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What’s Your Carrot?

Why are you seeking treatment for your migraine or headache disorder? Obviously, you  want to reduce the pain, but what else motivates you to find relief? Wanting to be pain free is certainly important, but it’s not enough.

The patients whose treatments are most successful are the ones who are working for more than to become pain-free, but also to have a better life, according to Dr. Rob Cowan, the director of Stanford’s headache clinic. In his words, “It’s very hard to help someone who doesn’t have a carrot.” Dr. Cowan said this at the American Headache & Migraine Association conference in November and, of everything I learned that day, this statement is the one that most firmly lodged itself in my mind.

We all need a carrot (or even a bunch of carrots). What’s your carrot? What would you do with your life if you had no health concerns to hold you back?

While it can be emotionally painful to ponder such goals when it seems like you’ll never achieve them, keeping them in mind provides motivation in the face of failed treatments. Last May, I wrote about my firsthand experience with this in Goals, Dreams and Chronic Migraine:

My goals were sitting on a shelf, put aside when getting out of bed and feeding myself were all I could manage in a day. They did not inspire me, but filled me with despair over all I had already failed to accomplish and everything it seemed I would never be able to do. Even though I felt better than I had in at least five years, I was still so sick. Goals did not feel like inspiration, but a reminder of defeat. What was the point in having goals, I wondered, when migraine demanded all my energy and attention?

Try as I might to pretend I had no dreams beyond finding an effective migraine treatment, my ambitions cannot be sublimated. As frustrating as it was to believe my dreams would never be fulfilled, it was even worse to imagine that my only role in the world was sitting on the couch in pain. The sentiment of that headache specialist whose name I cannot remember in the article whose location I cannot find were so true. Having goals keeps me believing that migraine will not forever dominate my life and that, even if I am, I will somehow contribute meaningfully to society. When my life feels unbearably small and worthless, these aspirations give me a reason to strive, even if getting out of bed will be my biggest accomplishment of a day (or week or month).

Eight months later, I’m pretty sure I’m on the cusp of significant migraine relief (more on that in a couple days) and am wondering which goal I should pursue first. Whatever I decide, it is sure to be one tasty carrot.

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Ask a Headache Specialist: Stanford Headache Clinic Director Taking Your Questions

Have a question for a headache specialist? Robert Cowan, MD, director of the Stanford Headache Clinic and a lifelong migraineur, wants to answer them. Submit your questions by 5 p.m. Pacific time on Friday, March 8, by tweeting with the hashtag #AskSUMed or commenting on the Scope blog post: Ask Stanford Med: Director of Stanford Headache Clinic taking questions on headache disorders.

Stanford Medicine asks that you follow these ground rules when submitting a question:

  • Stay on topic
  • Be respectful to the person answering your questions
  • Be respectful to one another in submitting questions
  • Do not monopolize the conversation or post the same question repeatedly
  • Kindly ignore disrespectful or off topic comments
  • Know that Twitter handles and/or names may be used in the responses

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Building Your Migraine Treatment Plan — A HealthTalk Webcast Tomorrow

A drawback of all the available treatments is that patients can be overwhelmed. Designing a personal headache treatment plan will help keep you and your doctor on the best path for you. It will help you choose the medicines that are most likely to reduce your most troublesome symptoms, can integrate alternative or complementary treatments and may even ease the stress if you have to go to the ER.

HealthTalk is producing a webcast called Building Your Migraine Treatment Plan with headache specialist Robert P. Cowan. He will answer patients’ questions during part of the show. You can submit your questions in advance or during the live webcast.

The program starts at 7 p.m. EST tomorrow — Wednesday, March 21. Starting about 10 minutes before the webcast, go to the program’s description page and look for a link that says “Join the Program.”

For more about treatment plans, see the ACHE article, Headache Medicines: Which One is Right for You?

You can also check out the two previous webcasts: What Makes a Migraine a Migraine? and Why Do Women Get More Migraines Than Men? I haven’t listened to the first one, but the second one has terrific information for women and men. Dr. Christina Peterson was one of the specialists on the show. I’ve been waiting for a transcript to write about it, but it’s so great that I should dive in anyway.