The Magical Mythical Migraine Pill
There are two types of Migraine myths — those that non-Migraineurs create for us, and those we create ourselves. They seem to fall into two categories: Snake Oil and Magical Pills.
I’d like to spend a few minutes talking about these myths and hopefully lend some encouragement. I’m struggling with these issues myself, so please stick with me to the end…
Snake Oil Myths
We can cure your Migraines in 5 easy secret steps!
I haven’t had a Migraine attack since making this one small change to my lifestyle, and you can do it too…
This experimental surgery/treatment/pill will permanently relieve your Migraines and change your life.
These are the myths that can create a small spark of hope in even this Migraine advocate’s eye. But, myths they are, and we need to remember that they are myths.
Every day I talk to patients and each day I have the obligation to tell at least one patient that there is no cure for our disease. Yet. If there were it wouldn’t be a secret, we’d all be using it — GUARANTEED!
There is no Migraine treatment that works for everyone.
Surgery may make us feel better that we tried something truly drastic. It may even help those around us to understand the depths of our desperation. Right now that option is experimental and it cures nothing.
If the evidence for a treatment (drugs or devices, including surgically implanted devices) is truly overwhelming, it will be FDA approved as fast as possible. Recently, the FDA has initiated their Patient Focused Drug Development Initiative, designed to include patient feedback about disease effect and burden when reviewing drugs for approval.
There are no cures for Migraine disease. Research is ongoing, and hopefully we will soon find something that helps all of us. Until then, there are no treatments that are going to be helpful to everybody. None. Good doctors with proactive patients ready to do the hard work that is necessary to get better are those who will be seeing the best results in this new year. I hope you’re one of them!
Magical Pills Myths
It breaks my heart to see patients dig in their heels with their doctors and their treatments. Patients often expect miracles from their doctors and from the treatments they try, yet they don’t understand that what they’re expecting are miracles. Yes, there are many, many treatments we can try along the way, but this disconnect between truth and reality can damage the patient as well as his/her physician relationship, leaving the patient struggling and searching… never finding what they’re looking for.
When a Migraineur still has frequent Migraine after a drug trial, they often get angry and depressed. They expected this to be the medicine that would change their lives. Going from daily attacks down to 15 Migraines a month is often not sufficient for their expectations. They want more. They want their lives back. They lose trust in their doctor’s judgment and abilities, and they often throw the baby out with the bath water in terms of letting their frustration with a chronic condition dictate how they proceed. For example:
- A new medicine *may* cause a side effect they don’t like. A patient refuses a drug because of something it *may* do. Or maybe they try the medicine, but a side effect hits that is unpleasant. This is sometimes a reason to discontinue a medication, but side effects are often transient, and I always encourage patients to stop and consider the next 3-4 months a good medication/treatment trial will take in comparison to the years they have lost to their disease, or the years ahead of them. Is 40 years feeling better worth the next 3-4 months of your life? Even feeling lousy? Which is worse – the side effect or living with Migraine and the possibility of progression to a worse situation? We must all make those decisions for ourselves, but we need to be smart about them.
- A patient worries that the process of a drug trial will cost them a job, or their family relationships, so they bypass the lengthy trial for a drug or treatment that is known to be helpful for some patients, for an obscure one they believe might help them yet be less intrusive.
- A patient with medication overuse headache or a bad habit like smoking, or poor sleep, exercise or eating habits which are complicating their Migraine treatment or triggering their Migraines, refuses to seek help to fix their problem first and continues to look for a magical solution that will work miracles despite what they’re doing to make their Migraines worse. The results of these self-sabotaging actions are often more pain and disability, and that drives patients to such desperation they will act dangerously, trying nearly anything. Specialists often refuse to address these patients’ destructive lifestyle choices because they know patients will get terribly angry with them. Patients often want to hang onto their comfortable habits and simultaneously find the relief they believe is out there despite what they know they need to do.
- Patients desperate for relief from their suffering will give up their search for a good specialist in favor of someone less knowledgeable who offers pain relief alone. They’ve stopped caring about the neurological issues and have been seduced by the promise of doctors who don’t even know how to treat the Migraine itself. This is a trick that many of us have been fooled by. YES pain relief is necessary for us to live our lives and is sometimes necessary as a rescue, but when that magical pill is taken too long and eventually causes patients to become worse and ruins their lives even further, it makes me as an advocate cry *foul*.
I know we’re worried about our families and bosses and friends and how they feel, as well as keeping up with our obligations. Instead of looking for a magical pill, let’s talk to them so they understand that this is important for us to try and that it might result in feeling better and doing more. Make arrangements ahead of time so we have less to feel guilty about. Encourage our kids to encourage us, ask friends and family and other Migraineurs to help hold us accountable. This makes them feel involved, needed and important too.
I know this post may smack of blame, but it’s not intended that way at all. I hope it’s empowering. Being a Migraineur is hard work! We all have things we can’t let go of and things we fear. Most of us have been here at some point or other. What I mean is… lets all work together and support each other as we strive to do the things we know we really should do, stop doing the things we know we shouldn’t, and remember that we need to be careful of those things that sound too good to be true. Yes, sometimes we are desperate, but we don’t have to stop being smart.
Let this post help to relieve some of our fears, allow us to step out in courage in 2013 and work together toward a better Migratude!