RSS FEED

Archive for the ‘Managing’ Category

Juggling Work & Illness

June 10th, 2009

Some of you may know that for the past few months I have been writing articles on Health Central’s My Migraine Connection on legal issues that relate to Migraine and chronic illness – doctor/patient confidentiality, protection of your Medical Records under HIPAA, Accommodations under the Americans with Disabilities Act, and look soon (in the next day or two) for an article on taking intermittent leave under the Family Medical Leave Act. You may know that in addition to coaching Migraineurs and others with chronic illness in how to manage life, get better, and live well with chronic illness, I am also a business coach, an attorney and a mediator, and I’m helping my husband develop several other web-based businesses for our family.

I try not to make too many recommendations that I haven’t tried myself, and so if I am going to coach and advise people in how to perform the extreme juggling act that is life with chronic illness, I guess I’d better be quite the juggler myself. I didn’t necessarily set out to do it on purpose – it worked out that way. When full time lawyering didn’t fit with chronic fatigue and triggered too many Migraines, when business coaching dropped way off in the current economy, when Migraine management coaching was a great idea but needed some time to develop, I have tried to keep nimble and keep using all my skills, trying new things and renewing old ones, all while getting sufficient rest, managing my triggers, and practicing my intentional relaxation.

I really started out this post to point you to the writing I’ve done on legal topics lately, because I think as you are managing your life with Migraine, these are useful pieces of information for you to have. But I do think a lot about all the many pieces that make up my life, the balls I have up in the air, as I work to manage it all, and to help those of you who work with me to manage what you juggle as well. It’s great to have something to work on. You don’t need to have as many things to manage as I do – I’m probably an extreme case. But it is important for us to have a sense of purpose and to be making a contribution in life – even when we are ill. It may not be work for pay – but if that’s possible, it’s a good thing! I recently added a little part-time job to my mix that keeps me on my feet for several hours, several days a week. Despite some initial exhaustion, over all my stamina seems to be building.

I hope for you that you have something that can get you out of bed and give you a sense of purpose – at least some of the time. Let me know how your juggling act is going!

– Megan

Street juggler image courtesy of Amit Bansal.

Tags: , , ,
Posted in Advocacy, Managing, Musings | Comments (2)

Migraines and Emotional Health

June 1st, 2009

We had a very exciting teleconference yesterday with Dr. Roger Cady of the Headache Care Center of Springfield, Missori.  I think everyone who was on the call will attest to what a warm and caring soul Dr. Cady is and how he puts everyone at ease. It was an upbeat call and I think everyone on the conference came away with some practical ideas they can put into use.

We discussed the extra sensitivity of a Migrainous nervous system and how to care for that nervous system – not as something wrong or diseased, but as a process of acceptance of who we are, of the unique person we are.  When we are blessed with that extra level of sensitivity, we are sensitive to emotional cues and issues as well.  Anxiety and depression are described as “co-morbid” with Migraine because they occur together but the causal relationship is not understood at this time. The connection is probably in serotonin which is implicated in Migraine and in anxiety and depression.

If you’d like to listen to the audio of the teleconference and you are already registered for the Managing Life with Migraine teleconferences, sit tight.  We will have the audio file posted within the week and will email you the link. If you aren’t yet registered, please go to Managing Life with Migraine and get on the list! This will give you access to all the teleconference recordings as well as a spot on future teleconferences.  Next month’s call on Sunday, June 28th will be with Dr. William Young of the Jefferson Headache Center.

– Megan Oltman

Photo of Dr. Cady and Dr. Diamond copyright Teri Robert, used by permission.

Tags: , ,
Posted in Managing, Medicine | Comments (1)

Time for a Change in Medication

May 23rd, 2009

I am stubborn and it takes a while to convince me. At this point I have to finally admit that Topamax is not helping me very much. I diary very carefully and keep statistics on my Migraines, and I can say that since I have been on the Topamax I’ve had about a 20% reduction in my Migraines and overall head pain. Better than nothing, but not much to write home about.  I started on 25 mg in the evening, tried that for a few months, and the first two months saw my Migraines go from 8 – 10 per month to 5 – 6, but I think that was a fluke, because every month since then has been back up in the 6 – 8 range, which is average for me.

My doctor suggested I take the dosage all at night, so that any sleepiness and cognitive side effects would be mostly worn off by morning. This was okay as far as it went, but I discovered after a while that I was having an awful lot of evening Migraines. I also learned that Topamax is pretty well out of your system after around 22 – 23 hours. So the level in my bloodstream must have been getting pretty low by evening, and Migraines were breaking through at that point. When I pointed that out to my doctor, he said that he wasn’t too concerned about it “just for headaches,” he’d be more concerned if I were on the medication for seizures. I have to say I’m getting a bit concerned with a headache specialist who uses the phrase “just for headaches.”

I decided to split the dose evenly between morning and evening and the Migraine preventive effect definitely increased somewhat, but the cognitive side effects became much more noticeable. So much so that after a month on 75 mg I decided it was intolerable; I was getting next to nothing done in the course of a day. So my doctor was certainly right that taking it all in the evening lessened the side effects, it just lessened the main effects as well! I went back down to 50 mg two weeks ago.

But even on 50 mg, I’ve been so slow I am hardly getting anything done and I have almost no days where I am full of energy. I just don’t feel like me, at all. I cut down the Topa to 25 yesterday, as per schedule with my doc. Well I took this morning’s half pill (12.5 mg) and felt all my energy and alertness just drain out of me within about 15 minutes – okay, now I’m eager to be done with the stuff!

The problem is where to go next. My doctor is recommending amitryptaline, an old tri-cyclic anti-depressant. Some people experience sleepiness, fatigue, and weight gain on it. I read on line that some of the top Migraine specialists don’t prescribe it because it is “primitive.” It’s actually off the market as an anti-depressant, but for Migraine prevention is prescribed at a much lower dose than for depression. On the other hand, some people experience no side effects.

I’d like to propose some alternatives to my doctor, but I’m feeling a little overwhelmed by the research involved. I look at side effects lists and I don’t like any of them. I read others’ experience but I know that what was true for them won’t necessarily be true for me. I just know that 6 – 8 Migraines a month is too many. I’ve had worse, and many of you out there live with worse. But I am sure I can do better!

– Megan

Still looking for that magic pill!

Block head image courtesy of Stefan; magic pill image courtesy of [O*] ‘BharaT.

Tags: , , ,
Posted in Communicating, Managing, Medicine | Comments (7)

Keeping the Faith

May 18th, 2009

I haven’t posted in a bit and I find myself feeling a little guilty about it.  The past few weeks have been busy, but that’s not unusual, and they have contained several Migraines, but that’s not unusual either.  My life is more complex than I like.  If I was my own coaching client I might advise myself to simplify.  Since I can’t get outside my own head sufficiently I don’t know what I would suggest cutting out.  The fact is that times are tough economically, and my family is not exempt from that, and I have several businesses to keep up with, a family, a house, and several chronic illnesses, and it’s a lot.

I do know, though, what works.  I know I need enough sleep, though when I feel like I didn’t really have any fun time all day, it’s hard to put down my novel or turn off the tv, or tell my darling daughter (who is 18 and likes to talk late in the evening) I need to go to bed.  I know I need a walk or some exercise in the morning, though when I haven’t slept well it feels like I need the extra bit of sleep more, and when work awaits it’s hard to remember that I will focus better and have a better attitude if I exercise first.  I know I sometimes need a nap after lunch if I want to avoid a Migraine or fatigue.  I know there’s no point in sitting at my desk trying to force myself to focus if my brain won’t do it – a break: a brief walk, a brief snooze, a ten minute clean-up in the house or office, any of these will refresh me and help me return my focus, and time spent trying to force myself is time wasted.  I know at 5:30 I need to leave my desk and focus on my home and family.

I have to confess, though, that knowledge is not the same as action.  I know all these things, but I don’t always do all these things, especially in the face of my anxiety – over finance, over my illnesses, over my daughter leaving home in 4 months, you name it.  Doing the right thing, when I don’t feel like it.  Now that takes faith.

Some days we get up, and we have no energy.  Saturday was like that for me; weather triggers have become much more prominent for me this year and thunderstorms were threatening all day on Saturday.  I felt oppressed – I was in Migraine pro-drome all day.  And so (with some encouragement from my wise husband) I went for a walk.  I did not want to go for a walk.  I wanted to crawl under a rock.  The exercise helped to restore my perspective, raise my endorphin level, and give me the energy I needed to enjoy the day. Going for that walk was an act of faith.

Keep the faith! What do you need to do to keep yourself on track, even when you don’t feel like it?

– Megan


Tags: , ,
Posted in Communicating, Managing | Comments (2)

May Headache and Migraine Blog Carnival

May 12th, 2009

The May Headache & Migraine Disease Blog Carnival is posted at Somebody Heal Me.  Diana Lee created the carnival to provide headache patients and people who blog about headaches with opportunities to share on topics of interest and importance to us.

This month’s carnival was on the topic of “Talk about where to find support: Where do you find it & where can other migraineurs find it?” It’s a very important topic – Headache disorders and Migraine disease are very isolating and we need support! Head over to Somebody Heal Me for a lot of good reading.  Enjoy.

– Megan

Tags: , , ,
Posted in Managing, Weblogs | Comments (0)

Getting the Support you Need

May 8th, 2009

If there’s anything that makes me want to throw up my hands and give up, it’s how complex Migraine disease is. Migraine disease has multiple triggers, can take multiple forms with different symptoms and effects on our lives, and has multiple treatment possibilities. I could not manage all of this without support. It’s lonely dealing with a disease that eats away days and weeks of our lives, and isolates us where the sound and the light won’t bother us. Treating Migraine takes managing multiple aspects of our lives and health – that takes support. The people who support me remind me that every day will not be so bad, that life is still worth living, that there is hope. The things that support me give a structure to my life that I can count on when I am not functioning at my best.

We need to cultivate our support systems – building them up when we feel well so they will be there when we need them. We need to do what we can for the people who support us, when we can. In other words, we need to build our stock of resources.

What kinds of support are there? Consider these:

Where is support missing in your life? Sometimes making a list of the pieces that are missing and taking just one step at a time can make a big difference. Like finding one person to talk to, or scheduling one doctor’s appointment.  Giving a teleclass a try, or stocking up on comfort supplies.

What can you do to build your support system?

– Megan

Hands together image courtesy of Maria Angelie.

Tags: , , ,
Posted in Managing, Medicine, Tips & Techniques | Comments (4)

MAGNUM – 15 years of Fighting for Migraineurs Rights

April 22nd, 2009

Coming up this Sunday, April 26th, at 4 pm Eastern time, I will be hosting the second of our monthly Managing Life with Migraine Teleconferences with Michael John Coleman, Co-Founder, President, and Executive Director of MAGNUM, the National Migraine Association.  The association was founded in 1994, and has been instrumental in many pieces of legislation that have made a difference to the lives of Migraineurs.  In their own words:

MAGNUM: Migraine Awareness Group: A National Understanding for Migraineurs, was created to bring public awareness utilizing the electronic, print and artistic mediums, to the fact that Migraine is a true biologic neurological disease, to assist Migraine sufferers, their families, and coworkers, and to help improve the quality of life of Migraine sufferers worldwide.

Michael John Coleman is one of MAGNUM’s Co-Founders, an award-winning photographer (though we can’t show you photos on the teleconference), and has been involved in many significant battles for Migraineurs in the past 15 years.  We’d love to have you join us on the teleconference.  The call is free but you must register to be on the call.  Go to Managing Life with Migraine Teleconferences to register.  If you already registered for last month’s teleconference there’s no need to register again.

– Megan Oltman

Tags: , ,
Posted in Advocacy, Managing | Comments (4)

Migraines, Travel, Social Life

April 13th, 2009

We had a nice four day trip over the weekend to visit friends in Boston. A wonderful family who lived in our town for two and a half years.  They were our around the corner neighbors, and our fourteen year-old sons are best friends.  They are warm and easy to be with.  It’s a six hour drive each way.  We were actually in Boston from about 7 pm Thursday until 1 pm Sunday.

It’s ridiculous how hard it is to plan for and face a simple weekend trip like that.  I needed medication refills and discovered various mistakes that had been made in the prescription that involved multiple phone calls and trips to the pharmacy.  I recently increased my Topamax dosage and I am experiencing once again the mental cloudiness I have had at each new dosage level – making it hard for me to stay focused on a task or remember what I need to do next in a sequence of tasks.  This is beginning to lift, but it’s not gone yet.

Of course I had to pack all my meds, for preventing Migraine, in case of migraine attack, all my supplements, my thyroid meds.  My husband and son had meds to pack.  My eighteen year-old daughter was staying behind to work and dog-sit, but we had to be sure she had food and instructions. My husband and I are both at rather crucial points in business and there were things that had to be finished before we could hit the road.  Our accountant called just before we were leaving with additional details needed for our taxes.

I get pretty stressed with highway driving, especially on high travel weekends like this one, especially in the high-speed, high-pressure, road-rage rampant, “I’m more important than you are and I own the road” Northeast (where I live). That kind of stress goes right into my neck muscles and can lead to headaches and Migraines.  We passed a couple of horrendous accidents on the way there.

I left without the spare pillows I usually bring – due to several injuries I sleep propped up so that I don’t ache so much I can’t sleep. I found myself a bit embarassed by my inability to find words and complete sentences in the morning and evening when my meds were strongest. And Saturday afternoon I passed on a trip to the Aquarium with the families, and lay down with a Zomig, a book, and eventually a nap, to get rid of a Migraine.

AND – you’ve listened to my litany of complaints, here’s my conclusion: I had a great time.  It was so nice to get away.  It was so lovely to spend time with friends.  It was worth the stress of driving.  So what if I had a Migraine – chances were way better than even I would have had one at home anyway, without the visit.  So what if I stumbled over words a little – entertaining though I may be, my conversation is not the only point of the visit (shocker, I know!).  We came back renewed and refreshed. Tired after our travel, yes, but it was so very worth it.

We don’t get out much. It’s hard to make plans when Migraine and other illness often comes along and changes them. Money has been tight. My house is not as clean and neat as I’d like it to be, so I don’t ask people over much. But it’s so important to be with people. Every little bit helps. True friends don’t love us for how perfect our housekeeping is or our speech is or any of that.

– Megan

Open door image courtesy of emdot/marya.

Tags: , ,
Posted in Managing, Travel | Comments (2)

How Do you Relax? (Is it Relaxing you?)

April 8th, 2009

I really do want to know. I’m very curious about this phenomenon – we seem to be so drawn to things that are fun, or enjoyable, or give us some kind of gratification, but don’t actually relax us. For instance (when in doubt, I’ll always tell one on myself) I am very drawn to playing Snood – a computer game that involves shooting down these silly faces with matching faces – lots of eye-hand coordination, speed, a danger-bar that raises the stress level, electronic music and noises, bright colors on a computer screen – Migraine hell, yes? Why would I want to do that? Is it relaxing? No! Fun? Yes!

Some people like roller coasters. Gut-wrenching fear. The sense you are about to die. The sensation of your heart about to burst from your chest (not really my cup of tea…). Is that relaxing? That’s a different issue, really. The endorphins your body releases after the ride, when it realizes you have survived, are probably what keeps you coming back. The endorphin rush is very sweet. But is it relaxing?

Now – a walk in the woods. A swim in the ocean, or a lake. A long gentle bike ride. Rocking on a porch swing on a breezy day. Meditating. Yoga. Deep breathing. Guided visualization. A really good laugh. A great talk with a friend. Loving and satisfying sex. A massage. A hot bath. Clearing your mind and practicing letting go. These things truly are relaxing.

When I am working, whether I am writing here on this site, creating more classes for you, working with coaching clients, or doing legal work, I enjoy what I am doing, and I can get into a zone where I just keep rolling and I don’t want to stop. I’ve learned to recognize when I need a break, and I know how important it is to relax. But I will tell you right here and now, it is not easy, even for me. It’s hard to break away. When we’re on a roll, we want to keep rolling. When we’re on the computer, we want to stay on the computer. But what our nervous systems need is for us to shift, to take a break, to practice relaxation.

Deliberate relaxation practice at least three times a week (preferably five) can reduce your Migraine triggerability. How does that work? You will be exercising your parasympathetic nervous system – strengthening your relaxation response. You develop your ability to relax, to release stress, turn off the pressure valve. Deep breathing and guided visualization are two great methods, and I use them in the BREESE relaxation teleclasses.  There’s more about the relaxation response in the Free my Brain Migraine Management Newsletter coming out this week, and if you’re not already receiving the newsletter you can sign up for it in the Six Migraine Keys box in the upper right corner of the page.

But I want you to know – I do my relaxation practice, as regularly as I can, and I take breaks and breathe, and take little walks, and do all those things I know I should, but it’s hard!  And I still like to do things that are fun, but not particularly relaxing.  I’m lucky – I get to lead relaxation classes, so I get a chance to relax with all of you.  What do you do to relax?

– Megan

Porch swing image courtesy of Elvissa.

Tags: ,
Posted in Managing, Tips & Techniques | Comments (3)

The MIDAS Touch

April 5th, 2009

I recently took a MIDAS (Migraine Disability Assessment) test, and the results were enlightening.   The MIDAS test was developed by Richard B. Lipton, MD, Professor of Neurology at the Albert Einstein College of Medicine, New York, NY, and Walter F. Stewart, MPH, PhD, Associate Professor of Epidemiology at Johns Hopkins University, Baltimore, MD.  It provides an objective measure of how much your Migraines disable you, or impair you from work and acitivities of daily life.  It is a useful test in several ways.  Many Migraine and headache specialists make use of it to determine how you are affected by Migraine disease, and to measure your progress in treatment.  The test is also useful if you need to build a body of evidence for a disability benefits application.  You can find and take the MIDAS test on line at the American Headache Society web site, Achenet.org.

In addition to being helpful in your treatment, the test may be helpful to you personally, in better understanding the impact of your Migraines.  The test has you look back over the past three months and count:

due to Migraines.  Then it asks you for the number of days you had head pain, and the average severity of your head pain.  After you fill in all these numbers, the web site will calculate a score for you, which will indicate mild, moderate or severe disability due to Migraine disease.  Taking the test again on later occasions will provide an objective measure of how your treatment is working.

MIDAS is not brand-new, but my headache specialist does not use it so I had not taken it before.  I do, however, keep a very detailed diary, which is necessary to do this test.  If you haven’t kept track of how many Migraines you had, when, how severe they were and how they affected you, you won’t be able to complete the test.  Here at Free my Brain we will have a diary available for you soon.

What I learned for my self is that I am considered severely disabled by my Migraines.  This might surprise many of the people who know me, as I am up and functioning most days.  I have most of my Migraines in the evenings.  This means, however, that I have virtually no life when it comes to socializing and leisure time, and it also means that I must constantly choose between work and family, work and household tasks.  I have to earn a living, which is a struggle, so I don’t have as much time with family as I would like, very little time with friends, and as for household tasks, ha!  Reading my MIDAS results, you could predict the layer of dust in my house!

I suppose the test confirmed things I already knew.  It is a kind of validation, though, and it helps me focus on what I need to work on.  I need to be vigilant about my lifestyle – getting enough rest, doing my relaxation practice every day, working with my doctor to find the right preventive regimen for me. I need to maximize my health so I can do my work, be with my family, and then if I have a little energy left worry about the house! The MIDAS touch? Keeping that focus is pure gold!

– Megan

Tags: , , , ,
Posted in Managing, Medicine | Comments (0)

« Older Entries
Newer Entries »

Learn to Manage your Life with Migraine:

The Six Keys to Manage Your Migraines and Take Back Your Life

You will also receive a subscription to the Free my Brain Migraine Management Newsletter.

We take your privacy seriously. We will never share your information with anyone

First Name:
Email:


That disclaimer thing...
Remember: nothing we do here is medical advice or treatment or is a substitute for medical advice or treatment. Get competent medical advice to learn more about your migraines, possible treatments and risks.

What's New on
Free My Brain:

Migraine Support Group Coaching
Register Now for 50% Off Your 1st Month!







Recent Comments

Categories

Archives