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June is Migraine and Headache Awareness Month, a dedicated time for migraine specialists and other health care providers, patient advocates and the migraine community to unite their voices to advocate for migraine recognition and treatment. The 2018 theme is “You Are Not Alone,” and it reminds people living with migraine that more than 37 million other people empathize and can feel their pain.
My wife routinely gets headaches that might level a normal human. While she still keeps going as if nothing is happening, I say this, not because I can feel her pain or truly know the level, but because she tells me she is in pain. If she says it, I know it would take me out, because she has superhuman pain tolerance – she labored, at home, for 36 hours without meds!
I suspect she is having migraines. She just keeps moving.
Myths and misconceptions around migraines abound. They perpetuate themselves and feed the stigma associated with Migraines. Below are some of the most prevalent Migraine myths and the corresponding truths as reported on Migraine.com:
Myth #1: A Migraine is just a bad headache.
Truth: Migraine is a neurological disease characterized by flare-ups most commonly called simply, “Migraines,” or “Migraine attacks.” The headache, when there is one, is only one of many possible symptoms of a Migraine attack. Migraine attacks can and do sometimes occur with no headache at all. These are classified as “silent” or “acephalgic Migraines.” There are four possible phases of a Migraine attack, and many possible symptoms. In fact, for a true diagnosis of Migraine, there must be symptoms other than headache.
Myth #2: Migraines don’t last for days, and nobody has a Migraine every day.
Truth: The “typical” Migraine lasts from four to 72 hours, but Migraines can last longer. They sometimes last days, weeks, or even months. When they last longer than 72 hours, contact about physician. Unfortunately, some people do have Migraines nearly daily and even daily. Chronic Migraine (CM) is all too real. By definition, CM is having Migraines or tension-type headaches 15 or more days per month. Although the symptoms and pain levels of CM are similar to those of episodic Migraine (less than 15 days per month), studies have shown that the frequency of the Migraines dramatically increases the burden and causes CM to have significantly higher impact than episodic Migraine. Other studies have shown that the stigma associated with CM is also higher.
Myth #3: Migraines aren’t life-threatening, just annoying.
Truth: Although a Migraine itself may not be life-threatening, complications of Migraines and risk factors associated with Migraine can be. Studies have confirmed a link between Migraine and stroke and other cardiovascular diseases and events. Studies have also confirmed a link between Migraine and suicide. Much could be written on this topic, but consider just these two statistics.
- “Greater than 1,400 more U.S. women with Migraine with aura die annually from cardiovascular diseases compared to women who do not have Migraine.”
- “Based on a sample of Americans, suicide attempts are three times more likely in individuals with Migraine with aura compared to those with no Migraine, whether or not major depression is also present.”
Myth #4: Any doctor will recognize and properly treat Migraine.
Truth: Mainly due to a lack of adequate physician education, this is definitely a myth. It’s also a misconception that all neurologists are Migraine specialists. They’re not; nor are all Migraine specialists neurologists.
In a 2011 report, the World Health Organization stated, “Lack of knowledge among health-care providers is the principal clinical barrier to effective headache (including Migraine) management.” This same report revealed that non-specialist physician undergraduate medical training included just four hours about headache and Migraine; specialist (neurologist) training included 10 hours.
Myth #5: Only women have Migraines.
Truth: 18% of women and 6 to 8% of men suffer with Migraines.
Myth #6: Only adults have Migraines.
Truth: People of all ages have Migraines. Some children have Migraines while very young, before they’re even old enough to tell anyone what’s wrong. With children that young, diagnosis is achieved by reviewing family medical history and observing the child’s behavior.
Myth #7: If you don’t have auras, you don’t have Migraines.
Truth: Only 25 to 30% of sufferers have Migraine with aura, and few of them have aura with every Migraine attack. Most people who have Migraine with aura also have Migraine without aura.
Myth #8: People who get Migraines are intelligent, highly-achieving, high-strung people with a “Migraine personality.”
Truth: At one time, there was a theory a set of “personality features and reactions dominant in individuals with migraine” existed that included “Feelings of insecurity with tension manifested as inflexibility, conscientiousness, meticulousness, perfectionism, and resentment”, referred to as the “Migraine personality.” These “notions regarding a generalization of the migraine personality have not withstood the test of time; in fact, current research suggests that there is no one dominant personality profile among those with migraine.”
Myth #9: There’s nothing that can be done about Migraines. We have to “just live with them.”
Truth: This is far from the truth. Although there is no cure for Migraine disease at this time, one dies not have to “just live with them.” With the help of a doctor who truly understands the disease, work on trigger identification and management and treatments aids in effective Migraine management. There are many options for Migraine prevention…more than ever before. There is a small percentage of sufferers, approximately 5%, with chronic and intractable (do not respond to medications) Migraines who continue to struggle, even with these options. The need for increased awareness and research funding on a federal level is largely responsible for the lack of progress in this area.
Myth #10: A Migraine is a Migraine is a Migraine. They’re all alike.
Truth: To begin with, there are several different types of Migraine. The two main types are Migraine with aura and Migraine without aura. Then there are subtypes of Migraine with aura: basilar-type Migraine, sporadic and familial hemiplegic Migraine, There’s also retinal Migraine; abdominal Migraine; complications of Migraine such as chronic Migraine, and more.
One person’s Migraines can be dramatically different from another’s and even one person’s Migraines can vary from one to the next.
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