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Tough Girl

Walking hunched up like a terrified rescue dog, I’m trying to ignore the pain reverberating in my head. It’s a day that I should be reading on the couch, but I have things to get done. They’re small, quiet activities, like packaging up some books I sold through Amazon and moving the basil plant I just bought outside. But this damn pain has me in its grip.

Finally I give in and make some tea. Caffeine might knock it down enough for me to put books in envelopes. The kettle on the stove, I’m struck with a brilliant idea — take some Advil. While no other painkiller or headache abortive does much for me, a small dose of an NSAID, like Advil or Aleve, often brings my headaches down a notch or two.

Yet I rarely take any meds. Whether this is a tough-girl complex or fear of rebound, I don’t know. It’s not like I need to prove to myself that I can handle the pain; that’s confirmed for me every single day. Nor do I have any history of rebound headaches.

I like to think that I save the drugs for when I’m on vacation or have plans with friends. Or when my head is so bad that all I can do is lie in bed and moan. Those aren’t the motivators either. I’m just conditioned to not take meds. Maybe it’s so I have something to be proud of.

Today I don’t have to pretend I’m tough. I take the Advil and drink the tea (and get bonus antioxidants!). I’m still waiting for relief. I may have gotten too far into the migraine for it to make a difference. It’s time to lose myself in a light, fluffy book.

I wrote this yesterday but wasn’t up to posting. After resting and reading for a couple hours, I did feel better. Probably just the course of the headache and not the painkillers or caffeine. In any case, I got the books ready to mail and the basil outside.

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News, News, News

There is never enough time for me to post about all that I want to write about. And there’s been a ton of headache news lately. Here are some highlights.

Detailed Results of Trexima Studies (the drug isn’t named in the study, but it looks like Trexima to me)

  • Neck pain and discomfort decreased significantly at two hours for the compound versus placebo in study 1 (35 and 44 percent) and study 2 (28 and 54 percent).
  • Sinus pain and pressure decreased significantly at two hours for the compound versus placebo in study 1 (19 and 33 percent) and study 2 (23 and 38 percent).(1)
  • More patients were pain free at two hours in both studies (52 and 51 percent) compared to placebo (17 and 15 percent) and sustained pain-free response was maintained for significantly more patients (45 and 40 percent), without the use of a rescue medication, to 24 hours, compared to placebo (12 and 14 percent).
  • The compound was effective in rapidly eliminating migraine pain, as measured by pain-free rates at 30 minutes, one hour, two hours and four hours.
  • Incidence of migraine associated symptoms (nausea, phonophobia (sensitivity to sound) and photophobia (sensitivity to light)) was lower with the compound than with placebo.
  • The compound was generally well-tolerated. In both studies, only nausea (3 and 4 percent) and dizziness (1 and 2 percent) were reported in at least 2 percent of patients who took the compound versus placebo (1 and 2 percent for nausea, 0 and < 1 percent for dizziness).

Confusion Over Safety Of NSAIDs For Pain Relief Leads Patients To Suffer In Silence
Almost two thirds of people surveyed (64%) said they were confused about what to take for pain relief because of conflicting information on drug safety that has emerged following the withdrawal of Vioxx (rofecoxib), a COX-2 selective non-steroidal anti-inflammatory drug (NSAID) . Around 4 out of 5 (78%) said they didn’t know enough about the risks and benefits of medicines, whether prescribed or bought over-the-counter. Almost half (47%) said they weren’t using any painkiller medication at all for a number of reasons. Some were concerned about side effects, often after reading worrying news stories about painkillers, some had been advised to stop medication by their PCP and some thought they could manage without them.

Triple Therapy Synergy for Frequent Severe Migraine (registration may be required to read this)
The combination of behavioral migraine management, preventive medication, and optimal acute therapy appears to provide a superior reduction in migraine activity measures, functioning, and quality of life compared with any one alone, according to a study presented at the American Headache Society meeting here.

For these patients, “effective migraine management may require three components: a tailored acute therapy, preventive medication and behavioral migraine management to get the optimal results,” said Kenneth Holroyd, Ph.D., a professor of health psychology at Ohio University in Athens, Ohio, in an oral presentation.

Overweight Kids More Likely to Get Headaches
Children with headaches are 36 percent more likely to be overweight, results of the new research suggest.

“The numbers tell us that being overweight may contribute to kids having more headaches, most often migraines,” said Andrew D. Hershey, M.D., Ph.D., director of the Headache Center and a pediatric neurologist at Cincinnati Children’s Hospital Medical Center. “There likely are a number of causes, including poorer general health, body stress, lack of exercise and nutrition. It may not be that being overweight directly causes migraine, but that the reasons for being overweight cause these children to have worsening headaches.”

Magnetic Device Short-Circuits Migraine Headaches, Suggests Early Research
A hairdryer-sized magnetic device held briefly to the back of the head may short-circuit migraines before the pain starts, suggests preliminary research being presented at the 48th Annual Scientific Meeting of the American Headache Society (AHS).

People With Near-Daily Migraine Headaches Get Relief From Anti-Seizure Drug
An anti-seizure medication “quiets the brain,” providing relief to people with near-daily migraine headaches, suggest results of a randomized, multi-center study being presented at the 48th Annual Scientific Meeting of the American Headache Society (AHS).

FDA OKs the Pain Drug Opana
The drug, called Opana, is an opioid pain reliever taken by mouth. It will come in an extended-release form, called Opana ER, and an immediate-release version, simply called Opana.

The drugs contain oxymorphone hydrochloride, which was previously only available by injection. Endo Pharmaceuticals plans to relaunch the drug’s injected version for hospital use under the new trade name.

If you know of an article that I missed, please add it to the comments. Thanks!

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Why We Have to Fight Docs for Painkillers

Graham, a med student and blogger at Over My Med Body, writes about an encounter with a patient in the ER:

“‘I usually get Dilaudid and Phenergan’ [said the patient]. These are the words that start to change my diagnosis from ‘kidney stone’ to ‘drug-seeking.'”

Check out the whole story in Graham’s post, entitled “I Usually Get Dilaudid and Phenergan.”

[via Kevin, MD]

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Helping Docs Understand DEA’s Assault on Pain Meds

Is the DEA targeting docs who prescribe pain meds to make up for the agency’s past failures? Critics of the agency’s recent crackdown think so, according to a May 19 article in Medical Economics.

“‘If the battles you’re fighting are being lost, then, to win the war, find battles that you can win,’ says David Brushwood, a professor of pharmacy health care administration at the University of Florida, Gainesville, and a critic of government narcotics policy. ‘Doctors are more conspicuous and easier to find than drug dealers, and, besides, they don’t have guns and they don’t shoot back.'”

The six-page article is written for health care professionals, but it is a concise explanation of the problems that doctors face in prescribing pain meds. The recommendations it gives docs to follow when prescribing pain meds can be helpful for patients to understand how to help the doctor function within the system, thus potentially lessening the struggle to get adequate pain relief.

Pain and the Law, a website dedicated to helping health care professionals understand how to work within the law, is linked to from the Medical Economics article and is worth perusing. The site recommends these pain links for patients.

This previous blog post describes a detailed educational document on the DEA’s stance on pain meds.

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Aspirin as Effective as Imitrex?

That’s what a press release on a study presented yesterday at the European Headache Federation’s 8th Annual Congress proclaims. Mind you, the study was presented at the “New Reasons for Aspirin in Headache” symposium, which was sponsored by Bayer. And the press release was written by Bayer. Doesn’t exactly inspire confidence in the findings, does it?

The press release caught my attention because I met a new friend yesterday who told me that her life-saving drugs were triptans and aspirin for her migraines and aspirin when her daily headache get bad. She’s the only person I’ve talked to who has had such success with aspirin.

Similarly, With all the drugs I’ve tried, Advil is still my best abortive. Do any of you have a like experience with a basic OTC analgesic?