Winter 2018

Puzzle pieces

Angel Moreno is a nurse practitioner who was recruited to provide clinical care and to develop new, non-medication approaches within the UCLA Goldberg Migraine Program. These complementary-alternative approaches include nonprescription vitamin and herbal therapies, essential oils, breathing techniques, yoga, and mindfulness and relaxation techniques. Part of the challenge regarding these techniques is the absence of high-quality evidence and a lack of understanding of how they are best used in combination with more traditional medication approaches. Angel has extensive experience with both traditional and complementary alternative therapies, and therefore is ideally positioned to provide an individualized treatment plan that includes all possible approaches that may be helpful for patients.

An example of a natural approach that has a basis in science is his use of essential oils. Cells in the nerves and brain that transmit pain signals contain channels called “TRP channels.” There is growing evidence that these channels may play an important role in migraine. These channels can be activated or inhibited by natural substances that are inhaled or absorbed through the skin. One of the TRP channels that is believed to play a particularly important role in migraine is activated by mint and menthol. Based on the patient’s overall clinical picture, Angel may instruct a patient on the use of peppermint oil as an adjunctive approach to medical therapy for migraine. He also may recommend specific dietary changes or supplements that are tailored to individual patients based on specific metabolic parameters that may be influencing their headache. By integrating alternative medicines into a complete picture of migraine care, Angel Moreno and the UCLA Goldberg Migraine Program fit the puzzle pieces together for each patient, to provide individualized and holistic treatment.