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Zev Meyers June 7, 2013 • 65 • Announcements
MigraMedic is still working to resolve the current product shortage. We apologize for an inconvience. Some of us here are chronic migraine sufferers and are also out. As soon as we have product on the ground we will alert everyone at once. Thank you for your support
Lisa May 23, 2013 • 3 • Feature Requests
A while ago I took a flogging in an online chat forum. The flogging came in the form of a biochemist who attacked me viciously for my support of a holistic, herbal approach to treating migraines. He called the use of traditional medicine systems such as the Ayurvedic or Chinese systems “woo.” He uses evidence based medicine, you see. And the thousands of years of clinical experience in the traditional systems do not, in his mind, count as evidence. Nothing short of a stage 3 double blind, randomized, placebo controlled study will do.
I left that conversation feeling hurt, deflated, and very, very frustrated that I could not provide proof of what I already knew. I had evidence, plenty of evidence, in front of my eyes, but none of it counted. The grand edifice of conventional medicine and the pharmaceutical giants loomed high over me. I knew that the herbal way could be far more effective and a whole lot safer, but economic reality makes it impossible to fund large scale studies of herbs that cannot be patented. So it seemed the appearance of scientific knowledge and certainty would always remain in the realm of conventional medicine.
Perhaps that is the case. But I recently came across an article that made me start thinking about the issue all over again. For years and years we heard that migraines are caused by vasodilation, and that the most commonly prescribed migraine medicines work because they constrict the dilated vessels. Now, it seems the entire theory is being turned on its head.
Recently, a report came out that the cause of migraine pain is not blood vessel dilation, but rather overactive neurons firing pain signals in the brain. Researchers at the University of Copenhagen in Denmark did a study on migraine sufferers in the midst of the suffering an attack, and what they found is that most of the blood vessels in the brain were not dilated, and the dilation in the remaining few was only slight. Then, the researchers gave the study participants triptans. Triptans are a family of drugs that includes the most commonly prescribed migraine medicines – Imitrex, Zomig and Frova, among others. Unsurprisingly, the pain levels of the subjects decreased. What was surprising is the fact that the drugs did not alter the dilation levels of blood vessels that were already slightly dilated. The triptans did, however, constrict blood vessels on the outside of the brain. The researchers are now exploring the idea that triptans work by quieting pain signals from neurons rather than by constricting blood vessels that are abnormally dilated.
Why do I mention this triptan story, and what significance does it have for the entire field of herbal medicine? I think what it shows is how little any of us knows. Even after years of research, millions of dollars spent, and the most rigorous standards of clinical trials possible, science got the mechanism by which the drug works wrong. The triptans still work – just not for the reasons we thought. Because a migraine, it turns out, isn’t what scientists thought it was, and everyone was working from the wrong premise the whole time. Yet, and this is the important part – yet, they were still able to come up with an effective drug, even though they didn’t understand what a migraine actually is or how their drug works.
I mention this because traditional medicine is much the same. For thousands of years knowledgeable practitioners have passed down their clinical findings to the next generation of doctor or healer. And each time they did that they honed their knowledge a little more. They tried, and they experimented and they reported their findings and passed down their knowledge again and again. Thousands of years is a long time folks. It’s such a long time that it makes up for some of the other failings of a case-history based approach to medicine. It’s not blinded, not randomized, not placebo controlled. But while that gold standard may be essential when doing a study on 50 or 100 or 1000 subjects over a few years, over thousands of years the vast accumulation of collective knowledge more than makes up for any lack of systemization.
So traditional medicine can be very good at knowing what works, because of the length of practical experience. But what about knowing why things work? Unless you are a devoted student of the ancient systems you might find some of their explanations a little strange.
In Traditional Chinese Medicine disease occurs when there is a disruption of the flow of “chi” (life force) through the meridian channels of the body. When you suffer from a disease, your TCM practitioner might tell you that your body has too much dampness, or an imbalance of cold energy, or excess wind. None of these terms can be taken literally in the way we use them in the West. They refer to states of energy, rather than simply damp or cold weather. Additionally, in TCM, great attention is paid to balancing the Ying and the Yang forces, which are essentially spiritual forces of female and male energy.
Ayurvedic medicine, like Traditional Chinese Medicine, uses the idea of the 5 elements, although the elements themselves are somewhat different. It describes people as belonging to one of several physical categories, with each type requiring its own unique treatment to achieve balance. The categories are based on which Doshas, also known as humors, are predominant in the body. Both the Chinese and Ayurvedic systems are deeply rooted in their respective spiritual traditions, and see disease as arising from both spiritual and emotional causes.
For a westerner, these ideas can be problematic. Where is the proof that Ying and Yang even exist? How do we know that such a thing as a meridian is real? Isn’t listening to medical advice based on the humoral system of medicine just really embarrassing?
Most people fall into two camps when faced with these issues. Either they totally align themselves with the holistic vision and treat the ancient systems as wellsprings of wisdom for both physical and spiritual well-being, or they totally reject it all and consider the whole field “woo.” I would like to propose a third way of seeing things. Just as we know that Western medicine discovers clinical applications before understanding the mechanism of the disease, or even while totally misunderstanding the mechanism of either the disease or the drug used to treat it, traditional systems can be used as sources of great received wisdom without necessarily accepting their explanations as to why and how. We can just empirically observe that these traditions offer non-toxic, effective treatments that can fill in the gaps where Western medicine fails. In short, we can take what works well for what we need, and leave any philosophical disagreements behind.
This is an approach that many people already take in other areas. Our culture universally accepts the moral precepts given in the Bible, and in fact those precepts make up the basis of our legal system. And we do that even though not everyone agrees that God spoke to Moses on Mount Sinai. It is possible to reject the idea that there is a God; reject the idea that there ever existed a leader such as Moses, and even find some parts of the Bible repugnant, yet still make the 10 commandments the basis of our legal system. We do that because it makes sense to do so. The 10 commandments are good regardless of who said them, or what else was said in that book. Yet in the area of holistic medicine it is far too common for people to throw the baby out with the bathwater. By the way, I’m not actually saying that it is bathwater. My point is just that it is not necessary or wise to take an all or nothing stance. Conventional medicine has much to offer, and the randomized, double blind, placebo controlled study is a great tool. But it is far from the end of the story.
In fact, the very notion that our current system of drug discovery yields truthful and accurate results is open to question. We would like to think that once a drug has gone through the extensive tests necessary to gain regulatory approval that the data would be pretty reliable by that point. Unfortunately the system we currently operate in is much murkier. Yes, drug companies need to present at least two double blind, randomized, placebo controlled studies to gain approval. But, and this is a very significant point, they do not have to report every study that has been done on the drug. In fact, the vast majority of study results are never reported at all. So a drug may have 6 studies done on it, with four showing negative results – i.e. the drug is either unsafe or not efficacious, but two studies that do show safety and clinical benefit, and it can gain regulatory approval based on those two studies. Clearly, this is not “evidence based medicine” as most of us would understand the term. In fact, I think it would be fair to call it a sham, a mockery of true science in which the outward appearance of objective science is just a cover. Yet this is the system we have, and we rely on it for all our prescription medicines. And most of the time, it works fairly well, despite its limitations. But there are times when it doesn’t offer what we need, or what it offers has side effects so dangerous they aren’t worth the risk, so we turn to holistic medicine, with its different benefits and different limitations. There is good and bad in both systems of medicine and it is not necessary to take sides. We can take what works from both systems and truly have the best of both worlds.
Jenny E. Lee April 14, 2013 • 11 • Feature Requests
After years of infertility, I was overjoyed when I found out I was finally pregnant. I was also scared to death. I’ve been a migraine sufferer since I was a teenager and had finally found an herbal supplement that helped manage them. But herbal or not, my doctor told me that it was still unwise to take these pills while pregnant. So what was I supposed to do? How would I handle the debilitating pain while my body was simultaneously going through so much else? I would never consider doing anything to harm my baby, but I was terrified of the migraines coming back and having no way of treating them.
First, I prayed. My doctor told me that, for some women, pregnancy actually lessens their migraines. Maybe I would be lucky and that would be my situation! It wasn’t. The truth is that pregnancy affects every woman with migraines differently. For some, migraines lessen during pregnancy. For others, the migraines worsen. Some experience their worst migraine pain in the first trimester, only to be relatively migraine free in the second and third trimesters. Other women might not have many migraines at all in the first trimester but find themselves hit hard in the second or third trimester. There is just not a one-size-fits-all model when it comes to migraines and pregnancy. And, of course, that makes dealing with them that much harder because what worked for one expectant mom won’t work for you or me.
In my case, I read books, talked to people in my support group, even called the help line for the migraine medication that I couldn’t take, and asked their advice. What I learned is that, even though most migraine medications are contra-indicated during pregnancy, there are a number of things that can help and are safe to do during pregnancy. Biofeedback is one. Acupuncture is another. Meditation and massage also can be helpful. And physical activity – just doing mild exercise – is yet an additional tool.
In my case, my first trimester was a terrible mix of morning sickness and migraines, so I was desperate to find something that might help. I tried every one of these things – with varying degrees of success. Biofeedback, which worked well for a friend, did little for me. But I found that meditation and massage were helpful, as was exercise. I learned that you have to start your exercise regime slowly as a burst of physical activity can actually trigger a migraine. I built up gradually – doing mostly walking and yoga. But I found that doing some physical activity helped relieve my migraine symptoms and, along with meditation and massage, even seemed to prevent them from developing.
It was a long nine months, but at the end of it, I gave birth to a beautiful baby boy named Dashiell. He’s now two years old and I’m a happy mama. Happy to have him and happy to be back on my migraine medication. I still walk and do yoga though – two positive things I introduced into my life during that that difficult nine months.
Greta Hinrich April 14, 2013 • 6 • Feature Requests
Probably the hardest thing I have ever experienced as a parent is finding out that my 5 year old daughter had migraines. It was devastating on so many levels. The most obvious one is of course, having to watch your child suffer. And nothing causes quite so much suffering as migraines do. There are lots of other terrible diseases, to be sure. But migraines are a pain disorder, so the pain isn’t just a possible side effect of other symptoms, as is true in most conditions – it’s the very essence of the thing itself. But the second, and equally devastating part of my daughter having migraines, is that I gave them to her. You see, I am a chronic migraine sufferer myself, as was my mother, so migraines are part and parcel of what it means to be a member of our family.
My own migraines began sometime during childhood, although truthfully I don’t remember at what age, nor do I remember getting the diagnosis. It’s just always been something I was aware I had. Through the years my migraines increased in frequency and severity and I began seeing specialists to deal with the horrible suffering migraines brought on. Eventually, when I got to the stage where I was getting a migraine every other day, I got the diagnosis of chronic migraines. Getting chronic migraines under control was difficult and seemingly hopeless for a very long time. Yet somehow, after a great deal of experimentation using different combinations of medication and herbal supplements as well as a strict avoidance of triggers, I have been able to get the migraines under control. If I hadn’t gotten them under control, I don’t think I ever would have considered raising a child. Heck, I probably wouldn’t have considered dating at that point. But date I did, and a few years later I found myself a wife and a mother to a beautiful baby girl. I hoped, oh how I hoped, that she would be spared the family curse. And for a few years all looked well. But it was not to be. When Allysa was 5 years old she began having severe headaches. The first time it happened I found her alone in her bedroom, hiding under her covers in the middle of the day. She told me the light was hurting her eyes. And right then I knew. I knew that she hadn’t been spared. She was going to endure the agony I passed on to her through my faulty family genes. I took her to my own migraine specialist – a neurologist I highly respect – and he confirmed my fears.
So far, her migraines are intermittent to occasional, so I hold out hope that she won’t be a bad case like I am. But seeing her suffer, crying with her pain at such a young age, and being able to do so little about it is the most soul searing pain you can imagine. Worse than a migraine, and that’s saying something.
Greta Hinrich, Northfield, MN