Miss Migraine Gets Angry

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. This post appeared first on my blog of the same name on November 21, 2012.

When my husband got laid off in September 2012, we had to purchase our own health insurance (Note: This was pre-ACA). This was not an easy task. I had to make sure to get a plan that had reasonable specialist co-pays, that covered all of our medications, that included chiropractic and behavioral services, AND that didn’t cost a million dollars. Overall, I’m pretty satisfied with the insurance. It’s not cheap and it’s not as good as what we had under my husband’s job, but it does what we need it to do.

Except when it comes to my abortive medication, namely, Maxlt.

Oh, sure, the insurance company says, we’ll let you refill that–but you only get nine pills (yes, we know your doctor prescribed you twelve pills per month) and we’re going to charge you $280! But wouldn’t you rather just take Imitrex? I mean, we’d really like you to take Imitrex. We think it’s way better than Maxlt. And you can trust us, even though we aren’t doctors or nurses. We’re an insurance company! We know what we’re doing!

(In case it wasn’t clear, the above paragraph was sarcasm.)

I knew that when I started this blog, and decided to sub-title it “A Girl’s Adventures in the United States of Pain,” that I was eventually going to have to talk about how ridiculous and (pardon my French) fucked up our healthcare situation is.

The Affordable Care Act is making things better for a lot of people, me included. Making insurance companies provide birth control with no copay is a huge thing. But what the Affordable Care Act does NOT do is force insurance companies to cover non-birth control prescriptions at a reasonable co-pay.

Let’s just say I’m furious.

I was even more furious when I called the insurance company and asked for the reason for the quantity limit. FDA regulation, they told me. Well, that’s blatantly false! Teri Robert covers this issue in her book Living Well With Migraine Disease, but basically, the FDA suggests a max of 3 pills per week to avoid rebound headaches. That works out to 12 pills per month.

My doctor’s office has clearly run into this problem many times. When I called them, they said they would send a form over asking for coverage and a quantity increase, and that it was almost always granted. This is definitely good news, but just because I will probably get the medication I need doesn’t mean I’m going to stop fighting this.

Living with migraines is a kind of hell. No one should have to suffer through more hoops and stupid red tape because an insurer wants to save a few bucks. On Monday, I’m going to be making a few phone calls.

Post script: This has since happened to me many more times. Now my co-pay for my abortive medication is $80 for 12 pills, and my new insurance company also tried to limit me to 9, citing the same “FDA regulation” as the previous one. Sigh.

Miss Migraine: Freeing Yourself From Anxiety by Tamar E. Chansky

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. This post appeared first on my blog of the same name on September 4, 2012.

Freeing Yourself From Anxiety, Tamar ChanskyTitle: Freeing Yourself From Anxiety
Author: Tamar E. Chansky, Ph.D.
Publisher: Da Capo Lifelong Books
Format: Trade Paperback
ISBN: 978-0738214832
List Price: $16.00

Freeing Yourself From Anxiety isn’t the kind of book I look for (as the possibility of it featuring explosions in space is right around zero). But my library, the Carnegie Library of Pittsburgh, recently released a smart phone app that lets you download and listen to electronic audio books on your phone, among other cool features. As an unabashed book junkie, I have been, pardon my French, using the shit out of this app.

The app’s only flaw is that it presents you with a list of every audio book currently available for check out and download (2018 update: This is now fixed). You can search for a specific book, but can’t, say, browse for science fiction books. So one day, Dr. Tamar E. Chansky‘s book came up on the first page of the long list of books available for download, and I thought, what the hell, stress is a huge migraine trigger for me, maybe this will help.

Although I felt the book could have been organized better, the information and strategies for dealing with anxiety, stress, and “negative” emotions more than made up for that shortcoming. At the book’s heart are four steps to help the reader overcome anxiety. These steps work both in the moment of anxiety and as a daily practice to help reduce the overall incidence of anxiety.

And here is the book’s real strength: Chansky doesn’t simply provide direction for calming the mind and body down when anxiety grips both, but direction and ideas for daily practice to train the body not to overreact to ordinary stressors and stimuli. Examples include instituting a time for regular, deep breathing to calm the body, keeping a gratitude journal to remind us of good things, and creating positive moments of joy (like playing with a pet) instead of waiting for them to simply happen.

Throughout the book, Chansky focuses on “possible thinking.” She actually advocates against false positive thinking, because studies have shown that telling yourself things are okay when they are not is just as bad as thinking negatively. Instead, she suggests re-focusing on reality: What is the actual situation? What do you truly believe will happen? Then, we can prepare ourselves for that situation instead of becoming stressed about out unlikely possibilities.

Admittedly, I haven’t been as dedicated in applying these strategies to my life as I should be (again, because stress is a huge migraine trigger for me), but even in my casual application I’ve seen a reduction in my stress and anxiety levels, at least in the moment. Just making myself pause and ask, “Kelly, do you really think that will happen?” is enough to calm me down. This book is overflowing with strategies, so I imagine almost every reader could find several that would work for him or her.

If you suffer from migraine or another chronic illness, and stress or anxiety trigger symptoms — or if you suffer from an anxiety disorder or simple depression — this book will provide you with something to fall back on when it feels like the world is slipping away from you, fast. I would, however, suggest reading a paper copy, because I often found myself wishing I could go back and re-read sections that I liked, and that’s a little more difficult with an audio book. This is an unpaid, unsponsored review.

How do you deal with stress and anxiety?

Miss Migraine: Migraine jargon

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The Adventures of Miss Migraine is an ongoing column about my life with chronic migraine. A version of this post appeared first on August 2, 2012, on my blog of the same name.

I
If you have migraines, they call you a “migraineur.” It rhymes with “entrepreneur,” but it’s not in the dictionary. I think it’s an ugly word, that it implies you create migraines or that you organize or manage migraines, usually with considerable risk. Migraines might come with considerable risks: pain, nausea, dizziness, weakness, blurred vision, more pain, depression, anger at circumstances, irritation at loved ones for incessant (but well meaning) “how are yous,” still more pain, inability to function on an adult level, etc., but so far the ability to organize or manage them has escaped me.

I know that’s not how the roots of the words really work. The roots of “entrepreneur” mean “someone with enterprise,” and the roots of “migraineur” just mean “someone with migraine.” I guess that’s me, but I don’t want to be called that. I don’t want to be that.

And, I already have a name.

This isn’t the place I wanted to inhabit. (Photo of the porch roof and street outside an abandoned house about to be torn down on Negley Avenue in Pittsburgh, PA, 12/1/2008. By Kelly Lynn Thomas)

II
They always tell you to avoid your “triggers.” What “triggers” your migraines? they ask. I hate that word, too. It implies a beginning to the pain. A beginning implies an end. But for me there is neither, just an endless line, or a circle, or a constant in an equation that always works out to the same number.

So I tell them everything. Everything triggers my migraines. When they look at me skeptically, I run through the list: weather, too much caffeine, not enough caffeine, chocolate, cheese, nuts, not eating enough, stress, not enough sleep, too much sleep, loud noises, bright lights, strong smells. Then they usually ask me if I need glasses.

III
Treatments: There are endless migraine treatments. Medications, vitamin supplements, diets, sleep behavior changes, occipital nerve stimulation, acupuncture, chiropractors, reiki, biofeedback. There is always a new one, and it is always a miracle for some random person on the internet.

The number of these things is exhausting. I read somewhere that it would take 25 years to try every single migraine medication available. I’m 25 now. Maybe if I had started when I was a baby, I could have found the right drug already.

How do you feel about migraine jargon/terms? Does it comfort you or irritate you?