Dealing With Headaches

Thankfully, the fractured health care system in America has been made one of the top issues of the 2008 Presidential campaign. Although migraineurs and those with chronic headaches may feel helpless due to the whims of their condition, there’s no need to make it any worse than you have to. If you are registered and give a darn about lowering your health care bills, vote for Obama.

I’ll make this real simple for you: If you make less than $250,000 a year and you vote for McCain — you are insane.

Won’t Obama Raise Taxes?

John McCain has made a big issue of Obama raising taxes. However, what McCain doesn’t tell you is that Obama will raise taxes on rich people and big businesses. Since the Republicans are the political party for rich people, of course they are concerned. Just look at how the health care system in America has crumbled since 1980, when Ronald Reagan unleashed the disastrous Reaganomics on the country, making everything for sale to the highest bidder. The Rebublicans’ answer to rising health care costs is “Tough. Get another job and make more money to pay your bills, you slacker.”

More Evidence Obama Will Help Your Health

Obama is for several things that can greatly impact youir health. First off, he has a much better economic plan than McCain. How can I say this? Because I will save about $3,000 with Obama’s plan and will wind up with nothing from McCain’s plan. I can’t be the only one.

Secondly, Obama is for alternative energy. That means less pollutants to give you a headache and more of a chance to not face an environmental Armageddon that will happen if steps aren’t taken now to halt climate change.

He’s also for a woman’s right to choose. This places womens’ health first and does not sacrifice the lives and health of women or girls on the altar of the Great Unborn just to have live babies to grow up to be dead soldiers. (Yes — I stole that line from George Carlin).

But Vote, Please

Even if you disagree with me entirely (and you have every right to do so), please go out and vote if you are registered. And don’t waste your vote by voting for a third party that doesn’t have any chance of winning. Like it or not, America in 2008 is run by two and only two political parties. Wasting your vote on a third party proves nothing except that you wasted your vote. At least make your vote count.

Besides, if you vote, I’ll shut up.

“We’re cursed. This doesn’t happen to any other city. Only here.” — Soaked Phillies fan Steve Levay, quotes in the Philadelphia Inquirer.

If you are thinking of traveling, phoning or even emailing anyone in the greater Philadelphia area — DON’T. As you’ve probably heard by now, the Philadelphia Philles are in some big sporting event and was looking to have a parade today. Didn’t happen. The game was suspended due to rain, rain and rain. That’s left a lot of people cranky.

The continuing icy mini-monsoon of today’s weather certainly hasn’t helped. I watched the garbage men (sanitation engineers) work today, shrouded in their neon-yellow rain slickers. I don’t remember them ever kicking and punching the trash cans like that before.

It’s not exactly Murphy’s Law, or Sod’s Law. It’s more like Philly Law.

I’d Rather Be In Philadelphia?

One of the reasons I stopped watching Philly sports teams on TV is that I really don’t ned the stress and the headaches. And when you are rooting for a Philly sports team, the headaches are not just metaphorical. With the stress, the holding of the breath, the bizarre plays, the shock of disbelief — this does stress your body out and can trigger headaches in those who are migraine-prone.

I now only follow the Philly sports scene from a very far distant place — I read about it in the newspapers the next day and see the highlights on the local news stations when I’m in the mood for a good laugh and have fully digested my Excedrin dose.

I slipped last year and actually watched a few minutes of the Flyers (or was it the Eagles?) when they were in the playoffs. Not suprizingly, they lost and that was it for their season. So now, I think the best way I can root for the Philly sports teams is not watching a single second of the game as it’s being played.

This also saves more time for me to get regular sleep and make wiser food choices. When I’m in front of the television for a sporting event like the Olympics or the Presidential election, I tend to have incredible cravings for junk food. And then it’s hard to keep track of just how much I’ve eaten. Having your diet and sleep patterns thrown off can also trigger headaches.

Someone please send everyone in Philly a free bottle of Excedrin.

From the “Is Anyone Really Suprized? Department”:

A new study done by the National Institues of Health found that half of their doctors surveyed admitted to giving out placebos to their patients, telling them that they were getting medicine. The study was only done in America and most of the particpants were internists (doctors who specialize in treating the internal organs, including the brain) and rhuematologists (doctors who specilize in treating arthritis). Although this is a common practice in drug trials, it’s not supposed to be done outside of the drug testing environment.

What Did They Give Instead?

The placebos given were usually vitamin pills, although the NIH study notes that some drugs not related to the patient’s problem were also given out. These medicines included NSAID painkillers, antibiotics or even a sedative. Traditionally, placebos were sugar pills or even empty capsules. They were made by the doctor in desperation.

But the study shows that the doctors are actually writing prescriptions for medicines and vitamins. I guess they know that in order for the placebo effect to really kick in, a patient has to do the entire ritual.

But If It Works?

In the few days since the study was relased, there has been a lot of shocked statements and outrage in the media and on the blogosphere. The American Medical Association is condeming the act of giving out placebos, but that has been their position for ages. The AMA says a doctor can only give out placebos “with the full knowledge of the patient.” That sort of kills the whole point of a placebo, doesn’t it?

However, is it more ethical to not help you patient in any way possible or to let the carry on in misery? The placebo effect is a proven, powerful means to help allieviate pain for a few weeks at least. If you are a doctor desperate enough (and badgered by a patient who is desperate enough), do you really have much of a choice BUT to offer a placebo?

Perhaps the best thing these doctors taking the survey could have done was to lie on the surveys and keep their mouth shut. Why wreck a good thing?

Although not specifically about headaches and migraines, this YouTube clip is a strange chapter in the breakdown of America’s health care system. Oregon had a propsition “measure 50″ where health care for children of poor families — would be funded by a new tobacco tax. So, if no one in Oregon smokes, no poor kids can go see the doctor or go to the hospital. The conversation is between baseball-cap wearing documentary filmmaker Michael Moore and my favorite news anchor, Keith Olberman. (Anyone who can make American politics funny gets my respect).

This was first broadcast on MSNBC on November 6, 2007, so it is going to sound a little dated. Thanks to “SickoTheMovie” for putting this up on YouTube.

Michael Moore made the documentary Sicko, which chronicles the pathetic state of American health care. I haven’t seen it yet because I’m depressed enough as it is. Perhaps one of the reasons why things are so bad in America is that we’re all way to sick and tired to able to march in any protests or riot in the streets. We just want a drink and go to bed.

I also have to wonder why Moore is so concerned for universal health care for people when he is opposed to animal rights to any way. You think that not eating meat and not getting accidently shot by a drunk hunter might be okay with Moore, but no.

However, I quibble. Anyone concerned about getting the health care we deserve has to have a few sickos on our side. (I mean that as a compliment.)

Enjoy.

The latest theory in migraine treatment is to have a drug targeted to peptides, a chemical that the brain apparently releases when under migraine attack. The shady suspect’s full name is target calcitonin gene-related peptide (or CGRP). The hope is to make something just as effective as triptan drugs, but without the side effects. No word as to how much more expensive the new class of drugs will be in relation to triptans (which already have price tags in the stratosphere.)

Go Philly

Philadephia may be proud of finally getting their Phillies to the World Series after 15 years, but Philly is also home to Thomas Jefferson University, one of the nation’s leading medical think-tanks. It’s also home to Dr. Stephen D. Silberstein, who wrote an extensive report about the current new drugs in development for The Lancet, perhaps England’s most prestigious medical journal.

Gap Blockers

If all of this seems familiar, it’s because reports of these new kinds of drugs have been coming out for some time now. There still isn’t a rock-solid reason as to why we get migraines, but Dr. Silberman’s report claims that blood flow and constricting blood vessles don’t have anything to do with it.

Instead, the blame is laid on “corticol spreading depression”. Once an attack starts, chemicals fire, which sets off a chemical chain reaction. New drugs in development such as the gap blocker Tonaberast are hoped to stop this chain reaction. It’s also hoped that the new drugs can stop the making of the peptides we talked about earlier. Gap blockers are available in very limited means and in clincial trials in the UK.

I’ll be honest with you — I’m having a very difficult time trying to find out if gab blockers are any different from this new drug, known as a CGRP antagonist. The latter apparently works by chemically telling peptides what to go do with themselves.

Would Not Be A Magic Pill

The study notes that even if gap blockers and peptide antagonists are proven to stop a migraine, it probably won’t bring 100% relief to 100% of migraineurs. There will still be a need for regular exercise, keeping a headache journal, getting regular sleep and learning all you can about headaches and migraines in order to avoid them.

No matter what clinical study, health care book or newspaper article you read, the importance of early detection is stressed. We’re going through the whole rounds of storoes about breast self-checks and mammagrams since October is now Breast Cancer Awareness Month. Urban legends and true stories litter our subconscious, such as the tragic death of Jim Henson, who may still be alive today if he decided to take his flu a little more seriously.

The Pros

The medical experts are correct in that early detection of a new or really strange problem is often the best first step to lead to a successful cure. But in the case of Migraines or chronic headaches, a cure is often a Holy Grail that’s lost in time and space.

But annual checkups can help you get to know your doctor better and help communicate with him or her better. This helps keep you in the doctor’s mind, so if he or she suddenly hears of a new treatment or drug, they can suggest it to you, but you have to ask.

The Cons

Annual check ups are free and relatively easy to get as a child, but once you hit 18, you’re on your own. Migraines tend to begin to occur in people’s mid-twnties, long after they’ve been dropped by their parents’ health iunsurance or state child health coverage. The onset of cripplingly painful cluster headaches also happens mostly to adults in their 20’s -40’s. Annual check ups for those suffering chronic headaches and migraines are always recommended. But none of these experts seem to realize that no one except the rich can afford them.

We have laws in several countires requiring yearly inspections of our cars and trucks in order to make them safer and reduce accidents. However, we don’t have anything of the sort for human check ups. Making them required is not enough — they need to be affordable as well, and not just for the rich.

Until that day happens, it’s a pipe dream for the average person to be be able to get yearly check ups at just the primary care doctor — let alone the dentist, the gynecologist or whatever specialist you are doomed to go see. I wish experts would stop recommending annual check ups until they can be affordable.

Although it’s called a medicine cabinet, you really shouldn’t keep any actual medications in it. When I refer to medications, I’m talking about pills or liquids. Ointments, creams or lotions tend to do okay in the bathroom medicine cabinet, since they are usually not as effected by humidilty and sudden swings in temperature as pills and liquid medications are.

Dr. Nancy Snyderman

Normally, I don’t tend to think about what’s in the bathroom medicine cabinet. Anything in there is out of sight, and then I’m more apt to forget that it’s there. I usually keep my pills as close to me as possible, such as in the top drawer of the desk I’m working on and in the kitchen cabinets next to things like pot holders that I use almost every day.

I had noticed that my Mom never keeps her medications in the bathroom, but I never thought to ask why. I just thought it was a Mom thing and I wasn’t meant to understand.

I’m currently reading Medical Myths That Can Kill You by NBC’s Cheif Medical Editor, Dr. Nancy L. Snyderman. Although the title is really alarming, the rest of the book isn’t. It has a lot of tips and interesting tidbits, such as “Medicine cabinets are best kept out of the bathroom.”

Why Dis The Bathroom?

Medicine cabinets in a bathroom that is used regulalry:

• Are humid, which can put moisture inside of your medicine containers
• Have a lot of temperature swings
• Don’t have that much space to begin with, so contents of overstocked cabinets always seem to leap out at your throat or your eyes. All right, that’s not in the book, but it should be.

All of this makes your pills age prematurely and can make them rot and stick together in gross clumps if they get wet. Even vitamin pills shouldn’t be stored in a bathroom medicine cabinet. Remember, just as it can be dangerous to take medication (or vitamins) that have long passed their sell-by date, you are also wasting a lot of money.

I don’t know who started the tradition of keeping medicine cabinets behind a mirror in the bathroom. Probably a guy who sold medicine cabinets for a living.

About this time last year, research from Chicago’s Rush University Medical Center noted the correlation between “hole in the heart” (PFO) and migraines.

The Truth Is Out There

PFOs (not to be confused with UFOs) PFO (patent foramen ovale) is a teeny-tiny hole in your heart thought to be caused by a birth defect. This is not a lethal condition, but it is thought to affect 25% of the human population. PFOs are also thought to have something to do with strokes.

At the time the Rush study announced their findings, they also were looking for volunteers for a clinical trial called MIST II held in over 40 medical centers and hospitals across America.

Sadly, that study was cancelled, but another study from Philadelphia’s Thomas Jefferson Univeristy Hospital is backing up last year’s study and a previous one done in the UK. The study was led by Dr. Stephen Silberstein.

What Did Silberstien Find Out?

Dr. Silberstein looked at 131 migraineurs. Of those 131, 86 for them has PFO as well. That’s about 66%. All of the migraineurs in the study did not know if they had PFO or not — but they sure as hell knew they had migraines.

Actually, 182 people werein the study, but only 131 completed it, so we’re just going to focus on that lot. Dr. Silverstein also noted that there were patients with other kinds of RLS, of which PFO is the most famous member. What’s RLS? That stands for “Right to Left Shunt”. This shunt, nomatter what string of letters you want to call it, apparently has some blood skip going through the lungs to be filtered. Silberstein also noted that 55 patients in the study had “a moderate to large amount of bubbles streaming into the brain.”

How this all causes migraines, exactly, is unknown. What bubbles into the brain has to do with ANYTHING is beyond me…but I tell you, I’ll never be able to look at a glass of carbonated soda in the same way ever again.

As always, this study ended with a call to do more clinical studies. Anything involving both migraines and strokes means big money to any Big Pharma agent sniffing around and hopefully the next logical step could be taken — can we close this hole in the heart witout surgery and, even if we had to get surgery, does it stop all migraines?

OK, it’s not exactly Sesame Street, but it’s catchy and certainly educational. Mom is finally home from what the doctors think may be a TIA (mini stroke). Both mini strokes and full blown strokes are serious events that need FAST attention and emergency care. FAST, of course, is an anycrymn for Face, Arms, Speech, Time. People seem to learn better with visuals or little jingles, so FAST is the easiest way to see if the person next to you is having a stroke.

• Face: Does the face droop on one side or is there a sudden migraine on one side of the head? (Mom had this)
• Arms: Have the person hold their arms out like they’re a zombie. If they can’t do it, it’s a stroke or TIA.
• Speech: Mom had this, too. Her speech was slurred and difficult to understand. That’s normal for me, but not for my Mom. People with TIA or stoke will usually insist that they shouldn’t go to the hospital. That sentence they seem to say VERY clearly, even if they just grab the phone from you and say “NO!”
• Time: Well, if any of the signs are exhibited above, it’s time to call an ambulance.

Also, sudden numbness on one side of the body — even just a hand or part of the face — is another sign to call the ambulance.

This video was produced by the Massachussetts Department of Health and also spawned the parody YouTube commercial “Zombie Heroes Act FAST”. Have a pain free weekend, everyone.

Welcome, Janet Jackson, to the ranks of those millions of us who have migraines and chronic headaches. You’re in good company. You also are lucky enough to have one of the nastiest types of migraines called vestibular migraines. It is a shame that they had to come along during a highly anticipated tour, but that’s migraines for you.

What Are Vestibular Migraines?

Vestibular migraines are not a one-trick pony. Not only do you get all of the fun of excrutiating head pains and nausea, but you also get vertigo. Vertigo is when the room around you spins, yet you feel pretty much still. (Although some people with vertigo do feel as if they are spinning as well). However, the effect is incredibly disorientating and can lead to danerous confusion. Singing and dancing is not adviseable in this condition, no matter what syle of music you are performing.

Other symptoms that you can get with vestibular migraines can also include extreme sensitivity to light and sound and auras. A persistant ringing of the ear of sudden hearing loss can also happen.

Treatment

There’s not many details about how Miss Jackson is being treated, but it’s common for anyone with migraines and dizziness or balance problems to be referred to a neurologist in order to rule out that the symptoms might be due to other conditions rather than vestibular migraine (such as inner ear disorders or inner ear damage).

As for the actual treatment, it’s the same old song for all of us with migraines or chronic headaches:

• Avoid triggers (such as the weather, certain foods, that time of the month)
• Take painkilling drugs as soon as you realize a migraine is coming
• Perhaps start taking a preventative daily medication, such as some kinds of blood pressure medication like verapamil or proplanalol
• Get as much regular sleep as you can (I’m sure that will be real easy on a pop music tour)
• Get regular exercise (which Miss Jackson does already)

When the attacks hit, you basically have to lie down in a pitch dark, quiet room in order for the painkillers to kick in. That, and start praying frantically.

The US government, in its infinite wisdom, bailed out Wall Street with what at first was a $700 billion bailout, but may spiral to $1 trillion before things settle down. Meanwhile, over 18,000 Americans die per year due to lack of health care that they can’t afford. Where’s the bailout to stop the price-gouging in America’s crap health care system?

We Already Have Socialized Medicine, In A Way

If the health care system was great, I don’t think I’d be so angry about having to pay a little extra. But, let’s face it — our health care system is no better than in England, Canada or just about anywhere else in the world that has universal health care. As someone who has lived in both England and America, I see no difference in waiting times, (in)competency of the doctors and hospital staff or access to medications. So, why are we paying more and not getting more in return?

A Recent Example

My Mom had what was thought to be a TIA (mini stroke) and went to the nearest hospital immediately. The screw ups were incredible. She got an overdose of one of her medications and nearly slipped into a coma. When she arrived in her room, there was a commode full of runny poo next to her bed which took a day to get rid of. Due to miscomunication between specialist doctors, Mom had to stay in the hospital for a day longer than she needed to. Her roommate with MS had to wait about two days before being given anything for her pain because the hurses would not believe what the paitent told them she had been prescribed, even after she had her doctor phone them.

And both Mom and I realize she got off lucky. Two years ago, she picked up a staph infection from an injection at a doctor’s office. One year ago, she had to have spinal surgey. The insurance is still battling Medicare and us on whether they will consent to pay for the spinal surgery or not, even though they had approved to pay before the surgery.

The US government has the money (OUR money) to fund unnecessary wars and make sure their pensions plans are protected. Surely, they have enough money and enough firepower to force down the costs of health care.

Where’s our bailout? Do we really need to get to the pathetic point where we have to put a gun to Washington’s wallet in order to get any results?

Step right up. Step right up. We have the specualar and freakish show on earth, originating in your head. Well, if your head happens to contain both depression and migraines. I’ll broaden the definition to those with depression and other types of chronic headaches, too, so you don’t feel left out. Both of these side shows are being spotlighted under the big top in this month’s Headache and Migraine Disease Blog Carnival, hosted at Diana Lee’s Somebody Heal Me.

Let’s Get Right To The Action

This month has been one of the best blog carnivals so far for anyone having to deal with chronic pain, let alone migraines. It’s definately appropriate to talk about depression and chronic pain in the month when the Presidential campaign goes to warp factor ten. Even those people who never have had a headache or a sad thought in their life are probably popping Excedrin like Tic Tacs and could beat out Smashing Pumpkins on the misery scale.

I do encourage you to at least skim all of the fine submissions this month, to at least let you know that you’re not alone in dealing with depression and chronic pain. The following list is what I consider the highlights based on my own narrow-mindedness and predudices.

• 12 Ways to Evaluate Migraine News from the revamped Headache and Migraine News Blog by James. I happen to have poor eyesight, so I really appreciate that the site is a lot easier on my eyes. I also appreciate the great tips and advice, such as in this article. This can also apply to depression news that you may read on the internet or see on the media, not just migraine news.
• Control a Chronic Health Condition with This Fun Project
  by Ellen Shankenberg. Although a little heavy on the exclamation marks, it is a slightly different twist on keeping a journal. I also like the avatar, which features a good looking horse.
• Migraines and Psychiatric Dosrders: Positive Reconstruction of Correlative Comorbidity gets the Most Respectable Title award. I think “Comorbidity” would be a great name for a band. It’s a great blog post, written with just the right amount of snark and sympathy by RainGem.
• And, oh yeah, one from me.

Thanks as always to Diana Lee. Check out Somebody Heal Me for details on November’s blog carnival.

A lot of work got gone in the last days of Pennsylvania’s political machine, but a bill to help 250,000 uninsured adults Pennsylvanians faltered, even after being scaled back to only provide for 115,000. Govenor Ed Rendell, a prime supporter of the bill, claims to be “deeply disappointed”. He did, however, get bill 2525 passed to strengthen humane care of dogs in commercial kennels and passed a very mild gun control law (PA HB 1845).

Now What?

The PA state legislature is taking a couple of weeks off because of the looming elections (which I can’t wait to get over with. Is this the longest Presidential campaign in history, or what?). Talk of of the estimated 46 million uninsured Americans will now become campaign slogans and promises.

This same plan will most likely make the rounds again in the spring of 2009. After the elections, not much works goes on in the PA state legislature until after the New Year. Not much gets done in in the House and Senate in Washington, DC, either. Thanksgiving and Christmas are the excuses used to take December off. What a life, huh?

Giving A False Name

What some Pennsylvanians are doing when they need emergency care is to go to the emergency room without ID and give the hospital staff a false name. No one then gets the ensuing bill, which can quickly reach five figures. To their credit, most hospitals in Pennslyvania are treating these critical cases, even when they suspect that they are being given a fake name. There’s been a 15% increase in bills with no names since 2006. It’s estimated that the uninsured using fake names to get emergency life saving care costs about $258 million. That’s just for hospitals in Southern Pennslyvania alone. Who knows what the results are for the whole state, let alone the nation.

Fortunatley, the uninsured are so far only using this ploy as a last resort, so they do not take advantage of the hospital’s generosity and don’t mess it up for the next uninsured Pennsylvanian with a heart attack.

$258 million is pretty cheap to save a few lives. That’s just $3 million more than the estimated cost of one day’s funding of the war in Iraq (according to MSNBC back in 2006).

TIAs are a warning that a full-blown may soon be on the way. Although it’s unknown why my Mom had to be hospitalized yesterday, the initial findings indicate that it was a TIA. She’s doing much better today and complaining that she wants to come home. Meanwhile, I’m trying to learn about TIAs as much as possible, so I thought I’d take you on for the ride.

According to the American Heart Association, about a half of all TIAs will also suffer a full-blown stroke in less than one year. One of the warning signs not mentioned in this video is a migraine-type headache, or a suddenly incredibly bad pain on one side of your head. But numbness in your limbs is a dead giveaway of a stroke or TIA (Transient Ischemic Attack). This is a particularly good video, in that it’s informative, short and not boring. It’s too bad that all medical educational videos on YouTube aren’t like that!

Keep in mind, non-American viewers, that this is an American video, where the emergency call number is 911. In England, it’s 999. It’s 000 in Australia, 111 in New Zealand and 100 in India. I’m sure I’m missing a lot of others here.

One thing that I particularly like about this video is that it showed a character named Steve arguing that he didn’t need to go to the hospital, even though he was clearly showing signs of a TIA. My Mom argued, too. I’m starting to think that arguing is one of the signs of a TIA.

I think my Mom had a stroke this afternoon. The doctors still don’t know what happened to her. She’s in the hospital and resting and being watched over. She must’ve been feeling better — she ordered me to go home, otherwise I definitely wouldn’t be typing this. So, I thought I’d just throw a reminder out there to everyone about the signs of stroke.

What To Watch Out For

These are the biggies:

• Sudden migraine, although a headache on both sides of the head can happen, too
• Numbness or tingling in arms or legs
• Nausea
• Blurred or double vision
• Trouble speaking
• Dizziness or inability to suddenly move around as usual

Despite popular belief, you don’t have to have chest pains to have a stroke. Also, if your loved one argues with you about how much they don’t need to go to the hospital, ignore them. Call an ambulance anyway. Mom started to put up an argument until she started to have trouble talking, so I got the ambulance.

Who Is At Risk For a Stroke

You don’t have to have all of these to be at risk for a stroke. For example, my Mom doesn’t smoke and doesn’t have high blood pressure. Anyway, the big risks are:

• High blood pressure
• Being a smoker
• Being a drinker
• Taking illegal drugs
• High cholesterol
• A family history of heart problems, stroke or TIA
• Being overweight
• Being black
• Having either type of diabetes
• Being on hormone therapy or birth control pills
• Cardiovascular disease or other heart problem

So, basically, if you’re a human being, you’re at risk for stroke.

Mom’s Headache

Again, I have to stress that at this moment I don’t know if Mom had a TIA, stroke or a really bad day. But all of the doctors and ambulance folk I bumped into said that they would’ve called an ambulance, too, had their mother exhibited these symptoms.

The very first sign was the migraine. It started when she woke up this morning around her ear on the left side of her head and was piercing. A Percoset took care of it for a while (Mom had spinal surgery last year, so she’s on Percoset for a good reason). However, by the afternoon, it had returned and brought along some friends.

Oy ee vey.