A woman with headaches

Jackie is the epitome of youth -- young, beautiful, black and smart. She moved here to start her first job as a social worker. But tonight she complains of a daily headache for about 2 months. The headaches start behind her right eye, pound, and cause her to have to go to bed when she returns home. She had never had headaches before coming to Grand Rapids, and they are not present in her family. I asked some probing questions, caffeine? alcohol? cheese? medications?... all met negative response. Finally I asked, " do you eat or drink anything with artificial sweetenters?" "Well, yes, since I started my job, I have been drinking Crystal Light most of the day," she replied. Ah, this is the clue, I remarked to myself. Crystal Light contains aspartame, and a continuous intake of this could precipitate the new onset of migraine headaches. After a neurological exam, I prescribe Jackie some medication in case she continues to have headaches, but most importantly, she will stop drinking Crystal Light. Hopefully, her headaches will resolve without need for an extensive evaluation and multiple medications.