Sunday, September 26, 2010

New Neurologist is like New Boyfriend

Sometimes I feel like a new neurologist is like a new boyfriend. What I mean by that is unfortunately for them, they have to put up with some of the old baggage we bring with us from our old boyfriends even if it's not in our best interest.

You know how it is, if we extend ourselves out too much or too soon, we might get hurt again. Never mind that we might be hurting ourselves or not finding our true love because we are holding back too much.

This could also be related to if we don't tell our new neurologist everything we should because they may jump to the same wrong conclusion that a prior old neurologist jumped to. This could be hurting us when our new neurologist should have the full facts about us so we can hopefully find that true magic bullet to help our Migraines. The other part of this is if our new neurologist is not going to listen to everything we have to say and jump to the wrong conclusions, isn't it better to find out upfront that they are not the right doctor for us?

Like many people, I have a lot of stress going on from everywhere. I don't talk about stress with my doctors because to me, it is just a part of life. I know that certain times of the year, my stress will be increased. I know that it can be increased at any other time without notice too and don't even think about talking about money.

I had an old neurologist that made it even harder for me to talk about stress today even though I never talked to her about my stress levels. With this old neurologist, she put me on an anti-anxiety medication alone and expected this to take care of my Migraines. She didn't seem to like when I called to say it wasn't helping and I needed something else before our next scheduled appointment. I also provided her with an interim solution which she reluctantly agreed to accept. Sometime later I found out that she was convinced my Migraines were caused by stress and could not understand why the anti-anxiety medication did not help. So you can see one of many reasons she is no longer my doctor.

With my current doctor, I have only casually mentioned stress once and only because my BP was very high for me during one of my visits where I was too stressed out to come up with something else. I have white coat hypertension during the first few appointments with any new doctor where I let them know upfront about it and my current doctor was no exception in the beginning. I have been well past my white coat syndrome with her.

I know I'm going to have to have the stress talk with my current doctor soon. I do believe, in addition to other things, stress is interfering with my Migraines to some extent, but I also believe that stress is an exasperating factor and not a direct trigger. I know when I have the stress talk with my doctor that I am going to have the bigger talk with her that is long overdue, but I need to be mentally ready for the talk. I really like my doctor and she has helped me in many ways, but I am going to have to have that general Is Stress a Trigger or Exasperating Factor talk with her too.

She has mentioned on a number of occasions how stress can be a big trigger especially for her; she is also a Migraineur. I have ignored these comments so far and not subjected her with my opinion or challenged her on that statement yet, but the time is coming that I feel I need to address it. I don't think I'm going to be comfortable talking about my stress with her until I let her know my opinion on stress and am able to talk about it intelligibly. My doctor has listened to me on many of my far fetched ideas in the past. She is smart enough to make up her own mind in many areas. As long as she is open to the idea and doesn't shut it down right away, that is all I can ask and I believe she will do that.

My doctor is also a member of the International Headache Society (IHS). The IHS had moved stress from their trigger list to their list of exacerbating factors a few years ago. I will mention that to her as well as a lot of the points that Teri Robert makes in her MigraineCast on Is Stress a Migraine Trigger which she also has as a transcript of the podcast written out.

I have a lot to cover during my next doctor's visit since so much has gone on since my last appointment. I'm not sure if I'm going to be able to have our stress talk then, but if I want to be fair to my boyfriend, I mean my doctor, no I really mean myself, then I am going to have to have this talk sooner rather than later.

Who knows, if I can open her mind on this one, she may even make a better boyfriend for some of her other patients...


Saturday, September 25, 2010

Help Your Neurologist be Included in Primary Care Incentives

I have to visit my neurologists every two months. During these visits, my neurologist gives me a mini physical, including a neurological physical, checks my medications to see if they need adjusting or replacing and verifies if I need any additional testing.

In my opinion, my neurologist provides me with a similar primary care that a PCP gives to their patients plus the extra care I need.

Why am I telling you about this and why is this such a big deal?

The recent health care reform act, the Patient Protection and Affordable Care Act (ACA), provides incentives to encourage primary care but didn't include neurologists among the eligible health care providers. As stated above, my neurologist provides me with my primary care. I wouldn't dream of going to anyone else at this point in my life. The fear is that with the exclusion of neurologists in this incentive program could further complicate the lack of Migraine and headache specialists we are already faced with.

How can you help?

Congressmen Michael Burgess (R-Tx) and Russ Carnahan (D-Mo) sent a letter to your US House members on September 21st. You can email your US Representative and ask him or her to sign this letter in support of your neurologist! It's real easy for you if you follow this link to send an email message to your Representatives As Soon As Possible.

You don't even need to know their email address! This automated system will allow you to add a personal message to an email asking your Rep to sign the letter and then will find your Reps email address based on your address. When I filled out my email, it took me about 10 minutes to complete everything.

Please contact your US Representative now!


Tuesday, September 21, 2010

No More OJ Oops

Sometimes I wonder if I was better off just jumping into the elimination diet or if I should have spent a little more time planning it like I did the first time I did the diet. You see, I normally have to plan everything. This allows me to get my mind in the right state so I will be ready for most things that come my way.

On the other hand, I really didn't want to delay any longer then I needed to after I convinced myself that this was the next option I had to take - again. From this perspective, the sooner I started, the faster I could get through it, but not rush through it.

The first week flew by quickly as there were so many other things going on that I didn't have much time to think about anything. In this case, not being able to think was a good thing. After the first week, I went food shopping. While putting away the groceries and without even thinking, this time not a good thing, I took a sip of some orange juice I just picked up which was definitely not on my diet.

When I do these types of blunders, I try to make the best of it. The good news is that I had a reaction to the orange juice. I view this as good for several reasons and not because it may be a food trigger - that wouldn't be good at all, but because it will help me to stay focused and stay on the diet in a much more determined manner.

The first time I did the elimination diet, orange juice cleared just fine. I'm not ready to rule it out yet as it could be some of the things that were added to the particular OJ I picked up. Hey, I have to keep some type of faith open. I really enjoy some OJ in the morning and I fear this is one of the things that may have been setting me off regularly, but I don't believe it was the only thing if it is a trigger.

This little oops is going to help me stay focused because I don't want to lose any ground that I have already gained while on the diet this time. I believe this cleansing time is a very important part of the diet. After reviewing my chart from the first time I did the diet, I could see I had no change in head pain during the first two weeks and then it started reducing week after week after that.

I've had other challenges this time that I didn't think about or have the last time; partially because I just jumped right into the diet. This is football season which means if I want to see my son play and he is not playing at his home college, then I have to travel to another state and further away. You could say 'big deal'. But, when you are on a very controlled diet where you can't eat out at all yet, it is a big deal. Luckily(?), I couldn't make it to his only away game so far.

Do you know what else is a big deal? Home games. Typically home games mean eating a lunch and dinner away from home. One of the things I loved the most about my son playing football last year is that it gave me the excuse/reason to intrude on him regularly and then we would go out to dinner together after the game. It was our time together as well as a little way of making up for me bombarding into his college life. He loved it too or at least I'll keep telling myself that!

What have I done so far? It's actually worked out pretty well. For home games, I packed my lunch and dinner. I ate my lunch before the game and then dinner right after the game or just before we got to the restaurant. I wanted to make sure I was not hungry at all which is a lot tougher with one of the medications I'm on now where I want to eat all of the time. My son ordered a delicious, non cafeteria food and even a desert while I had my glass of water. Believe me, I am not complaining. It actually worked out great. I liked watching my son enjoy his meal and warm apple pie.

The other good thing about really wanting to stick with the elimination diet? In the two and a half weeks I've been on it, I've lost three and a half pounds so far! Although it's a great side effect and I can afford to lose a lot more, I'm not in this to lose weight. I have to find out if I have more food triggers. I do believe I have new food triggers that passed the elimination diet the last time I did it. I guess I'll find out soon enough. No more slipping up!


Sunday, September 19, 2010

Which Rat are You?

I was talking with a very interesting character recently who does something in the medical field. I don't know exactly what he does as he was very secretive about many things, but he is some type of a consultant that works with many different types of doctors including doctors who make sure different medical studies that go on are legitimate where all protocols and avenues of a study are followed.

Anyway, we got onto the subject of Migraines which led to many other different conversations. One place he went is that he talked about a rat study that was done on pain.

He said that there was a study done where they took three rats from the same family so the genes would be very similar. The rats were put on a heated surface where they wouldn't be able to leave that surface. I really hope this study was done with more than three rats or I don't know how viable such a small study would be, but then, that was not the point of his story.

Anyway, Rat A hopped many times after the heat was set on - let's say 180 times in a given timeframe to try to evade the heat, Rat B 100 times and Rat C 10 times. Then they gave the three rats an opiod derivative and repeated the test.

Which rat did the opiod affect the most? Which rat cut down their percentage of hops the most? What do you think and why?

The rat that the opiod helped the most was Rat A. It seems that if you are more sensitive to pain, then you are more sensitive to pain medications where it will help relieve your pain better than it may help other types of rats or people. Like I said, this is what this character said, but where it made the most sense to me is that I feel that Rat C explains me.

I am not the type to keep hopping around to avoid the heat or pain and I don't take much pain medication. I went most of my Migraine 'career' not taking any NSAIDs or even knowing that triptans existed. I recently received a synthetic opiod, but didn't find it to be very effective. I am sure I am not taking this pain med as often as I should either.

Which rat are you?


Wednesday, September 15, 2010

Up and Down Week

This has been such an up and down week. So far, I've been doing pretty good with the elimination diet although you wouldn't be able to tell by the reduction in Migraines yet. I think the first week can be very tough on many levels.

I can tell it is already helping; not by the reduction of Migraines since that hasn't happened as this has been an unavoidable trigger week, but I realized that my face was only numb one day this week. That is a great improvement and something I suspect is from food. Whenever I start craving other foods, I have to focus on my goal. I want less Migraines and if I have more food triggers, I need to find them. For me, this is the best way to find them.

This has also been a fun filled week - both good and not so good. Here is a list of some of the things from this week:

> I was approved for my IFMLA. I have to say, my doctor is really smarter than me especially when it came to filling out the health care certification form. She didn't put down a certain number of days per week or month. She put down an estimated number of episodes per month with up to a specified number of days per episode. I thought that was brilliant. My company's leave department accepted this along with a six month recertification period!

> We were told that they are selling the building I work in. We don't know where we will be moving yet, but we should be moving within the year. I have no guarantees about my light accommodations right now either. This is what makes me the most nervous as it has been the biggest savior to me.

> My desktop at work crashed.

> Someone on our team was carted away by ambulance this week. She's fine and actually came back to work the next day.

> This was an extremely busy short week at work. It seems this week we needed to cram in five days of work into the four days we were there because of the holiday.

> I babysat for two nieces/two nephews at the beginning of this week and then another two nieces at the end of the week. I've gotten into showing up with those silly bands on my wrist and then let them choose whatever ones they want until they are all gone. That seems to start the night off right.

To start cutting back, I decided I would not drive to my son's football game which was played a few states and quite a few hours away. I really don't like missing his games, but I didn't think I should be driving there at that time. He was better with this decision than I was which made it easier.

With the impending move to an unknown building with unknown lighting and other surrounding triggers, I am real happy to have the IFMLA. I keep flashing back to a horrible multiday client visit I had a while back where I was under these lights that were just awful. By the time I left there, I had a multiday mega-Migraine which was tough to beat. I can't go through that everyday.

I am hoping this next week will get a little better. I feel the harder I am trying at work right now, the more I am falling behind. Sometimes I think if I cut back more that I may actually get more done than I am now. I just need to get over a couple of hurdles. I will get through this. I have to...

PS - I was set to post this last Sunday. Can you believe my laptop crashed too?!?!


Saturday, September 11, 2010

One Lovely Blog Award

Jamie from Chronic Migraine Warrior and Migrainista from Migrainista both thrilled me by nominating my blog for the One Lovely Blog Award. I want to thank Jamie and Migrainista for the nominations. It's hard to think that the everyday life and thoughts of a Migraineur can be thought of as lovely, but I really appreciate the award and for being recognized by these wonderful bloggers.

Here is how the rules work:

> Accept the award and post it on your blog with the name of the person who has granted the award and his or her blog link.

> Pass the award to 15 other blogs that you’ve newly discovered. (if possible)

> Remember to contact the bloggers to let them know they have been chosen for this award.

I enjoy reading many Migraine and other related blogs. Many have already been nominated. Below are five additional blogs I like to read.

Head Wise

Gypsy Shalunya

Pink Pearl Girl's Migraine World

Sweet Migraines

Mimi's Primrose Lane

Please make a visit to the blogs I've chosen to pass the award on to. They're all great!

Sunday, September 5, 2010

Impulsive eDiet

I've been doing a lot of thinking since my last doctor's visit. I've kept this long term monthly Migraine chart for almost four years. Prior to going to my last doctor's appointment, I was able to identify some seasonal Migraine peaks which I hadn't notice before. Another thing that I observed on this chart is that the number of Migraines I've developed was never as low as it was while I was doing the elimination diet even during my seasonal peak periods. I think I've seen this before, but was able to excuse it away as other things which is probably partially right.

Although I've been pseudo thinking about the elimination diet recently, I haven't been serious enough to try it again. I've always been someone who has to plan out everything I am going to do and definitely something as big as changing my dietary needs to have every detail planned out. That's what I did the first time I completed the elimination diet.

When I did it before, I tried to do everything as thoroughly as possible so I would never have to do it again. Before that, I had never done any type of diet and knew I would never want to do it again. This first time, I planned it down to the date I was going to start it, the Migraine medication I would change back to for it and my daily food menu. I read everything I could find on the internet and even bought a couple of books to read.

Anyway, I did something very atypical of me today. I jumped into the elimination diet again this morning as a spur of the moment thing. I started seriously thinking about it last night. I gave away the books I had originally used and could only do minimal reading online. I am nervous about the medication I am on now as I always want to nibble which is not a good thing while on any type of diet. Being a planner, this is very hard for me to just jump into, but I felt like I needed to put a stake in the ground and just go for it. Exhale. I know I need to do this again and I figured the sooner I started it, the better off I would be.

Using my suspicions and upon reviewing my charts, I finally came to the conclusion that I really have no choice but to find out if I have any additional food triggers. I really don't want to do this, but I have not been able to identify if I have any other food triggers even if I suspected them.

When I did the elimination diet the first time, I found a lot of good triggers. However, I believe I have developed additional food triggers since then. When I did the diet before, I chose one meal for breakfast, one for lunch and one for dinner along with a snack that I could have whenever I felt like munching. I am doing that again this time because I can't remember how I would have changed it up from the last time.

I want to stick with this basic diet for at least six weeks. Of course this is not the best time to do the diet, but there really never is a good time to start. Since I didn't even know until today, I haven't told anyone about it yet which usually gives me the inspiration to keep going. I don't want to deviate from the diet as I really want to figure out if I am missing any other foods or ingredients that I should stay away from. I am hoping it will be easier to add back this time because I know many foods I won't have to add back since I already know they are triggers.

The other thing that keeps running through my head that really shouldn't be is the reaction of two previous doctors I used to go to. I totally don't understand why, but they were both down on the elimination diet. I know it is ludicrous, but this type of ignorance always baffles me into thinking I must be missing something although I really don't think so.

I don't see how I can justify, even to myself, going to a better Migraine doctor than the one I currently go to if I feel there are still things I should be trying to get my Migraines under better control first. I feel that if I were to go to a different Migraine doctor today and he were to ask me about my diet, I would have to say that I don't know if I have additional food triggers. At that point, I think he would tell me to find out. Unfortunately, he would not be able to tell me what my food triggers are since there is no easy test to tell us. That would be real nice!

So I am jumping feet first into another adventure I have not prepared for. Although I have been down this road before, the road is very different than it was the first time I traveled it. I don't really see another choice for me right now, but I know I need to embrace it.

I know it's only day one, but I think I've already endured my first hurdles while food shopping this morning. Ready or not, I've just started it again...


Saturday, September 4, 2010

Vacation for Migraines

Have you ever taken a vacation to help with your Migraines? Wait, I don't think I asked that question right. Have you ever taken a vacation so you could work on your work from work to try to help with your Migraines?

That's what I did this week. OK, you can put that big "L" on my forehead now. I know it belongs there, but I had to take a week of vacation from work for a few reasons. I have not been able to catch up or even keep up with work so the thought of taking time off was a huge stressor until I realized I could get caught up during my vacation time on an overdue project and a couple of other things that must be done without having the everyday interruptions from email, phone calls and people dropping by with questions or giving me more things to do.

This big project was due in July so it has been hanging over my head for some time. Although it is due in July, I do not get the information I need to start putting everything together until July. There are also other extra things due that month that do not have the same wiggle room that this project has in due date, but the pressure is kept on until it is completed.

These are all in addition to the normal work we have to do too and it is virtually impossible to do during my already normally expanded workday. These projects reoccur annually. I believe this added stress is a big reason for my increased Migraines since it will exasperate the extra heat and weather triggers that come with the summer time.

With the rise in Migraines and symptoms during this time, I am not able to put in extra time at night or during weekends to work on this project either. By the time I get home, I am exhausted. On weekends, I need to physically rest up on one day and take care of home stuff on the other day. I wouldn't be able to function if I didn't do this.

During this vacation week off, I have been able to finish the majority of the project. After I return to work, I will still have about another sixteen hours of work left on it that could not be done during the week since it has to be completed in the office.

I will keep track of this week off to see getting more caught up has helped with my Migraines. I am now contemplating taking a week off in July every year so I can finish the project then, when I can be away from the office so it does not hang over my head as long.

I know I still deserve that "L" on my head, but I also feel like I've given up a lot more for my Migraines than a few vacation days especially if it does help put my head back on straight and allows me to stop being so stifled while I am able to move forward again.

What kind of things have you done that you really should not have had to do in order to help with your Migraines? Did it help?