Family Matters: Coping with Headaches at Home by Sylvia Sullivan Villarreal, M.Ed., M.P.H. The child's birthday party has been scripted to the last detail. The balloons are hung, and the table is set. As the party hour draws near, Mom has a growing sense of unease. Her vision is playing tricks, the back of her neck feels like it's in a vise, and the first stirrings of nausea begin in her stomach. Once again, an eagerly anticipated event has been visited by an uninvited guest--and another headache begins. Deane, who related this story, told of her struggle to make it through the party, and how she was finally forced to retreat with a pounding head to the relative quiet of her bedroom. Her husband salvaged the afternoon as much as possible, but Deane and her family learned an important lesson that day. "My sense of having to control every moment of that party and the tension which it evoked were part and parcel of the particular headache. I discovered that not having back-up, and having everything revolve around my plans was not very realistic, given the severity of my headaches." Deane has made some major changes in her life since the party episode, many of them grounded in the acceptance of and the ability to work within the limits of her situation. In those families coping with a member's headache, acceptance, flexibility and establishing support systems both in and outside the family are critical in maintaining equilibrium in the family structure. Kathy's husband and children have come to understand that she is not necessarily going to be out skiing with them every day on their winter trip. Kathy is prone to altitude headaches. "The bright sun and the glare off the snow can also trigger a tremendous headache if I overdo it. So now, I take plenty of good books and spend lots of time by myself in the lodge while my husband and the kids ski their hearts out. We are all enjoying ourselves in different ways, and just doing what I needed to do for myself has made the experience much more pleasant for us all." Maryann has had to deal with the guilt she feels when she cannot complete her daughter's bedtime ritual of bath, play, and story time. There are times when the headache is so severe that her husband has to come home early to take over. "I used to push myself to keep going long past the point when I needed to give in, take the medicine, and rest. Now I look at the silver lining: my husband and daughter are spending intimate time together that they might not have if I were available every second to tend to her needs. My daughter can get comfort and nurturing from both parents, and I get to realize that the routine can go on without me." Robert, the father of two elementary-aged children also sees a positive side to the pain and toll of headache. His children show kindness and sensitivity to his pain, bring icepacks and massaging his temples. "I try not to frighten or burden them with how bad the pain can be. I look at it this way: my children are learning compassion at a very young age, something of value that they will benefit from all their lives." All families affected by headache spoke of the need for planning balanced with the necessity of being flexible. Those families who deal with headache successfully sound similar in striking ways. Rather than isolating and blaming the sufferer, they share the load with a "we're all in this together" attitude. A realistic acceptance of the way things are, a gentle stance of encouraging without pressuring, and taking care of each other and of themselves are hallmarks of families who thrive despite the problems this disorder brings. In maintaining a balanced life in the presence of chronic illness, family matters. (Sylvia Sullivan Villarreal, M.Ed., M.P.H., Houston Headache Clinic, Houston Texas) Headache, vol. 5, issue 3, September 1994. Reprinted from the web site of  the American Council for Headache Education (www.achenet.org)