Boston Red Sox Pitcher Jonathan Papelbon on Migraine

Revered Boston Red Sox pitcher Jonathan Papelbon is a rare athlete willing to admit how debilitating a migraine episode is. Most athletes say they push through it, fueling the public’s perception that a migraine is “just a headache” — and that migraineurs are whiners. Papelbon said:

“They don’t go away,” he said. “You can usually feel the effects of them the day after, the aftereffects. But it’s hereditary, they don’t go away.

It’s just something that I’m going to have to deal with. It’s not just a headache, it takes over your whole body. People that don’t get them, they don’t really understand them.”

Papelbon later says that he is able to push through a migraine — only after he has taken the migraine abortive Imitrex. It seems like a small thing, but “tough guys” admitting the agony of migraine helps spread the word that it is a serious disorder.

Study: Chronic Migraine is Disabling and Severely Affects the Ability to Lead a Productive Life

The National Headache Foundation‘s American Migraine Prevalence & Prevention Study data have been reanalyzed to reveal just how debilitating chronic migraine is. Chronic migraineurs have migraine episodes at least 15 days a month and most have pain every day. Approximately one million people -– mostly women -– have chronic migraine.

Key findings of the study, from a NHF press release:

Chronic migraine remains a largely under-diagnosed and under-treated medical condition.

While the vast majority of individuals with chronic migraine (87.6%) had sought care from a healthcare professional, just 20.2% of those with chronic migraine received a diagnosis of chronic migraine, chronic daily headache or transformed migraine. Another nearly 14% were told that they had rebound headache or medication overuse headache.

Migraine-specific acute treatments were used by 31.6% of respondents with chronic migraine. Almost half (48%) of the individuals with chronic migraine were satisfied with their acute therapies. A third of those with chronic migraine (33.3%) were currently using preventive medications.

Although most individuals with chronic migraine sought medical care for this disorder, the majority did not receive specific acute or preventive medications.

One in five chronic migraine sufferers cannot work due to the severity of their condition.

Over a 3-month period, 8.2% of the chronic migraineurs missed at least 5 days of work and school. Further, slightly more than a third (33.8%) of these sufferers reported at least 5 days of significant reduction in productivity during the same time frame.

Chronic migraine severely impacts one’s ability to lead a productive life.

More than half of those with chronic migraine (57.4%) missed at least 5 days of household work, and 58.1% reported a reduction in productivity in household work for at least 5 days within the last three months.

Chronic migraineurs also reported missing out on at least 5 days of family activities within the three month period.

“With one in five chronic migraine sufferers not being able to work due to the severity of their condition, the human and economic costs to these patients, their families and their employers are staggering,” said Suzanne E. Simons, Executive Director, National Headache Foundation. “This report shows there is much work to be done to help them get the proper diagnosis and treatment they need to be able to lead productive lives.”

National Invisible Chronic Illness Awareness Week

In addition to living with the symptoms of headache disorders or migraine, having an illness others can’t see can be extraordinarily frustrating. Rest Ministries is raising awareness of life with invisible illness this week during National Invisible Chronic Illness Awareness Week. Check out the following press release for information on the week.

Nearly 1 in 2 people in the USA have a chronic illness and according to U.S. Census Bureau about 96% of illnesses are invisible. So it comes as no surprise that with hundreds of thousands of people on the Internet searching for health support and information, thousands of people now post daily blogs about the emotional trials they experience while facing chronic pain on a regular basis.

National Invisible Chronic Illness Awareness Week is being held September 8-14, 2008. Part of their outreach includes over thirty days of guest bloggers as well as bloggers all over the web posting about invisible illness issues. For example, what happens when someone with an invisible illness parks in the handicapped spot, even though they are doing so legally?

Lisa Copen, who founded National Invisible Chronic Illness Awareness Week in 2002 says, “Though we live with thousands of different illnesses, we have more in common than not. For example, illness impacts our families, careers, finances and daily living, to name a few. We can all learn from one another and share during this journey.” She adds, “And frankly, people are tired of hearing, ‘But you look so good!’ and they want others to know that their illness is legitimate despite how well they seem to be holding it all together.”

Laurie Edwards is the author of a recently published book called, “Life Disrupted: Getting Real About Chronic Illness in Your Twenties and Thirties.” She has blogged about her illness since 2006 and says, “When you are a young adult, people expect you to put in long hours to establish a career, to jump into the dating world, and to build a life for yourself. But they certainly don’t expect you to be sick. There’s no such thing as ‘too young’ to be sick! That is just one of the many reasons why Invisible Illness Week is so important!”

If you would like to participate in this unique chance to blog for awareness and increase an understanding about invisible illnesses, visit www.invisibleillness.wordpress.com. You can receive updates, participate in surveys, win prizes, and learn more about the telephone workshops at the Invisible Illness Week website.

Mini-Medical School from UCSF’s Osher Center for Integrative Medicine

National Headache Awareness Week: Get a Head S.T.A.R.T. on Your Headaches

In recognition of the 15th annual National Headache Awareness Week, the National Headache Foundation (NHF) is announcing a series of events across the country in order to educate the public about types of headache and their impact on daily living, as well as stressing the importance of seeking an accurate diagnosis and appropriate treatments. This year’s National Headache Awareness Week takes place June 1-7, 2008. Nearly 21 million people were reached last year through this successful annual campaign.

“One of our primary goals during National Headache Awareness Week is to gain recognition of headache pain as a real and legitimate condition,” said Dr. Seymour Diamond, Executive Chairman of the National Headache Foundation. “Over 45 million Americans get chronic, recurring headaches. Of this number, nearly 30 million have migraine headaches.”

Activities taking place across the country this week include headache screenings, educational seminars led by expert physicians, menstrual migraine awareness events and a 5-part podcast series focusing on women’s headache issues, a radio news release and the launch of a non-profit NHF channel on YouTube.

This year, the NHF is encouraging sufferers to “Get a Head S.T.A.R.T. on Your Headaches,” offering five easy-to-remember strategies for effective headache management and treatment:

  • Seek diagnosis — Obtaining the correct diagnosis for your headache is the first step toward effective treatment.
  • Triggers — Identify and track your triggers (e.g., foods, stress, hormonal and weather changes) by keeping a headache diary and share this information with your healthcare provider.
  • Advocate — Be an advocate. Be informed. Be a participant in your headache care.
  • Resources — Utilize the National Headache Foundation as a resource. Visit www.headaches.org for the latest information about headache causes and treatments, or call 1-888-NHF-5552.
  • Treatment — Successful treatment may include medications and lifestyle changes. Work with your healthcare provider to find the right plan for you.

For the first time, this year’s campaign is drawing specific attention to menstrual migraines by designating Wednesday, June 4th as National Menstrual Migraine Awareness Day. In support of Menstrual Migraine Awareness Day efforts, the NHF will also be releasing new survey data from a recent poll of its website respondents suffering from menstrual migraine.

Additionally, the NHF is hosting a five-part podcast series specifically addressing women’s headache issues including Hormones & Headache, Contraception & Headaches, Pregnancy & Headache, Menopause & Headaches and Menstrual Migraine. Podcasts and expert questions and answers are available through links on the National Headache Awareness Week page.

This post is adapted from a National Headache Foundation press release. -Kerrie

LSD’s Therapeutic Uses to be Studied in Medical Trials

Albert HofmannAlbert Hofmann, the chemist who discovered LSD, died last week, but not before seeing his “problem child” return to it’s use as a medical treatment. Originally celebrated as a potential treatment for psychosis, mania and depression, the drug’s therapeutic uses were studied widely in the 40s and 50s. Then came the 1960s. Not long after the counterculture embraced LSD, toxic knockoffs hit the streets. LSD’s therapeutic benefits were lost in the chaos.

Having “spent the latter part of his life consulting with scientists around the world who wanted to bring his ‘problem child,’ as he called the drug, back into the lab to study as a therapeutic agent,” Hofmann was rewarded with news that Switzerland health officials approved the first medical trial of LSD in more than 35 years. The trial will test if the drug can ease end-of-life distress. Several more trials are in the works:

“I think people in this country, when they see a patient in pain, will not deny that person a medication just because the drug has abuse potential,” said Dr. John Halpern, a Harvard psychiatrist who is testing the effect of MDMA-assisted psychotherapy in late-stage cancer patients. “LSD is always going to be a touchy subject but I think it’s kind of fallen back to earth.”

LSD is a potential treatment for headache disorders, particularly cluster headaches. With a similar chemical structure to serotonin, LSD has possibilites for other headache types as well.

Photo by Philip H. Bailey

Treating Migraines with Codeine, Oxycodone or Barbiturates Increases Risk of Chronic Migraine

Treating migraine episodes with opioids or barbituates as few as eight times a month doubles the risk of developing chronic migraine. I’m in a Phenergan fog, so I’ll let the American Academy of Neurology‘s press release tell the story:

Overuse of Codeine, Oxycodone and Barbiturates Increases Risk of Chronic Migraine

People who overuse barbiturates and opioids, such as codeine, butalbital, and oxycodone, to treat migraine are at an increased risk of developing chronic migraine, according to research that will be presented at the American Academy of Neurology 60th Anniversary Annual Meeting in Chicago, April 12–19, 2008. People with chronic migraine have headaches on 15 or more days a month.

For the study, 24,000 people with headaches in the United States were surveyed about the types of medications they use to treat their headaches. From this sample of people with headache, the researchers selected those who had been diagnosed in 2005 with episodic migraine (fewer than 15 days of headache per month). Their risk of chronic migraine was then calculated based on the types of medications they used in 2005. Among those with episodic migraine in 2005, 209 people had developed chronic migraine in 2006.

The study found people who took drugs containing barbiturates or opioids for only eight days a month were twice as likely to develop chronic migraine a year later as those who didn’t take such drugs. [emphasis mine]

“People who use drugs that contain barbiturates and opioids, if only for a total of seven to eight days a month, appear to significantly increase their risk of migraine progression,” said study author Marcelo Bigal, MD, PhD, with Albert Einstein College of Medicine in Bronx, New York. “Strict limits for these types of drugs should be enforced among people with migraine as a way of preventing their migraines from becoming more frequent and more painful.”

The study found no evidence that the risk of developing chronic migraine increased among people who frequently used triptans, which are commonly prescribed drugs to treat migraine, or non-steroidal antiinflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen.

The study was supported by the National Headache Foundation.

Another interesting conundrum of treating pain with opioids: Opioids appear to change the brain so that the patient actually becomes more sensitive to pain. Building tolerance is not only your body getting use to the drug (called desensitization), but you actually become more sensitive to pain overall (referred to as sensitization), not just the pain that you are specifically treating. Treating Pain With Opioids has information on this research.