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Volume 3, Issue 9, September 1998
September 8th Meeting:Headaches and Alternative Medicine
John P. Toth, M.D., has been in practice for 42 years and spent the last 25 years incorporating "alternative" medical choices into his general medical practice. Many of these alternatives will be explained in his presentation to our support group on September 8th.
Born in Wisconsin, Dr. Toth graduated from Marquette University Medical School in 1956, interned at Queen of Angels Hospital in Los Angeles, and spent 2 years at Norton Air Force Base in San Bernardino before starting practice in Concord. He’s a father of 5 children, grandfather of 14, and has interests in flying, golf, tennis, reading, philosophy, and politics.
Dr. Toth continues to work closely with all "conventional" physicians in the area, and was elected Chief of Staff at Mt. Diablo Medical Center in 1985-1986.
Join us in the Ball Auditorium at John Muir Medical Center on Tuesday, September 8th, from 7:30 to 9:00 pm. Call (925) 938-5252 for more information.
Spread the WordIt seems like almost every week I discover another of my acquaintances, friends, or relatives is troubled with headaches. What is even more disturbing to me is that many of them have not heard of the latest medications/therapies that have been developed in the last few years—therapies that actually do help many headache sufferers lead a better life.
How can we reach those who are suffering in silence? One way is to not be afraid to let others know that you have headaches. Migraine has been referred to as a condition, like diabetes, and it is not cause for shame.
The East Bay Headache Support Group is dedicated to educating and supporting headache sufferers and their families. We now have more than 450 names in our database, but I know there are many more in our com-munity who could use an encouraging word and help in alleviating their suffering. An unbelievable number of people (120!) came to our first meeting in January 1996, many after reading about us in the newspaper. I would like to see another article in the local newspaper and am seeking help from any of you who can assist me in that endeavor. Send e-mail to LADAVIS98@aol.com or call me at (925) 228-1084. Leslie Davis, Editor.
Future Meetings:October 13th: Stephen Peroutka, M.D.— Genetics and Migraine.
November 10th: Alison Ridenhour—Working and Worried.
December 8th: Talk It Over Night.
Migraine Disability Assessment (MIDAS) Questionnaire
Migraine affects about 10% of the adult population and imparts a considerable burden both on the sufferer in personal terms and on society due to the direct and indirect costs of illness. Treatment choices for migraine should reflect diagnosis and the impact or severity of illness. A simple, self-administered questionnaire that measures the impact of migraine might improve patient-physician communication and facilitate treatment decisions. The Migraine Disability Assessment (MIDAS) Questionnaire is a new instrument designed to assess headache-related disability.INSTRUCTIONS: Please answer the following questions about ALL your headaches you have had over the last 3 months. Write your answer on a separate piece of paper. Write zero if you did not do the activity in the last 3 months.
SCORING: Grade Definition MIDAS Score
I Little or no disability: 0-5
II Mild disability: 6-10
III Moderate disability 11-20
IV Severe disability: 21+
© Innovative Medical Research 1997 Excerpted from World Neurology Volume 13, Number 2
Headache and the FamilyJanice J. Carnes, Ph.D.
"When I arrive home at night, I don’t know what to expect. My wife may be in a great mood, she may be in bed with the curtains closed, or she may be up with a headache but feel irritable and depressed."
"Mac is one of the nicest guys at work. The trouble is his headaches. Sometimes he calls in sick at the last minute, which puts a burden on the rest of us. When he gets a headache at work, his mood is terrible. Since I don’t know what to expect, I just tend to avoid him."
"We are not like other families. If we make plans and Mom has a bad headache, we feel guilty if we go without her, but resentful if we have to give them up."
"Headaches are ruining our marriage. My husband pushes himself constantly to work through his headaches because he is afraid of losing his job. When he comes home after work or on the weekends, he just collapses. There is nothing I can do—I feel so helpless and lonely."
"I know it sounds like an awful thing to say, but I feel like my girlfriend sometimes brings her headaches on herself. I think she could do something about them if she really set her mind to it. She just gives in and doesn’t really try to overcome them."
These are examples of the kinds of responses I have experienced over the years in working with families with headache problems. These typical comments remind us that headaches affect the whole family or work system, not just the individual. Yet the system is often ignored in the efforts to treat the individual with a headache.
Frequent headaches tend to amplify any other problems in a system as well as create new ones. For example, in an already stressful work
environment, the person with a headache may become the target for frustration and irritation that rightfully belongs elsewhere. In a family or marriage, the headache may bring into focus other problems such as difficulties in expressing needs or communicating effectively.
There is still a lack of understanding about the causes and treatment of headaches. People feel helpless in the presence of the headache. They may deny it, underestimate it, blame the person with the headache, or withdraw from the person as a way to deal with their own feelings of helplessness. There continues to be a strong tendency to blame the victims by suggesting that they are not trying hard enough, they brought it on themselves, or they have poor abilities to cope with life’s everyday stresses. The headache person may engage in self-blame which leads to guilt and low self esteem.
Systems can become more and more dysfunctional as they try to cope with the difficulties brought on by the unpredictable headaches. For example, one person may find him/herself in a care-taking role and the headache person may experience increasing feelings of dependency and low self-esteem. Resentment is a
natural feeling for all under these circumstances, especially when plans change or extra tasks have to be done. Anger and resentment lead to feelings of guilt and helplessness which contribute to the lowered functioning of the system.
But the situation is not hopeless. A system can adapt to the presence of headaches with less upset if adequate planning, education, communication and flexibility are present. Education is especially crucial if we are to learn to accept headaches as a normal (though certainly not desirable) facet of human life, just as we are increasingly more adaptable to the needs of people who suffer a variety of other disabling conditions. If we can, through education and increased flexibility, shape the general attitude toward headaches in a way to allow the individual with a headache to function at the maximum level, we can reduce the dysfunction in work and home systems that result from rigid, inflexible attitudes. The self-esteem of the individual with a headache will improve and society will benefit from the increased productivity and contributions.