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Is a Placebo as Effective as Maxalt?

When the general media got hold of the study results about the efficacy of a placebo versus that of the triptan Maxalt, the reporting — and comments — inevitably became about thinking one’s way out of a migraine. Readers, and even some reporters, pointed out that of course a placebo works for migraine, but it wouldn’t work for a legitimate illness, like cancer or heart disease. Wrong, wrong, wrong!

Starting from when we learn about it in grade school, the placebo effect gets oversimiplifed to: if you think a sugar pill is effective medicine, it will provide relief. The phenomenon is far more complicated than that. The placebo effect may have a positive-thinking element to it, but it also involves complex brain activity — in the physical brain, not the thinking mind — that’s only now starting to be understood. And it has shown to have an effect for all sorts of ailments, not just those that involve subjective reporting.

The placebo effect also involves information and patient empowerment, as Diana Lee explains in Placebo Effect & Migraine: What Does the Research Mean? It’s worth reading the entire insightful piece yourself, but here’s an excerpt:

Rather than demonstrating you can think your way out of experiencing the symptoms of a migraine attack, the results support the idea that how we talk about a treatment can increase the effectiveness of that treatment by 50 percent or more…. If we know a particular medication is likely to be effective for a migraine patient and couple that knowledge with a physician/patient discussion that empowers the patient with the same knowledge, this can only benefit patients.

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Olfactory Overload

Does anyone else hear about companies’ attempts to “enhance” our olfactory experience and think, “NOOOOOOO!”?

The latest of these endeavors to assault our senses is the oPhone (“o” for olfactory). A person can attach an smell to a message and the recipient “gets” to smell it. Both the sender and receiver have to have oPhones for this to work, so you won’t be forced to smell every text message.

Of course, if this technology takes off, it won’t matter if you don’t have an oPhone yourself. We will all be surrounded by people who are not only shouting into their cellphones, but polluting the air with even more artificial scents than already abound.

As someone who has scent-triggered migraines, news reports of odor-spreading technology fill me with an almost visceral dread. Living in the modern world with heightened senses is already hard enough. At least sounds can be muffled with ear plugs and lights can be managed with TheraSpecs. There’s no effective way to block odors.

Let’s hope that even people who aren’t sickened or panicked by sensory overload will have no interest in smelling a fake version of the croissant their friend just ate.

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Thank You!

Many thanks to everyone who donated to my birthday fundraiser to benefit the American Migraine Foundation’s 36 Million Migraine campaign! I appreciate your thoughtfulness and everyone with migraine appreciates your support.

You raised 28% toward the $1,000 goal and the fundraiser is still open. If you haven’t joined us yet, please consider donating today. Your donation doesn’t need to be large. In fact, if every American with migraine donated just $1, $36 million dollars could go to migraine research.

Some astonishing facts about migraine:

  • Migraine is the third most common disorder on the planet.
  • It is the seventh highest cause of of disability globally.
  • It is by far the most disabling neurological condition worldwide.
  • 36 million Americans have migraine. Most have three or fewer attacks each month, but 3% have chronic migraine.
  • Migraine costs the United States more than $20 billion each year in direct medical expenses and indirect expenses, like missed work and lost productivity.
  • Less than 1/20th of 1% of the budget of the National Institutes of Health – about $16 million a year – is allocated to migraine research. $260 million would more accurately reflect the prevalence and magnitude of migraine.

 

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Our Thoughts Do Not Cause Illness, We Cannot Think Our Way to Health

What’s the likelihood that the content of the community college meditation class I’m taking in order to qualify for student health insurance would infuriate me? Almost inconceivable, I would have thought, just as I would have thought it impossible that a PowerPoint could cause me to literally shake with rage. The first slide says:

“If you don’t want to be ill… Speak your feelings.

Emotions and feelings that are hidden, repressed, end in illnesses as: gastritis, ulcer, lumbar pains, spinal. With time, the repression of the feelings degenerates to the cancer. Then, we go to a confidante, to share our intimacy, ours “secret”, our errors! The dialogue, the speech, the word, is a powerful remedy and an excellent therapy!”

And it goes on slide after slide with similar explanations after each of the headings, “If you don’t want to be ill…”

  • “make decisions”
  • “find solutions”
  • “don’t live by appearances”
  • “accept”
  • “trust”
  • “do not live life sad”

Really? All I have to do is think the “correct” way and I won’t have chronic migraine? Gee, sure wish I’d known how easy it is to erase a neurological disorder. And I bet my doctors haven’t told me about this quick fix because they’re shilling for pharmaceutical companies.

Our thoughts do not cause illness. In case that’s not clear: OUR THOUGHTS DO NOT CAUSE ILLNESS!

As with so many widespread misguided notions, there’s a grain of truth in the connection between thoughts and illness. Stress, which is often intensified by thoughts, can exacerbate many already existing illness, including migraine and other headache disorders. Chronic stress can lead to ulcers, heart disease or adrenal failure. Still, stress is not solely perpetuated by thought, but also by circumstance. Furthermore, a genetic predisposition to a particular illness is usually present in those who develop so-called stress-related illnesses, and environmental factors can also contribute to illness. In other words, the connection is not as simple and clear-cut as this PowerPoint states.

Illness is fickle and cruel. It cannot be controlled, despite our greatest wishes. It can’t even always be treated. Our thoughts can make illness easier to bear (read How to Be Sickfor fabulous guidance on this), they can inspire us to keep trying, but they cannot, cannot cure us. Perpetuating this belief comes at the great cost of further alienating the sick from the healthy. People with illness do not need judgment and righteousness, but understanding and support.

Plenty of people are brimming with negativity and hatred, but are perfectly healthy. Many others are fonts of optimism and hope, yet are mired in chronic or life-threatening illness. We are not to blame for being sick, our thoughts are not to blame. No matter how many people, how many teachers, how many PowerPoints by doctors with unspecified credentials may tell us otherwise.

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HIPPA Doesn’t Always Protect Your Health Records

Legally, law enforcement or an “officer of the court” — which includes private attorneys in some states — can subpoena your health records, according to an NPR report on digital information. Even under HIPPA, health care providers “may disclose protected health information” in response to subpoenas. Think this doesn’t apply to you? Your health records could be subpoenaed for legal disputes with an employer, insurance company, or former (or soon-to-be former) spouse, for example. The NPR story tells of a father whose mental health records were used against him in a custody case.

When asked why health care providers provide records willingly, an attorney interviewed for the story said, “The companies generally want to comply with the law in the way that’s least expensive to them. They don’t want to have to hire lawyers; they don’t want to have to send doctors or other representatives to depositions or court hearings. They just want to give you the records and move on.”

While the law has always allowed for the subpoenaing of health care records, electronic records typically turn up more detailed information and cover a longer time span than paper records, according to the NPR story. Logistically, it’s also easier and faster for the office staff to print or send electronic records than it was for them to dig through and copy paper files.

Despite the unlikelihood my medical records will ever be legal fodder, the thought that they could be is chilling. As soon as I heard the story, I wanted to share it so that you all would be aware of it, as well. I’m relying on the accuracy of NPR’s report, since I have no legal background. If you can share a legal perspective, please leave a comment with your insight.