What Do You Want to Read on The Daily Headache?

Two years into blogging, I’ve learned that sharing isn’t complaining, writing about myself isn’t necessarily self-centered, and that many people read blogs for the personal connection they feel with the blogger. I’ve also found that I certainly have enough to say without whining and moaning. (I’ve also gotten e-mails asking me to write more about my experiences.)

So, I want to know what you think. Should I write more about what I go through? Essentially, I want to know what keeps you reading The Daily Headache. Here’s a poll to make it easy, but I’d love for you to leave a comment with your thoughts.

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Newsweek on Chronic Pain Research & Treatment

Pain research and treatment are the topics of this week’s Newsweek cover story. The article centers on chronic pain caused by physical injuries in war, but it has gems for anyone with chronic pain. There’s a great illustration of how opioids and nerve blockers affect pain signals in the Pain and its Pathways graphic.

“‘The public understanding of pain has been that it’s a stubbed toe or a broken bone,’ says Will Rowe, executive director of the American Pain Foundation. ‘But that’s just one aspect of it. Now there’s a growing awareness that pain is a disease of its own.’

“This is far more than a semantic change, Rowe adds: it’s ‘tectonic.’ Docs now know that the brain and spinal cord rewire themselves in response to injuries, forming ‘pain pathways’ that can become pathologically overactive years later. They are trying to sever this maladaptive mind-body connection with a host of new drugs and approaches. Some focus on recently discovered chemical receptors in the brain and muscles. Others pack all the punch of narcotics with less of the specter of addiction. . . . New types of electrical stimulators targeting the brain, the spine and the muscles hit the market almost every year. Fentanyl skin patches, first introduced in 1990, have evolved into a patient-controlled, push-button device called IONSYS, available by the end of this year.”

Later in the article:

“Some of the most promising pain treatments of the past decade have turned out to be disappointments. Studies of some radiofrequency therapies show they work no better than placebos. Spinal-fusion surgery, a recent review found, has ‘no acceptable evidence’ to support it. And if a treatment does work, says Edward Covington, a pain specialist at the Cleveland Clinic, ‘for most people, the effect is temporary.’ There is no cure for chronic pain, period.

“There’s not even any ‘single drug or technology alone’ that can treat all the types of pain, says Eugene Viscusi, director of acute-pain management at Thomas Jefferson University Hospital in Philadelphia. Most people need two or three therapies in combination. Scientists’ new understanding of pain’s broad effects on many levels of the nervous system explains why: a multipart syndrome requires multipart therapy. Viscusi notes that patients under anesthesia still have elevated levels of the pain enzyme Cox-2 in their spinal fluid following surgery. They may not feel pain, but some parts of their brains still think they’re in it. For any treatment to work long term, it will have to address not just the immediate sensation of pain but the other, subtler aspects—and there are surely some of those that scientists don’t know about yet.”

Current Clinical Trials for Headache, Migraine & Cluster Headache

NIH’s clinical trials database is brimming with clinical trials for headache disorders. There are currently 110 headache, 65 migraine and five cluster headache studies either actively recruiting or will do so soon.

Topics include:

And there are many, many more. Many are for drugs, but others have minimal risks.You can search by which phase trails are in, I, II and III. The website breaks down how the trials differ:

  • In Phase I clinical trials, researchers test a new drug or treatment in a small group of people (20-80) for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
  • In Phase II clinical trials, the study drug or treatment is given to a larger group of people (100-300) to see if it is effective and to further evaluate its safety.
  • In Phase III studies, the study drug or treatment is given to large groups of people (1,000-3,000) to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.

To learn more about clinical trials and for definitions, stay tuned for tomorrow’s post.

This Time Last Year, April 9-14 & 2-8

Year_reviewApril 9 to 14

Broadway Play Examines Issues of Illness
An insightful and moving New York Times article describes the blurred lines between wellness and illness shown in the play Well. An excerpt: “‘. . . [W]henever the cause of an illness is mysterious, it’s assumed to come from psychological problems or a moral weakness? And once science finally figures out the medical root of the illness, that assumption disappears.'”

Partnering With Your Health Care Provider
Recognizing your relationship with your health care providers as a partnership is a way to feel empowered and get the most useful information from your doctor.

Too Much Sleep as Headache Trigger
Sleeping in can relieve a migraine for me, but sleeping late without a migraine can trigger one.

Lyrica Aids Sleep
In addition to its role as a chronic pain reliever, Lyrica (pregabalin) may also be an effective sleep aid for people with chronic pain. In turn, better sleep may also help relieve chronic pain

Trapped
For the last few years, we’ve gotten season tickets to the theater. . . . I’m filled with anxiety in the days before each show. What if my headache is bad? What if I’m stuck next to someone wearing too much perfume? What if…?

April 2 to April 8

Inconclusive
X-rays showed that the leads of my occipital nerve stimulator hadn’t slipped significantly, but they would certainly slip more.

A Waiting Game
After meeting with my pain specialist and neurosurgeon left me with the simple decision that I should wait and see.

High Frequency & Severity of Migraine in Teens
A nationwide study of 18,714 adolescents found that headaches are causing a lot of disability for kids 12 to 19 years. Researchers found that adolescents’ migraines often go from one or two times a month to 10 to 15 times a month within a couple years.

Trexima Study Presented at AAN Meeting
I first ask the question I posed last week: If the treatment that most accurately compares to Trexima is Imitrex taken simultaneously with naproxen, why wasn’t the combination studied?
My comments about the patent was based on misunderstanding how the process works. See my latest Trexima post for an accurate explanation how it works.

This Time Last Year, March 25-31

Daily_headache_archive
Glued to the couch because the wires (aka leads) of my occipital nerve stimulator had moved is how I spent this week last year. I had to face answers to big questions I hated to ask.

Lead Migration 2006
The continuing movement of my leads and the associated pain became too much to ignore. This began my deliberations over whether to keep the stimulator or not.

On Asking for Help
I know I need help to cope with my latest nerve stimulator mess, but why can’t I bear to ask?

The Big But
The leads can’t stay where they are, so I’m forced to make a decision about the stimulator: Do I have the leads replaced or do I call it quits and have the stimulator removed?

Does it Even Work?
It’s the ultimate question and I’m not sure I want to know the answer.

A Stimulating Week
The week’s entertainment from the couch.

What Questions Do You Have?

What do you want to know about headaches and migraines, biology and physiology, or anything else health-related? The Daily Headache is a resource for you as much as it is a catharsis for me. So, what’s on your mind?

At the risk of sounding like every teacher you’ve ever had, there are no stupid questions. And if you have a question, it’s likely that others wonder the same thing. Really. If you’re embarrassed to ask it in the comments of a post, you’re always welcome to e-mail it to me.

This Time Last Year, March 3-10

Posts from The Daily Headache, March 3-10, 2006

Nerve Stimulator-Imposed Restrictions
According to Medtronic’s Living Well newsletter, these activities
might be harmful for people with nerve stimulators: using an electric blanket, skiing, sledding, golfing,
amusement park rides. Would I have still gotten the implant if I knew about all these limitiations?

Woman Heartbroken After Ending Love Affair
After years of agony, I finally say goodbye to one of the great loves of my life.

Getting the Attention We Deserve
ABC News aired a piece on new treatments for migraine, the first of a three-part series on migraine. It appears to be a good step toward reducing the stigma of migraine.

Acupuncture & Birth Control Deja Vu
Results of new studies on these migraine topics were released.

Pain Resource: Doctors for Pain
Get a glimpse of this excellent website on treating and coping with chronic pain.

The Ultimate Question
I finally try to answer the question about my occipital nerve stimulator that I’m asked the most: How much does it help? Since I had my stimulator removed in September, this post now seems quaint.

News From Annual Pain Meeting
Studies discussed at the American Academy of Pain Medicine‘s meeting included nerve stimulation and opioid levels in the blood of chronic pain patients.