Playing by the rules is effective

Don’t cut off your nose to spite your face.

Webster’s Dictionary defines this phrase:
to create a disadvantage to oneself through one’s own spiteful action.”

It happens when we focus on being right or fair despite the negative personal consequences. For migraineurs, there are a lot of  opportunities for this to happen.

  • Insurance companies that limit triptans, deny coverage for needed treatments, or force the use of less effective medicines are the bane of a migraineur’s existence. In order to get what we need, we must file appeals, enlist our doctor’s help and jump through unreasonable hoops.
  • Pharmacies create their own bureaucracy that can drive us crazy. There are long lines, unnecessary consultations, ignorance about our medications, medications out-of-stock, and failure to use our discount cards or insurance benefits.
  • Doctors’ offices have their own bureaucracy, too. The long wait times, bright lights, noises, and paperwork are enough to tempt us to walk out and never return.
  • Emergency rooms are the worst. Some are staffed by nurses and doctors who view migraineurs as drug-seekers. We often endure unreasonable treatment and unnecessary testing just to get a little relief. My own experience with an ER is a perfect example. Forced to endure bright lights, loud noises, and repeated blood pressure checks (lying down, sitting up, and standing), I was told that my request for Toradol to break a migraine was “not medically necessary.”

effectiveDoing what is effective

It is exhausting to play by their rules just to get needed treatment. It can be tempting to just tell them all to “go to hell” and refuse to play. Unfortunately, that means we don’t have a chance of getting the medicines and treatments we need. Many times we have to submit to treatments we know won’t work just to finally get what we need.

My first experience with a headache clinic is a good example.

My goal for making that first appointment was to gain a prescription for Imitrex. It was new to market and there were many concerns about cardiac safety when using it. The doctor insisted I break Medication Overuse Headache first. That took three months. Plus, I was required to keep a headache diary and food log to identify triggers. And finally, my first dose of Imitrex had to be in the office so I could be monitored. Since most of my attacks happened on the weekend (due to stress let-down), it was several weeks before I finally experienced a migraine attack during office hours. At any point in the process I could have walked away. If I had focused on all the barriers to my goal, I might have decided the doctor was being unfair or unreasonable. I would have lost sight of my goal.

That’s what it means to be effective. Right or wrong, fair or unfair, sometimes we have to play by someone else’s rules. It can be difficult to swallow our pride in order to get what we want.

Mindfulness wrap-up

Using Wise Mind, observe the situation. Describe and participate fully in each experience. Focus on the facts with non-judgmental stance, putting aside your own opinions. Stay one mindfully in the moment, doing one thing at a time. Set aside ideas of what should be and just do what is effective.

Next up: Introduction to distress tolerance skills »


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3 thoughts on “Playing by the rules is effective

  1. My experience with doctors and headaches – they don’t know what to do about them.

  2. Unfortunately, doctor’s do have a protocol to follow and they won’t deviate. Your site is a wonderful resource especially the items that you listed for comfort measures i.e. mini massager and heat wraps. Thank you.

  3. Thanks, for years my doctor has been trying to figure out where the headaches are coming from.

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