Dealing With Headaches

Last year, when my Mom was getting consultations for spinal sugery, (which turned out to be successful), we walked into her surgeon’s office. It was stacked with trays of gourmet food. “Ah,” said Mom. “I see the drug reps have been here.”

“I don’t prescribe drugs,” said the surgeon, and then laughed at the absurdity of his statement.

Mom’s surgeon will still be able to get free food sent to his office by representatives of Big Pharma, but that’s about it. All of the free office supplies emblazoned with logos (making a pen, coffe mug or notepad look like it was ready for NASCAR). All of that has now been banned by the Phramecuetical and Research Manufacturers of America (The ban is, of course, just in America). The ban takes effect in January, 2009.

Why The Free Stuff?

Since doctors are the only legal people to prescribe drugs, companies make sure they court evey doctor they come across with the same ardour as Howard Hughes collecting actresses (except the doctors see the drug reps a lot more than Hughes was suppossed to see his harem). They shower doctors with all kinds of goodies — not just lunches and office supplies. Years ago, doctors were given such perks as free vacations, free concert tickets or even free small appliances. They got all of this whether they actually prescribed the company’s drugs or not.

Those more expensive gifts were dropped to legal pressure on Big Pharma to stop wasting on so much money pimping their drugs. That’s when the first annoying drug television ad campaign hit American airwaves. Big Pharma does anything it can to keep the costs of their drugs high — and that means big bucks spent in advertising. In this way, they can “justify” costs.

No Free Lunch

Gradually, the general public and lawmakers are catching on to all of Big Pharma’s tricks. This ban is the latest modification to start forcing Big Pharma to lower the costs of their products. It remains to be seen whether Big Pharma will actually lower their costs — chances are, they will just find some other way of blowing a huge bundle on advertising. I can just see Imitrex logos now on race cars.

The Non-Profit Group No Free Lunch offers a “pen anmesty program” where it offers to replace pens that doctors would otherwise receive from drug companies. The doctors have to send the drug-emblazoned pens to them in exchange for pristine pens that only have the brand of the penmaker on them. The group then donates the evil druggie pens “to a worthwhile cause”.

Just on a personal note, when my doctors discover that I am a freelance writer, I suddenly get showered with pens before I leave the office. The pen I’m using right now (when not on the keyboard, that is) has a Zaditor logo on it (Zaditor has nothing to do with treating any medical problem I have, sadly). My doctors are clearly as sick of free pens from drug companies as the Pharmecuetical Reasearch and Manufactuerers of America.

However, they won’t give me any of their coffee mugs.

Many people who suffer with migraines or chronic headaches take medicines called “preventives” or “abortives”. Or, perhaps they are like me and take both kinds. Until recently, I didn’t think there was ANY difference between an abortive and preventative medication, and I have two college degrees. I was recently set straight by my primary doctor, Dr. Fountain Of Youth Face.

However, if I made the mistake, then perhaps other readers out there in the blogosphere will, too. I’ve seen the terms used interchangeably in medical websites, and I’m sure I’m guilty of doing the same thing on this blog. I’ll be going back through some of my older posts to correct that mistake.

Anyway…

An abortive medication stops something once it already begins. Such a medicine would be Zolmig nasal spray, or Imitrex (sumatriptan), which is taken as soon as you feel a migraine coming on. (And remember — an abortive does NOT mean it will give you a sudden abortion. It’s just a name.)

On the other hand, a preventive medicine stops anything from even starting in the first place. In the wacky world of migraines, you would have to take this medicine every day, no matter how you were feeling. Such a medicine would be DHE. Another medication would be verapamil, which is actually a high blood pressure medication that (as a side effect) often reduced the frequency of migraine attacks in migraineurs.

Still, It’s Not A Cure All

No matter if you take an abortive or a preventive medication (or both), you still need other painkillers, ways of coping with stress and to identify and avoid anything that might trigger a migraine. Keeping a headache journal helps you identify your triggers.

Hope this helps.

Hello, Gentle Readers. My apologies for the absence of the last two weeks. This was due to the technical problems on the part of 451 Press, the network this blog is on. Having blogs go up and down like yo-yos is part of the nature of the beast we call Blogging For Pay. So, if you were thinking that perhaps a new blogger was needed for Dealing With Headache, forget it.

Dealing with Downed Web Sites

I’ve had quite a lot of physical and metaphorical headaches trying to get things worked out. In case you ever get into a situation where you feel your server/network/web whatever has abandoned you, here are a few tips:

• Email the advertising department of the site, network or ISP. It doesn’t matter if you have a tech problem, just bring it to the attention of advertising and magically your email will be forwarded to the correct pair of eyeballs.
• Be a bitch, no matter what your gender. Although it’s no fun being a bitch, sometimes it’s the only way to get things done.
• Give yourself a certain time frame to freak about your dead website and then THAT’S IT. Fifteen minutes is generally good enough. It’s not the sky falling in huge bloody chunks, here — it’s just a website (even if it does mean that your income will drop substantiably for a while). Stress is good only up to a point, and then it becomes really unhealthy. Also, the stress can make you prone to shopping online and watching celebrity gossip television shows.
• Keep taking the medicine.
• Complain, complian, complain (self explanatory).
• Eat ice cream. Okay, that’s not the most practical of advice and it won’t get your website back up, but it works for me and makes you feel as if you are doing domething productive. Just dont eat it fast enough to get ice cream headache.

How’s the Head, Rena?

My head hasn’t been that brilliant, but I have just started taking yet another high blood pressure medication called verapamil, which I affectionately call velociraptor (hense the image at the top). More on verapamil in a future blog post — especially when I have a good idea of what it does to me. Right now, your bet is as good as mine.

Also, I have to burn the midnight oil in trying to write enough blog posts in order to make my monthly quota. This will be a good time for any fans of this blog … whoever you may be. Let’s see how many spelling errors slips by me in my blog this week! I would offer a prize for the person who finds the most spelling errors for this week, but then again, I’m not that great with spelling to begin with, so I probably wouldn’t know how to judge.

Onwards! And, since this is a blog, upwards!

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

George Carlin was one of my heroes, partially because of his love of wordplay and partially because his jokes could make me laugh even when I was suffering from migraines. For a while, I could bathe in his soothing absurdity (which often made a great deal more sense that just about anything else you’ll read.) No other human being could say the word F*** and make it sound like art.

As you’ve probably heard, George Carlin died on Sunday of heart failure. The news broke this morning. It makes me wonder if George did this on purpose, another “yet another reason to hate Mondays” sort of thing. I wouldn’t put it past him. He could be a cantankerous old sod at times.

But then again, according to his own jokes about euphamisims help brainwash people into things are much better than they really are, no one ever dies any more. “Dies” is too harsh and final-sounding of a word. They just “pass away”.

I discovered that he’s not very well known in England (to my advantage). George’s monologues helped me adjust to the culture shock of moving to England (especially his diatribes against airplane travel) — and then moving back to America. One of the ways to break the ice with strangers in a country you are not native to is to tell a few jokes. Boy, was I looked on a comic genius in the Bath homeless community, or what? And since I didn’t revcieve any money for those jokes, I don’t think it quie falls under the category of “plagerism”.

Life is full of headaches, both real and metaphorical. Just look at the evening news. Just makes you want to curl up in a ball in the basement, coat your thumb with tramadol and suck on it, doesn’t it? George was a preacher, in a way, but with a far more catholic message than from…well, from Catholics. He wanted to try and get people to think for themselves and demand better from big companies and governments, but he also made you laugh while subtly getting his underlying message across.

At least there are recordings from George’s routines from vinyl to DVDs to help soothe us when life’s headaches get to be too much.

Thanks, George. Hope you’re reunited with Tiny the dog and having the Bong to End All Bongs.

The American Medical Association grew a bigger set of balls when it released a report blasting one of its main sources of revenue — the health insurance industry. Even brain surgeons are complaining that health insurance forms are too complex (see — it’s not just you!) They also report that it’s taking doctors 14% of their salaries just to try and get the money owed to them from health insurance companies.

What’s Up, Doc?

This report blasts the industry as a whole and not just one particular health insurance company, although the AMA did give a sobering diagnosis to some of the nation’s most prominant health insurance companies. This is the number based on how often the particular company did not argue with the doctor when he or she wanted to be paid:

• United Health Care: 62%
• Aetna 71%
• Medicare 98%

Wow. Do you mean doctors may actually be concerned with getting their patients better without bankrupting them? Stranger things have happened.

A Case Study

I remember back when I worked at Macy’s and got a concussion on the job from a Macy’s fixture (don’t ask). Macy’s called an ambulance to take me to the closest emergency room. After waiting ten hours, I finally got examined.

A year later, long after I quit Macy’s, I was still getting reminders about the bill. I just forwarded them to Macy’s, which, to its credit, paid up and I wound up not having to pay anything. But this was over a year of back and forth letters, print outs, postage, yadayadayada between the Macy’s and their health insurance company.

And this is considered normal in this country. And we wonder why our health care industry is so screwed up? Going to voodoo healers makes more sense because insurance forms aren’t involved. You walk in, get some bones shaken at you, given a potion or two, you pay up front and then when you walk out and get on with your life.

Thank you, AMA, for actually giving a damn. And I think bodypaint and grassskirts would look great on you lot.

Mine went crap, thanks. I became more aware of my headaches this week than I have in the past month. My apologies for the smaller than usual number of blog posts this week. If 451 Press wasn’t down, then I was. Perhaps 451 Press or Word Press or the server gets migraines, too. I had some real beauties this week.

Keep a Headache Journal

I think I’m going to have to start keeping a headache journal again. I thought I was done with that crap years ago when I lived in England and decided, one fine Boxing Day, to do an experiment. I had a suspiscion that lack of caffeine was giving me the migraines. So, I stopped ingesting any caffeinated product cold turkey.

Not something I recommend.

I’ve been assured by authors, anti-caffeine activists (which I’m sure exist on some corner of the web) and everyday people that the migraine goes away after four days. A mere four days. Of course, in migraine-time, four days is the equivelent of one year in real life time.

I’ve cut back on my caffeine intake to about six cups of black tea a day. So, why did I get such blinding headaches this week? That’s the six and a half dollar question.

Theories

One of the theories I have about why I get so many headaches and migraines is that it’s other peoples’s fault. Somehow, their stupid thoughts float through the air like so much ozone and infect all of us who happen to have at least one thought in our heads. And the originators of the thoughts don’t get headaches or migraines because their brains never can hang onto an idea. Those painful thoughts just slip away into the atmosphere.

I also couldn’t help but notice that, except for a few internet sites, not one thing has popped up in the local or national media about National Headache Awareness Week. Way to go, guys. Then again, you did pick a bad week, what with natural disasters, NBA finals and that Presidential election bugaboo.

So I had a great National Headache Awareness Week. I even was too ill to send a submission in to the June Headache and Migraine Blog Carnival, darn it!

Actually, the NHF’s YouTube channel went up late last month and I’ve only just discovered it now. What can I tell you? I get headaches. They eat up your time researching for blog posts and goofing around on YouTube. The National Headache Foundation wanted to be sure there were some videos available in time for this week, National Headache Awareness Week.

There are only eight videos up as of this writing, but they do give some good general information geared at people who DON’T get chronic headaches. At least, this is my impression. For example, the “Headache Overview” film (seen below) mentions that most people get at least one headache during the course of their lives. I think those of us who get chronic headaches already figured that out. But there is a lot of ignorance and intolerance about migraines and chronic headaches by those who don’t suffer from them, so any easily digestible information is welcomed by me.

So, celebrate National Headache Week by taking in the National Headache Foundation’s YouTube channel. It’s yet another good excuse to devote precious hours of your mortal life at YouTube.

(And try to ignore the background music sounding alarmingly like an eighties soft-core porn film’s soundtrack. Not that I would know.)

Soon after I graduated elementary school, my Mom forbade me to tell her what I dreamt of the night before. She claims it’s because she never had nightmares until I told her mine. (What can I say? I like to share). But now I have reached a new level of weirdness in even my dreams.

Not only did I have a lucid dream early this morning, but I sick got sick during the lucid dream. I felt fine when I went to sleep. Then I got a migraine in my dream and woke up and still felt like crap. What up? I’ve approached the phenomenon of getting migraines in dreams before, but you usually feel better an hour or so after waking up. This was different in it’s intensity.

What’s a Lucid Dream?

A luicd dream is where you realize you are dreaming. Once you realize you are actually dreaming, that’s when the fun begins. Although you can manipulate your background and events in your lucid dream to a point, mostly you just get the complete freedom to be yourself without any repercussions.

Tibetan monks learn to lucid dream in order to help them on their path to enlightenment. Ancinet shamans used lucid dreams in order to ask spirits for healing rituals. I use lucid dreams (sometimes) in a high-brow way, but mostly I use them to get my rocks off. Lucid dreams are better than sex and drugs combined.

Except when you get sick in the dream. Usually, when I dreamt of getting ill, I didn’t realize during the dream that I ws dreaming. This morning, I knew I was dreaming, and yet was vomiting becuase of a migraine that couldn’t possibly be happening, anyway. Perhaps throwing up shows that I’ve reached the next stage in my spiritual development.

Next Time

The next time I get sick in a lucid dream, I’m going to ask to see the dream doctor that must be lurking about in the lucid dream universe. Of course, then I’d be asked what kind of lucid dream universe health insurance to carry, and I’d be in a bit of a pickle there. I really don’t want to spend my time lucid dreaming having to fill out application forms and comparing quotes.

Or maybe I should just go back to being an insomniac.

Swallowing a pill is a very personal thing. When you have chronic headaches or migraines, you better get your own system down fast and stick with it. Throughout my life, I have been told and lectured of various ways of swallowing a pill that are all better than mine (at least, that’s what I’m told). But I can only get the pills down my throat in my way, so it’s the best system for me.

What I Do

I swallow only one pill at a time. This saves me from gagging, choking or getting the inside of my throat scratched (which is a misery from the first layer of Hell).

I drink a couple of swallows of water or whatever liquid in my cup. I never dry swallow.

I curl my tongue back.

I place the pill behind my lower front teeth.

I take another large gul of liquid.

I let the liquid swirl around the pill and lift it.

Then, I toss my head so the liquid and pill go up over my tongue and start to position itself to my esophogus.

Then I cross my fingers and swallow.

What Normal People Do

There are various other methods used by other, presumably normal people to swallow a pill, including:

• Dry Swallowing: Hugh Laurie’s character House does this a lot. Tough cops in murder mysteries seem to do this a lot, too. Perhaps they get special training. I’ve never been able to manage it. This is where you stick a pill in your mouth and (without any preamble) swallow. I noticed Hugh Laurie tosses his head back when he dry-swallows the fake pills on “House” (or, at least, the clip shown on “Ellen”). This is advanced pill-swallowing. You need years of training and severe migraines to get this maneover down pat. Either that, or youhave to become a committed drug addict (neither of which is recommended).
• On the tongue: You take a swallow of water, then place the pill directly on the middle of the tongue, take another drink and swallow the lot down. My Mom is able to do this. I can’t.
• Back of the tongue: This is just a variation of the above method, only you place the pill as far back as you can on the tongue without gagging.
• Pretend it’s all a milkshake from Heaven: You take the pill and water, but pretend it’s a thick, creamy milkshake and suddenly the pill is down and your taste buds are saying, “Oi! You lied to us!”
• Stick the pill in the center of a tiny meatball or lump of cheese and swallow whole. Oh wait — that’s how I give pills to my dog!

So, how do you swallow pills? Or do you not bother with solid pills and insist on liquid medication? I’d write some more in this article, but I have to go take an Excedrin now.

Yes, I’m copping out again from writing a full article and resorting to a YouTube clip. This is because at 10:30 pm last night, when I was starting to drift off to sleep, WHAM. A migraine began. I usually get them in the daytime, not the night. The pain has been been coming in waves, but in between the waves, I’m doing pretty good. Unfortunately, another wave is starting, and I’m due to give all of you a blog post, so I’ve stumbled across this really good basics on migraines and also sinus headaches are mentioned every now and then. I’m glad to see that PBS now has it’s own channel on YouTube. I think I’ll be stopping there more often — well, after this migraine pain wave receeds.

This clip is especailly recommended for people who don’t have migraines and want to understand what’s happening to the people around them that do get migraines or sinus headaches. And remember, make friends with your nervous system.

Gee — guess what you think I’m going to say. Universal health insurance coverage is a big issue in America (where it doesn’t exist) and England (where it’s dying fast). Americans, especailly older generation Baby Boomers, have been conditioned to pay through the nose for health care. They have had it drilled into their heads that you only get what you pay for — so if it’s free, avoid it like the plague (sorry about the cliche and the pun).

And this attitude is killing them fast, as well as their children. There are more than 47 million uninsured Americans and who knows how many underinsured Americans. Underinsaured is actually about as worthless as not having insurance at all. Underinssured could mean that you have to pay a few hundred dollars of your own medical bills before the insurance will begin to cover it. Some means that they will cover emergency trips to the hopsital — but not prescription drugs or routinge office visits. The list of exclusions goes on.

What About Comunism?

I had this argument about universal health care coverage with my Dad (who is of the afore-mentioned generation) and he argued that socialized medicine could lead to Communism. He said that paying doctors more than in other countries encourages America to get the best doctors. They studied hard — they had the right to get paid more than other doctors.

This was before his wife (my stepmother) was dropped from her health insurance company. Now, he sings a slightly different tune.

But, you can see what proponents of universial health care coverage are up against.

What About Long Waiting Lists?

One of the biggest arguments against universal health care coverage is that the countries that have remnants of it (Canada, England) have long waiting lists for operations or to see specialists. This wouldn’t be the case if there were more doctors and dentists in the program. When given the choice of going into lucrative privitization practices or sticking with the NHS, are you really surprised that most English doctors and dentists remove themselves from the NHS progam?

Doctors, hospitals, Big Pharma and medical insurance companies have turned something that can save lives into big business. And, as we know, Big Business is sacred and not to be touched.

We deserve better than this. It’s our lives that are at stake. We don;t pay the police very well and we don’t pay firefighters anything (or next to nothing), and they save lives. Why should the health care business bleed us to death? If you insist on paying them fabulous sums of money, then we need at least a 40% rise in wages, free marijuana or free something to counterbalance these outrageous health care costs.

Perhaps if enough people die (or enough celelbrities, or politicians, which apparently count as more than one person), then maybe something will happen. Until then, we all suffer.

I watch the sea
It helps to anchor me — Geddy Lee

OK, I’m going to put something a little different up on the old Dealing With Headaches blog today. I think we need a musical break from the clincial trials, drug studies and health insurance blues. I have been insprired buy an other 451 Press blog which occassionally features “Musical Monday”s, so I’m going to steal — er, I mean, repectfully imitate — this idea.

We’re off to See the YouTube

If you play this loud enough in your work cubicle, even on your earphones, you could probably induce a headache in order to get out of work. You could probably induce a migraine in in the annoying co-worker next door who has to argue with his Internet connection every five point five seconds.

The song and the album it’s off of is called My Favourite Headache (yes, there’a “u” in there, so don’t panic, all of you American spelling sticklers (and we know who you are) The artist is Canadian, so the British spelling applies). If the singer sounds familiar, that’s because he’s Geddy Lee, the singer from Canadian hard rock band Rush. This is a solo album that came out in 2000.

The YouTube clip here has good sound quality, but is entirely lacking in the visuals department. It’s just the track playing behind a perpetual stare at the interesting album cover.

The song takes some getting used to if you’re not into Rush (and I admit, I’m not, but I like this track a lot). There is an interesting element of calm in the ominous bass guitar and pounding drums. It reminds me that even in the midst of the headache attack, there is a lifeline to cling to — even if it’s just the thought that eventually the headache will go away.

A lot of art has been inspired by suffering (including almost any novel written by an Irishman), and I think “My Favourite Headache” is a good musical metaphore for what a headache is like.

This blog tends to go into medications and alternative therapies for migraines and chronic headaches, my personal misadventures like the pain and other details on trying to manage the pain and on the debilitating symptoms (with a whip and a chair, preferably). But perhaps you need a quick review of the basics.

First off, migraines are different from headaches. Yes, the pain is still located in your head, but also becomes the center of your world. There are a lot of other symptoms and debilitating problesm with migraines. To go over the basics, here’s a neat little video by Illumistream that I discovered today on YouTube. I’m especailly glad that they note that “there is no such thing as a typical migraine.”

Just a couple of personal critiques on the video. When I have a migraine, my dog knows. She also knows when I’m trying to fake it. (I wonder if migraines put off a particular smell?) So, the chances are very good that the Golden Retriever at the beginning of the video, knew the model was faking it.

One critique — they say a migraine can last “as long as a week.” My longest migraine lasted TWO weeks.

Also, be sure to check out the visuals around “Feeling Off Balance.” Just think of what Stephen King could do with that character!

And, as always, don’t use any YouTube video (or a blog post) in the place of a qualified doctor’s diagnosis.

A study from Drexel University doctors have come out claiming that those with PSTD (more commonly known as Post Traumatic Stress Disorder — once known as “shell shock”) most likely get migraines. This is not really a surprise for migraineurs. After all, going through a migraine is a pretty traumatic experience in an of itself. Like most current medical studies, this one was done in respose to an earlier study.

What Is PTSD?

It needs to get back to being called “shell shock”, that’s what it means (as George Carlin pointed out years ago). Ever see a Mack truck come at you and just miss sending you to The Wild Blue Yonder? The response you feel after that is shell shock, or PTSD. There is some talk that shell shock is only what immediately happens after the scary event and PSTD are the long-term effects. For some of us, that’s pretty much the same thing. There’s probably a lot of doctors who’ll disagree with me and feel free to do so. I’m not a doctor. But I have been diagnosed as having major depression, migraines and PTSD.

After living my life, you’d have shell shock, too, as opposed to PTSD.

The practical upshot is that with both migraines and PSTD, legal acess to powerful prescription drugs is involved. Unlike many people with migraines, though, PSTD can lessen it’s grip on you over time, while the migraines tend to hang around.

To qualify migraineurs for this study as having PTSD, they had to have at least one traumatic event happen to them. This could include surviving a natural disater, seeing a friend get killed, or being forced to listen to Justin Timberlake’s “SexyBack” for the millionth time. People with chronic migraines had higher percentages of having shell shock or PTSD than people who only get migraines once in a while (called episodic migraines. Oh, how I wish to merely have episodic migraines. Oh, God, if You could do anything, just boot me from the chronic migraine list to the episodic migraine list.)

The study also notes that people with clinical or major depression are also more prone to getting chronic migraines.

Ooo, don’t you just wish you were me? Like me, you could have a happy Trinity living in your head — major depression, chronic migraines and Post Traumatic Stress Disorder.

I’m not entirely sure that announcing the findings of this study was such a wise idea. We migraineurs are already depressed. Don’t give us even more misery to look forward to.