Monday, July 30, 2007

migraine news roundup 39

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The Wisconsin Supreme Court has ruled that a man's employer had illegally failed to accommodate his disability in firing him for absences related to migraines.

State Supreme Court Says Company Can't Fire Man Over Migraines

The Wall Street Journal recently reported on the trend toward alternative treatments for mental illness.

The Unmedicated Mind
Now, spurred by the growing disenchantment with antidepressants, an increasing number of people are seeking treatment for depression, anxiety and eating disorders from naturopaths, acupuncturists and even chiropractors. At the same time, more traditional psychiatrists are incorporating massage and meditation in their practices.

The treatments go beyond needles and spinal manipulation. They include Emotional Freedom Techniques -- tapping on the body's "energy meridians" as the patient thinks about upsetting incidents -- and craniosacral therapy, which involves a gentle rocking of the head, neck, spine and pelvis. In cranial electrotherapy stimulation, a AA-battery-powered device sends mild electrical currents to the brain. (The procedure has its roots in ancient Greek medicine, when electric eels were used.) Clinicians are also prescribing supplements like omega-3 fatty acids, found in fish oil, or amino acids like L-theanine, found in green tea.

Do any of you have experiences (positive or negative) with the techniques discussed in this article? I've been using an omega-3 supplement, but I can't say that I've noticed any difference in my depression or anxiety. Anti-depressants have been a good solution for me, but I can understand the desire to find other treatment options to supplement or replace them. Many people experience intolerable side effects or desire a more natural approach. The bottom line for me is finding something that helps.

This great article is full of advice for improving communication with your doctor:

Don't Tell Your Doctor "A Lot"
try to remember that the typical primary care physician is responsible for more than 2,000 patients and sees about 30 of them a day. Because of the time limit alone, your doctor needs to focus fairly quickly on your most serious health problems. If you start the appointment by revealing only a minor symptom or two, or by telling a long story about your summer vacation, your doctor will likely either interrupt you (in about 20 seconds, according to research) or feign interest while wondering whether "Grey's Anatomy" will ever be the same without Isaiah Washington. Although you might feel awkward about it, disclose your most pressing health concerns at the outset.

This article has some highly practical advice on ways to adjust our diets to avoid a drop in blood sugar and a good explanation of why migraineurs may want to try this.

Oh, My Aching Head: Migraine Triggers - and How to Keep The Pain At Bay
Although certain foods may trigger migraines for some people, true food allergies, such as peanut allergy, have not been found to contribute to migraines. However, your food intake pattern may make a difference. The majority of migraines occur after people have not eaten for at least five hours. This may explain why migraines often occur in the early morning. People who suffer from migraines, and who fast for religious or other reasons, are at higher risk of getting a headache during or after their fast.

The brain depends on glucose for its energy, and a drop in blood sugar during fasting may trigger a headache. Migraine sufferers also may be more sensitive to the effects of insulin release in the blood.

What does this mean for you? Here are a couple of things you can try:

• Avoid refined carbohydrates. They cause a rapid rise in your blood sugar, which then triggers insulin release, which then plunges your blood sugar, which may trigger a headache.

• Your brain uses about 10-15 grams of carbs per hour, so try to get about 40-60 grams of healthy carbs per meal and 20-40 grams per snack.

• Eat every four to five hours while awake; combine healthy carbs with some protein or fat, which will keep your blood sugar level more steady.

• Don't skip meals.

• Eat a piece of fruit right before you go to sleep. The natural fructose in fruit may help keep your blood sugar a little more steady while you sleep and prevent that morning headache.

Stress is one of a migraineur's worst enemies. The blog Achieve -It! offers ten helpful suggestions for reducing stress in your work day.

10 Ways to Have a Happy Work Day

In response to high-profile prescription drug debacles, Congress has approved increased funding for prescription drug oversight.

House OKs Bill to Improve Drug Safety

The House approved 403-16 a bill giving the Food and Drug Administration nearly $400 million, collected as fees from the drug industry, to spend on drug safety over the next five years. The Senate already has approved similar legislation.

Both bills would give the agency the ability to require drug companies to do follow-up studies on certain medicines.

"It's become increasingly clear FDA needs more of two things: It needs more resources and more authority, particularly in the area of postmarketing surveillance," said Rep. Henry Waxman, D-Calif.

The House version would require the FDA to review the safety of certain drugs annually for the first three years following approval and then again during the seventh year. It also would require drug ads to include a toll-free number and Web address for consumers to report side effects and would permit only a single outside expert with a potential conflict of interest to be cleared to serve on any agency advisory panel.

Rep. Michael Burgess, R-Texas, criticized the restriction on those outside advisers, noting it's already difficult to find scientists who are experts in some fields.

Research indicates naratriptan (also known as Amerge) may be effective in preventing menstrual migraine.

Triptan May Safely Prevent Menstrual Migraine

Chronic Babe recently featured an awesome, information article on how first-hand examination of the human body can increase our understanding of what migraines do to it.

What Does a Migraine Look Life? Bodyworlds Offers Some Perspective

According to the Centers for Disease Control, anti-depressants are the most-prescribed medication.

CDC: Antidepressants Most Prescribed Drugs in the U.S.

Many psychiatrists see this statistic as good news -- a sign that finally Americans feel comfortable asking for help with psychiatric problems.

"Depression is a major public health issue," said Dr. Kelly Posner, an assistant professor at Columbia University College of Physicians and Surgeons in New York City. "The fact that people are getting the treatments they need is encouraging."

She added that 25 percent of adults will have a major depressive episode sometime in their life, as will 8 percent of adolescents. "Those are remarkably high numbers," Posner said.

While Posner says genuine depression is driving the prescription numbers, Dr. Robert Goodman, an internist in New York City, says the real force behind skyrocketing antidepressant prescription rates is pharmaceutical marketing to doctors and to consumers. "You put those two together and you get a lot of prescriptions for antidepressants," he said.

He questions whether all those prescriptions are necessary. "It's hard to believe that number of people are depressed, or that antidepressants are the answer," he said.

While often lauded as a way to improve patient care, some research indicates that electronic medical records may not serve this goal.

Electronic Health Records Don't Aid Patient Care
Of 17 measures of quality assessed, electronic health records made no difference in 14 measures, according to a study published in the Archives of Internal Medicine.

The study by researchers at Stanford and Harvard Universities was based on a survey of 1.8 billion physician visits in 2003 and 2004. Electronic health records were used in 18 percent of them.

In two areas, better quality was associated with electronic records, while worse quality was found in one area, they said.

Many experts believe electronic records can help prevent costly medical mistakes, but few studies have evaluated whether the records actually improve the level of care when compared with paper records.

"Our findings were a bit of a surprise. We did expect practices (with electronic medical records) would have better quality of care," said Dr. Randall Stafford of Stanford University. "They really performed about the same," he said in a telephone interview.

The 14 quality indicators for which electronic records made no significant difference included such factors as prescribing recommended antibiotics; diet and exercise counseling for high-risk adults; screening tests; and avoiding potentially inappropriate prescriptions for elderly patients.

The records seemed to help doctors treating patients with depression to avoid prescribing certain tranquilizers. They also helped to avoid offering urinalysis during general medical exams.

Finally, the New York Times reports that anti-depressant use has been shown to reduce suicide risk, calling into question the view they sometimes increases the user's propensity toward suicide.

Suicide Findings Question Link to Antidepressants

These two studies clearly show that the greatest risk for suicide is depression,” he said.

“Failure to treat depression, either using pharmacotherapy or psychotherapy, will lead to dramatic increases in the rate of serious suicide attempts and completions in the U.S. and in the world.”

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