Migraine & Job Productivity and Worries

Sick and Vulnerable, Workers Fear for Health and Their Jobs
This title of a front page article in Saturday’s New York Times says it all. But I’ll summarize anyway… With an illness that requires a lot of time off work, a person’s job security suddenly flies out the window. The worries then extend beyond the illness; potential loss of income, identity, insurance and normalcy are all in jeopardy.

Artin of Pain in the Head, a blog that Moogle’s Thoughts introduced me to in this week’s Carnival of Compassion, experienced some of these dilemmas yesterday. The post title, Enter Dementors, is fabulously descriptive.

How much does migraine affect work life?

"A diary study of migraine sufferers from the general population revealed that over a three-month period, 69 percent of employed migraine sufferers experienced reduced work effectiveness.1 When people work with migraine, their productivity is reduced by 41 percent. Further, about 40 percent of all migraine sufferers account for 75 percent of all productivity losses.

"The best estimates suggest that migraine costs U.S. employers $13 billion per year in lost productivity. Of that amount, the largest part is due to reduced productivity at work, not absenteeism. As a corollary, workplace programs for treating migraine might help cost-effectively reduce the burden of illness. Since the current cost of migraine treatment in the U.S. is $2 billion, the productivity gains might more than offset increased spending for better healthcare. In addition, human suffering might be reduced immeasurably." (Migraine in the Workplace: Impact and Hope, from a 2004 ACHE newsletter)

If you’re still not convinced, read these summaries of findings from more than 20 studies on migraine and productivity.

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Merry Christmas, Happy Hanukkah and Happy New Year!

I’ve had to use a spreadsheet to figure out when will get to see different friends while we’re in Phoenix. Even though I planned to blog, I’m going to follow my own advice and de-stress the holidays, starting today.

Thank you for making the last half of my year fantastic. I’m thrilled to see how many people are reading and enjoying the blog. It’s something I look forward to doing every day. In fact, I had to make a conscious decision to take weekends off to spend with Hart and our friends. I’ve learned so much in the process and hope you have too.

Have a safe, relatively pain and other symptom free, and joyous week. I’ll see you on January 2.

Credibility of Medical Blogs (including The Daily Headache)

Can you trust medical blogs? Clinical Cases and Images describes an initiative among medical bloggers to establish the credibility of their blogs. Using a variation of the National Center for Complementary and Alternative Medicine‘s 10 questions to ask when evaluating online medical sources.

Although I’ve never thought of myself as a medical blogger, I suppose I am. So here’s my disclosure.

1. Who runs this site?
Me, a patient

2. Who pays for the site?
Me, with a little help from Google ads and Amazon sales

3. What is the purpose of the site?
To create a supportive community of people with headache; and to help people with headache know that they aren’t alone, be informed on current headache- and pain-related news, and be more involved in their own medical care

4. Where does the information come from?
News sources like the New York Times, Medical News Today and Reuters; other medical blogs; research and articles from headache organizations, like ACHE and the National Headache Foundation

5. What is the basis of the information?
I’m a long-time migraine and CDH patient with a background in writing, teaching and social science, which helps me evaluate, understand and share information

6. How is the information selected?
What’s in the news, on blogs or a hot topic on a forum; headache books and articles; my own experiences

7. How current is the information?
I try to post every weekday, usually in relation to topics that are typically no more than a week old. When I find old articles that are interesting, I check for updated information on the topic.

8. How does the site choose links to other sites?
I share the source of inspiration or information, typically other blogs and only link to sites that I’ve evaluated as credible. The only time I link to sites that I don’t know much about, it is to link to a news story that’s no longer available in a wider arena, like Google or Yahoo news or Reuters.

9. What information about [visitors] does the site collect, and why?
I collect site statistics through Site Meter and StatCounter. My primary goal is to see how many people visit the site and what sites refer visitors to me. I also look at what search terms people use to find the site and what other sites their search pulled up — I use this information to make sure I’m covering topics that are relevant to readers.

Through the statistic sites, I’m able to access IP addresses of readers and locations of visitors. I sometimes look at IP addresses to see if major companies visit the site (like drug companies) and where visitors come from so I can be sure the information is geographically relevant.

But, honestly, I rarely look beyond the visitor numbers, referral sites and search terms.

10. How does the site manage interactions with visitors?
I respond to e-mail in as timely of a manner as I can manage. I respond to comments unless they don’t need a reply. Sometimes I reply via e-mail, sometimes directly in the comments. I delete comments that are obviously irrelevant spam.

Stress Reduction

Even though it’s a little late in the season, stress reduction is crucial to getting through holidays in tact. Since stress is a vital component of holidays, I figure it’s still relevant. The Mayo Clinic article I link to is basic information that’s good to be reminded of.

I have to get my two cents in, of course. Planning ahead is on the list, but it doesn’t include the most important way to do this: Make simple meals that you can prepare ahead. If you’re at a loss, pick up this month’s issue of Real Simple (the best magazine ever) and turn to the holiday insert immediately. You’ll find a collection of menus for different types of parties, including a shopping list and a break down of what can be prepared in advance.

After attending one party and hosting two more between Sunday night and this afternoon, my mom told me that she plans for Christmas dinner to be a re-creation of a Thanksgiving meal. My response? "Are you trying to kill yourself and dad in the process?" (not in those exact words). Enter Real Simple.

If you’re also inclined to overdo it, give yourself a break. Who wants to be laid up with a horrendous headache on Christmas, Hanukkah or New Year’s? Even if you’ve done your grocery shopping, ask your guests to help. People like to pitch in and it will help you relax — as long as you don’t try to control the results of your sous chef.

Now I have to convince my mom long-distance to not go crazy for our meal. I’d say I have a 5% chance of success.

Posted in Coping. 3 Comments »

Yoga Provides Relief from Chronic Illness

This won’t be the first time I wax poetic about how great yoga was for me when I felt like my body was broken; but it’s the first time I’ll link to an article where others do the same. I loved how strong and capable my body felt. Similarly, one woman interviewed for the article said that the classes gave her back "a sense of reinhabiting my body."

Unlike the HIV- and cancer-specific classes described it the article, you probably won’t find a headache clinic that offers yoga classes for patients. Hospitals or health clinics may provide classes for people with wide-ranging illnesses. Even yoga studios who have gentle or restorative classes are likely to provide many of the same benefits. Even if you’re classmates don’t have the same illness or illness at all, there’s benefit to the supportive, non-judgmental environment.

That’s enough of my preaching. Here’s a paragraph from the article to back me up:

"Often [yoga] is something their doctors recommend for the stress-relieving benefits of both exercise and meditation. But many patients find that the sessions, which make them feel more comfortable, also lessen some of their symptoms and the side effects of their medications. And because students exercise alongside others with their same medical problem, the classes also provide emotional support."

Carnival of Compassion #14

Tracy of Moggles Thoughts, a fellow migraineur, is hosting this week’s Carnival of Compassion. All her links are headache-related, so be sure to take a look.

Not Just a Headache: Migraine’s Other Symptoms

The usual description of migraine includes visual aura, one-sided throbbing pain, nausea, and sensitivity to light and sound. There’s a lot more to it than that. The following information, which comes from my very favorite migraine book, Migraine: The Complete Guide, is a list of the other symptoms of migraine. It’s organized by the phase that the symptoms they occur in and by which part of the body is involved. I’ve made a few changes to the information from the book; most noticable is that I’ve collapsed the book’s sections on aura and prodrome into one.*

Prodrome (the period before the pain begins)

Visual (aka aura)

  • a bright shape that spreads across the visual field of one eye and appears to block some or all of the vision; can be seen whether the eye is open or closed
  • flashes of light and color
  • wavy lines
  • geometric patterns
  • blurred vision
  • partial loss of sight

Sensory

  • numbness or tingling on the face or upper extremities
  • a sense that limbs are a distorted shape or size
  • smelling odors that aren’t actually present (like natural gas or something burning)

Motor

  • partial paralysis
  • weakness or heaviness in the limbs on one side of the body

Language

  • difficulty finding words
  • problems understanding spoken or written language

Cognitive

  • mental confusion
  • disorientation
  • transient global amnesia (similar to amnesia that follows a concussion)

Digestive

  • food cravings (particularly for carbohydrates, candy and chocolate)
  • stomach rumblings
  • constipation

Fluid disturbances

  • increased thirst
  • bloating/fluid retention
  • frequent urination

Mental/Personality

  • mood changes
  • irritability
  • high energy
  • lethargy

Headache Phase

Sensory

  • sensitivity to light and noise
  • intolerance of being touched
  • heightened sensitivity to odors

Digestive

  • nausea
  • vomiting
  • intolerance of food odors
  • loss of appetite
  • diarrhea
  • constipation

Skin

  • paleness
  • cold, clammy hands and feet
  • facial swelling
  • goose bumps
  • bloodshot eyes
  • black circles around eyes
  • sweating

Fluid disturbances

  • water retention
  • frequent urination

Respiratory

  • frequent yawning
  • sighing
  • hyperventalating
  • nasal congestion
  • runny nose

Mental/Personality

  • irritability
  • depression
  • anxiety
  • nervousness
  • difficulty concentrating

Circulatory

  • changes in blood chemistry
  • changes in blood pressure
  • blood vessel dilation
  • difficulty regulating temperature
  • changes in heart rhythms

Postdrome (24 hour following headache)

Cognitive

  • inability to concentrate

Respiratory

  • frequent yawning

Mood/Personality

  • fatigue
  • depression
  • euphoria
  • feeling of intense well-being
  • lethargy

Having the variety of chronic daily headache that is caused my migraine, I’m not convinced that these symptoms only occur in their respective phases. I certainly have different symptoms that don’t seem to be connected to severe headache pain. It could be that people with CDH have trouble knowing when they are in a particular stage or that we experience the symptoms more frequently than in these rigidly defined phases. I also wonder if people who have been diagnosed with tension-type headache experience similar additional symptoms, particularly the cognitive ones. (Don’t take anything in this paragraph as fact — these are my vaguely informed, non-medical musings.)

So you’re not crazy, losing your mind or faking it. Perhaps it’s a link to send to those who question your illness.

*Some sources maintain that an aura only encompasses the visual changes that can happen before a migraine. Others, like this book, include sensory, motor, language and cognitive difficulties as part of aura. The more common approach is that aura is only visual, but one of many symptoms of prodrome.