Sunday, May 31, 2009

No Trigger Today!

I had a food today that triggers me every time I eat it, but I feel wonderful! Ok, let me step back a little bit. It's normally a trigger food because of the way it's prepared and it's one of the all too irresistible type of foods that I've just recently learned to be able to turn away.

I love chicken franchise. So how come I ate it if I can now pass it up? I was part of the planning committee for the end of season party for my son's sports award dinner and the caterer for the event was also on this committee. I asked preparation questions and we were able to arrange to have the chicken franchise cooked in way that I could eat it too. She said they can normally have any dish made with special requests; that they get them all of the time.

I really was prepared not to have any. I had requested the dish since it is one of my son's favorite foods too. In the past, I was able to talk myself into believing that I was not really hurting myself too bad just having a very tiny piece of it even though I would get multiple Migraine symptoms almost instantaneously before I would get the inevitable. I can tell you now, I know I am not going to get a Migraine from the serving I had today. It usually hits me pretty fast and I don't feel a thing. Nothing! Not one single symptom coming on!

It really does pay to know your triggers and if you have food triggers, I strongly recommend you go down to the ingredient detail level of your food triggers. In chicken franchise, I only have one ingredient that triggers me. Once this was substituted, I was golden and ended up enjoying one of my favorite dishes which I had pretty much written off.

I am a happy camper today.

Sunday, May 24, 2009

Stackable Trigger Confusion

The more I have learned about Migraines, in a layman's sense, the more I feel I don't know about them and need to learn additional information. It seems triggers are one of the big keys to Migraines and what you do with your triggers is one of the most important factors for you as triggers can be very individual.

Right now, stackable triggers (podcast on triggers; transcript of podcast) are what is confusing me. Stackable triggers are triggers that don't necessarily trigger a migraine by itself, but can trigger a Migraine when we come across other stackable triggers or stress. What confuses me is that I'm not sure if I should just avoid stackable triggers all of the time too, that is if it is an avoidable stackable trigger. I would imagine this would be the prudent thing to do.

You see, I have a lot of triggers. Some are avoidable; some are not. I have gotten so much better about avoiding the triggers I can, but it does take time to break some old habits or to just not do something on impulse - without even thinking about it. Or worse yet, to do or eat something because you don't want to hurt someone else's feeling. This only ends up hurting you in the end. I am really trying to not play around with my triggers in general and stackable trigger limitations anymore.

I think these stackable triggers are still triggers even if they do not cause a full blown Migraine by themselves. I also do not know when an uncontrollable trigger may be lurking around and going to show it's evilness which will cause that dreaded Migraine. I can't afford the time or money that a Migraine costs any longer. I know how hard this is since I am faced with my triggers everyday.

One stackable trigger I find hard to give up right now is chocolate. It has always been my stress reliever. This is a time when I need my chocolate the most, but I also know I have to stay away from it if I want to get through this period of time. Talk about stress on top of stress!

I have a lot more to say about food triggers - just not right now. Food triggers have become a very sore subject for me; some justifiable, some not. I will not whine about my food triggers or whine because I ate something that caused me to get a Migraine especially if it was my fault. What I may do is complain about the number of food and other triggers I do have. But even then, I don't really like to complain unless I've just had too much to handle for too long or am just having a plain old rotten day. Right now, I should find out within the next month if I still have a job.

Now where's that chocolate when you really need it? Just kidding. That's not going to help me if I need to find a new job.

Sunday, May 10, 2009

No Past Ghost Doctor Regrets - Part II

Although I don't really regret the path of doctors I have taken, some of their absurd comments still haunt me. While their comments may repeat in my head at times, I like to think of them as a way of trying to keep me in check or another chance to get a good laugh at the past doctors ignorance's and glad I knew enough to fire their sorry butts while not wasting any more of my time or money on them.

Let's see, what are some of my favorite comments? I think some of the more common comments we tend to hear from doctors that I have gotten are: "they're just headaches, there's nothing I can do"; "if this medication doesn't work, I don't know what to try next"; "your Migraines are caused by stress"; "just get more sleep". All of these comments show the ignorance about Migraines on the part of the doctors.

The more unique comments I have received from doctors: "it's not worth trying the elimination diet"; "sometimes you can go a little too far in finding triggers"; "you can keep doing what you're doing or retry this medication"; "you don't need to keep as much detail in your Migraine diary". Ok, these also show Migraine ignorance from my doctors.

First of all, I can't imagine any doctor not wanting a Migraine patient to try to find any triggers. What better way to identify food triggers then the elimination diet? Not worth it? Give me a break!

Second of all, how can you find too many triggers? If a trigger is a trigger for you, isn't it great that you've identified it and are able to eliminate another trigger if it is avoidable? And if it's not avoidable, perhaps there are other things you can do to make it less severe, but the bottom line is that at least you are aware of the trigger. On the other hand, I can understand if I feel I have too many triggers, but it's still better to know what they all are and not put some kind of a quota on the number of triggers I can have.

Third, if you have bad side effects to a medication that didn't work the first time, how can being bullied into taking it again make it work and cause no side effects the second go around? Honestly, if I wanted to keep doing what I was doing, I wouldn't have switched to going to him as my neurologist. I switched up again real quick after that visit!

Lastly, how can you keep too much detail in your Migraine diary? I can tell you, I didn't really keep too much then and especially now, I don't keep enough which is a big shame on me.

I've gone back and forth between Neurologists and GPs. I no longer see any of the doctors who made the comments above. I am currently seeing a pseudo Migraine specialist. Almost all of her practice is devoted to Migraine and headache patients. I like her, but like all relationships, she has her little quirks too. Nothing to make me fire her which is good because the next real Migraine doctor to try is a few more hours away!

Anyhow, whenever I think I may have found a new trigger, the comment about finding too many triggers inevitably pops into my head. I've always been a double and triple checker and am much worse now. I've got to prove it beyond any doubt before I will say it is a trigger for me.

As I stated upfront and in Part I, I really don't regret my decision about any of these doctors. If I didn't learn anything Migraine related from these doctors, I certainly learned other valuable lessons from them. These comments truly remind me that doctors aren't perfect and don't know everything. We have to stay on a quest to find a doctor who will fit our big picture need which is someone who we are comfortable with, we can ask questions of, give suggestions to and have real conversions with that is someone who will be a true partner with us.

Although I have some little idiosyncrasies with my current doctor, so far we have a good rapport. I have only gone to her twice so it is still a pretty new relationship, but I am grateful that it was not one that lasted only one visit like some of the others had as you could imagine by some of the comments above. She has plenty of fresh ideas which is something none of my other doctors ever showed.

I feel I am no longer a puppet of any of my doctors. I can now make my own choices and ask appropriate questions. If needed, I know where to go for research before and after a visit. It makes me feel so much more liberated.

Sunday, May 3, 2009

No Past Ghost Doctor Regrets - Part I

I still get visited by my scary ghosts of doctors past. I'm not going to say that I regret having gone to any of them because I have learned from all of them one way or another - one lesson or another. If anything, they have helped me to grow up and assert myself better.

I have also had my sister Pam come back to me with stories of how she has used me as an example of when she taught someone else how to stand up for themselves to a doctor; so how could I ever regret the path of doctors I have ended up taking?

If you know anything about Migraines, you know that if you spend just ten minutes researching it on the Internet that you will come across the name Teri Robert. She is a patient advocate, author and manages the MyMigraineConnection website. I mentioned Teri because much of what I have learned, I have learned from her; including standing up for myself. I honestly don't know where I would be if I didn't bump into her, learn what I have about Migraines, how to stand up for myself and become more assertive with doctors which includes firing them when they are not providing me with the level of service I am paying them for and deserve.

In the beginning, I was a true marionette of these doctors. Although I didn't know much about Migraines, it just didn't seem right what they were saying or doing. But who was I? Just little old me. After all they were doctors! My mama taught me well; taught me how to respect others, right? WRONG!!!!!

Do you know what? Doctors don't know everything about Migraines! Did you know that doctors fresh out of medical school can sometimes have only ONE HOUR of training on Migraines? And then neurologists aren't necessarily Migraine specialists either, but there actually are doctors who do specialize in treating Migraine disease. Only if a neurologist chooses a sub-specialty, will they be a neurological specialist. Otherwise, they will be like a general practitioner of general neurological diseases. So if you go to a general neurologist, they may not be a Migraine specialist. Not many neurologists will go on to specialize in Migraines or headaches. Luckily, not everyone needs a true Migraine specialist. Unfortunately, those who need a true specialist may need to drive many, many hours or even fly to a true Migraine specialist, but then they usually find it worth it to go to someone who knows what they are doing.

Let me just straighted some things out. I read a lot about Migraines and have more than a basic understanding of them. I don't understand medications. I never cross that line when I am talking with a doctor. I never try to come across that I know more than I do. I never try to come across as an Internet know it all. I do come across as knowing about my Migraines, my triggers and knowing me. It is very important to understand yourself.

If I don't understand something I will ask the doctor. And yes, I have been known to ask the doctor questions I do know the answers to. I do this for a few reasons. I need to understand their knowledge, to know if they will make up answers, their approach to answering my questions, their willingness to converse with me, my willingness to ask follow up questions, to get clarification on answers I'm unsure about the validity of, how comfortable I am with them, if I can learn additional things on top of something I already know about, how they take my questioning and more. I think you get the idea.

My ultimate goal is to find a doctor I can partner with. I need someone I feel comfortable working with, who feels comfortable working with me, someone I can trust and someone who trusts me. They also need to understand Migraine disease and the over 100 medications which have been used as Migraine preventatives.

Teri taught me enough about Migraines and standing up for myself with doctors that I will find the right doctor and treatment for me. I am not there yet, but I have the confidence that I will get there.