. My hearing sense were heightened. I could hear everything, everyone did or spoke inside their houses. I even heard somebody inside my house and opening my pots and fridge🤭.

However, it was better. Better than be conscious and be ravaged by your very own demons. It wasn’t about the sleep, it was about not sane enough to bear the burdens.


Crazy, how somebody had thought I must be high to write the things I write. I cannot even think when high

What you need know about headaches

Photos from https://www.health.harvard.edu/diseases-and-conditions/top-7-reasons-you-have-a-headache

I returned home one night and my eyes were almost blinded by a headache. In fact, I was headache blind. It was a repeated pattern of pounding in my head. my god, right now I cannot recognise the feelings. Thanks to Human Anatomy I knew about the cause of my headache and the type I had.

Headaches:

There are two types of headaches;
Primary headache and secondary headache.

Primary headaches are headaches not caused by anything else. The headache is the main problem. Primary headaches are mostly bilateral. That means they affect both sides of your brain. They are not life-threatening.

There are three different categories of primary headaches which 90% of the headaches we experience fall into.


A. Attention/featureless headache
B. Migraine headache
C. Cluster headache

Let’s talk about the differences between these headaches.

Tension headache is the most common primary headache. They are mild to moderate severity and often bilateral. Affects both sides of the head. The pain is described as non-pulsatile, dull band-like tension or pain around the head, sometimes radiating down around the neck. They can last for hours even days in some cases. It is known as a featureless headache.

It is not associated with other symptoms such as vomiting nausea visual changes or even an aura as common in migraine. They are not aggravated by physical activities like other headaches and there is nothing as photophobia (light sensitivity) and phonophobia (sound sensitivity).

Causes of tension headaches.

Tension headache was originally thought to be due to prolong or sustained contractions in the neck or head and the face. The idea was that since the stated contracted muscles were connected to the skull and their connective tissues blend and become a continuous blend with the connective tissues in the skull if there are problems with them, they can cause pain that would radiate to the head and create tension headaches. E.g the trapezius, splenius capitis, and sternocleidomastoid. Even the jaw muscle called the masseter attached from the mandible or jaw bone up to the skull.

People who have tension headaches will suffer pain and tenderness in these muscles. If they palpate and push on them or massage them, they elicit more pain and tenderness than in someone without a tension-type headache. Tension headaches are caused by nociceptors; a pain receptor that becomes sensitised in the connective tissues of the head of people who have tension-type headaches. As connective tissues of the head are continuous with the connective tissues and tendonous attachment of those muscles written earlier. The idea is, as nociceptors of the connective tissues get sensitised, the associated muscles that are continuous their pain receptors get sensitised helping to explain why we experience pains in those areas.

What causes the sensitisation of the nociceptors is not known. It cannot be said that tension headaches are gotten from prolonged contractions, it cannot also be definitively said that it is purely originating from the connective tissues of the head and radiating down to the muscles. The useful information to draw from is the most common precipitating factors for tension headaches are things like stress and mental tension.

Remedies for Tension Headaches

Relaxation can aid relief tension headaches.
Breathing
Meditation 🧘🏾‍♀️
Light stressing of the muscles and gentle massage 💆🏾‍♀️.
Analgesics Ibuprofen compared to placebo.

If the above doesn’t work, try a combination of; Aspirin, caffeine, and Tylenol.

Do not take too much medication not to cause Medication Overuse headaches.


B. Migraine/Phasic Headache:
Migraines are unilateral. They cannot affect both sides of the head. The pains are described as a pulsatile throbbing type of pain. Migraines are not featureless headaches, as tension-type headaches. They are associated with nausea vomiting, sound sensitivity, light sensitivity even physical activity can aggravate migraine.

Neurological symptoms associated with migraine are visual changes and aura. Migraines are phasic headaches

Four phases of Migraine

i. Premonitory phase
ii. Aura phase
iii. Headache phase
iv. Postdromal phase


The premonitory phase is often difficult to notice or pick up on because it can occur one or two days before the actual pain of the headache started. Its symptoms are irritability, food craving, and frequent yawning.


Aura phase. Aura is a fully reversible neurological symptom and not everybody experiences or notices it. Symptoms of aura are visual aura where you get blurred lines or specks in your vision is most common. Sensory aura on one side of your body where you feel tingling and language aura where you find difficulty in speaking. The motor aura is a weakness in one part of the body.


The actual headache phase. It is unilateral pulsatile pain.

Post drone or postdromal phase. This is the residual effect of the headaches the following day. The main portion of the headaches has resolved but you may notice that when you turn your head or cough or sneeze. You realise there is still some effect or pain there.


Migraine headaches are caused by the trigeminal nerve, a major player in the cause of migraine headaches. There are certain sensory pathways specifically pain and nociceptors pathways within the trigeminal nerve thought to be more easily activated or sensitised in people that have migraine vs people who don’t. Again that sensitisation can linger for two days.


Causes of Sensitization or activation of the trigeminal nerve are;

Emotional stress
Neck pain
Food
Alcohol
Light
Sleep disturbance
Odors
Weather
Not eating
Hormones
Smoke
Exercise
Sex (😳😳😳???)


The trigeminal nerve is one of the twelve trigeminal nerves and it comes directly off the brain stem and often refers to the great sensory nerve of the face that’s because it brings sensitisation from the face it hooks it up to muscles that move the jaw and makes a connection to cerebral blood vessels to the brain.

The most common place of migraine headaches is the forehead and the eye.

There is a crossover treatment for migraines and tension headaches.


C. Cluster headache.

Cluster headache is the least common type of headache. Their cause isn’t much known. There are beliefs that during cluster headaches, there is some activation of the hypothalamus structure in the center of the brain. Hypothalamus will activate certain autonomic pathways during a cluster headache.

Autonomic division or portion of your nervous system controls things automatically at a subconscious level so you can do things without thinking about it. It hooks up and controls things like the smooth muscle of your digestive tracts and even your blood vessels, the pupils of your eyes have smooth muscle in them so they can constrict and dilate.

Autonomic nervous system also hooks up to various glands throughout the body.

Cluster headaches come on suddenly and the pain is described as stabbing and severe. There are unilateral so one-sided in or around the eye or the temporal region because of their sudden onset and severity. These can be mistaken for more serious or life-threatening headaches.


Symptoms to distinguish Cluster headache

Ptosis. Drooping of the eyelids.
Miosis. Constriction of the pupil.
Conjunctival Injection. Bloodshot eyes. Blood vessels of the conjunctive of the eye start to expand or dilate.
Lacrimation. Production of tears or tearing.
Rhinorrhea & congestion: fancy name for a running nose.
Periorbital swelling: swelling around the eye.
Facial sweating.

Each episode or attack last fifteen minutes to three hours. However, each attack can reoccur as frequently as once every other day up to eight times per day. Cluster periods can last days, weeks, and even up to months. The cluster periods are followed by periods of remission with no headaches.
Periods of remission can last for a year.

Treatment for Cluster Headache
Oxygen. They put people on oxygen with non-rebreather masks which is pretty effective.
Sumatriptan.


Preventive medication for Cluster Headache
Verampa Mill and prednisone are used for prevention. One or both can be used depending on the person’s pattern.

Secondary headache is a headache caused by sicknesses or conditions eg brain tumour, flu or cold, traumatic head injury, bacteria meningitis, sinus infection, etc.