Headache Weeks During Pregnancy

My OB's office is set up where I see each of the OBs instead of sticking to one; that way I'll know the person who delivers my baby...I may not know them very well, but at least there won't be a chance of me having to introduce myself as they're staring up my vagina. (Too blunt? Sorry...)

The good thing about that is I've been able to ask each OB about my headaches/migraines to get lots of opinions. At my most recent appointment, the doctor told me that common headache weeks for pregnancy are weeks 15-21 (I'm 25 weeks along), so he said they could be going away or at least getting better soon. I had never heard that, but I told my sister (a nurse) and she had heard the same thing. I'd always heard headaches are most common during the first and third trimesters. So I guess there's a chance they could get better, but they could also get worse.

Last month I had 16 headache days and 4 migraine days. This month I've already had 6 migraine days, but I've had more headache-free days so maybe things will improve.

FIL Update
Taking care of my father-in-law has been exhausting, but weirdly rewarding. I've always liked volunteering and serving others, and I had to cut back due to my health, so it's nice to be able to help take care of someone. Also, Hospice is now involved, and they have been amazing. He moved in with us about a month ago and the VA (Veterans) clinic isn't able to see him until MAY - you read that correctly...it's seriously sad. So now a Hospice nurse visits him once a week, and Medicare covers it! We also have help from a CNA, social worker and volunteers. They give him supplies and meds too. I can't say enough good things about Hospice.

Bye, Google Reader
If you use Google Reader to read blogs, you may have heard that it's going away. My friend tweeted about a good alternate called Feedly, and they're making it easy for Google Reader users to transition. I've already made the switch, although I have yet to catch up on my blog reading. I'm not slacking, I just spend too much time reading baby name books right now. Girls are difficult to name. Please leave a comment if you have a suggestion, by the way! We want something different, but not too different. The husband already said no to Harper, one of my top choices.

Cute Puppy
I haven't shared any pictures of my darling Ellie in a while, so here's one I took when I was playing with my new DSLR camera (graduation gift from my wonderful parents). She looks innocent because she had just woken up from a nap and was in a daze. Don't let her fool you.

Ellie

Ask Stanford Med

I received an email informing me that the Director of the Stanford Headache Clinic, Robert Cowan, MD, is taking questions related to headache disorders. Considering I don't have a neurologist at the moment, I'm definitely planning on posting a question; I just have to give it some thought.

If you would like to submit a question, you have until 5 p.m. Pacific Time THIS Friday (March 8). Questions can be submitted by posting a comment to this Stanford Medicine blog post or by writing a tweet including the hashtag #AskSUMed. I just set up a column on my TweetDeck to follow the hashtag. (That really makes me sound like a geek, doesn't it?)

Please read the blog post linked above before posting a question because there are some ground rules and the questions should be "about headache disorders, recent improvements in managing them, and the use of a multifaceted approach to treating symptoms."

Answers to selected questions will be in a future Scope (Stanford Medicine's blog) post, and I'll try my absolute best to remember to link to that post on my own future blog post once it comes out.

We're having a girl!

We found out that, according to the ultrasound, we're having a girl! My husband seemed happy although we both wanted a boy. I had to fight back tears...I know that sounds awful. I love my baby girl, don't get me wrong, but part of me wants the ultrasound to be wrong. And it's not just because I hate princess stuff and girl drama. I'm terrified that a girl would be more likely to inherit my migraines. Statistically, girls are more likely to have migraines than boys. I have a friend who has migraines and her daughter (in elementary or maybe middle school) is getting them already.

If my daughter does end up having migraines, I hope my experience will help give her the knowledge she needs to fight them, and maybe something that doesn't work for me will work for her. Or maybe by the time she gets them, some new treatment option would have been developed by that time. Or she might not get them at all.

I'm going to try my best not to stress over this because it might not even be an issue, but it's tough!

Medication update: my insurance wouldn't approve Orbivan so I'm taking a generic Fioricet. My OB said that even though it's a Category C med, she would prefer I take it over Vicodin because it makes the migraines go away better than Vicodin does. With Vicodin, the migraine usually starts to come back as it wears off. This happens with Fioricet some too, but sometimes it knocks it out. Migraines have been about the same, but I'm still hoping they improve later on in the pregnancy. Gotta have some hope!

Scent-sitive

Yup, that's my nose. I would NOT have shared this if it was a profile angle!

Last weekend my sister helped me register for baby items while our husbands put floors in our condo. She's a nurse and just had a baby last April, so she was extremely helpful and had lots of knowledge to share. It ended up taking over an hour, maybe two - I'm not sure how long exactly, but I had to pee three times while we were there! She ended up getting frustrated with me because I had to do sniff tests or check ingredients if items weren't clearly labeled "Fragrance Free" or "Unscented" (yes, I ended up having a HUGE headache that day). She even smelled one product she recommended, I think it was face wipes, and said she didn't smell anything, but I took a whiff and it made my eyes water.

She said, sarcastically, that my baby will end up extra sensitive with various allergies because I'm going to shelter him too much and he won't get the exposure he needs - I say "him/he" not because I know but because it makes it easier to type and "it" sounds harsh typed out. :) It makes me mad that manufacturers put so many fragrances, parabens, dyes and other harmful chemicals in products for babies - or ANYONE for that matter - in the first place. But aside from that general vent, I'm wondering if my sister is right. It seems that since I've switched over to scent-free shampoo, soap, laundry detergent, etc. I seem to be even more sensitive to smells when I'm exposed to them. A friend gave me a ton of maternity clothes (new wardrobe, sweet!) but I had to rewash them all because I could smell her laundry detergent, and even after washing them I still smell it a little.

I haven't done any research on this and I'm not sure if any research findings are even out there, but have any of you gone through this? Do you think limiting exposure to fragrances and other chemicals can make you even more sensitive? And if so, what can be done? The only thing I can think of is keep avoiding them like they're the devil and hope my child doesn't inherit my sensitivity!

Oh and I don't want this post to make my sister sound bad, she's awesome and was more joking about it than anything. Needless to say, she doesn't get headaches or migraines so it's hard for her to understand. Plus I've been on plenty of long and torturous shopping trips with her, so this was payback! :)

Fun Stats

Here are some fun stats. And by "fun," I mean "I want to hide in bed under the covers, hug my puppy and shed gentle tears." The stats are my headache and migraine days since around the time I got pregnant.

• November
• Headache Days: 20
• Migraine Days: 7
• Pain-free Days: 3
• December
• Headache Days: 15
• Migraine Days: 5
• Pain-free Days: 11
• January
• Headache Days so far, and it's only Jan. 24th: 12
• Migraine Days so far: 7
• Pain-free Days so far: 5

I'm at 17 weeks in my pregnancy which is around the half way point, so my hope that my headaches and migraines will get better (or even go away!) is definitely going down the drain. The pain compared to pre-pregnancy is a lot worse...while I'm used to having 20+ headache days a month, I generally only had one or two migraines a month, and now I'm having multiple migraines a week. Also, I can't take Aleve, which helped with the headaches as long as I didn't take it too much. Here's what I can take:

• Extra Strength Tylenol
• Vicodin
• Fioricet (Orbivan)
• Benadryl (to knock me out)

The first three contain acetaminophen, so even if I alternate them, I still run the risk of getting rebound headaches or having to take more and more for them to work (there's a term for that, I can't think of it though). While I was excited that my OB wrote me a prescription for Fioricet, which has been my go-to migraine abortive for years - side note, I didn't know a brand name of this, Orbivan, existed, but sadly my insurance hasn't agreed to cover it yet...still using samples for now - I'm nervous about using it because it's a Pregnancy Category C drug, which is risky. Same for Vicodin. I've only used these two a handful of times during the pregnancy, only when the pain was too intense to handle.

Thankfully, while I've been getting enough work to help pay bills (praise God!), I can do most of that work from home. I had a migraine today - not a bad one but a migraine nonetheless - and was still able to put in about six hours, and I plan on working another hour or so later tonight. So far my migraine hasn't gotten bad enough to have to take any medicine, but if it does I can take Benadryl to force sleep without having to worry about being anywhere. 

I've also decided not to make any concrete plans the rest of my pregnancy (except my baby shower, since I can't really avoid that). Just making this decision has made it easier to deal with the pain because I know that I won't be forced to do anything that would likely make the pain worse. I've already had to reply "maybe" to two birthday parties. I hate to be that person, but true friends understand. It really feels good to take care of yourself, and I think everyone should do that whether they're pregnant or not!

Pregnancy and Migraines

Christmas ornament from my sister

I'm so happy to share some good news with you all - Jonathan and I are going to be parents! I'm 14 weeks pregnant and the due date is July 1, 2013.

This is actually a hard blog post to write. From reading some of your blogs, comments and Tweets, I know that some of you can't have kids, whether it's due to infertility, not being able to stop migraine medications for nine months, and various other reasons. Last May after my surgery I found out I have endometriosis, which can cause infertility. Soon after the surgery when I told my gyno that my husband and I were planning to start trying once I graduated in December, she warned me not to wait even that long because the best time to try is right after surgery when they clean out the endometriosis tissue. Needless to say, I was nervous about the possibility of infertility and although, looking back, it didn't take long to get pregnant, each time I got my period it was heartbreaking. That gave me just a glimpse of what some of you are going through, and I just want to say I'm praying for you and I'm so sorry if I or anyone else has ever been insensitive to you.

When I told my friends the news, many of them asked how my headaches have been...they know me well. I was hoping my head pain would have improved during the pregnancy, but it's actually been much worse. The only meds I've been able to take are Extra Strength Tylenol, Benadryl to knock me out, and Vicodin for the full-blown migraines. My doctor said I may be able to take Fioricet too, and I'm definitely going to ask for a prescription at my next appointment because I've had a lot of migraines. Just this past weekend I had a migraine for three days straight, even after caving and taking Vicodin, and it went away for a day but came back this morning. Now that I'm into my second trimester, things might improve, but I'm not going to get my hopes up.

I hope this doesn't come across as complaining. I'm SO thankful for the baby, and if I have headaches and migraines anyway, then I can handle a few more. Luckily I'm finished with school and only work at an office a few hours a week, and I'm planning to do freelance graphic design from home full time once I get enough clients. Not having to go out every day helps me deal with the pain and avoid taking medicine as much as possible. Also, I never threw up during the first trimester, I just had food aversions and nausea, so aside from the head pain, it's been a pretty good pregnancy!

I'll be sure to post updates, but War on Headaches will remain a headache/migraine blog, so I won't transform it to a pregnancy or "mommy" blog, don't worry! ;)

Book Review: Knock Out Headaches

Hi readers, I've missed you! Now that I've graduated and have a 2-year degree in graphic design (WOOHOO!), I've been able to catch up on reading some of your blog posts (for those of you who are also headache/migraine bloggers) from the past month, and I'm hoping to have more time to post on here. Of course, I'm also starting a freelance design company, Heather Hefner Design (shameless plug!), so no promises!

I'll do a more personal update in an upcoming post, but first I'd like to share a book review with you. This is a brand new book called Knock Out Headaches, by Gary Ruoff, MD. My review covers the good, the bad, and - unfortunately - the ugly.

The author of Knock Out Headaches, Dr. Gary Ruoff, is a founder of the Westside Family Medical Center in Kalamazoo, Michigan, and presently serves as Director of Clinical Research at that facility. His main research interest is pain therapy and management, including headache and acute and chronic pain. The book features a foreword by Dr. Seymour Diamond...I think we all know who he is (that sounds sarcastic, but it's not, I promise!). He's now being called the Headache Godfather.

The Good: Knock Out Headaches starts right off by acknowledging that headaches are not "curable." It's well-written and easy to read, but it also has sidebar sections that give more in-depth, scientific information. It covers types of headaches, migraine, triggers, treatments and medications, and health problems that typically accompany headaches. The back of the book includes a headache diary, anxiety rating scale, migraine disability assessment and a checklist to develop your own treatment plan. It's a good book if you have frequent headaches and/or occasional migraines and you want to read a book that doesn't contain outdated information. 

The Bad: If you've read other headache books, don't expect this book to be very different. It covers the basics and provides real-life stories. To my surprise, one of the stories didn't end with "and then we figured out that X treatment worked and the patient is now able to manage her headaches" (that's a quote from me, not the book, although it's definitely a paraphrase). I felt guilty that I was hoping for a story without a happy ending, like my own, and even more guilty that I was excited when I actually read one. This particular story doesn't have a happy ending, it just says that there's been some improvement and the doctor is optimistic. Unfortunately, the story starts by saying that it's an "extreme case." Dr. Ruoff also seems to indirectly blame the patient for not having much improvement, saying that it's like pulling teeth to get her to go to bed and get up at the same time each day or eat regular meals. Perhaps that's true, but it could be that she simply can't be helped, or it will take more time to figure out what will help, as seems to be the case for me and many of you. 

The Ugly: I do not want to write this part, but I have to be honest when I write reviews, so here goes... Near the end of the book is a section called "When Treatment Fails." Again, I was excited to find this section because it would address my situation. Near the beginning of the short section, it said, "In some cases, we will never know the answers, but through experience we have identified a few possible explanations." The first part may be true, but let me sum up the "possible explanations" to which he is referring: (1) When a lawsuit or disability claim is involved, so the patient may not get better intentionally or subconsciously. Same thing when headaches elicit sympathy or provide an excuse for not working. (2) When a patient is taking a narcotic regularly for another pain condition which causes rebound headaches that are impossible to control. (3) When headaches are part of deeper emotional or psychological issues which can interfere with treatment. These three explanations may be true in some cases, but to me they're a cop out and are insulting.

In summary, this is a good generic headache book and will be helpful to people who don't have chronic-level headaches and migraines. Knock Out Headaches is available for $15.95 on the publisher's website.

Disclosure: Spry Publishing provided me a free copy of Knock Out Headaches in exchange for me writing this review, but my review is unbiased. 

Shop Online and Give to National Headache Foundation

I blogged about iGive back in 2009 - check out the post here if you're curious. Since then, I've raised about $5 for the National Headache Foundation by doing my online shopping through them. I just log in and then go to the online store (usually amazon.com) through iGive's website, and it automatically gives a percentage of my purchase to the NHF. The retail stores pay for the donation, so there's no extra cost to me.

The problem is, I almost always forget to use iGive when I shop online. Luckily, I no longer need to log in because iGive has created a browser button that lets participating stores know that I use iGive and that I want the donation to go to the NHF. Below is a screen shot of my button (in Firefox). Update - I've noticed when I go on sites that are in iGive's system, the top of the page automatically lets me know that a certain percentage will go to the NHF or it will ask me to click an icon to activate the giving. This is even better because I don't have to remember to use iGive! Sweet! Having it up there should make it easier for me to remember to use it when I shop online. I can program the stores I want (amazon.com is already up there but that might just be for mine) and when I click on the button, I choose the store from the drop-down menu and it goes directly to the store's website.

If you want to give the button (they're also calling it a browser "app") a try, iGive is donating $5 to the NHF for each person who signs up and downloads the button by Cyber Monday. Just follow this link: http://www.igive.com/welcome/lp2/wr15.cfm?c=44422&m=650756.

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Random, but have any of you seen the TV commercial for mychronicmigraine.com? It's a website by Allergan that has migraine resources. What's cool is their tagline is "Don't live a Maybe life." Isn't that the best tagline for migraines? It's exactly how I feel, never sure if I actually will be able to make plans or attend events or even step outside because there's always the chance of a migraine that will keep me in bed. I know you all can relate.

Hope you all had a wonderful Thanksgiving! :)

Fragrance Free Zone at Church

Earlier this year I worked with the staff and pastors of my church to establish a Fragrance Free Seating Zone at all three services. They were completely on board with it and very supportive. They asked my opinion on wording and where the zones should be located. They even put a writeup in the bulletin requesting that the congregation limit the amount of scents they wear. Here's the sign at the service I attend (the contemporary service):

Small print says: "Please sit here only if you are not wearing any fragrances -
perfumes, colognes, powders, lotions, etc."

The seating area is in the back corner of the church, a few yards behind the regular seating (as I requested), and usually has two rows of chairs. For a while the only ones who sat there were me and my (sweet, supportive) husband. Since then, another couple has joined us. I know the husband suffered from headaches until he had back surgery (pretty sure it was back surgery), so I don't know if he still gets some headaches or if he or his wife is bothered by the fragrances, or maybe they're just being supportive. Occasionally some other people will join us. There are also times when the church is so full that the section becomes overflow seating, but usually people wearing heavy fragrance avoid the area. One time when all the seats were full I went to the "cry room" where parents and babies sometimes go and can watch the service via TV, but that room has bright fluorescent lights (and can get loud, obviously) so I try to avoid it.

Overall, this is a great move for our church and I'm so happy they took me seriously. It had been common for me to develop bad headaches and even some migraines after church because of all the perfume, and this separate seating has made a huge difference. If you're thinking of getting a fragrance free zone started at your church, GO FOR IT! :)

By the way, this isn't the first sign I've managed to get posted. See the bottom of this post. Lesson: it doesn't hurt to ask!

Free iPhone App from WebMD

I received the below press release from WebMD. It would be neat to try out this app, but I haven't had the time (I've been awful about time management lately). In fact, I haven't had time to do a blog post in a while (sorry) which is why I'm simply copying and pasting the press release below.

Just a quick pain update. I haven't been running as much (time management - see above) and my headaches and especially migraines have been a lot worse. I went to the mountains over fall break and while I got a lot of exercise, I also got an awful migraine and had headaches the rest of the time. I'm thinking the altitude change may have affected my head. Also I didn't bring my night mouth guard so that probably didn't help. So I've been trying to take it easy since then and so far this week hasn't been too bad. My lower back hurts more than anything...so now I'm afraid to try running again. Not sure what that's about.

Oh and one more thing - I just noticed this blog has 100 followers - WOW! Thank you ALL for thinking my ramblings are somewhat interesting. I really hope that I've helped some of my readers over the *five* (again - WOW) years I've been blogging!

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WebMD Launches Unique New Mobile App for Those Living With Chronic Pain

WebMD Pain Coach™ engages patients across seven pain conditions to provide helpful answers and motivation

New York, NY - WebMD Health Corp. (NASDAQ: WBMD), the leading source of health information, today announced its new WebMD Pain Coach™ for iPhone, a unique free mobile application for consumers and patients living with chronic pain. As the leader in mobile health, WebMD provides trusted health information anytime and anywhere with its mobile web and applications for consumers and physicians. The new WebMD Pain Coach™ app builds on WebMD’s market-leading mobile applications through a holistic approach that helps users create a balanced lifestyle.

WebMD’s new app is a mobile companion to coach consumers through daily health and wellness choices so that they can better manage their pain while living a healthy life. It offers patients a personalized experience by delivering daily physician-reviewed tips about managing their specific condition(s) to their mobile device. With the app, WebMD helps consumers take control of their lifestyle choices by enabling them to easily review their pain patterns so they can understand triggers, set goals and share progress with their physician.

“WebMD recognized that many who suffer from chronic pain have more than one condition, which is why WebMD’s Pain Coach™ uniquely enables tracking of multiple chronic pain conditions all within one app.  With WebMD’s Pain Coach™, users can track and view symptoms, triggers, treatments and goals on a daily basis, further monitoring progression,” said Dr. Michael Smith, Chief Medical Editor at WebMD. “WebMD Pain Coach™ is also a portable reminder and checklist for patients to reference when communicating with their physician at the point of care, enhancing patient-physician communications to help with health decisions and treatments.”

According to the Institute of Medicine of The National Academies, there are over 100 million Americans suffering from a chronic pain condition. WebMD Pain Coach™ provides tools and resources to help those suffering from chronic back pain, neck pain, nerve pain, fibromyalgia, migraine, osteoarthritis, and rheumatoid arthritis, with customized information based on their condition, treatments and lifestyle. 

In recent studies conducted by WebMD of its leading consumer and physician communities, both groups expressed interest in the ability to track pain through a mobile device to enhance patient-physician communication at the point of care. In a recent survey* of chronic pain sufferers who visit WebMD through a mobile device,  89 percent would use a mobile pain diary through a smartphone app at least weekly and 70 percent would be likely to use an app which featured relevant WebMD condition-focused content to help better manage and track pain.

Other key survey findings include:

• Approximately 40 percent of respondents felt very strongly that this type of application would improve discussions with their physician.
• Over 50 percent of respondents suffer from frequent or recurring pain and are actively treating their pain with guidance from a physician; 83 percent of respondents see a doctor; 50 percent treat pain with Rx medication; and 38 percent treat pain with OTC medication.

The physician survey** also found:

• 92 percent of respondents would prefer if their patients had an easy way to track symptoms between visits, with 65 percent noting a mobile app could allow their patients to easily track their chronic pain intensity and share that information during visits.

Similar to WebMD’s other leading health apps, WebMD Pain Coach™ provides contextual advertisements for the engaged user with ad experiences that are woven into the fabric of the app.  

WebMD Pain Coach™ features include:

Journal: The journal puts consumers in control of their lifestyle choices, allowing them to see patterns, discover potential triggers, show tangible progress through goal setting, share progress with their physician, and track to gain a measure of control.

Goals:  Consumers are able to browse and select physician-reviewed goals from five lifestyle categories related to their pain condition(s):  food, rest, exercise, mood, and treatments, or create their own goals. Each related tip can be viewed before selecting a goal, and the goal duration can be set from one day to one year. 

Tips:  Tips are delivered daily and provide consumers with a highly personalized experience to help them meet their specific goals. Tips are categorized by food, rest, exercise, mood and treatments and are physician-reviewed.

Library: The Library contains WebMD’s trusted physician-reviewed content relevant to the patient’s condition(s) and pain management. The Library contains hundreds of articles, videos, slideshows and quizzes, all organized within categories including: Living Better with Chronic Pain, Pain Management Techniques, Treatment & Care for Chronic Pain, and Understanding Chronic Pain.

WebMD Pain Coach™ is available for free from the App Store for the iPhone and iPod Touch or at http://itunes.com/apps/webmdpaincoach.  Detailed information on the app is available at http://www.webmd.com/webmdpaincoachapp.

*WebMD Mobile Survey Methodology: 531 people responded to a WebMD survey targeting chronic pain users conducted in May-June 2011 on WebMD’s mobile web and iPhone/Android apps.

**Medscape Survey Methodology: 131 physicians responded to a Medscape Poll targeting physicians who treat patients suffering from chronic pain. It was conducted from June 3-June 11, 2012, online in Medscape’s Physician Connect Community.

About WebMD

WebMD Health Corp. (NASDAQ: WBMD) is the leading provider of health information services, serving consumers, physicians, healthcare professionals, employers, and health plans through our public and private online portals, mobile platforms and health-focused publications.

The WebMD Health Network includes WebMD Health, Medscape, MedicineNet, emedicineHealth, RxList, theheart.org, Medscape Education and other owned WebMD sites.

All statements contained in this press release, other than statements of historical fact, are forward-looking statements, including those regarding: our expectations concerning market opportunities and our ability to capitalize on them; and the benefits expected from new products or services. These statements speak only as of the date of this press release and are based on our current plans and expectations, and they involve risks and uncertainties that could cause actual future events or results to be different than those described in or implied by such forward-looking statements. These risks and uncertainties include those relating to: market acceptance of our products and services; relationships with customers and strategic partners; and changes in economic, political or regulatory conditions or other trends affecting the healthcare, Internet and information technology industries. Further information about these matters can be found in our Securities and Exchange Commission filings.