Monday, 30 July 2012

Plugged into my TENS – pain reliever extraordinaire.



New York, Lower East Side. 2008.

Tisch School of The Arts, NYU. Graduate Musical Theatre Writing Programme.

Boy: Yo V, you Brits sure are sneaky!

Me: Oh and pray tell, why is that?

Boy: I saw you pretending to listen to Michael John in that lab but really you were listening to your iPod, weren’t you? I can see the wires, don’t deny it!

Me: Um well actually –

Boy: You talk all posh but really you is baaad aassss.

Me: Yes. I’m a bad arse.

Boy: Do you know Kate Middleton?

Me: No.

Boy: What were you listening to?

Me: Er I was comparing the Original Broadway Cast of “Company” to the more recent revival.*

Boy: Nice. I like your style. Personally I think that Elaine Str… hang on wait. Where are the earphones for your iPod?

Me: What ever do you mean young man? Oh is that the time we’re going to be late for Playwrighting.

Boy: Your iPod doesn’t have any earphones? What are those pads things stuck on your neck.. wait! That isn’t an iPod at all!

And with that the ruse was up, for I wasn’t listening to an iPod during class: I was in fact wearing a TENS unit. The tall blond American didn’t think I was quite such a bad arse after this conversation and had attempted to explain what a TENS unit was, that I was essentially electrocuting myself.  But you have no idea how often the white wires which poke above the artsy scarf I usually have wrapped around my neck get mistaken for those of an iPod.

So what is a TENS unit & why do I often have one stuck onto me?

TENS stands for Transcutaneous Electrical Nerve Stimulations (TENS) and they generate a small electric current which is believed to “over-ride the pain message trasmission to the brain.” [Coping with Headaches and Migraine by Alison Frith pg 117]  According the Lloyds Pharmacy website they also work by “stimulating the body to produce higher levels of its own natural painkillers, endorphins and encephalins.”

Basically it feels like a nice massage (not electrocuation at all) and can signficantlay reduce neck and shoulder pain and is, for me, a wonderful distraction during a migraine.

I was first given one at the Dartmouth Hitchcock Medical Centre in Hanover, New Hampshire in 2004 after my Inner Ear operation for misdiagnosed Migraine Associated Vertigo. Following the operation I saw another ENT Doctor (with a specialism in Vertigo) and explained how my saga began after I was involved in a Road Traffic Accident where I was hit from behind and suffered from, what I believed at the time, to be severe whiplash but I now know was, in fact, a minor spine fracture. This misdiagnosis has led to a slew of other neck issues. That Doctor had done several studies and believed that if you stabilized the neck and back, vertigo often decreased. If you think about it there are many balance mechanism within the neck which, I guess, can literarily pull on the inner-ear. (He put it far more eloquently. If I can ever find the studies he gave me I’ll post them.) So he wanted me to work on strengthening the relevant muscles in my neck which had, at this point 5 years after the accident, atrophied, as well as doing other vestibular rehab.

So I was sent downstairs to Physiotherapy and there I was given the Power Ranger of all TENS unit. At the time my US Health Insurer paid for it. I was told to cut one pad in half and stick it on the back of my neck where it hurt and the other half on my shoulder, or wherever the pain and stiffness was, and to then gently turn it up to the desired level. And here is where you can have some fun with TENS machines, I have often turned it up too high, or put the pads in the wrong place and had arms flaying about beyond my control like some deranged Robot. I was warned NEVER to place a pad on my head. This can be dangerous.

With a TENS unit (they’re also called machines?) you really just have to carefully experiment. I often like to put the pads on each shoulder, or one on my neck and the other of my shoulder. Like so!

Apparently the pads should always be a 'pads' width apart. Apparently I should also do something
with my mullet. 

In the UK you can now buy them in most major Pharmacies or on-line (Amazon seems to have a good selection.) They range in price from £9.89 up to about £60.  Replacement pads are also readily available. A ‘Dual’ machine allows you to have four pads, I only ever use two though and find that adequate. In terms of settings, personally I prefer a constant setting, I cant stand the programs that pulse or augment up and down but again, it’s a question of taste. You might get some strange looks going to buy one, however, as they’re often sold as aids for child birth but more frequently they’re being sold for back and pain management. I have a beautiful purple one called a ‘Femme Tens’ and do not believe I’m pregnant. Though if offered a seat on public transport I will take it without any shame. My current TENS unit is not nearly as sophisticated or as powerful as the Power Ranger one I was given in the US but seems to do the trick. I don’t think there’s any real difference between the birthing ones and the back pain ones. Friends of mine who have used them in labour said they aren’t much use anyway….
My Femme Tens on the left with the cover open to change settings
Mum's Tens on the right. 

But I find if my left shoulder muscle begins to ache, or go into spasm, or my neck starts to hurt I whack it on and sometimes it can negate taking pain killers and stop a migraine or tension headache developing. Once I have a migraine it really is a great distraction, it helps dull the pain somewhat but it is, obviously, by no means a cure and not a replacement to my precious triptans. Sometimes I find it annoying when I have a mega migraine but more often than not I crave it, especially when my back is sore or I have to sit for a long time. If you are prone to tension headaches, or have any type of muscular ache, I’d really recommend trying one. For those of us in danger of Medication Over-Use Headache this is a good tool to have at hand, so mine is always in my handbag and Mum swears by hers too. It’s up there with the old ice pack in terms of my migraine survival kit. So if you see a girl with wires peeking over the top of her scarf… and nodding along to imaginary music, just humour her allusion and madness.


Useful links:
A chronic pain patient's view of using a TENS, also a fabulous blog in general! http://365painfreedays.com

p.s
Do obviously check that it’s safe for you to use a TENS unit before you plug in! i.e if you have a pacemaker, or other implanted medical devices.

Coming up:
Nerve Blocks of all sorts
Topamax Trials and Tribulations Part II
Migraine Rituals and Comforts
National Migraine Centre - Migraine Mecca

*I do also realize that Tisch school of the Arts is probably the only place in the world where listening to the original broadway cast recording of any musical could be classed as cool. Hence why is was the best two years of my life…. Sigh. 

Tuesday, 24 July 2012

Physiotherapists get the right to prescribe medicines in the UK

Breaking news!

British Physiotherapists are to gain the power, apparently, to give prescriptions to their patients. This will not come into affect until 2014. Personally, I trust my Physio way more than a lot of my Doctors and most of the GP's I've ever met - but she's very special, she got into Med school - and is unlike any other Physio, Chiropractor, Osteopath I have ever met. And I've met a lot. She is councillor, friend, advisor all in one. When I first met her I could only walk about ten minutes before some part of me spasmed, I wasn't sleeping or eating properly, I had Medication Over-Use Headache (MOH) and basically was in a total mess. She was the first person, after seeing countless posh Neurologists, specialist Consultants at spine clinics and Inner Ear Doctors who not only helped with my Migraine Associated Vertigo but got my migraines under control and allowed me to come off the SEVEN pills I was taking daily. I can say, without any exaggeration, that with out her I'd be in a wheel chair (a Doctor told me this so this isn't my usual over dramatic flourish!)

It's not unusual for her to send me to GP's and specialist Consultants to ask for certain medications (and they usually agree with her recommendations.) She often can tell me more about the side effects of the medications I'm on than the Dr's who have prescribed them -  so I can completely see where this new ruling is coming from. I'll describe, in more detail, how I work with this wonder woman in another post.

BUT

Finding a good Physio is like finding a golden ticket in a Willy Wonka Chocolate bar. They are very few and far between. My Physio advised me that you should generally look for someone who trained in a teaching hospital (obviously I'm biased towards the London ones) is in their 40's (as apparently the training has changed and is now much more basic) and should be able to explain, completely, all of your symptoms - you would be surprised how many can not comprehensively do this! If you're not better in three months - move on. Sadly, even these simple check marks are no guarantee of good care.

So, I will be interested to read more about this and look forward to hearing your opinions too. I've got no idea if prescriptions will be issued through the NHS or just privately. I'm assuming NHS?

Read more here:
http://www.bbc.co.uk/news/health-18955680
http://www.telegraph.co.uk/health/healthnews/9421045/Physios-and-podiatrists-to-be-able-to-prescribe-drugs-Department-of-Health.html
http://www.dailymail.co.uk/health/article-2178025/British-physiotherapists-world-allowed-prescribe-medicines-patients.html

Relevant Past Posts:

Saturday, 21 July 2012

The Healer Part II


I am the first to admit I was a sceptical cynic (which is probably an oxymoron but I like the sound of this ‘near’ alliteration so kindly piss off and don’t point out my grammatical flaws) about the idea of seeing a Healer. But when it came to actually meeting my lovely Lady Healer her genuine and warm personality, not to mention her instantly heating hands, melted my inner cynic and started to win me over.

[You can read about my first appointment here if you haven’t already clicked on the many links imbedded above.]

So, it was with a glad and open mind that I returned for my second visit. And, quite conveniently, I had a rather nasty migraine coming on. For the purposes of ‘science’ I decided it would be interesting not to take my usual medication. Let’s really put Lady Healer to the test, I thought. As the hour of my appointment grew closer, however, the pain got worse. So much so, Mum cancelled her own plans and insisted on driving me to the Healer’s house. She said it wouldn’t be safe to let me loose on the London Underground. I’m still not sure if she was worried for my safety or that of the general public…  

By the time I arrived for my appointment I had caved and taken some pain killers, not my usual triptan (Zomig) which I would normally have taken by this point. I was doing this for 'science' after all - i.e this blog. Lady Healer wrapped me up in a blanket, stuffed cushions round me so I was comfy, and let me lie on her sofa. Intuiting that her usual interesting chatter would not be quite so welcome today, she just quietly got on with it! I didn’t want her to touch my head yet, so asked if she’d work on the sore shoulder muscles instead.

Before long the hands that were cold upon greeting me were toasty warm and had done wonders relaxing my muscles. I seriously think she should market her hands as some kind of non- nuclear heating devises, she could be the answer the national coal shortage. 



Anyway, despite her heater hands, the migraine was still on its menacing way. Then Man Upstairs arrived. If you remember, this is the guy with the MRI vision. I sat up and he did his thing again. As if looking through me, he said my left side was in spasm beause the right side was all out of kilter: collar bones were in the wrong place, cervical vertebra were twisted etc etc. He said he could ‘see’ the pain. Personally, I was mainly concentrating on not trying to feel it. I was beginning to feel quite sick and kept having to remind myself to breathe the pain was getting so bad, despite all Lady Healers magic hands were doing for the muscle spasms.

In an attempt to distract me, I think, he asked me what my blog was called and beacuase I wasn’t quite with it – I stupidly told him! And right there and then he wipped out his iPad and read the blog entry  about my last visit there!!! Pleading with him not to, I despearely tried to remember what I’d written about them… but he then started to read passages aloud while Lady Healer slowly put her hands around my neck.  I wondered if she had the power to kill at will.

Luckily, he seemed pleased with my blog post but has asked that I point out that his MRI/X-ray eyes is not a gift, it can be learnt, and that he is also a hands on healer. What he does is also far more complicated and intricate than I can explain here – but it does seem quite clever.

Having decided that I hadn’t completely derided both of them he continued to intruct my Lady Healer where to place her hands to get my bones and muscles in the “right place”. I really could feel things very gently beginning to move, even though her hands barely touched me. The muscles seem to first relax then shift. She really just lays her hands on you and it’s as if she’s willing things to move; she doesn’t force a manipulation in the way that a Chiropractuer does, for example. It’s all quite soothing. They both agreed it would indeed take more than 3 appointments to get me better but that, together, they could.

Before they could work too much on my neck I asked them to stop as even though it is very gentle things were moving a lot. I have an uber, uber sensitive neck (my neck can go into spasm just from tilting back to put my hair into a ponytail) plus I’m hyper mobile so I wasn’t sure I wanted people mucking around with "Gwyneth Paltrow swan neck" (that's what Dad calls my neck,) especially when I was well on my way to a migraine. They had, apparently, re-alligned my collar bones and I must say the migraine pain did waver, as in dimmed somewhat, while I was there. 

Standing up to go, I was shocked at how stiff I felt, like the old granny my 11 year old niece is always at pains to remind me I am. Once safely home, however, I inhaled my precious Zomig and under piles of ice packs and hot water bottles passed out into oblivion.

As before Lady Healer and Man Upstairs had warned me I’d feel stiff, but the next day I felt bizarrely stiff, like I’d ran a marathon. I’m slightly wondering if this is all a bit too much for me – I already work quite hard with my physio, do my swim walking and pescribed exercises about three times a day. I have a pretty robust treatment plan already in place. I do think we migraineurs should be fairly methodical in how we approach our ‘get better’ plans so:

a) we can assess our progress and
b) so we know what is actually working and how. 

But I was just quite curious about all this Healing malarkey, which is kind of why I went in the first place. But I do wonder if I’ve simply got too much on already with physio/Topamax/nerve blocks etc etc. I am starting to make slow progress after after all and I'd hate to jeopardise that. 

But I have booked into see them again and will go – as will all migraine preventatives and treatments there are no quick fixes and you can’t make quick judgement calls. Conversely, you can tell quite quickly if something is harmful. But then again, as I did note when I started physio, often when you use new muscles you sometimes feels a bit worse before you see progress (sometimes, I believe, the same is true of preventative medications.) God I’m full of useful tidbits and am annoyingly indecisive today!

Here endeth the life lesson from Victoria. But I’ll be sure to keep you updated on how I go with my next session - and if I can make a decision on committing to it.

Be well. 

Past Posts you might enjoy:

Remember if you want more information about Migraines check out:

Tuesday, 17 July 2012

What happens during a migraine?

Hello migraine monologuers.

I've just found these rather fabulous series of videos featuring Professor Anne MacGregor and Alison Frith, formerly of the National Migraine Centre (formerly the City of London Migraine Clinic.)

This video starts with one of the best and most simple explanations of what actually happens during a migraine attack that I've seen for ages* - and Professor MacGregor and Alison Frith know more about migraine than most people know about... well most things. There are tips and info galore. The videos have been put together by Dr David Kernick, while Headache Champion of the Royal College of General Practitioners.


When you've watched the above video you MUST watch this one which talks about how to treat a migraine attack, MOH and different Tritpans. I'll be sending this link to anyone who asks me about migraines and how to treat them from now on! I think there are about 7 videos in the series. 

If you have any type of headache or migraine run (or gently jog) to the National Migraine Centre. You don't need a GP referral and all they ask for is a donation. I'll be writing a more detailed blog about this migraine mecca shortly. I go there myself... what more do you need to know!


In the meantime here is their website. Check it out and give them a call:
http://www.migraineclinic.org.uk/

*As always there is some debate as to what actually happens, no one really knows, but this is pretty good!

Coming up:
The Healer Part II
Topamax Trials & Tribulations: Is it starting to work?
TENS units
Migraine rituals

Thursday, 12 July 2012

Serena Williams - Migraine Champion!

Women who suffer with migraine are spindly spinsters who sit at home in the dark, don't get out much, lack motivation and are generally neurotic hypochondriacs.

Oh really. Care to say that to this woman's face?????



I'm pretty sure it wouldn't go down very well. Not only is Serena Williams this years Wimbledon Champion she is a Migraine Champion (cheesy I know but get some crackers and deal with it!) It's a little known fact that she's suffered with severe menstrual migraines since she was 18. If ever there was a person who debunked nearly all of the myths and misconceptions that surround migraineurs, it surely must be Miss Williams. I mean, let's be honest, not only does she wear rocking tennis outfits but I'm willing to bet she could beat most chaps at an arm wrestle. Spindly and lacking in motivation she is not.

As is sadly all too typical for many migraine sufferers it was years (5 to be exact) before Serena was correctly diagnosed and got the help she needed. If only she'd come to me with her problems I could have told her instantly what was going on, but we're not besties yet. Serena we'd get along so well, do get in touch! But this highlights once again the lack of awareness and education out there, amongst the public and even more frighteningly: the medical profession. Just read this quote to see some of the comments made to her by ignorant Doctors (I'm almost impressed they dare say these things to such a world class athlete.)

Serena Williams is doing her bit to raise awareness but I wish she'd do more. If she's still in the UK I think she should stop by The Migraine Trust and the National Migraine Centre and become their Sports Personality Of The Year.

There are many other famous faces, from actors, athletes and writers, who suffer with migraine which may surprise you and I will be talking about them in due course.

p.s I'm off for my second session with the Healer today, wish me luck!

More information on Serena Williams & her Migraines & Menstrual Migraines:
http://www.migrainetrust.org/factsheet-menstruation-and-migraine-10883
http://www.migraineclinic.org.uk/wp-content/uploads/2012/03/Factsheet-Menstrual-Migraine-12.1.122.pdf
http://www.thedailybeast.com/newsweek/2005/05/09/it-s-one-of-the-worst-things.html
http://thatmword.com/post/24808298997/a-spokesperson-for-migraine
http://conditions.healthguru.com/slideshow/mvps-with-migraines/serena-williams


Coming up on Migraine Monologues:
Topamax Trials and Tribulations: Is it starting to work?
The Healer Part II
The Dietician and the FODMAP Diet
The TENS  Unit
Nerve Blocks
Migraine Rituals and Comforts

Friday, 6 July 2012

Champagne Migraine Diet!

Picture sourced by the fabulous Hudson Meredith

Um, so in the interest of um Science, for the greater migraine community, I am willing to put myself through a "Champagne Migraine Diet". I can't really drink wine but I can drink the odd glass of Champagne quite happily. It has been suggested this is psychological. I can't help that my migraine has expensive tastes. But I must confess to having had the odd Champagne migraine (even though I would argue that white wine and Champagne are very different commodities.) 

The visit to the Dietician (which I'll write about properly) did result in me cutting out gluten, and as I already don't do dairy, I think it only fair to add in more Champagne. I'll let you know the results of this most scientific and serious of experiments one day soon. Good weekend. 

p.s I must add that the Dietician did not suggest the "Champagne Migraine Diet" - it is entirely a creation of my own genius! 

Serious Medical Note:
Please don't all get drunk - alcohol really can trigger a lot of migraines. Drink responsibly. 

Monday, 2 July 2012

Stomach Spasms, The Dietician and Me.


“AHHHHHH. Urgggggg. Oh God!”

“Remember the birthing exercises, eeeeehhhh, oohhhhhh, eee eeee, ohhhhhh”

“AAHHHHHHHHHHH. I’M NOT GIVING BIRTH! Mummy I think I’m going to fai…” 

Black spots started to appear before my eyes and the room began to swim. No, I was not in the throws of a migraine aura but in the midst of a horrific stomach spasm that often accompany my migraines.

“It’s OK I’ve got you, just keep breathing.” Mum held onto me, applying cold flannels to the back of my neck and forehead.

My legs had turned to jelly and I was sweating through my clothes. My mind flashed back to one particularly vicious incident when these stomach spasms first started happening: I was in the kitchen of our old house and I realized if I didn’t lie on the floor I’d pass out. My cheek stuck to the floor varnish, I noticed a piece of carrot was stuck under the oven and I really hoped the friends I had staying wouldn’t come downstairs and find me lying prostrate on the kitchen floor. When it finally passed I stood up and there was a Victoria shaped pool of sweat. Attractive.

But back to the present day, and in a haze I was aware of Mum doing some puffing and panting thing and telling me to copy her. So I did.

I’d also just like to clarify that I’m not, never have been and don’t plan to be for a long time yet, pregnant (on a side note by the time I do give birth I want to lay an egg, or grow my baby in a nice pouch like a Kangeroo then painlessly crack it open in the comfort of a 5 Star Hotel such as The Four Seasons.)

Anyway, Mum’s birthing breathing techniques did seem to be helping and the spasm eventually passed. I flopped against Mum and waited for the next one to strike. She wiped away the sweat from my forehead and said,

“So now will you see that Dietician?”

“No! It won’t make any difference! What can some 12 year who probably got their qualification online teach me about diets and migraine?” 

Clearly I wasn’t in my most charming mood. But I already don’t eat dairy (I’m lactose intolerant) and I even gave a friend a book about healthy eating for Christmas, I know, I give the best gifts but I am pretty good about healthy eating. I just didn’t see the point of yet another consultation.

“You’re being a bit arrogant and narrow minded if I may say so.”

“You mayn’t say so I’m about to give birth another one’s coming! I think it’s Twins! Ahhhhh!”

And with that another spasm struck: cue two women puffing and panting like blowfish (Mum puffs/groans/sighs along for moral support.) Gripping my hand tightly, Mum tried once more, “She might be able to prevent this from happening again, you just don’t know. Isn’t it worth it!?

“OK - OK - OK!” I yelled on each out breath (I was getting good at this birthing breathing) and then “Eeee oohhhhh, eeeeee ohhhh.”

What I haven’t yet told you, is that this conversation all took place on The Throne, The Jon, or what we like to call it here in Great Britian: The Loo. These spasms often culminate with a release, shall we say. Don’t worry that’s all I shall say on the matter, I’m from Great Britain after all. And yes, I realize my Mother deserves some kind of Saint Hood for hanging on in there with me.

My stomach spasms, which are apparently lower intestinal type spasms, started shortly after my migraines did. They never occur with my migraines, thank god, but after a bad bout of migraines. I only put two and two together quite a few years after I was diagnosed, as usual I had to do the detective work. The spasms also used to occur after I’d been taking a lot of strong NSAID, for said migraines. For anyone’s mild interest, they don’t always end on The Loo.  

Why does this happen? IBS & Migraine
As my neurologist likes to say the gut goes on strike during a migraine, i.e the gut and stomach shut down during a migraine even if, like me, you don’t vomit. This is why it can be so difficult for some people to get their medications into their system. To me, therefore, it makes total sense that after a three day migraine, when your stomach starts to work again, there are going to be some kinks in the system, some seriously painful trapped wind that needs to work its way out. Research, however, is beginning to suggest that stomach issues might be a problem for migraineurs full time, i.e not just during a migraine episode, or like me – just after a bad spell.

I recently learnt a new word: comorbid (try and be pretentious and drop it into daily conversation as much as possible today) and did you all know that IBS and migraine are comorbid? I’ve been putting off writing about my delightful stomach spasms for ages but The Migraine Girl’s post on migraine.com reminded me that I’m not alone and that stomach upsets of various sort are all too common for us migrainuers and as usual – it’s not common knowledge. I had no idea until quite recently that IBS and migraine were comorbid. (By the way I'd like to be comorbid with Johnny Depp now that he's single.) I’m very lucky in that I don’t actually have IBS but I do get occasional IBS like attacks. And often migraineurs are mis-diagnosed with IBS when, in fact, it's all part of of life with migraine. 

So what does all this have to do with a Dietician? Can food help with this? Well I’m afraid dear readers I’m still in what I call migraine hangover land so I’ll save the story of meeting The Dietician and all that I learned for the next exciting episode of migraine monogloues…..

But…. some top tips in the meantime:
What do I do when I get a stomach spasm?
  • Peppermint oil – put a few drops in hot water (works faster than peppermint tea)
  • Magic pink pills – from France (if I take these in time they can stop the spasm. They're called Spasfon! Got them OTC one time in France, work far better than Buscopan or anything I've ever tried in the past. My Gastroenterologist says he has no idea what's in them but if they work keep taking them! Vive La France! I'll talk more about them next time)
  • For painful trapped wind – try to move about, if you're lying in bed pull up your legs and roll them from side to side to 'move' the wind...
  • Hot water bottle
  • Try to get less migraines...! 

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