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Severe Migraine Today

Can’t write more — computer screen too bright to look at.

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Pain Receptors in the Bone, Skull & Scalp Pain, and Botox

Headache specialist Christina Peterson‘s comments on the news that a patient’s skin sensitivity may help predict Botox’s effectiveness for migraine explains the exciting research behind the story. Dr. Peterson attended the lecture on the topic at the International Headache Society’s annual conference. She wrote:

This was far and away the coolest lecture, although it was also given at the American Headache Society Meeting. Dr. Rami Burstein, who is a basic science researcher at Harvard, has done some ground-breaking research.

It has been conventional wisdom that there are no pain receptors within bone; the only pain receptors are on the periosteum–the lining on the bone. Dr. Burstein took it into his head to wonder if this were actually true of the skull, and set out to trace the pain pathways in rats. He showed amazing slides of fluorescent lime green nerve fibers shooting right through holes in the bone of the skull (so, yes, your skull can hurt), and terminating at the hair follicle.

So–when people say they have headaches that feel as if their hair hurts, it can be literally true. These nerve fibers were most dense at the sutures in the skull, where the bony plates of the skull come together. And now we know why craniosacral therapy works!

Dr. Burstein has also determined that there are three major types of headache pain:

  • Explosive pain (like you feel as if your brain is too big and will explode out of your head)
  • Implosive pain (as if your head will cave in the pressure is so great)
  • Orbital/eye pain (your eye hurts, or it hurts behind your eye, or it hurts to move your eye)

Unfortunately, you are permitted to have more than one of these in a given headache. He has found that it is the implosive type of pain that is most likely to respond to Botox. [all emphasis mine]

Dr. Peterson’s latest e-mail newsletter, which arrived in my inbox today, explains more about the research. If you aren’t subscribed to the newsletter, you’re missing out on an excellent, up-to-date resource. Take a look at previous newsletters and sign up for future issues.

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It’s a Baby!

Congratulations to Jackie and her husband Jamie who welcomed Donovan James Taylor into the world yesterday morning. Mom, dad and baby are all doing great. We wish their new family all the best!

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Migraine Down, Motivation Way Up

I often worry that even if my migraines were under control, I still
wouldn’t accomplish anything. That the problem isn’t my illness, but
that I’ve become lazy. The last three days have shown me just how much more motivated I am when I don’t have a migraine and my headache is mild.

I’ve taken care of many tasks that hang over me but I usually don’t have the energy for. Even now, with the house picked up and all my phone calls made, I’m looking for more to do.

The voice in my head is saying, “You need to rest. You feel great now, but will crash — hard — if you keep pushing.” I’m proud of that voice. It took so long for it have a permanent spot in my head that I truly appreciate the reminder. I’d listen to it if I didn’t know that a migraine could make my head explode and steal my energy and mind at any moment.

What a relief to know that migraine and chronic daily headache haven’t permanently snatched a integral part of my personality. Maybe they’ve made me appreciate it even more and have (almost) taught me to back off before I overdo it. I’m not ready to give it the Pollyanna treatment, but maybe, just maybe, there are some hidden blessings in this illness.

I’m going to try to listen to the wise voice in my head now. I need to eat a sweet and then will snuggle up with Harry Potter. I encourage you to relax and enjoy your weekend too. Taking care of yourself can be magical.

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Seeking Patients’ Perspectives on Pain for Journal Article

Trisha, an RN with chronic migraine and occipital neuralgia, is seeking patient input for an article for she is writing for a nursing journal. Her focus is patients’ perspectives on chronic pain and what their health care experiences have been. She says,

The reason I want to write this article is because after almost two years on the other side of the fence, so to speak, it’s become glaringly obvious that there is a need for the healthcare community to hear first-hand how it feels to be treated with discrimination simply because you have a disability that isn’t visible to the naked eye. Being refused treatment in the ER, being accused of drug-seeking behavior, and not having access to adequate pain relief complicates the issues at hand and may, in fact, make the pain and suffering we face worse than it already is. Chronic pain sufferers deserve just as much respect and dignity in treatment situations as any other person with a disabling disorder.

Trisha has created a questionnaire for patients who would like to contribute. She asks many questions, but many only require short answers. More importantly, they are questions that anyone with chronic illness should think about. Your responses will help you better understand your headache history and the impact of illness on your life. Think of it as self-administered therapy.

Chronic Pain Questionnaire
I have a questionnaire I’d like to get as many people to fill out **realistically and kindly** as possible in order to base the article on as wide a reference base as I can reach and get responses from. If you’re interested, please fill this out and email it back to me by September 1.

Thank you in advance for taking the time to fill out this questionnaire. Please note that doing so gives me permission to use this information, in context, in an article or articles having to do with chronic pain and associated issues. If you prefer not to answer a question or two, please put N/A in that spot so I know you didn’t overlook it. I appreciate your input.

  1. What is your diagnosis?
  2. How long have you been ill?
  3. What would you say is the attitude of society today toward people with chronic pain issues?
  4. What is your biggest struggle in day-to-day life?
  5. If you could say one thing to the healthcare community, what would it be?
  6. In your opinion, what is the biggest obstacle to receiving quality care and pain control?
  7. Do you feel your pain relief needs are adequately met?
  8. How many doctors did you have to see before you found one willing to treat your pain in an effective manner, if you have found one at this point in time?
  9. Do you feel that chronic pain sufferers are seen as people with legitimate complaints?
  10. Does the use of illegally-obtained medication by high-profile individuals negatively impact the chronic pain patient seeking relief today?
  11. What would you tell society about your situation if you were given the opportunity?
  12. Do you believe there is a medication that, if made available to you in the correct dosage, would assist you in living a more pain-free life?
  13. Do you feel that chronic pain sufferers face discrimination when applying for Social Security Disability?
  14. Do you feel that chronic pain sufferers face discrimination in the workplace?
  15. How has your quality of life been affected since you became ill?
  16. Have you ever been refused treatment or accused of drug-seeking behavior in an emergency room setting when you’ve gone to one while in intense pain?
  17. Have you ever been told that your pain is all in your head?
  18. Does your pain significantly impact what you can do on a day to day basis?
  19. Have you lost your job or livelihood because of chronic pain?
  20. Has your family situation changed because of chronic pain?
  21. Have you lost friends because of chronic pain?
  22. Do you need help doing things that you used to be able to do independently because of your pain?
  23. Does your pain cause you to say or do things that embarrass you?
  24. Are you being treated for depression or anxiety due to chronic pain?
  25. Do you often pretend to feel better than you actually do in order to avoid uncomfortable situations or comments?
  26. What modifications have you had to make to your home to accommodate your chronic pain?
  27. Do you take narcotics for your pain?
  28. Do you take anti-seizure medications for your pain?
  29. Do you have trouble sleeping? 30. Do you have trouble concentrating?
  30. Do you have trouble staying awake?
  31. Are you able to exercise on a regular basis?
  32. Have you gained weight since you became ill?
  33. Have you lost the ability to enjoy the things you used to look forward to?
  34. Have you had to change careers or cut back on your work hours due to chronic pain?
  35. Do you feel like people avoid you because you are ill?
  36. Do you see a pain management specialist?
  37. If so, is this sufficient for pain control or relief?
  38. Do you feel that people with invisible disabilities are looked at differently than people with obvious physical handicaps?
  39. Is there anything else you’d like to say?
  40. Please provide your first name and last initial or a believable pseudonym I can use:
  41. Just for statistical purposes, can I please have your gender and age? You don’t have to answer this one, but it would assist with data groupings.

Thanks again. I appreciate your time and effort. –Trisha