|
|
|
Book Review: Stop Picturing Your Audience Naked
Author: Scott Ann Setzer
Publisher: Setzer & Associates
Publisher Address: 2580 Sierra Blvd. Suite C , Sacramento, CA 95825, 800-767-6316
Publisher Website Address: http://www.StandUpAndTalk.com
ISBN: 0-9768250-0-7
Price: $12.95 ...
Busting Acne Myths Requires Individualized Treatment and More Research
If you have acne, you know the deal- everybody has a cream or suggestion to help you get clear skin. But how do you separate myth, medicine and folklore to find an acne treatment that works for you? That’s what researcher Parker Magin set out to do...
Eating Healthy in a Time-Starved World
Americans are literally running out of time. Achieving a work-life balance, which is still a luxury for tens of millions of working parents, has been overtaken by an even greater demand: a work-life-nutrition balance. Unfortunately, this increasing...
Stress The Unseen Killer
Introducing Stress Management There are very many proven skills that we can use to manage stress. These help us to remain calm and effective in high pressure situations, and help us avoid the problems of long term stress. (Teaser) These skills...
Water, Water Everywhere on the Waterfront!
Waterfront living is among the most desirable of locations in our area. The views and vistas are fantastic, not to mention the ability to walk out one's door to drop a line to fish or untie a line to enjoy boating. However, all this joy is not...
|
|
| |
|
|
|
|
|
|
Preventing Headaches and Reducing their Impact
Whether speaking of migraines, tension-type headaches or other recurring head pains, it's safe to say that the best headache attack is the one you don't have. Even if you have found an effective treatment for resolving a headache that is already underway, there is nothing about today's as-needed treatment that will keep next week's attack from occurring.
Headache treatments come in two forms—abortive and preventive. The abortive form is familiar to most people. It means something you do to get rid of a headache that has already started. Usually it consists of an over-the-counter or prescription medication, but in some cases, a non-drug approach works. By contrast, a preventive treatment is something you do every day with the goal of keeping some future attacks from even starting. These, too, can involve drug and non-drug strategies.
Billions of dollars are spent each year on abortive remedies. For the most part, they are dollars well spent. And for people who have infrequent headaches that are rapidly and reliably resolved by an abortive treatment, a preventive treatment might be needless.
But if attacks are frequent, hard to resolve, interfere with usual activities—or side-effects from the abortive treatment interfere with usual activities—then a preventive treatment should be considered. Employing a preventive remedy does not preclude also using an abortive measure: each can be part of an integrated plan.
Before discussing specific treatments for specific headache types, let's consider the impacts of recurring headaches. The more obvious impact is the sheer unpleasantness and suffering involved in an attack. However, another impact—though less obvious—is in its own way just as important. And that is the associated disability or loss of function that comes with an attack.
If a headache attack is severe, then whatever else was planned for that day goes out the window—it's just not going to happen. If an attack is moderate in intensity, then usual activities might be possible, but occur more slowly, less efficiently, or require more effort to produce. This, too, represents headache-associated disability.
An increasing trend in the field of headache management is for practitioners to address their patients' loss of function as well as their pain and suffering. Drs. Richard Lipton and Walter Stewart designed a questionnaire to estimate headache-associated disability, called the MIDAS (Migraine Disability Assessment) scale which can also be used for non-migraine headaches.
Measuring and then re-measuring MIDAS is one method for judging if a preventive treatment is effective. But to accurately detect the effectiveness (or lack of effectiveness) of a preventive headache treatment there should also be some sort of day-by-day recording system.
It might be as minimal as a check-mark on the calendar for each day with any symptoms. Another system is to summarize at the end of each day that one day's headache-impact by selecting one of the following four descriptions—none, mild, moderate or severe. Numerically inclined people can assign scores of 0-3 to these choices and then run averages and other statistics for each calendar month.
For people with recurring or continuous pain there is a tendency
to live moment-to-moment without a view of the longer-term pattern. A recording system helps capture the big picture. It would be a mistake to judge the effectiveness of any treatment by what happened with symptoms in just the last few days. Generally, a month or longer is required to judge fairly and accurately.
So now that we have decided to consider a preventive treatment for our headaches and have put in place a system for measuring the treatment's outcome, what specific remedies are available?
It depends, of course, on the kind of headaches being treated. Let's discuss two of the most common types—migraine and tension-type headaches.
For prevention of migraine, the best-studied and most effective drug treatments are available by prescription only in the U.S. These include propranolol (brand name Inderal), amitriptyline (Elavil), divalproex (Depakote) and topirimate (Topamax).
Riboflavin (vitamin B2) at 400 milligrams per day was shown in one controlled study to have migraine-preventing actions. (At this dose—far higher than what is needed to treat vitamin deficiency—riboflavin should be considered a drug rather than a vitamin.) The herb feverfew has also shown benefit in controlled trials, but it is important to remember that this, too, is a drug and can have side-effects. As is the case with other drugs, it should not be used during pregnancy.
Non-drug strategies of proven effectiveness in migraine prevention include therapist-supervised programs of stress management, relaxation, biofeedback and cognitive-behavioral therapy. Studies of acupuncture have shown mixed results. Avoiding individually determined triggers for attacks carries no risk and can reduce the attack rate.
For tension-type headaches amitripyline is the best-studied drug for prevention of attacks. Note that this drug is also a leading treatment for migraine, so people unlucky enough to have both kinds of headaches can obtain benefit from just one drug. Unfortunately, even at the low doses used for headache prevention, amitriptyline can cause daytime drowsiness (even when administered at bedtime) or annoying oral dryness. Because of this, substitution of a better-tolerated, though less-studied drug in amitriptyline's family (tricyclic antidepressants) is sometimes required. Tizanidine (Zanaflex) has also shown benefit in controlled trials.
Non-drug strategies for tension-type headache have also been proved effective. These include similar behavioral interventions to those mentioned for migraine—stress management, relaxation, biofeedback and cognitive-behavioral therapy.
It would be wonderful if preventive treatments stopped headaches entirely. If they did, a measurement system would not be necessary. But a more realistic goal for preventive treatment is to reduce overall headache symptoms by at least half, or to an extent that an individual patient finds meaningful. When this occurs, a preventive approach can be a valuable addition to a program of headache management.
(C) 2005 by Gary Cordingley
About the Author
Gary Cordingley, MD, PhD, is a clinical neurologist, teacher and researcher. For more health-related articles, see his website at: http://www.cordingleyneurology.com
|
|
|
|
|
| Stress Management Tips and Techniques from Mind Tools |
| More than 100 stress management tips and techniques, helping you manage the job-related stress in your life. |
| www.mindtools.com |
|
| Stress Management Techniques, Stress Relief & Stress Reduction ... |
| Mind Tools helps you manage the causes of stress and teaches useful stress management techniques. |
| www.mindtools.com |
|
| Stress Management |
| Stress Management. What is Stress? Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical ... |
| www.ivf.com |
|
| Stress Management: Information and Resources on Stress From About.com |
| Find a wide variety of stress management strategies you can use in your daily life. Learn about the causes and effects of stress, healthy and effective ... |
| stress.about.com |
|
| Stress Management |
| Links to stress management information on the web. |
| www.pp.okstate.edu |
|
| Links to Stress Related Resources |
| Return to the Stress Management and Emotional Wellness Page ... Cognitive Restructuring Approaches to Stress Management ... |
| www.imt.net |
|
| International Stress Management Association(UK) |
| The leading professional body for stress management. The ISMA website has articles from their journal Stress News, links and general advice on lifestyle and ... |
| www.isma.org.uk |
|
| Stress Management for Patient and Physician |
| Stress management for patient and physician. Stress is the most common cause of ill health, probably underlying as many as 70% of all visits to family ... |
| www.mentalhealth.com |
|
| Stress Management: Counseling Services, University at Buffalo |
| The description on stress management. ... Stress Management. Introduction Stress is a part of day to day living. As college students you may experience ... |
| ub-counseling.buffalo.edu |
|
| Stress Management and Anxiety Relief |
| Welcome to stressmanagement.co.uk - We specialise in managing your stress. |
| www.stressmanagement.co.uk |
|
| Stress Management for effective ways to manage stress |
| Our stress management services allows you to find the solutions to all types of stress. We also have professional stress management counsellors available 7 ... |
| www.stressmanagement.com.au |
|
| Stress Management--UIUC Counseling Center |
| Self-help Brochures. What is Stress? Stress is the "wear and tear" our bodies experience as we adjust to our continually changing environment; ... |
| www.couns.uiuc.edu |
|
| The Stress Management Society |
| Congratulations to taking the first step to freedom from the stress trap. This is the place to learn more about stress and its management. |
| www.stress.org.uk |
|
| Stress management - Wikipedia, the free encyclopedia |
| Stress management encompasses techniques intended to equip a person with effective ... Definition of stress: Stress management defines stress precisely as a ... |
| en.wikipedia.org |
|
| Stress |
| Stress Management. Everyone experiences stress from time to time, so it is perfectly normal ... Fortunately, stress management is largely a learnable skill. ... |
| www.cyberpsych.com |
|
| SBC Academic Resource Center | Stress Management |
| With stress management training, you can learn to avoid procrastination and other stress-producing situations. Stress Quiz: How Stressed Are You? ... |
| www.arc.sbc.edu |
|
| Mind Tools - How to Master Stress |
| 3. Stress Management Techniques. Raising Stress Levels - Psyching Up · Stress Reduction Techniques · Reducing Short-Term Stress - Mental Techniques ... |
| www.psywww.com |
|
| Stress, stress management, occupational stress, stress prevention ... |
| A recent survey showed that 70-90% of us feel stressed at work and outside. Unless we learn to manage stress, we will get sick. |
| www.holisticonline.com |
|
| HSE - Stress Management Standards Homepage |
| The International Stress Management Association has produced a leaflet showing how employees can work with their employers to tackle work-related stress ... |
| www.hse.gov.uk |
|
| Stress Management Tips for Stressed and Overworked People. |
| Free weekly stress management tips and relaxation CD plus practical resources for stressed people. |
| www.stresstips.com |
|
|