Month: February 2008

Coping, Triggers

Sunny Weather = Fewer Migraines? The Everlasting Hunt for Triggers

Kerrie Smyres

Seattle from Kerry ParkYummy food, Rock Band, neighborhood walks, warm weather. Mild chronic daily headache levels and nothing more than moderate migraine symptoms. That’s what the last four days have been like for me. I’ve been so happy.

Is the convergence a coincidence? The good mood and beautiful weather certainly go together; the mild pain and weather do, too. On the big question, if mild pain and great weather are related, I have no answer.

Most people with migraine — I don’t know about other headache disorders — will tell you that weather is definitely a trigger. Researchers and headache specialists agree. Unfortunately, data are sparse and self-reports of headache pain and weather connections are inherently flawed. According to a Mayo Clinic neurologist,

Several studies suggest that weather changes trigger migraine headaches in some individuals. Study results indicate that some people who have migraines appear to be more sensitive to weather changes, such as changes in weather patterns, temperature, absolute humidity and barometric pressure. The mechanism by which these factors may trigger migraines in these individuals isn’t known.

There’s no clear evidence of a link between weather changes and other types of headaches.

Changes in weather patterns, temperature, absolute humidity and barometric pressure are potential triggers. Anyone with migraine is prone to a migraine episode from any change in weather? A little vague, isn’t it.

This is no different than saying I’m more likely to trip on a curb when the sun is shining than when it isn’t. Finding a reason should be easy. Some possibilities: I spend more time on sidewalks when the weather is nice. I’m looking around and not paying attention. Or the shoes I wear when it isn’t raining don’t fit as well as my winter shoes. Or the sun is so bright I can’t see the step. Or there are so many people in the crosswalk I can’t see where I’m going. Or the coffee I had made me shaky.

You get the point. Isolating variables in everyday life is impossible. Maybe two or three parts of my tripping scenario are to blame. Could be just one or something altogether different. I could trip on a Tuesday and again on Saturday. Unlikely that they will have the same cause.

I understand all this rationally, but still want to know what’s triggering my migraines! I’m second guessing every possible angle. Funny that when my chronic daily headache or migraine is bad I search for a reason. And when they are good, I search for a reason. Sounds like someone has control issues.

I cannot change the weather and I haven’t had any luck in tracking its relation to my head. Even if I could know when the weather would trigger a migraine, I don’t know if I’d want to. I don’t care if I can predict a migraine two days in advance. I can’t change it and I’ll spend the interim anxious it will hit any moment.

Have you found a strong correlation between weather and your migraines or headaches? Is it useful information to have? Answer on the online support group and forum or leave a comment below.

Chronic Migraine, Coping, Friends & Family, Resources, Society

Helping Others Understand: A Letter to People Without Chronic Pain

Kerrie Smyres

Wish that your friends, family and coworkers had a better idea of what you’re going through? This anonymous letter has circulated on forums and by e-mail for a few years, but is always worth repeating.

Letter to people without chronic pain:

Having chronic pain means many things change, and a lot of them are invisible. Unlike having cancer or being hurt in an accident, most people do not understand even a little about chronic pain and its affects, and of those that think they know, many are actually misinformed.

In the spirit of informing those who wish to understand:

These are the things that I would like you to understand about me before you judge me.

Please understand that being sick doesn’t mean I’m not still a human being. I have to spend most of my day in considerable pain and exhaustion, and if you visit, sometimes I’m not much fun to be with, but I’m still me– stuck inside this body. I still worry about school, my family, my friends, and most of the time, I’d like to hear you talk about yours too.

Please understand the difference between “happy” and “healthy.” When you’ve got the flu, you probably feel miserable with it, but, I’ve been sick for years. I can’t be miserable all the time. In fact, I work hard not being miserable. So, if your talking to me and I sound happy, it means I’m happy. That’s all. It doesn’t mean that I’m not in a lot of pain, or extremely tired, or that I’m getting better, or, any of those things. Please don’t say, “Oh, you’re sounding better!” or “But, you look so healthy!” I am merely coping. I am sounding happy and trying to look “normal.” If you want to comment on that, you’re welcome.

Please understand that being able to stand up for ten minutes doesn’t necessarily mean that I can stand up for twenty minutes or an hour. Just because I managed to stand up for thirty minutes yesterday doesn’t mean that I can do the same today. With a lot of diseases you’re paralyzed and can’t move. With this one, it gets more confusing everyday. It can be like a yo yo. I never know from day to day how I am going to feel when I wake up. In most cases, I never know from minute to minute. This is one of the hardest and most frustrating components of chronic pain.

That’s what chronic pain does to you.

Please understand that chronic pain is variable. It’s quite possible (for many, it’s common) that one day I am able to walk to the park and back, while the next day I’ll have trouble getting to the next room. Please don’t attack me when I’m ill by saying ” You did it before” or “oh I know you can do this!” If you want me to do something, ask if I can. In a similar vein, I may need to cancel a previous commitment at the last minute. If this happens, please do not take it personally. If you are able, please try to always remember how very lucky you are to be physically able to do all of the things that you can do.

Please understand that the “getting out and doing things” does not make me feel better, and can often make me seriously worse. You don’t know what I go through or how I suffer in my own private time. Telling me that I need exercise, or do some things to “get my mind off of it” may frustrate me to tears and is not correct. If I was capable of doing some things any or all of the time, don’t you think I would?

I am working with my doctor and I am doing what I am supposed to do.

Another statement that hurts is: “You just need to push yourself more, try harder.” Chronic pain can affect the whole body or be localized to specific areas. Sometimes participating in a single activity for a short or a long period of time can cause more damage and physical pain than you could ever imagine. Not to mention the recovery time, which can be intense. You can’t always read it on my face or in my body language. Also, chronic pain may cause secondary depression (wouldn’t you get depressed and down if you were hurting constantly for months or years?), but it is not created by depression.

Please understand that if I have to sit down, lie down, stay in bed, or take these pills now, that probably means that I do have to do it right now. It can’t be put off of forgotten just because I’m somewhere or I in the middle of doing something. Chronic pain does not forgive, nor does it wait for anyone.

If you want to suggest a cure to me, please don’t. It’s not because I don’t appreciate the thought, and it’s not because I don’t want to get well. Lord knows that isn’t true. In all likelihood if you’ve heard of it or tried it, so have I. In some cases, I have been made sicker, not better. This can involve side effects or allergic reactions. It also has includes failure, which in and of itself can make me feel even lower. If there was something that cured, or even helped people with my form of chronic pain, then we’d know about it. There is worldwide networking (both on and off the Internet) between people with chronic pain. If something worked, we would KNOW. Its definitely not for lack of trying. If, after reading this, you still feel the need to suggest a cure, then so be it. I may take what you said and discuss it with my doctor.

If I seem touchy, its probably because I am. It’s not how I try to be. As a matter of fact, I try very hard to be “normal.” I hope you will try to understand my situation unless you have been in my shoes, but as much as possible, I am asking you to try to be understanding in general.

In many ways I depend on you — people who are not sick. I need you to visit me when I am too sick to go out. Sometimes I need you to help me with the shopping, cooking or cleaning. I may need you to take me to the doctor or to the store. You are my link to normalcy. You can help me to keep in touch with the parts of my life that I miss and fully intend to undertake again, just as soon as I am able.

I know that I ask a lot from you, and I thank you for listening. It really does mean a lot.

Someone asked if I thought it was appropriate to share the letter with her family and boss. Will it backfire if the recipients haven’t shown an interest in understanding your pain?

photo credit: desi.italy

Coping, Mental Health, News & Research, Treatment

Treating Depression With Music Therapy (and Lifting a Funk With the Dave Matthews Band)

Kerrie Smyres

guitar music therapy depressionI was in a horrible mood the day before I emerged from hibernation. Disgruntled, “a state of sulky dissatisfaction,” according to the Visual Thesaurus, is too mild a word, but combined with gloom and self-hatred it paints the picture. I made it through the day OK, but was out of my mind by evening. Hart had a work dinner, so he wasn’t around to break me out of my funk.

I considered turning music on, but craved silence. When my mood hadn’t lifted by 8:30 p.m., I was willing to try anything to break free from my self-imposed cage. Perhaps the Dave Matthews Band could cheer me up.

A smile blossomed as soon as I hit play. Duh, Dave Matthews and the Dave Matthews Band have never failed to make me happy. Except when I need to wallow in bleak lyrics and feel sorry for myself. Actually, I feel better after listening to them then, too.

Recent research indicates that music can be an effective depression treatment. The study was of listening to or creating music with trained music therapists, not simply turning on your iPod. Still, the power and potential of music is undeniable.

The finding that music therapy offers a real clinical benefit to depression sufferers comes from a review by the Cochrane Collaboration, a not-for-profit group that reviews health care issues. Although there aren’t many credible studies of music therapy for depression, the reviewers found five randomized trials that studied the effects of music therapy. Some studies looked at the effects of providing music therapy to patients who were receiving drug treatment for depression. Others compared music therapy to traditional talk therapy. In four out of five of the trials, music therapy worked better at easing depression symptoms than therapies that did not employ music, the researchers found.

Two findings really jumped out at me: Music therapy is appealing to many people who aren’t interested in conventional depression treatments, like teenagers. Also, people less likely to drop out of music therapy than other therapies.

My only question is if playing Rock Band qualifies as making music.

Related posts:

Resources, Symptoms

Migraine’s Visual Aura & Hallucinations on the New York Times Migraine Blog

Kerrie Smyres

The deep explorations of visual aura and hallucinations in the two latest entries on the New York Times migraine blog provide education far beyond what most migraineurs encounter; including one who writes about headache disorders and migraines nearly every day (me!). Check out the following posts to expand your knowledge.

Patterns
Acclaimed writer and neurologist and migraineur Oliver Sacks explains the neurophysiology of visual auras and describes the patterns, or “geometric hallucinations,” some see during an aura. His intricate depiction is a fascinating eye-opener for those without aura and excellent information for those with it.

Lifting, Lights and Little People
Siri Hustvedt, author and migraineur, wrote of the hallucinations she has had with migraine episodes.

It is comforting to think that visual perception is a matter of taking in what’s out there, that a clear line exists between “seeing things” and the everyday experience of looking. In fact, this is not how normal vision works. Our minds are not passive containers of external reality or experience. Evidence suggests that what we see is a combination of sensory information coming in from the outside, which has been dynamically translated or decoded in our brains through both our expectations of what it is we are looking at and our human ability to create coherent images. We don’t just digest the world; we make it.

You can hear more from New York Times migraine bloggers Siri Hustvedt and Paula Kamen on NPR’s Talk of the Nation. Headache specialist and founder of the Michigan Headache and Neurological Institute Joel Saper weighed in and responded to callers’ questions. Congratulations to Migraine Blog, Migraine Chick and Somebody Heal Me for being mentioned on NPR’s website.