WEBVTT 1 00:00:02.590 --> 00:00:04.760 Sometimes it's a stabbing pain. 2 00:00:04.870 --> 00:00:07.970 Other times is just this massive pressure in my head. 3 00:00:08.150 --> 00:00:10.630 Sometimes I can't see anything from a certain angle 4 00:00:10.630 --> 00:00:13.650 or my arm, or mouth and tongue feel numb. 5 00:00:14.110 --> 00:00:17.390 And I can't find the right words, so I say weird stuff. 6 00:00:18.310 --> 00:00:21.470 When it first started, I panicked a lot because I never knew 7 00:00:21.470 --> 00:00:22.489 when it would stop. 8 00:00:22.750 --> 00:00:24.540 Or if it would even stop at all. 9 00:00:27.840 --> 00:00:31.840 Jonna Koser's headache attacks turned into severe migraines 10 00:00:31.840 --> 00:00:35.630 with neurological symptoms, including what's called an 'aura'. 11 00:00:36.229 --> 00:00:39.140 In acute cases, the 21-year-old did what many people do: 12 00:00:39.150 --> 00:00:41.540 she took painkillers. 13 00:00:41.550 --> 00:00:42.540 They helped at first. 14 00:00:42.550 --> 00:00:45.450 But her headaches grew more frequent and more severe. 15 00:00:47.159 --> 00:00:51.400 I very often resorted to painkillers because sometimes I just couldn't 16 00:00:51.400 --> 00:00:53.070 do anything and you have to function. 17 00:00:53.080 --> 00:00:54.983 I took pretty high doses. 18 00:00:56.593 --> 00:00:59.247 Jonna visited a specialist clinic for headaches, 19 00:00:59.247 --> 00:01:01.990 and decided to undergo inpatient therapy. 20 00:01:02.000 --> 00:01:04.613 There she learned that her frequent use of medication 21 00:01:04.613 --> 00:01:07.060 actually made her migraines worse. 22 00:01:07.120 --> 00:01:11.200 A kind of vicious cycle, medically known as painkiller-induced headache. 23 00:01:16.077 --> 00:01:18.777 We suspect it comes from a hypersensitization 24 00:01:18.777 --> 00:01:22.050 of the pain receptors, which are permanently stimulated. 25 00:01:22.450 --> 00:01:26.083 Then they change through feedback mechanisms, and no longer respond 26 00:01:26.083 --> 00:01:28.790 in the same way to these medications. 27 00:01:29.370 --> 00:01:32.650 They become so overstimulated, so to speak, that they can cause pain. 28 00:01:34.400 --> 00:01:37.540 The doctor first gave Jonna a neurological check-up 29 00:01:37.540 --> 00:01:39.500 and examined her secondary symptoms. 30 00:01:39.560 --> 00:01:42.933 The migraine aura resembles the precursors of a stroke, 31 00:01:42.933 --> 00:01:46.480 but the physician rules this out and advises Jonna to take 32 00:01:46.480 --> 00:01:48.060 a break from painkillers. 33 00:01:49.270 --> 00:01:53.190 Classic migraine or tension headache medicines don't cause dependency, 34 00:01:53.190 --> 00:01:56.050 so we call it a 'medication break', not 'withdrawal'. 35 00:01:56.070 --> 00:01:58.743 The patient didn't take the pain reliever because she wanted it, 36 00:01:58.743 --> 00:02:00.330 but so she could function. 37 00:02:00.350 --> 00:02:03.510 To break this cycle, we can also use medicine to support 38 00:02:03.510 --> 00:02:04.970 the 'medication break'. 39 00:02:07.760 --> 00:02:11.910 This means no more painkillers, but instead cortisone support 40 00:02:11.919 --> 00:02:14.840 for the first few days and then antidepressants 41 00:02:14.840 --> 00:02:16.470 to take the edge off the pain. 42 00:02:16.480 --> 00:02:18.419 The adjustment was not easy. 43 00:02:20.483 --> 00:02:21.650 It's hard! 44 00:02:21.870 --> 00:02:25.206 At times I almost said, 'Can I please take something?' 45 00:02:25.206 --> 00:02:28.500 But you have to persevere and think, 'You're going to do it now.' 46 00:02:28.510 --> 00:02:32.346 It's hard at first but it gets better. 47 00:02:32.680 --> 00:02:36.660 What's called a 'multimodal treatment' is meant to help. 48 00:02:37.190 --> 00:02:39.930 One element is progressive muscle relaxation. 49 00:02:42.480 --> 00:02:45.639 It involves exercises that get patients to feel 50 00:02:45.639 --> 00:02:47.460 where tension build-up occurs. 51 00:02:49.490 --> 00:02:52.850 In behavioral therapy, Jonna also learns about the link 52 00:02:52.850 --> 00:02:55.840 between migraines and frequent painkiller use. 53 00:02:55.850 --> 00:02:59.610 Instead of taking lots of medicine, she needs to find new solutions. 54 00:03:01.330 --> 00:03:05.730 Her medication intake was ultimately what limited her, since, as she put it, 55 00:03:05.730 --> 00:03:08.930 she was already taking it prophylactically out of fear 56 00:03:08.930 --> 00:03:10.310 she would have an attack. 57 00:03:10.370 --> 00:03:13.282 The most important thing was getting her out of that mindset 58 00:03:13.282 --> 00:03:16.830 and giving her certain behavioral rules that she can use. 59 00:03:21.470 --> 00:03:24.180 Alternative treatment includes physiotherapy. 60 00:03:24.190 --> 00:03:27.130 Jonna's migraines are linked to neck pain. 61 00:03:27.190 --> 00:03:31.880 Passive treatment initially helps the 21-year-old. 62 00:03:31.880 --> 00:03:35.320 The physiotherapist plays a key role in the process. 63 00:03:37.520 --> 00:03:41.280 It's important for you to pay attention to your posture, 64 00:03:41.280 --> 00:03:44.413 be sure to take regular movement breaks and do strengthening exercises 65 00:03:44.413 --> 00:03:47.860 for your cervical spine muscles two or three times a week. 66 00:03:48.520 --> 00:03:52.430 An important element of treatment is exercise, such as Nordic walking 67 00:03:52.430 --> 00:03:53.940 for light endurance. 68 00:03:53.950 --> 00:03:56.843 Also helpful: loosening Jonna's tense muscles 69 00:03:56.843 --> 00:03:59.740 and tackling her main trigger factor: stress. 70 00:03:59.750 --> 00:04:03.077 16 days of inpatient therapy without any painkillers 71 00:04:03.077 --> 00:04:04.970 brings some positive results. 72 00:04:06.480 --> 00:04:09.560 I already notice that I'm leaving here with more energy. 73 00:04:09.720 --> 00:04:12.880 So I know where I can start, what I can do for myself. 74 00:04:13.160 --> 00:04:14.950 It's a challenge, but I'm in good spirits. 75 00:04:19.060 --> 00:04:23.060 Jonna Koser will do her best to integrate the alternative therapies 76 00:04:23.120 --> 00:04:24.620 into her everyday life. 77 00:04:24.920 --> 00:04:26.766 She also wants to become more mindful 78 00:04:26.766 --> 00:04:28.950 and hopes to have fewer migraine attacks 79 00:04:28.950 --> 00:04:31.761 and avoid painkillers.