Wednesday, January 26, 2011

Dear Marketing Bozos,

Thank you for this helpful sheet on things my patients should avoid to prevent migraines.






1. Head trauma. Wow! I was completely unaware that patients should avoid this. I figured it might toughen them up, and openly encouraged it. Perhaps I should rethink my opposition to seatbelts and motorcycle helmets, too.

2. Menstruation. I'll let all my lady patients know to stop doing this immediately. I had no idea it was under voluntary control, so I'm glad you told me.

3. Weather changes. I'll tell my patients to immediately move somewhere that has absolutely no weather changes. Like Pluto.*


* Actually, sometimes this doesn't sound like such a bad idea.

45 comments:

R. May said...

On the menstration thing. Since you can actually stop periods indefinitely with the use of birth control. Not being the medical type I don't know - would that be beneficial to migraine sufferers? I I know bc is a hormone, but since it would be a steady level....just curious.

Grumpy, M.D. said...

It varies in my practice experience. Sometimes works, sometimes not. It's highly individualized.

The Merry said...

That would have the added benefit of avoiding cramps too. :)

Lars said...

I wouldn't recommend living on Pluto though. It quite cold out there and the weather is bound to be varying a lot, considering it highly elliptical orbit around the sun. ;)

Grumpy, M.D. said...

Okay, how about Charon? Does Charon have an atmosphere?

Lars said...

Don't know. Never been there.

Munk said...

Sunspots! They forgot sunspots. Talk about not doing your research ...

The Reader said...

@ R. May, when I was on bc pills, it only made my migraines more predictable. I would have one, the day I took the first placebo pill, every month. Never tried the whole skip the placebo thing of only taking the actual pills. Maybe that would help....who knows.

@ Dr. Grumpy, love that you are calling out this ridiculous marketing company. Would that avoiding migraines were as easy as avoiding menstruation & weather changes. (sigh) Do the kooks at the marketing company really think migraine sufferers go around loading up on migraine triggers just for the fun of it??? I mean, most people I know who've identified what their triggers are already do avoid said triggers even without a marketing co. telling them to.....

I think I need a job at a marketing firm. Getting paid to state the obvious and impossible....sounds like a cake walk.

donna said...

I have had migraines since my teens. They occur in my family back 4 generations that I know of.
Wow never knew all of these were
triggers *snicker*. One thing they should add are big screen t.v's, especially when there are flickering or alot of movement.
Your posts are such a delight, though you seem to be such such a magnet to the whackos!
BTW: husbands such be also added to the trigger list! LOL

23 Skidoo said...

Marketing people do not attend any science or medical classes. They just know how to make pretty brochures.

Meg said...

I have several friends who suffer migrains around menstruation. There is a once-every-four-month pill that works for some of them, and others just skip the placebo week eleven out of every twelve months (apparently if you don't bleed ever it can lead to cancer). I know two who have tried to get hysterectomies, but neither was able to find a doctor who would perform the procedure on a still-potentially-fertile woman, even if they were incapacitated for one week out of every month.

They didn't find my suggestion of never taking the placebo week and getting uterine cancer so that someone would remove it particularly helpful.

jimbo26 said...

My migraine trigger is potato/starch , haven`t eaten any in 40 years ( not even potato chips ) .

Packer said...

I always thought that red wine and chinese food loaded with MSG were big triggers.

I have a part timer who works for me, when she stresses---bam down for the count.

So stress reduction inductions work for her.

emmy said...

So it's the marketing companies that make the innane lists and not medical people. How interesting. I wonder why some doctors give them out. My personal favorites are the ones that detail ways to avoid nausea when you are on chemotherapy. Apparently if you keep eating small amounts while you are puking your guts out you can avoid getting sick at your stomach.

Grumpy, M.D. said...

I don't give them out at all. With rare exceptions, they get put in the paper recycling bin.

Old MD Girl said...

Huh. When I get a headache, I've been hitting my head against the wall until it stops. I guess I should stop doing that?

terri c said...

I think I need a job in marketing, too. This list is just so colossally stupid that you have to love it.

Jen in Cincinnati said...

On the menstruation topic: progestin-only birth control often stops periods altogether, or reduces the flow immensely. For me, depo-provera and the "mini pill" (Micronor) both have resulted in cessation of bleeding - yay! Maybe that is why my migraines have been so few and far between.

Sandra said...

Sorry, Dr. G, Charon does not have an atmosphere.

Titan, moon of Saturn has an atmosphere. Of course, it's all nitrogen, but, hey, I'm sure we could evolve to breathe that, right? It also has the only large, stable body of water in the solar system, except for Earth. And a great view of the rings, to boot. Only downside: It has weather changes, too. :-(

Grumpy, M.D. said...

That's the point! It should be a place without atmosphere (like the Chinese buffet down the street).

I figure having an atmosphere is a key part of generating weather systems. No atmosphere, no weather changes, no migraines.

Diana said...

I suffer from tension migrains and have had to make a trip to the ER a couple times due to pain and nausea. When I was put on medication for high blood pressure my migrains suddenly weren't so severe. They are quite managable now. I thought I was imagining it and told my doctor about it. He confirmed that sometimes it does have that side effect. That's a side effect I can live with!

PirateJenny said...

Yeah, I love this advice. Given my biggest triggers are weather changes and my period. So thank those marketing guys for me.

Meaghan said...

Wow why didn't my dr tell me these things? 25 years of migraines, and all I had to do was avoid weather changes, and not menstruate. Maybe I can now go back to drinking red wine, eating stinky cheese, and stop everything else I'm doing.

If only it were that simple, sigh

Jen said...

I think maybe the head trauma suggestion was actually for "avoid too little head trauma"...because then you can be a marketing person.

Headstrong said...

Pfft. I love these.

1. Tell that to the drunk, dualie driving puke who ran me into the ditch and left me with a chronic subdural hematoma.

2. Ah, check plus. The chemo has left me menstrual-less.

3. Still looking into a portable, affordable "life in a vacuum" kit. Amazon still isn't carrying them...

If it were really that simple, wouldn't we have already thought of that?! I've tried to ID and abstain from every possible trigger. Even with an ever evolving and goodly handful of "anti-migraine" meds - in addition to my cytotoxics, DMARDs, and steroids to stymie any lupus contribution - still have 3-5 a week. (I'm considering amputation at the neck, but my neuro says, as that's never been clinically tested and there are no good cochrane reviews on the best procedure, he can't recommend it in good faith.) But, nice try, ye marketing gods of Almotriptan.

Thanks for the fun post Dr. Grumpy!

Bibliotekaren said...

Oh man, I busted a gut laughing on this one!

I so know all of these triggers. Guess I should have avoided that brain tumor, being a girl, and living in the Pacific Northwest.

Thanks for the laugh.

Cartoon Characters said...

Ok...I stopped doing #2 on your list.....MENOPAUSE.

Nope. STILL get migraines....
;)

Can't win for losing here.

RSDS said...

I see aspartame is on that list as a trigger. It is one of the ingredients in Zomig-zmt, the disintegrator form of Zolmatriptan.

Zomig-zmt also contains an artificial orange flavor that I find to be extremely nauseating, no matter what product I find it in.

RSDS

Not House said...

Reminds me of how nearly every disease has "low socioeconomic status" as a risk factor.

'Now, Mr. Jones, if you could just putt it together and get a job, I'm sure your lupus would clear right up"

pharmacy chick said...

we get more redundant and worthless pamphlets delivered to the pharmacy. most of the time they go from the mail to the garbage. why waste my counter space with this worthless drivel.

Kat's Kats said...

::head:very very very soft pillow:: Weather changes!! Weather changes!! That's why my head is falling off!! Which reminds me, where is my Imitrex injector refill?? Oh reeeeeefillllll! Oh reeeeeeeefillllll! Come to mi... uh, come to momma!

(who really really needs to stop being an idiot, get off the computer and track down either the refill or that preloaded syringe now)

Anonymous said...

I wasn't even dx'd with migraines until after MENOPAUSE, when my headaches got so much WORSE!

(I probably did have migraines from childhood on, they just never were dx'd as such since I don't get auras.)

Not every menstral period had a headache, and not every headache came at my period, but they coincided often enough that I had arrived at my own conclusion that there had to be some kind of correlation between them.

Cal said...

@ Diana: Propranolol was wonderful to reduce the number of migraines for me too. Wonder drug!

Once my neurologist gave me a list of foods to avoid, which could be triggers for migraines. Included in the list were canned figs... who has actually ever eaten canned figs? Or seen them?

Claire said...

We get a "helpful" brochure every couple months from our health insurance company about "preventing asthma symptoms" (because my son and husband both have it."

It's the same damn information every 2 months. Use your peak flow, take your maintenance meds, use dust mite covers, etc etc. We've got it already! My husband has had asthma for over 30 years, WE FUCKING KNOW.

Anonymous said...

another migraine topic. This is bound to go at least 60 comments or more. ;-)

sparkly jules said...

I've wanted to stop menstruation since it started over 35 years ago. Does this company know something we don't? Because I think they should damn well share. Periods suck!!! No fair keeping information secret!! :D

Cyndi said...

Hysterectomies are wonderful things! I also read that Hawaii has the lowest amount of pressure and weather related changes, so all of us with migraines and/or fibro should immediately claim HI for ourselves.

Wayne Conrad said...

Which reminds me: I saw, a few years back, a researcher at UW talking about migraine triggers. According to her, it was still up in the air which comes first: The trigger, or the migraine. She pointed out that migraines start at least hours before any symptoms, with unusual activity in or very close to the parts of the brain that deal with breathing, appetite, &c. She said it is at least conceivable that migraines trigger a person's urge for chocolate or what-have-you, when they're back in the "getting started but you don't know it yet" stage.

Not only am I not a neurologist, I don't even play one on TV. I passed a test, way back when, on the parts of the brain, but I couldn't pronounce them correctly then and still can't. So everything I just wrote could be bunk, either because it started out that way, or because I misunderstood what the smart lady was saying.

Anonymous said...

I skip my period with the pill and it does decrease my migraines, which thankfully I am growing out of. But I've always wonders - what happens when you get pregnant? Do menstrual migraine sufferers get migraines during pregnancy?

The Mother said...

Unfortunately, avoiding menstruation often means bcps, which may also trigger migraines.

Conclusion? A man wrote that one.

C said...

yeah, I like avoiding stress, but trying to avoid it all the time is stressful too...and I like "sleep"- too little or too much...I hope there's a big margin there because if it is just a few minutes either way, maybe they just made that up...

Anonymous said...

@ Anonymous Jan 28 11:48
2nd trimester pregnancy = near daily migraines for moi, rather than the manageable (and apparently avoidable?) monthly ones.

lovinmyjob said...

Here's a related issue. My husband has severe allergy related asthma. He cannot use standard medications such as inhalers because they change his voice. He uses his voice to make a living. So, he has opted to wear a mask--all the time. It really, really works for him and has changed his life. However, you would not believe how many people, especially doctors, are actually offended because of this. He chooses to avoid his triggers by altering his life-style, which is what we all preach to our patients, but the very people who do the preaching get pissed off. I don't get it! Isn't life-style modification way better than pharmaceuticals any day? He actually had a surgeon refuse to preform surgery on him because he "didn't trust someone that wore a mask all the time". What the F is that about? Have we become so used to no one following the life-style modification advise that we think there's something wrong with someone who does? Would we become suspicious of a diabetic who lost weight?

Kat's Kats said...

His doctor doesn't trust him for being proactive about his health?? Okey dokey! That's the kind of doctor I avoid at all costs.

Anonymous said...

Hmmm...triggers are "stress" and "poststress activity." Sooo, the only thing that won't trigger my migraines is "PRE-stress" activity??? Perfect! I'll stop working, stop paying bills, stop raising my kids, and stop watching my diet & exercise. But wait...then I'll end up unemployed, homeless, obese, and lonely (because my kids would get taken away from me by the state!). What would that situation bring--prestress, stress, or poststress??? GEEZZZZZ!!!!! Are they serious????? While I'm busy ONLY allowing prestress in my life...guess I'll give them my uterus, too!!!

 
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