"Sometimes people suffer from headaches and they think it's a migraine, but the cause is actually from strained muscles in the neck or shoulders," so says Chen Hui Wen, an occupational therapist from Changi General Hospital (CGH).
"Seven in 10 adults (Ed.- office workers; Singapore General Hospital survey, 2004) suffer from some form of work-related ache or pain, usually from improper posture during computer usage."
Chen Hui Wen and Patrick Ker, the later being an occupational therapist from Singapore General Hospital, give a couple of advises on a proper "work-place-posture-computer-sitting-in-front" for office workers. You don't have to live in Singapore to benefit from this particular bit of wisdom. So, if you spend a lot of time sitting in front of a computer, do tune in:
Sit at a more reclined angle slightly beyond 90 degrees, provided your chair has back support.
Laptops should not be used for extended periods without a break, because the screen and keyboard positions are fixed, causing users to bend their necks most of the time. Raising the laptop and using an external keyboard is recommended.
If your company gave you an ergonomic chair, do take your time and adjust it, don't just use it in it's stock configuration.
Kicking off those shoes and raising one or both legs up on the chair while you work is cosy, but this only adds extra pressure on the spine.
It's very important for office workers to take breaks in between. Preferably every 20 minutes.
If you can't spare the time, some simple stretching exercises will also help.
This is basically a straight-forward, common-sense way to avoid unnecessary tension headaches. Which, in our cases, as my gentle readers know all too well, may trigger proper migraines. So, lets common-sense-up our working environments and see if it helps.
Did you know that Indian traditional medicine does not recognize depression as a disease? I bet you did, you smart cookie you.
Anxiety, on the other hand, is recognized. Lucky for us too, since those ancient Indian healers had some simple solutions for "when the mind is dizzy with thoughts, there is a sense of nervous tension, or when you are having trouble getting to sleep at night". In other words - anxiety.
Place the thumb of your right hand against the right nostril, pressing it closed.
Allow the breath to move in and out of the left nostril only.
Keep the breath smooth, slow, and deep.
If you are feeling congested, usually the left nostril will open with practice.
The benefit of this technique is best achieved if the breath is kept through the left nostril.
If practicing this breath when trying to go to sleep, lay on your right side. (This will help direct the breath through the left nostril.)
Practice for 3-11 minutes, or as long as you feel is needed.
So, there you go, my gentle readers. Forget those Valium pills and keep on breathing. If you are planning on using kittens as breathing aids for this exercise, please make sure the kittens are lead-free and FDA approved.
Treximet is finally appearing in the pharmacies all around the country. The price-tag is, as expected, matches that of Imitrex, GlaxoSmithKline's flagship migraine abortive. Unfortunately for them, sumatriptan (Imitrex) is going generic later this year. Thus the introduction of Treximet, a "new" medicine to take it's place.
A new book (well, booklet) is written by Daily Minder, one of my favorite non-migraine bloggers. He hopes it will help people to deal with stress, anxiety and depression.
Will it? It actually might - the book is about "a few simple but powerful Buddhist meditation techniques" that Daily Minder learned while traveling in the Himalayas.
Now, that's old-school. Much respect. That is all the reason yours truly needs to plug it here.
In return, my gentle readers, Daily Minder asks to subscribe to his blog's RRS feed. As catches go, this one is pretty benign. Getting a book for adding a link to Google Reader still counts as getting a book for free.
While we, the migraine people, might not have ADHD, we do have to deal with certain concentration lapses, some brain fogginess and even short memory loss. Be it from the pain or as side-effects of the meds we are taking, this fog-of-war can definitely be annoying.
According to Dr. Nicole, some simple changes in our eating habits might help. Here's the highlights of Do's and Dont's that she recommends:
Do's:
Eat protein for breakfast
Avoid a high carbohydrate lunch
Determine if you have food allergies
Enjoy caffeinated beverages in moderation
Eat plenty of antioxidant rich foods
Do eat a whole foods diet
Do eat fat!
Do add herbs in to your diet
Do try some concentration exercises
Dont's:
Don’t load up on sugar, sweets, and white refined bread products
Don’t drink juice
Don’t eat food coloring!
Don’t eat only carbohydrates at meals
For the Why's to these Do's and Dont's, check out the complete article. As usual, it's well researched and referenced with a couple of nice twists; a good read.
And now, Dr. Nicole, we'll be waiting for that "Foods for Migraine Relief" article (hint, hint :P).
As yours truly has reported earlier, Treximet is making a landing in the pharmacy near you. Brought to you by the good people of GlaxoSmithKline, the makers of Imitrex. And priced accordingly, no doubt.
Debbie, who runs Down The Rabbit Hole blog, has noticed something interesting - a little subversive disinformation campaign as propagated by sloppy journalists and uninformed patients alike. There are plenty of little news blips if you care to search for them that say pretty much the same as this little article: New Drug Could Be Best Migraine Medicine On Market.
So that you don't get switched to a more expensive meds by your doctor just because he or she gets their medical news from pharmas press releases, once again here are the facts about Treximet from the horse's mouth, so to speak:
"Treximet contains 85 mg sumatriptan, formulated with RT Technology(TM), and 500 mg naproxen sodium. Sumatriptan is the active ingredient in Imitrex(R) Tablets, available in 25 mg, 50 mg and 100 mg strengths. In clinical trials, Treximet provided a significantly greater percentage of patients migraine pain relief at two hours compared to sumatriptan 85 mg or naproxen sodium 500 mg alone. In addition, Treximet provided more patients sustained migraine pain relief from two to 24 hours compared to the individual components."
Those who follow the rantings of this humble scribe have already heard the call; as for the readers who are only now joining us, here it is again, yours truly's recommendation:
"As this Fall rolls in, change your Imitrex prescription to the generic Sumatriptans and Naproxen and you'll have you own hand-rolled generic Treximet."
Not that you need to heed it, my gentle readers, but just because we are talking medication, it does not mean we should tune out the voice of our inner wallet.
Does sound like those two things are at a cross purpose, doesn't it. When you want to "chilax", you don't really want to "concentrate" on stuff, and when you need more focus, relaxing isn't the first thing that comes to mind.
Well, lets think about it again. In a long run, depression will weaken and water-down your concentration. The loss of focus on things that need to be done or things that are important might lead to more depression later on. It's a self-feeding loop of misery.
Sounds familiar to some of you, my gentle readers? It should. This is one of the perks of having a migraine - feeling blue and blurry-minded.
There are plenty of pills that should fix us up. Except, until they come up with a mix of Prozac and Ritalin, it will still be the same never ending circle of annoying side effects.
I came across a couple of excellent articles recently that list some natural remedies, one for depression, another for improving concentration. While most of the items on the lists were familiar, I did trip over a surprise item or two.
Not only I was not aware of Schisandra, I never thought one could overdose on Vitamin D. The whole write-up is extremely well documented and detailed with some pretty specific recommendations. It looks more like a research paper than a blog post. A must read.
Notice the interesting overlap of Omega 3 Fatty acids in both lists. It would be interesting to read about it in more detail; questions like - "Do Japanese make anime because they eat more fish and if we start eating more fish, do we start making anime too?" need to be answered.
Brahmi is a new thing to me as well. Curiously enough, it's not only used to improve the "noggin-werkz" but also recommended for treating anxiety and stress.
There's also a nice observation on coffee - the "more often you drink coffee the less effective it can become". Caffeine is somewhat of a controversy among the migraine people and it's something we should pay attention to. As Megan recently pointed out, for migraine patients, it's recommended "limiting caffeine to one cup per day, and using more to treat migraines when they arise."
Do give all the above-mentioned articles a read-through, you won't be disappointed.
For some days now, the Migraine News are filled with pointless reminders of how codeine, butalbital, and oxycodone can lead to a development of chronic migraine; no-news of skin pain and sensitivity - cutaneous allodynia - of migraine patients; with a bit of Treximet sprinkled in for the taste.
The Migraine News Network has reported on all three stories some while ago. Anyone who wants to stay in the loop has already read it here. Move on, various world news organizations, fresh content is where it's at.
Here's a hint - Compact Fluorescent Lights might not be the default energy-efficient lightning source in year 2012 that every one bets them to be. Not if the Migraine Lobby has anything to do with it, and it does. 10% of US citizens have migraines - that makes for one very sizable constituency. A bit of organization on our part and some laws might not be worded the way some people thought they would.
But I digress. Hidden inside the well-regurgitated news I've stumbled across an article by Linda M. McCloud about how wasting time could be good for one's health. One of the passages caught my attention: "Napping can even nip a headache from turning into a vicious migraine, if done in its earliest stages."
Really? I, personally, can't nap even if I am payed to do so. On those rare occasions when I had, I woke up with a headache.
My gentle readers, I ask you - does napping (not sleeping, mind you, napping) help you with your migraines? And a related question - what does one need to do to actually be able to nap? Is there a trick to it? If there is, please do share.
In my daily search for migraine and headache -related information I happened to stumble on an article that describes some simple steps to prevent developing a headache while at work. This piece is not aimed at the migraine crowd, mind you; just simple, garden variety headache one gets toiling 9-to-5 in the office cubicle or wherever you place of enslavement is at.
My first reaction was the obvious - "Oh, the normals, they amuse me so." Then I started thinking - there's many a time when a proper migraine can be triggered by a minor headache. We, migraine people, don't usually say that the head hurts until it hurts so much that we are ready to put a bullet through the said head. (It's a migraine thing; normals, ask your "silently disabled" friend for an explanation.)
Still, and I repeat, a "normal" headache is often a trigger. The article I mentioned lists several pretty easy to do things that might prevent that trigger from developing:
Don't get de-hydrated
Do some stretches from time to time
De-stress yourself (easier said than do but needs mentioning). And the most interesting of all-
Practice some simple Chi Kung breathing exercises
Here's the excerpt from the article on how to practice that particular kind of breathing:
"To do it simply sit at your desk and place your right elbow on the table. With your right thumb block your right nostril and with your right index finger press firmly on your “third eye”. The third eye is simply the point right in between your two physical eyes and up a bit on the forehead.
Hold your fingers in this position and breathe in slowly through your unblocked left nostril. Try and bring the air all the way down into your deep stomach. Breathe out slowly and imagine sending the air up your spine to your third eye. Repeat this for about a minute with each nostril."
Look through that article with an open mind, my gentle readers. We could always learn something new, even if it comes from the "normals" :P.
I've been on Treximet for years without realizing it. Even when it was called Trexima and even before FDA approved it, I was loading on it every time the migraine attack hit.
Treximet is expected to be available in U.S. pharmacies by mid-May, 2008. I've been taking it for years. Inconsistency? Not at all. Even without an ability to time-travel (one looses it as one grows older, as you know) it was made possible by combining good old Imitrex and even gooder and older Naproxen.
There goes the mystery... Or does it? Let's check the facts the good people of GlaxoSmithKline and POZEN Inc. laid out for us.
"Treximet contains 85 mg sumatriptan, formulated with RT Technology(TM), and 500 mg naproxen sodium. Sumatriptan is the active ingredient in Imitrex(R) Tablets, available in 25 mg, 50 mg and 100 mg strengths. In clinical trials, Treximet provided a significantly greater percentage of patients migraine pain relief at two hours compared to sumatriptan 85 mg or naproxen sodium 500 mg alone. In addition, Treximet provided more patients sustained migraine pain relief from two to 24 hours compared to the individual components."
The above basically says that either Imitrex OR Naproxen alone don't work as well as Imitrex AND Naproxen taken together. That's has been known for a while (ask your doctor).
So, why mix two in the same pill when you can get a prescription for both and get the same result, you ask.
The only answer one can think is that GlaxoSmithKline is not too keen on loosing all those profits from the sale of Imitrex come November 2008 on the account of Sumatriptan going generic. Naproxen (Aleve) has had this status for longer than there has been recorded history, it seems.
By combining the two, GlaxoSmithKline and POZEN can still sell brand-name drug that's sufficiently different (an extra ingredient and the dosage) from your ran-of-the-mill generic Sumatriptans. Sufficiently different to charge the premium for the brand-name alone.
Not to put down GSK, P. and Company but seriously... We've been paying sometimes up to $30 a pop for those Imitrex pills. We've been holding our collective breaths for GImitrex to get here so we could actually have money on something else besides Migraine Abortives. Now they going to introduce "the latest and the greatest", premium-priced drug that one has got to have.
And people are going to buy into that, and doctors are going to start prescribing it, and no one would know any better.
Of course, the ones who've read this article will have the option of saving at least 2/3 of the cost on the migraine abortives. As this Fall rolls in, change your Imitrex prescription to the generic Sumatriptans and Naproxen and you'll have you own hand-rolled generic Treximet.
As for the people who haven't read it, well, you should have :P .
...Because hinting, complaining or spraying Oust on her would not likely get you the results you want. She'd still wear that perfume and you'd still have a headache.
According to boston.com's Business Etiquette advise column, you start with cornering her in private (check sexual-harassment guidelines of your company first so not to over-do things...)
Begin the conversation with these three things clearly emphasized:
If the tables were turned, you hope she'd talk to you
This is an incredibly difficult thing for you to do, but you believe it's important for her own success and for the success of the business
And while it's an issue for you, you're concerned it could be an issue for others as well including clients and prospects
Whether you believe the above statements or not, it's important to keep things non-personal and business-like. If she tries to switch the subject to personalities, get the conversation back on the message.
Some companies might already have scent-in-the-workplace policies. That should make things simpler. If yours doesn't yet, try to make it sound like it does. "By making it a matter of policy, it ceases to be a personal issue between individuals," and less likely to get you punished for having an extra-sensitive smeller.
Imitrex and operating heavy machinery just don't mix. There's a good reason Imitrex is called a "stupid pill" - you take it and in about 5 minutes you have cognitive abilities of a new-born kitten.
Here's a good example: Associated Press reports that "The pilot of a freighter that caused a huge oil spill in the San Francisco Bay was confused about where he was headed and immediately regretted setting off that foggy morning." They are talking about John Cota, a pilot managed to guide "Cosco Busan", container ship, smack into San Francisco-Oakland Bay Bridge on November 7, 2007.
The follow-up investigation by National Transportation Safety Board (NTSB), reveled that capt. Cota was on quiet a few prescription drugs, including Imitrex for his migraines. He was also taking Valium as a sleep aid.
On a side-note - kids, take some time and write it down - DO NOT mix Valium and Imitrex. It might seem like fun but it does a number on the serotonin levels in your brains. Not only you will feel "blue" (read - depressed) 24/7, your mental concentration will drop right through the floor.
Even taking Provigil (Modafinil), a hardcore stimulant, did not help capt. Cota in this particular instance.
Taking Imitrex alone is a trip. If you are caught in a situation when you have to, say, land a plane, fire a rocket or, I don't know, pilot a huge freighter through San Francisco Bay in a midst of a fog, wait with that Imitrex until you are done. And if you already taken it, just call it in, the results most likely be the same as if you were actually doing it.
The rule of the thumb recommendation for operating heavy equipment after taking Imitrex is - don't. The largest piece of machinery you can effectively handle for a while would be a remote control. If you can remember where you've put it that is, seeing as you just took the "stupid pill".
Making oneself a cripple for a day - that's how the students of Argosy University are trying to promote awareness of disabilities. The end goal is to force the administration make the campus more disabled-persons-friendly. Participating volunteers will be wearing an eye patch, others will have earplugs, and then there will be some using crutches or wheelchairs. In other words, a bit of a cosplay with a moral - lots of fun for everybody, by the sound of it.
The organizers of the campaign do admit that "There are also students with many different types of invisible disabilities that won’t be represented in this campaign." Those conditions are chronic fatigue syndrome, learning disabilities, migraine or tension headaches, seasonal affective disorder, etc.
The problem seems to be rooted in the fact that "invisible disabilities" are not so easily simulated. I thought I'd help a bit by describing how one could imitate a migraine headache.
First, start binge drinking. About three days should do it to guarantee a nice hangover. Upon dragging yourself out of bed on the morning of the campaign, equip yourself with the following items:
You will need an assistant who will carry some more items, such as:
Hummer, icepick or a crowbar
Flashlight
Drum kit
Several vials of strong-smelling substances, such as powdered sulfur, ammonia, cat fecals, etc
While nursing that hangover, walk around the campus wearing the broken glasses and looking through kaleidoscope at periodic intervals to approximate migraine aura. Take the emetic to induce vomiting and nausea every couple of hours.
Have your assistant snick up on you from time to time and either hit you on the side of the head with one of the tools mentioned above, flash some light in your eyes, hit the drums when you are trying to concentrate on something or sprinkle the smelly stuff in your immediate vicinity.
When you think that you had enough, you can try and approximate the "relief" from the migraine headache. Take as much painkillers as you can without throwing them up; take whatever "recreational" substances you can get your hands on (surely you can find some, it's a college campus, after all) until you cannot stomach them anymore. Rinse and repeat.
Doing this for a day should give you a remote idea of what a migraine headache feels like. Multiply your experience by the factor of 10 and you'll know what those "silently" disabled friends of yours go through.
And it doesn't even require wearing an eye-patch.
Just kidding, you can still wear it if you want. Here, have a kitten:
From Canada, we have today a couple of tips for keeping your surroundings healthy, runt against commercialism and a walk on the beach. Here's the useful bits:
Using dehumidifiers - any enclosed building needs adequate amount of humidity to prevent potential heath problems. Irritated sinuses, flu, headaches, all could be caused or made worse by low humidity.
Fluorescent light bulbs - if one must to use them, Full Spectrum lighting bulbs are a better choice than the regular, yellow kind. It will help avoid cataracts, fatigue, glaucoma and, to some degree, migraine attacks.
Air fresheners - "Fresheners do nothing to get rid of odors or their cause. They simply deaden your sense of smell so that you don't notice the odors." Most of them are heavily scented - might not be the best idea when you are trying to make your environment "migraine-friendly".
Ionizers - "There are many reasons for a buildup of positive ions in our surroundings, that cause headaches (particularly migraine) stuffed nose, irritated throat and many other ailments. The answer is to balance them out with negative ions which work in our favor."
Lots of action, some jerky camera work, explosions and gunfire. That's a type of movie that's guaranteed to give migraine people a mother of a headache.
So what do we do when a movie like "I am Legend" (or whatever is the latest at the time you are reading this, my gentle readers; be it "Iron Man", "Speed Racer", "Indiana Jones and the early bird special" or any other flash-bung-head-hurters) comes out on the DVD? Tough it out, load up on meds and sleep-watch it or skip it altogether?
You probably already passed on "I am Legend" while it was in theaters but it is going to catch up with you. It has Will Smith, a dog (german sheppard, good choice) and bunch of zombies. If not you, someone in your household will want to watch it. Even if you successfully manage to skip through this one, they'll get you with the next blockbuster.
There are a couple of things that we could try to make the experience go "smoother" and hopefully less painful.
First, we'll adjust the TV screen.
A movie like that is easier to watch on an old-fashioned tube TVs. Due to the phosphorous coating of the screen, there's less rip and tear, especially during "jerky" scenes. For those unlucky bastage that have large-screen LCD or plasma HDTVs, here's a checklist to reduce the jerkiness:
If you can play it in Blu-Ray format (requires Blu-Ray DVD player!), don't be a scrooge and choose that over a regular DVD. The more bits are sent to the telly, the better the picture quality is. As a result, the transitions between scenes are smoother.
Press "Menu" or "Setup" button on the TV remote and use arrow buttons to scroll to "Picture" or "Screen" section of the menu (whatever you've got, it should be there somewhere). Reduce Contrast and Sharpness a little bit, it should help to smooth fast-moving sequences and produce more "movie-like" experience.
While you are there, reduce Color Saturation; if it's set too high, the colors might "leak" and the picture will have more after-effects. Migraine people have been known to have better color perception than most "normals". If it applies to you, there's no reason to overload your brain with extra-bright colors.
If you have a separate "Black Color" adjustment, use it. It will help to produce a more "natural" image so that your eyes won't try too hard to decipher those dark spots.
Same applies to smaller LCD's and tube TVs as well. Just because your TV doesn't cover the entire wall, doesn't mean the picture on it cannot be tweaked a little.
Also, don't forget to leave a bit of ambient light in the room. Not only because it's a movie about zombies - it will help to smooth out the images on the TV and reduce the possibility of you getting a migraine while watching it.
Secondly, lets play with the sound.
There's going to be some explosions (Bass) and some high-pitch noises, like bullets flying, etc. (Treble). Those two might need to be adjusted as to not have too much sonic impact on your sensitive ears and at the same time provide the sound clarity that would allow you to leave the volume on as low level as possible.
You can use a movie DVD or a CD (most DVD players will play CDs) that you know well so that you can clearly distinguish the adjustments you made.
If the sound is coming from TV speakers, the TV remote is once again the tool you need. Press "Menu" or "Setup" button on it for some sort of menu should pop-up. Use arrow buttons to get to the "Sound" menu. That's where you'll find the Bass and Treble. The important thing to remember is that they are tied together - reducing one might increase another. Play with them until you find a balance that sounds good to you.
If the sound is coming from big speakers next or around the TV, chances are there's an amplifier that controls the sound. This one is trickier but not all is lost. Most of them do have little knobs on the front panel that are either conveniently labeled "Bass and Treble" or say "Tone Mode" or something silly like that. If there's no knobs on that amp, get someone who can operate the remote for it and threaten them to get into amplifier's built-in menu and make necessary adjustment.
On a related note - have you ever tried to use headphones for TV listening? You really should - they block outside sounds and the sound quality and clarity is way better than most TV speakers can reproduce. As a result, you can keep the volume relatively low and still hear every single thing. Majority of TVs and amplifiers have a special jack for headphones built in. If yours does as well, borrow a pair of cans from someone and give them a listen - you might actually like it.
Lastly, you might consider having a "wingman" for watching a potentially scary movie.
Kittens or puppies are the best choice. They are soft, warm and squishy.
If you must go with a human, apply generous amount of duct tape over his/hers mouth so that he/she does not start talking during the most interesting scenes, making you try and listen to two things at once thus triggering a migraine attack.
If no living things are available, a blanky or a fluffy pillow will do just as fine.
Now, you should be prepared. Only one thing remains to be seen - and that is whether you actually want to watch it. Every one says it's great but you still have that lingering doubt... Here's a trailer to help you make that decision:
and here's some pictures:
I am Legend
I is Legend too...
Both Blu-Ray and regular-definition DVDs of "I am Legend" are out on March 18, 2008. Have fun :P
