Wednesday, August 30, 2006

migraine news roundup 14

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Chronic Headache Sufferers Not Receiving Optimal Treatment
According to a recent online survey conducted by the National Headache Foundation (NHF), fifty-nine percent of respondents indicated that they have experienced headaches for more than a decade. Fifty-three percent have ten or more headache days per month.

Beyond Bedside Manner
They have no right to do so, but some physicians try to take charge of a patient’s life as well as the technical details of treatment, like a grownup dominating a child—and the sad truth is that many patients let them. Physicians are created as much by their patients as by their training, and most patients want to give up all decisions to the omnipotent father figure.

Participation in the decision-making process, more than any other factor, determines the quality of the doctor-patient relationship.

When and How to Get a Second Opinion
A second opinion can help you better understand your medical condition, answer any outstanding questions, remove any doubts, help you weigh the plusses and minuses of the recommended treatment options, and help you make an informed, educated decision as to what treatment is best for you.

Because medicine is not an exact science, and many conditions can mimic the symptoms of other conditions, diagnosis can be difficult. As a result, getting a second opinion can be integral to making certain that the original diagnosis is correct.

Dr. Jerome Groopman, professor of medicine at Harvard Medical School and author of the book, Second Opinions, feels there can be another important benefit to asking for a second opinion.

"It causes me," says Dr. Groopman, "to wonder whether I failed to fully communicate with him my thoughts and my understanding of his condition. His question about a second opinion may be his way of saying that I need to reopen our dialogue, to listen again, more carefully, to his words."

Migraines common among nasal-allergy sufferers
Many people with nasal allergies suffer from migraine headaches as well, new research indicates. This suggests that the compound that causes allergy misery -- histamine -- may also be involved in triggering migraines.

In a study of nearly 300 children and adults, researchers found that 34 percent of those with allergic rhinitis -- better known as hay fever -- also had symptoms that met the diagnostic criteria for migraine. That compared with only 4 percent of study participants without hay fever.

Medical Errors? Patients May Be the Last to Know
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When the error was obvious, like an improperly written prescription that led to an overdose, 81 percent of doctors said they would definitely disclose the error to a patient.

But when presented with an error less apparent, only 50 percent thought it was worth mentioning. One example was a blood chemistry reading that had been overlooked. If it had been noticed, a serious complication would have been prevented.

“It isn’t that doctors routinely make a conscious decision to conceal errors,” said Dr. Thomas H. Gallagher, the study’s lead author and an associate professor of medicine at the University of Washington.

But when an error is less obvious, he continued, “the doctor is thinking about what the patient really needs to know to understand what happened.”

Care by the Hour
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As it is now, insurance companies — following Medicare’s lead — pay primary care doctors according to the number of patients they see. Each patient visit is generally reimbursed at a flat rate of slightly more than $50. The payment is the same whether the patient is a healthy, young person with a runny nose or an elderly person whose multiple chronic illnesses require many tests, referrals to specialists and detailed explanations to both the patient and his or her family.

Studies Link Depression, Heart Disease

Bipolar Disorder and Migraine Comorbidity
More recent studies have now shown Migraine disease seems to be comorbid to bipolar disorder. A 2003 study showed that the prevalence of Migraine disease among patients with bipolar disorder was high enough for the researchers to conclude, "Bipolar disorder with migraine is associated with differences in the clinical course of bipolar disorder, and may represent a subtype of bipolar disorder."

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