Archive for August, 2008

Shop for a Cause

Migraine Research Foundation has joined Macy’s Shop for a Cause fundraising program in an effort to raise funds for migraine research. For every $5 donation to the foundation, Macy’s is offering a 20% discount shopping pass (some exclusions apply) for September 20th, 2008 good at all Macy’s stores and at Macys.com. So, have you been admiring a new pair of shoes, back-to-school clothes for the kids, or maybe a down comforter for a wedding present save the trip for September 20th. Save 20% by ordering your shopping pass today.

Here’s how: mail your request along with your $5.00 donation for each pass to Migraine Research Foundation 300 East 75th Street, Suite 3K New York, NY 10021. Or go to the MRF donations page and enter “Shop for A Cause” in the comments field. All donations must be received by 9/10/08. So, if you feel the urge to shop ’til you drop, why not do it for a cause. I am one of 36 million migraineurs who thanks you.

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Dr. William Young and Dr. Stephen Silberstein are two of the many headache specialists who have furthered our understanding of migraine disease. I would classify their book, Migraines and Other Headaches (2004), as one of the “must haves” for migraine sufferers. It is a perfect introduction to the topic of migraine disease so it could easily be a “first read” for migraineurs. There is enough new material so even well read migraineurs will benefit from reading this book. Eucation about migraine disease and the necessity in having a strong patient-doctor team are two threads that are carried throughout the book.

“It is important to realize the difference between a headache cause and a headache trigger. Among other things, stress and weather changes can trigger a [migraine] headache….A brain tumor, a high fever or head trauma can cause a headache” (p. 19).

Usually well-meaning friends and family pinpoint certain foods as causing migraines. I am sure most of you have heard something along this line, “My husband’s second cousin’s wife had migraines and ever since she stopped eating chicken (beef, pork, chocoloate, brocolli, seafood) her headaches have stopped.” The authors make it clear that foods are NOT a cause of migraine, but they can be triggers. However, they were not as clear about other factors.

The scenario they chose to illustrate the difference between causes and triggers was less than helpful. They introduced a migraineur with easily treatable migraines who developed a change in her migraine pattern and a new headache. The change was caused by a herniated disk that, when corrected, reverted her to the previous migraine pattern. The authors did not make it clear that the herniated disk triggered more severe migraines and caused the new head and neck pain. They failed to emphasize that even after the herniation was corrected that the woman still had migraines and that, it could not be the cause of her migraine attacks. A less than careful reader may decided that migraines are caused by herniated disks. While that may be obviously not the case (not all migraineurs have herniated disks), I have had more than one person tell me that my migraines are caused by the problems in my neck.

Some readers may consider this to be a minor point, but my biggest battle is in explaning the difference and that, because there is no one discernable cause, migraine has no cure. There is no silver bullet.

“Headache treatment should be a two-way street, with the patient contributing a goal and desires about his headache mangagement, the physician contributing her knowledge and values, and the final plan incorporating both perspectives.” (p. 45)

Balance, give and take, progress and regress are all a part of living with migraine. Nowhere is this more evident that in the doctor-patient relationship. The authors encourage open communication about goals and expected outcomes. Migraineurs are encouraged to share their experiences, expectations, and goals with their caregivers. Physicians have the responsibility of educating their patients, letting them know what is known and not known about migraine. They need to let their patients know what is a reasonable treatment outcome. Young and Silberstein equally encourage patients to have reasonable and acheivable goals. Migraine is complex and treatment is often individualized. It takes time to acheive proper migraine managementPatients have the responsibility in making some lifestlye changes.

I found this book to be a useful resource, but I also have one more concern. There are no citations or references. I was disappointed not to have a reference for “… an important study conducted to help doctors determine what strategy to use in selecting treatments…compared two strategies of care: sequential care and stratified care” (p. 89). I would like to read the study and its outcome. It may become helpful in determining which would be most helpful for me.

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This was intended to be for the Blog Carnival hosted by http://somebodyhealme.dianalee.net/2008/08/august-headache-blog-carnival-when.html#comment-form at Somebody Heal Me.

Eduating others can be an arduous task that is usually done one-on-one. The most effective tools I have for explaining migraine disease are my blog and the interview on WegoHealth. Both have a comprehensive descriptions of migraine disease. I am in the process of educating my friends at church. When I post something on my blog that they may be interested in, I send an email. I also have my blog URL in my email signature.

The other tool I have is myself; I need to speak up and take advantage of the opportunities I have to educate others. It is ironic that the inappropriate comments people say can be used to educate someone. For example, the comment “But you look so good” can be a perfect time to explain that migraine is an invisible disease. What they see on the outside is definitely NOT what is going on in the inside. I have yet to try this, but there are other diseases that are invisible: diabetes, chronic fatigue syndrome, fibromyalgia, some forms of multiple sclerosis, epilepsy, and depression. I plan on using these better known and “more legitimate” diseases as a comparison. I think MS and epilepsy are particularly good parallels.

There are other comments that can be seized as opportunities for further education. “You are too stressed. You only need to relax.” can be used to explaind the difference between cause and triggers. “How’s your head?” can be used to explain that migraine is more than a headache. I will have to remember to say, “My head is fine, but the rest of me is not.”

In the end, I can only educate those who want to understand. The others may come around with time, but for now, I can only deal with those who are interested.

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