Waiting on the world to change

The reality is that migraine is a difficult condition to treat and even harder to live with. Even in the best of circumstances, living with migraine is unpredictable.

1. There is no cure.
2. Treatments are borrowed from other conditions and are only effective for about half of all patients.
3. When a treatment does work, we can only expect a 50% reduction in severity or frequency of attacks.
4. Triggers are unique. Trying to avoid them all is impossible.
5. Migraine is highly stigmatized by society and the medical profession.

That’s the bad news. Unfortunately, many migraine patients stop right there. Take a look at these alarming facts:

• Less than half of those who have migraine ever talk to a doctor about it.
• Less than 13% of those who could benefit from preventive treatments are actually using them.
• Many people who think they have tension type or sinus headaches are actually experiencing migraine.
• Few people realize that taking ANY pain relievers more than twice a week can make their headaches worse.
• Too many doctors still prescribe narcotics and barbiturates as first line treatments for migraine.
• People who live with migraine tend to hide their symptoms and keep their condition a secret out of fear of ridicule, rejection, or job loss.

What most do not realize is that there are options. Early diagnosis and intervention produce the best outcomes. The sooner you get started treating migraine, the lower your risk of developing chronic migraine, medication overuse headache, or other complications of migraine. Everyone with migraine should be evaluated by a competent doctor and offered first-line treatments to abort migraine attacks. These first-line treatments are in a class of drugs called triptans. While they do not work for everyone, they are the drug of “first choice.” They have been widely used for over two decades with very few adverse events. All the fears of cardiovascular risks have simply not panned out. The side effect profile of triptans is much lower than even over-the-counter pain medicines which can cause stomach irritation, liver and kidney damage. Because these drugs are the ONLY thing specifically developed to abort migraine, they are a natural first choice.

One mistake that patients make is to believe that if one triptan doesn’t work (or has unwanted side effects), then all the others are equally ineffective (or harmful). However, each variation reacts differently, has its own half-life, and unique side effects. Unless there is a true allergic reaction (difficulty breathing, swelling, skin breakouts, etc.), I wouldn’t give up on triptans until I had exhausted every single one of them in all their delivery forms.

Another mistake that patients make is believing that insurance should cover all of their health care expenses. When you have an complicated, incurable disease, it is essential to accept that you will spend a greater percentage of your income on health care expenses than the average person. You can get creative with discount cards, assistance programs, and even appeals to your insurance provider. Yet ultimately, you will still have to spend a great deal to properly treat your condition. It is unacceptable to ignore your health needs in deference to that bigger house, newer car, or more expensive gadgets. Let’s face it — being sick costs money. Refusing to invest in your health care is foolish and dangerous.

Lastly, many patients believe their doctors when they are told that there is nothing more that can be done to help you. No doctor should ever give up on a patient. In fact, they are ethically bound to help a patient find the right care when they are no longer able to help that patient. To do any less is considered abandonment of a patient — a definite breach of ethics. There is always another option, another doctor, another treatment. It may be out of your reach for the moment, but if you really want to feel better, you will find a way to keep trying.

No one should ever be allowed to get away with treating your poorly because of migraine. If you struggle to assert yourself and your medical needs, then please, get help. No one is going to take you seriously if you don’t take yourself seriously. No one is going to automatically accommodate your needs if you never speak up. Ridicule, name calling, insults, etc. are never okay, no matter where it comes from. The trick is that you need to have enough self-respect to stand up for yourself. No one is going to respect you if you don’t respect yourself. You must believe that you are worth good medical treatment and that you deserve to feel better.

We can sit around complaining about how bad we’ve got it or we can decide to do something about it. The world is not going to change just to suit us. If we want a better life with migraine, it is up to us to make it happen. Not sure how to get started? Stay tuned for more details coming every day this month in honor of Migraine & Headache Awareness Month.

Stop waiting on the world to change. Be the change.

Today’s post was inspired by “If I could change the world” by Eric Clapton.