Wednesday, June 08, 2011

Stuff Your Well Meaning, Ignorant Migraine Advice in a Sack & Shove It


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Sometimes I feel guilty bringing you guys a lengthy rant in a new post, but I try not to do it too often. This time I just have to.

I was delighted when I saw the fantastic Wall Street Journal article about migraine disease published earlier this week (Beware, A Big Headache is Coming). It contains most of the latest research and solid information about migraine disease. Although I wish the headline writer hadn't used the word "headache", the article was very, very well done, and I wanted to leave a comment to give my kudos to the writer.

After leaving my comment I started reading through the other comments and came upon one that set my blood boiling.

"None of my patients has Migraine again if taking Metoprolol tartrate 50 mg 2x/d, $10 for 90days. It has no side effects or habits It blocks most fight and flight adrenalin. Ask your doctor for that recognized prevention. You - and your family - will feel better"

How wonderful for those patients, doctor. Unfortunately it doesn't work that way for everyone. I've been on that exact medication (was actually on it for years, at a therapeutic dose) and saw no reduction in migraine frequency. It's completely ignorant to act like all of us living with chronic migraines would be healed if only we pulled our heads out of our assess and got on metoprolol. I left a polite reply to that effect and went on about my day, which included an appointment with my primary care doctor.

(Ironically enough I started back on metopropolol on that very dose that very day because we discovered Savella has been giving me hypertension. Hey, maybe a miracle will happen, right?!)

When I got home from my appointment with my primary care physician I saw I had an email from the Wall Street Journal telling me the doctor wanted to connect. He included this message. Wait for it, it's good.

"Diana, When your personal physician reviews your eating often enough and avoiding caffeine to avoid hypoglycemia, and you exercise briefly every hour to reduce desk fatigue and otherwise do what you would tell your child - and if needed increase the frequency of metoprolol , naps, etc, you will be rewarded."

Okay, first off, is it even appropriate for an MD to give someone this advice over the Internet? I'm not so sure. (You'll notice I put a disclaimer on every single post because I'm not so much a fan of getting sued.)

Aside from that, he knows NOTHING about my rather complicated medical history, and I'd venture to guess I know more about migraine disease than he does based on his comments. For what it's worth, my primary care physician agreed when I happened to mention to her what he said in his original comment.

And since when does caffeine cause hypoglycemia? I suppose he meant the hypoglycemia comment to refer back to the reference to having my doctor review my eating habits, but who knows? Also, let me just remind you, in case you'd forgotten, dear readers, that I'm a type 2 diabetic. Though we're striving for good glucose control, which can sometimes lead to lows, suffice it to say that hasn't been an issue for quite some time. Next.

Furthermore, I am so debilitated by 8 years of chronic migraine disease that I cannot work. I cannot keep a job. I've been fired from two of them. So while his advice that I exercise every hour and take breaks from work may be well meaning, it comes off as condescending and ignorant. Shit, why didn't I ever think of that?

I have a fabulous primary care physician, a local neurologist, a migraine & pain specialist, a psychotherapist and a relationship with the local pain clinic. All of these care providers know my story and are in a better position to help me. Thanks, but no thanks, sir.

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DISCLAIMER: Nothing on this site constitutes medical or legal advice. I am a patient who is engaged and educated and enjoys sharing my experiences and news about migraines, pain and depression. Please consult your own health care providers for advice on your unique situation.