Dealing With Headaches

Oh, joy. Sitting in a doctor’s waiting room hearing “Benny and the Jets” over and over again, staring at the same pile of magazines that was there two years ago and wondering if the stain on the wall just moved. This is a great time for doctor’s office waiting games. Enjoy!

Guess Who’s Contagious

The big problem with doctor’s office waiting rooms is that a lot of sick people truck in and out and you don’t know what they have. Well, with this game you can guess who’s contagious. The winners win a chance of not dying. Losers wind up getting hooked to IVs and being rolled around on hospital gurneys. There are no rules to this game. You let your instinct take over. Cheaters actually write down the names of patients and check the obituary section of the local paper for the next few weeks.

Toss The Offensive Literature

Despite the best efforts of nurses and office staff, many pieces of offensive literature are slipped into the magazine piles or into the magazines themselves. These can include anything from anti-birth control crap to pro-Nazi crap (and its hard to tell the differnce, sometimes.) The office staff and nurses have so much to worry about already. Do them a favor and don’t complain to them. Just throw the crap out. Extra points if you can get it into a covered wastebasket.

The gist of the game is to do this when nobody is looking. You don’t know if that guy hawking and spitting into a hanky in the corner was the fella who put the offensive metrail there in the first place.

Good luck!

People with migraines or cluster headaches may be perscribed anti-convulsants at one point or another. As their name implies, these are drugs that were originally meant for helping people with epilespy or other conditions that cause seizures. Now, anti-convulsants are prescribed off-label for bipolar disorder, schitzophrenia, Alzheimer’s, obsessive-compulsive disorder, restless leg syndrome, drug addiction rehabilitation and pre-menstrual syndrome.

Common Anti-Convulsant Meds

These can include Stavzor, depakote, gabepentin and the big one — Topamax (topamirate).

Normal Side Effects

These include feeling dopey all of the time, having nightmares and having an increase in appetite. Many people also loose interest in sex. Your blood pressure may go down when on these, so guys — your body may not be able to pump enough blood to Mr. Happy in order to get or maintain an erection. Some people also lose their hair or get thinning hair.

Long-Term Effects

These are a little more serious. For some people, the loss of interest in sex winds up being a long-term side effect instead of a short-term side effect. Same for baldness or thinnng hair and feeling sleepy all of the time.

Perhaps the most common long-term side effect is weight gain. You feel sleepy and your appetite increases, so weight gain is kinda inevitable. You need to be sure you are eating sensibly when on thiese kinds of medications.

But you may not be that hungry, because some anti-convulsants like depakote give chronic heartburn. Yummy.

With some meds like depakote, you may need to take tests to be sure your liver is functioning properlym because the medicine could make your liver very cranky.

For a more complete look at anticonvulsant medications, I recommend taking a look at Crazy Meds.

I’m seriously thinking of switching my perscriptions over from a bricks-and-mortar store to an online pharmacy. But you hear about the dangers of online meds every week, or so it seems. The fears are that the medicines will be sugar pills, out of date or mixed up with some dangerous ingredients.

But online pharmacies have worked very well for pet medication. These online pet pharmacies do require a veterinarian’s prescription in order for them to send anything. And reputable human online pharmacies work the same way.

Say Hello to VIPPS

If there’s a lot of money in it, there must be some sort of organization associated with it. In this case, the organization is VIPPS (Verified Internet Pharmany Practice Sites). A legitamate online pharmacy not only requires you to send a prescription, but they also will be listed as certified by VIPPS.

Still Delete All Spam

The same rules still apply when it comes to all of those fun spam emails you get that clog your inbox like plague in a blood vessel. They shouldn’t come to you — you need to go to them. If you eer get an email from an address you don’t recognise, delete it — and then delete your delete file.

Same thing goes for any pop-up windows or for any tempting messages promising deep discounts on medications on forums or chat rooms. Don’t click on any links.

The only time an online pharmacy should contact your via email is because you contacted them first.

What About The Cost?

You won’t necessarily save money by using an online pharmacy, but if you don’t live close to a pharmacy or are house-bound, this may be a viable alternative.

Hope this helps.

Although you shouldn’t use any website as a substitute for a real flesh and blood doctor’s diagnosis, some websites are more reliable than others for sorting out the medical facts from hearsay. For example, because of the this blog, a lot of information here is anectodotal. Blogger and commenters write about their experiences with certain treatments or medications — and what happened to us may not necessarily happen to you. I also try to link up to one of these reputable medical websites once in a while.

Here’s a good list of reputable medical websites for those with migraines or chronic headaches to get started. Enjoy:

• Mayo Clinic: Although there are certainly better medical websites out there, I haven’t found them yet. This one remains at the top of the list for me because the writing is comphrehensible, there are often helpful illustrations, the layout is user-friendly and there is a section where you can ask questions to real doctors. They also have details on some really obscure medical conditions that some other medical websites just gloss over or won;t even mention.
• WebMD: This is probably the best-known medical website, but I find it lacking in ways to Mayo Clinic’s site. However, I have noticed that the site has improved in just the last year (especially with information on depression, which many people with migraines or chronic headaches have). Keep in mind that this site is loaded with adds, including pop-up ads and may take a while to download.
• Centers for Disease Control and Prevention: Although I’m not the biggest fan of the US government, occassionally they do something right, like this helpful and ad-free website. This is geared for American readers. BIG PROBLEM: They do not have a section on migraines. But they do have good tips that migraineurs can use, such as travelling with prescription medications.
• NHS: Not to be outdone by those damn Yanks, the UK’s National Health Service has also put up a helpful website with incredibly good information on alternative therapies. Obviously meant for a UK audience, but not exclusively.
• Drugs.com: Notable for the Pill Idenitfier and a section for veterinary drugs, but mainly an easy-to read, well-organized encyclopedia of the manufactuerer’s information on just about every drug known to man or woman.

Topamax (topimirate) was originally made to treat eileptic seizures when it was unleashed on the world in 1995, but now is most often prescribed for migraines. It’s also currently undergoing studies to see how well it works as a weight loss medication and if it can help alcoholics lose their desire for alcohol. Soon, they’ll study to see if Topamax can help win the war in Iraq.

Anyway, like any other drug (or herb), it’s loaded with side effects. Just because I’m listing them here doesn’t mean that you’re going to get any of them. I did search around to see just how many people get side effects out of all of the thousands and thousands of people prescribed Topax, but I couldn’t find any concrete numbers. All I could find was that “Many” people taking Topamax live happily ever after.

Don’t stop suddenly taking Topamax, especially if you have epilepsy. This can lead to withdrawal symptoms.

*Note: I’m not a doctor. I’ve never taken Topamax, and have no plans of ever doing so (knock on wood), so I can’t give you any first hand testimonies, recommendations or rants.*

Minor Side Effects

These include the following:

• Nausea
• Vomiting
• Dizziness (more so than usual)
• Feeling very tired all of the time
• Increase in urine output
• Loss of appetite
• Weight loss

More Serious Side Effects

Oh, these are fun. Happy happy. Joy joy:

• Back pain
• Kidney stones (apparently, you have to take Topamax for at least a few months before these set in. This happened to only 1.5% of adults taking Topamax, according to a 2006 study.)
• Painful urination
• Suicidal thoughts
• Psychosis
• Depression
• Fainting
• Swelling or tingling of the mouth or other parts of the body (an allergic reaction that kicks in right away)
• Birth defects
• Extreme confusion
• Loss of the ability to concentrate

Call An Ambulance Immediately Side Effect

If you get a sudden pain in one or both eyes and suddenly get vision problems, call the ambulance. This could be glaucoma. This happens very rarely — something like 23 patients out of every 800,000 (still looking for the study where I read that) — but you should know. Also, also if you’re not taking Topamax and get these symptoms, call an ambulance. If could be glaucoma or stroke.

That’s your happy thought for the day.

“The only thing that seperates us from the animals is mindless superstition and pointless ritual.” –Latka Gravas, Taxi

In these modern times, we may like to think that we are far more intelligent than our ancestors, but that’s a load of rot. We act just the same now in 2008 as we did in 1008. Case in point: the placebo effect. Healers have known for thousands of years bout the power of belief. Some of the magic of the shamans and medicinie men of anicnet times was in getting the placebo effect to work in the patient.

The Old

Diseases and aliments like chronic headaches were seen to be caused by the spirit world. In one sense, we can’t see the bacteria and viruses that get ill or the chemical reaction in the brain that bring on a migraine, so that’s just as mysterious and unseen as spirits are.

A Native American healer didn’t just say, “Take two herbs and call me in the morning.” That didn’t quite cut it — even when all the patient needed to do was take two herbs. An elaborate ceremony was held, with drumming and beseeching the spirits and then the healer would extract the source of the sickness with his mouth. The healer would then show the patient the object — an arrowhead, worm or whatever — and say, “There! It’s out of you now. You will get better.” And invariably, the patient would get better.

A ritual like this is detailed in The American Indian: The Spirit World put out by Time-Life Books in 1992. It notes that an unnamed shaman admitted, “We could cure without that just by singing and remembering the vision, but people need something to see.”

The New

In 1987, Philadelphia decided to construct the very first building that would be larger than the top of the statue of William Penn on the tower of City Hall. Many buildings in Philly are now larger than William Penn’s hat.

Philly’s major sports teams lost a lot. Granted, they had been loosing before 1987, but I digress. FOr some reason, lots of Philadelphia sports experts concluded that the reason Philly sports teams could not bring home a championship was because

of a curse from William Penn, because Philly built skyscrapers taller than his hat.

Now, William Penn was a Quaker and would be mortified by the thought that he would dabble in curses, but again, I digress. And so this local legend became known as “the curse of Billy Penn’s hat.”

When the Phillies were headed for the World Series, no chances were taken. A small statue or Willam Penn (which you can get in any Center City souvenier shop) was glued to the top of Philly’s tallest building, the Comcast Center.

I kinda doubt that little statue helped make the Phillies better players, but I guess it worked, because the Phillies went on to win the World Series.

The more things change, the more they stay the same.

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).

It’s amazing what you discover when you’re a freelance writer with a headache and migraine blog. Somedays, I find out more about headache treatments reasearching other sudjects than I do when pursuing items specifically for headaches and migraines.

Case In Point

I recently had a client who asked me to do a series of articles on Native Americans. I jumped at the chance, because I’m part Native American (only 1/16th or so, but there you go). Since no one in my family knows anything about the tribe we’re from (long story), the only way I get to find out anything about the most vital part of my heritage is to take assignments on Native American tribal customs and spirituality.

Anyway, in my library’s copy of the Time Life series The American Indian, I found some interesting information on how the Seminole Indian healers used to treat headaches. (Seminoles used to live in the Southern woodlands of America and then were shoved to Florida.)

How Did They Cure a Headache?

First off, just like today, you were better off finding a headache specialist than going to just any old medicine man or woman. Seminole headache specialists usually wear the feathers of the yellow flicker. This specialist then diagnoses what animal spirit you have offended to give you such a bad headache. (Hey — whatever works!)

Then, you may have to lay back and cut small incisions made on your head. The bad blood is then expelled from your body. (Oddly enough, this is still practiced, in a way.)

Or, if you’re lucky, healers may give you a tea made from a shrub such as prarie willow (Salix humilis, var. tristis. This tea also was said to help bring down a fever, too. The magic didn’t lay entirely in the plant, but in the loving way it was prepared by the healer for you, kind of like when you feel better after someone makes you homemade soup.

Another plant used for Seminole Indian headache treatment was white sage (also called western mugwort, cudweed or Artemisia ludoviciana). Instead of making a tea out of it, you used it like an incense or like aromatherapy. You crushed the leaves and breathed in the scent. We still do something like this today with sniff lavender oil or peppermint essential oils to help ease a headache.

The more things change, the more things stay the same.

Lyrica (pregapalin), originally an anti-seizure medication, seems to be the cure-all for modern times. I’m sure soon it will be used to cure the economy and win the war in Iraq. All kidding aside, it is an incredibly effective pain reliever for fibromyalgia. It’s also one of the few painkillers that works reliably for my Mom and I can’t help be grateful for that. But Lyrica is also prescribed for migraines as an off-label use. Should it?

As always, please don’t use this blog post in the place of your doctor’s or neurologist’s adivce.

Can You Get Addicted To It?

You can get addicted to Lyrica, but you can also get addicted to any strong painkiller. Although I’ve never taken it, Mom reports that Lyrica can make you feel really dopey and makes whatever chair you are sitting in a whole heck of a lot more comfortable. The FDA claims that taking Lyrica can produce the same effects as Valium (diazepam).

But there are many, many people who take Lyrica or who took Lyrica and didn’t become addicted to it. If you take Lyrica and don’t actually have any pain that needs killing, then you have a really big risk of getting addicted.

And Lyrica is expensive stuff. It’s cheaper to get crystal meth. (Sad, but true.)

Does It Work?

Just in researching this article, Lyrica seems to work on migraines or chronic headaches just like any other prescription medicine — for some people it helps, some people it hurts and some people it doesn’t do much at all. The only things for sure is that your appetite will increase, you’ll sleep better than you did when you were a baby and you will have to pay a lot of money. Not all health insurance companies will cover Lyrica.

Is There a Generic?

Sadly, no generic Lyrica is available and won’t be until October 2013. However, Lyrica’s makers Pfzier will most likely apply for a patent extension long before then, possibly for migraine prevention. Let me stress this — there is no such thing as generic Lyrica. Not legally, anyway. Taking any “generic Lyrica” you may find advertised on the Internet is the pharmacological equivilent of playing Russian Roulette.

So far, the only known treatments for cluster headache are injections of sumatriptan you have to give yourself and oxygen therapy, which insurnace companies won’t cover in America and requires running to a hospital with an oxygen chamber. Is there a more conveinent solution? Hopefully now, there is. Clinical studies have concluded that Zomig nasal spray(zolmitriptan) can help reduce the pain of cluster headaches a half hour after taking it.

Study Details

Zomig comes in tablet, injectable and nose spray form, but the European studies were done with just the nasal spray. 121 adluts were goven a double blind test where they may be snorting either Zomig or a placebo. Two doses of Zomig was used in the test — one at 5mg and the other at 10mg. Bother doses helped to cut the intensity of the pain.

There are two kinds of cluster headache victims. There is the usual episodic cluster headache (comes and goes) and chronic cluster headaches (never goes away). The studies included members from both groups, with more episodic than chronic cluster headache volunteers.

There were several studies performed. The results were pooled together and presented at the European Headache and Migraine Trust International Congress, held in London last week. I’m afraid I haven’t been able to find out who funded these studies. I’ve got a teensy-weensy little feeling it might have been Astra-Zeneca, the makers of Zomig. WebMD reports that Astra-Zeneca “supported this research”. Hmmm.

Zomig is only licensed for migraine treatment and not licensed for cluster headache treatment in the UK or the USA. It is in Germany, the Netherlands and Denmark.

Fellow triptan drug Imitrex has also been used as a cluster headache treatment, but results have been mixed. Verapamil can lead to heart problems and can’t stop an attack once it starts.

Cluster Headache FAQ

Cluster headaches is one of the most painful conditions a human being can have. Even as a long-time migraineur, I concede that cluster headaches are more painful than migraines or even concussions. Cluster headaches usually affects more men than women and sets in when you are about 28, 29 or 30. Attacks tends to come in cycles, usually starting a short time after the victim falls asleep and happening for many nights in a row before mysteriously vanishing into the choas from whence it came.

Hooray! The monthly headache and migraine blog carnival is up! It almost makes up for having chronic headaches and migraines…well, not really. But it does make for good reading, good publicity for your blog and good research for those trying to learn more about life with chronic pain. And this month, I actually remembered to submit a blog post. The topic this month was “Doctor and Patient Communication.”

Highlights

These are the posts that jumped out at me and got the attention of my tiny little brain. Once again, if your post is not mentioned, that is not meant to reflect on your writing ability.

• How to Talk to Your Migraine Doctor written by a doctor Mary Kay at Headache Advisor. This lets you know the information that your doctor needs to know from you in order to help you quickly.
• Getting the Most from Doctors Appointments from this blog. It covers the basics froma patient’s point of view.
• Hypnosis Reduces Headaches in Children by Michael Lovitz. This focuses more on stress headaches, but has the results of an interesting study.
• Saturday Thoughts by Sue at Inner Dorothy just for the guinea pig picture. Although the article about Dorothy’s participation in a drug trial is also worth a look.
• Although aimed for dealing with children’s migraines, Have Your Child Draw Their Migraines is also good advice for adults. Not suprisingly, this is yet another brilliant post is brought to your by James at the recently streamlined Headache and Migraine News Blog.

Next Month

November’s topic hasn’t been determined yet, but if youy have a blog post that would be of general interest to migraine or headache patients, then submit a link to it for November’s blog carnival. Contact Diana Lee at SomebodyHealMe.com for details.

Off to collapse.

Many posts ago, I talked a bit about biofeedback for tension-type headaches. It was difficult to find accurate information for that blog post. (Come to think of it, it was also hard to find innaccurate information on biofeedback for migraines, but I digress). This news story done by Washington, DC ABC affiliate WJLA gives a bit more information for those who could be interested in neurofeedback for migraines.

You do have to get past the stutters and stumbles at the very start of the clip, but once you’re past that, it’s all systems go. They show PacMan as helping you learn how to control your brainwave activity, but there are also other games available. However, you probably won’t get to choose what game you play when you go to a certified specialist.

The clip does go on to claim that “doctors report patients having as much as 90% improvement with neruofeedback”, but they didn’t name their sources. However, if you’ve ever been able to will yourself not to sneeze, cough or vomit, than you already know how powerful the mind can be in controlling some bodily functions once assumed to be involuntary.

If you are interested in neurofeedback or biofeedback for migraines or tension-type headaches, then you could ask your doctor for a recommendation or try checking the virtual Yellow Pages.

The complete title is Headche Survival: The Holistic Medical Treatment Program for Migraine, Tension and Cluster Headaches, but the book is only 260 pages long with large print and wide margins, so you know right away that this far less than a comprehensive guide. It was published in 2002, so you already know that some medical information may be out of date. It was co-written by Robert S Ivker, D.O. (Doctor of Osteopathic Medicine) and Todd Nelson, N.D. (Doctor of Nursing degree).

Head’s spinning already, isn’t it?

It Sucks

Hey, I have two college degrees (Liberal Arts and English), so when I say, “It sucks”, I have the schooling to back my review up. The main problem with the book is that the authors don’t get migraines, tension headaches or cluster headaches. Ivker claimed to have cured his sinus problems (and the sinus headaches with it), but that’s not the same as migraines, tension-type headaches and cluster headaches. The book would have been better off to claim that it can help people with sinus headaches and possibly tension-type headaches, but seems to wander off into the stratosphere whenever cluster headaches or migraines are mentioned.

Ivker’s best known book is called Sinus Survival, which my Mom read years ago and can’t remember anything about. Ivker is an expert on dealing with sinuses and allergies (and does a pretty good job giving suggestions on handling stress) but a lot of what he recommends doesn’t seem to have any practical application for those with migraines and cluster headaches.

The book is also very poorly organized. In the beginning of the book, Ivker says basically, “the first thing I want you to do, Reader, is go take the Quiz in Chapter 3 and then go through the list in Chapter Five and then come back here.” Flipping around a book like that is not really an option for people with migraines and cluster headaches. We can just barely manage turning one page at a time, let alone flip through here, there and everywhere.

In Summary

You can’t find anything in this book that isn’t already up on websites, YouTube video serials and blogs. In fact, you are better to get your information from your doctor and the web as this gives you the latest breaking news, theories and testimonies by people with the same problems as you.

Wow. Complaining about the book has actually cleared up my current sinus headache.

I went to my doctor yesterday and broke the news ablot proplanalol not working for me. I thingk he was more disappointed than I was. So, I’m going to try a new medicine, verapamil, as a daily preventative as well as try out a couple of samples of Zomig nasal spray. Actually, both verapamil and Zomig (zolmitriptan) have been out a while, so they’re new for my body but not on the migraine medical scene.

I didn’t realize I’d have to try the Zomig so fast.

Flipping Pills

Why the nasal spray samples when I’ll be taking pills and don;t have trouble taking pills? Well, when I get a migraine, my stomach gets really upset and sometimes I throw up. When my doctor heard this, he said the nasal spray works for people who have trouble “flipping pills”. I had to have him repeat that.

Note to self: Latest medical euphamism for vomiting is “flipping”.

Now, I will never be able to hear the term “flipping houses” again without having a really bad mental image.

I’ll Give It A Nine

I got a migrine this morning. This was a scary kind — one that comes on without any warning (unlike most of my migraines or migraines in general). This hammered the left side of my head instead the right (as is usual for me). On the scale of 1-10 for my migraines, this was a 9.

Trembling, I ripped into that Zomig box, where the instructions are written in everyday English and have color photographs as to how to take it (which was great, because at that point, I couldn’t focus my eyes enough to read).

You only need to shoot it up one nostril, but remember to inhale and THEN shoot it. Otherwise, it will drip out of your nose. I was so desperate, I licked what dripped out. Then, I staggered off to lie down. My Mom was alarmed when she saw me.

It was worth licking what dripped out of my nose. An hour and a half later, I felt good enough to sit up and eat lunch. Two hours later, I could go back to work.

Granted, this could in part be a placebo effect kicking in, but at this point I really don’t care.

Now, I guess I really should get that prescription for verapamil filled…

Here’s one from the “Say It Ain’t So!” Department:

A study from the University of Pennsylvannia has come in about how barcodes on medication given at hospitals were to cut down on errors. Turns out, barcodes don’t seem to make a positive difference and also seem to contribute to errors by already overworked nurses.

Perhaps the Hospital Had A Bad Day?

Nope, sorry. The study lasted a lot longer than a few days — it lasted a few years covering five different hospitals that have a barcoding medication system already firmly in place. The study also suggested that the barcoding system that we currently have often cuases more problems than it solves. When a harried nurse encounters these problems he or she will try to use shortcuts in order to get whatever medicine they think the patient needs.

The conclusion from the study wasn’t “Technology is bad.” Rather, it was, “We can make this SO much better by concentrating on changing these areas.”

And, quite frankly, we need all the suggestions we can get with our hospitals. Another study which came out in 2007 showed that errors in hopsitals (including being given the wrong medication or wrong dosage of your medication) rose 3% from 2003-2005 alone.

But I Gotta Go To The Hospital Tomorrow

As medical systems go, ours is still about the best around in care (if not cost). If you have surgery scheduled for tomorrow, don’t freak out reading this! Still go for your surgery, please. But there are some things you can do to help reduce the chances of medical errors while you’re loopy on painkiller.

• Put identification tags on your luggage or daybag to help nurses coming on shift idenify you while you’re loopy in your hospital room
• When you get your ID bracelet, make sure they put the right name on there (no, I’m not kidding).
• When you have a test done in the hopsital and never hear about the results, that could be a mistake. Unless you are specifically told “no news is good news”, keep asking about the results.
• Write down a list of your allergic reactions and medications and tape them to your forehead.
• When you can, ask what any medicine is and what is it for. When my Mom had her last surgery, she called me to Google information about the drugs the nurses wanted her to take. I was able to help confirm that she was to get the meds.
• If you’re in the hospital and loopy and can’t figure out what’s going on, call someone you know to call or visit the hospital and find out for you and then give you a report. If you don’t have a friend or relative to do this, call your primary doctor to do it.

Hope this helps