Surprising Cause of Post-Surgery Headaches -- Caffeine Withdrawal

My friend's 24-year-old daughter Alexia* recently had her tonsils removed. Aside from the predictable sore throat, she had a complication the day after surgery she had not expected: a splitting headache. Since post-surgical headaches can be caused by blood clots or other risky health conditions, she was whisked to the Emergency Room on the advice of her doctor's nurse. Instead of enjoying the blissful post-surgical recovery she had looked forward to, loafing around the house in her pajamas while snacking on Jello and Popsicles, Alexia underwent several hours of tests. Ultimately, the ER doctor found no medical reason for her headache, leaving the most likely cause of the headache one of the easiest to prevent: caffeine withdrawal.

Link Between Surgery and Caffeine Withdrawal Headaches

If you drink a lot of coffee -- at least three to four cups per day -- you know what happens when you suddenly stop getting your caffeine fix. You get a headache. Since most surgical patients are instructed to refrain from coffee as well as other foods and liquids prior to surgery, it could be predicted that patients who normally drink multiple cups of coffee each day will suffer from a caffeine withdrawal headache.

Why Does Caffeine Withdrawal Cause Headaches?

Citing an M.I.T. study, New York Times health writer Jane Brody explains that the brain goes through caffeine withdrawal when you suddenly stop drinking coffee, making it more sensitive to a chemical called adenosine. This neurotransmitter causes the dilation of blood vessels, the expansion of which is a well-known cause of headaches.

How to Avoid Post Surgical Headaches from Caffeine Withdrawal

Coffee, Tea, IV? Researchers at the Mayo Clinic in Scottsdale, Ariz. found that one way to lessen or avoid a post surgery caffeine withdrawal headache is to put caffeine in a patient's IV after surgery equal to the amount found in two cups of coffee.

Pre-Surgery Perk: Another group of Mayo Clinic researchers suggested that regular coffee drinkers should drink their last cup of coffee closer to the time of surgery than is normally suggested. "Liquids leave the stomach so quickly that for most people it's probably not a problem to have eight ounces of a caffeinated drink no less than two hours before surgery," said anesthesiologist Joseph G. Weber.

Stay Away from the Starbucks: Patients can also pro-actively wean themselves off coffee a week or two prior to surgery, sticking to maybe just one cup in the morning instead of a steady flow of Joe throughout the day.

Why Doctors Don't Warn Patients About Caffeine Withdrawal Before Surgery

When instructing patients on how to prepare for their surgeries, doctors tend to dispense advice mainly about prescribed and over-the-counter drugs the patient is taking -- perhaps reflecting the hyper-focus of most medical schools on pharmaceuticals. Doctors often ignore the effects of other chemical substances that patients commonly ingest -- from caffeine to herbal remedies -- despite the fact that the absence or presence of these in the patient's bloodstream could cause a post-surgical complication, such as caffeine withdrawal headache in the case of caffeine.

What's a Patient to Do?

If you hate getting headaches (and who doesn't), discuss with your doctor how much coffee you normally drink at your pre-surgery consultation. You and your doctor can then create a plan to avoid the headache of getting a headache while recovering from surgery.

*Real name not used to protect patient's medical privacy

Sources:
http://emedicine.medscape.com/article/1182710-overview
http://findarticles.com/p/articles/mi_m1272/is_n2629_v126/ai_19841026/
http://www.nytimes.com/1982/04/24/us/bodily-interaction-found-to-explain-caffeine-withdrawal-headache.html
Weber, Joseph G; Klindworth, Jacinta T; Arnold, Jacqueline J; Danielson, David R; Ereth, Mark H. "Prophylactic intravenous administration of caffeine and recovery after ambulatory surgical procedures." Mayo Clinic Proceedings. Mayo Foundation for Medical Education & Research. 1997. Retrieved July 29, 2010 from HighBeam Research: http://www.highbeam.com/doc/1P3-15342395.html