Category: Books & Products

Books & Products, Chronic Migraine, Coping, Mental Health

Identity & Strengths Finder 2.0

Kerrie Smyres

After writing about the loss of identity that I experienced with chronic illness, I wanted to give some suggestions for rediscovering one’s sense of self. Most of the recommendations are time-intensive and arduous — like finding a good therapist, practicing mindfulness, and learning about Buddhist psychology — but there’s one little gem that brought me rewards far greater than it’s $15 price tag.

It’s called Strengths Finder 2.0and is marketed as career guidance, but that’s beside the point. It’s a book, but it’s mostly a personality quiz that you access online using a code in the book. As the title indicates, the quiz results focus on a person’s unique strengths, something that I had trouble doing after years of migraine and depression. Instead of reminding me of the weaknesses I’d spent years dwelling on, the quiz refocused my attention on my strengths, which was invaluable in regaining a sense of my true self.

I took the Strengths Finder quiz two years ago, when I was too sick to put the findings into any practical use. I still haven’t applied them directly to my percolating career goals, but I have benefited enormously from the reminder of my core characteristics, which remain untouched by chronic migraine. The peace of mind of remembering who I am was well worth $15.

Books & Products, Triggers

Announcing TheraSpecs Classic, a Timeless Fashion Frame

Kerrie Smyres

TheraSpecs Classic, our newest, lightest, and most affordable frame style is now available! As you can see, this timeless style looks great on both women and men, whether worn indoors or out. Plus, they weigh in at only 22 grams. Classics are only $99 for indoor lenses and $129 for polarized outdoors lenses. Classic frames can also be ordered with prescription lenses for a slightly higher cost. Email us for details on Rx orders or on sending in frames for totally custom TheraSpecs at custom@theraspecs.com.

class-combo-K_J

Wondering why I’m advertising migraine glasses? TheraSpecs is the company my husband, Hart, and I started after my neurologist told me that wearing sunglasses indoors was increasing my photophobia. He told me about a special tint that reduces light sensitivity, but I had trouble ordering glasses with that tint. Hart used his product management background to source frames that fit all my requirements and I loved them so much that we decided to start a company to make them readily available to anyone who is sensitive to light. You can read about our journey to start TheraSpecs in Big News for Relief From Photophobia & Sensitivity to Fluorescent Lighting (CFLs) and learn more about TheraSpecs on our website and by following us on Facebook and Twitter.

Books & Products

Ear Plugs

Kerrie Smyres

“Ear plug connoisseur” is not a title I strove to achieve, but I’ve become an expert nonetheless. My requirements are fairly simple: cylindrical foam without a flange at the end, which makes them too long and applies pressure when I lie on my side. Seems easy to find, but it isn’t.

Flents Quiet Please! are my gold standard. Though even they have diminished in quality in recent years and no longer last as many wearings as they used to. I blame it on the recession. At less than $20 for 100 pairs from Amazon, at least they’re affordable, even though my internal environmentalist cringes whenever I throw them away.

I’ve been fooled recently by CVS’s version that looks to be identical. They are more rubbery than foam, which means they expand and hold their shape great. Unfortunately they expand so much that they exert enough pressure to make my ears sore, even when I don’t have a migraine. During a migraine, when my left ear often hurts, the earplugs make that pain excruciating. Also, they are so tight and impermeable that they cause moisture buildup in my ears even when I don’t have migraine night sweats. Ew.

Rite Aid, however, makes an excellent look-alike that I might even prefer to the latest incarnation of Flent’s Quiet Please! Unfortunately, they don’t sell them online and they have no stores in Arizona.

Because I wear ear plugs every night and often when I’m running errands — and I’m an environmentalist at heart — I’ve often considered custom-molded ear plugs, but Hart had a pair for a previous job and they never fit right, even after multiple adjustments. The potential hassle has kept me from pursuing this option.

Do you have a favorite ear plug or an experience with custom-molded ear plugs? Please share — I can’t be the only unintentional ear plug connoisseur with a story to tell!

Books & Products, Treatment

Cefaly: What it Feels Like & My Early Experiences With It

Kerrie Smyres

You know what Cefaly is, now here’s an overview of using the device, what it feels like, and my early experience with it.

Cefaly has three programs: abortive (programme 1), preventive (programme 2), and relaxation (programme 3). Each program slowly increases in intensity for the first 12 minutes, the levels off  and remains at that strength for the remainder of the 20-minute session. You can push the button at any point to stop the intensity from increasing any further. However, according to the manual, “The effectiveness of the treatment depends on the power used. It is consequently advisable to work with the maximum power possible.”

With this in mind, and because I had a migraine coming on, I started with the abortive program (programme 1). Both the lead researcher and the manual say the sensation isn’t painful, so I was surprised by just how intense it is. I agree that pain isn’t the best description (especially for someone used to migraine pain), but the sensation is far from comfortable. Initially, it feels like a mild buzzing vibration with a sharpness to it that’s not quite pins-and-needles. As the program intensifies, so does the vibration and a feeling of pressure develops, like someone is pushing hard against my head with the heel of their hand. Then a sort of clenching sensation begins, almost as if the muscles were tightening. Again, none of these sensations are exactly painful (unless I already have allodynia), but I am always greatly relieved when the program is over. Anyone with significant allodynia will probably find this device unbearable to use.

The first time I used the Cefaly, I had to stop before reaching maximum intensity. It was just too uncomfortable to continue. When the 20 minutes were up, the migraine felt unchanged. I started it up again (one touch of the button in the wind-down period returns the stimulation back to the maximum strength for the session and it remains there for the next 20 minutes), as the manual says,

“The standard 20-minute session is generally too short, except for mild headaches. Usually it is necessary to carry out programme 1 several times, and for at least 40 minutes. Generally, 2 to 6 sessions of 20 minutes each are needed, depending on each individual. This is not always the maximum either, since Cefaly can be used all day long if needed.”

An hour at not quite full strength eased the migraine from a level 5 to a 3. Not only was I able to go to dinner with friends, I was chatty and felt good. The migraine came back three hours later, which has since proven to be a pattern. Multiple times since then, using the device at almost full strength continuously for an hour has reduced the pain by two levels and I’ve been able to function for a while, though the pain is always back after two or three hours.

What’s most interesting about this is that not only is the pain decreased, but so is my primary prodrome symptom of tooth sensitivity. For the last nine months or so, sensitive teeth on the upper left side of my mouth are a reliable indicator that I have a migraine coming on. Even before I notice increased pain or other symptoms, I feel the sensitivity in my teeth, often testing them with a drink of water. Before I use the Cefaly, my teeth are sensitive; afterward they are not. This makes me think that the migraine process is actually being interrupted, though I don’t know if the science backs me up.

Since the manual says the device is most effective if used at full strength, I kept trying to get there. If the migraine is bad enough and thus my allodynia high, the sensation is unbearable. When I have gotten it up to full strength, the muscles in my eyelids twitch, I feel spasms in the muscles around my eyes, and I cannot keep my eyes open. As I am a master at not listening to my body, I ignored these sensations by distracting myself with a podcast while the Cefaly was on. I was rewarded with a broken blood vessel in my eye.

Thanks to a phobia for all things eye-related, this was a message I could not ignore. I backed off after that, setting the Cefaly even lower than I did for the first few sessions. And it stopped being as effective. It simmered a migraine down one level on the pain scale, reduced my tooth sensitivity without eliminating it, and gave me an hour of productive time before the pain came back.

My final assessment won’t come for at least a few months, by which time I should know if it is preventing any migraine attacks. In the 10 days I’ve used it, I believe it has already given me multiple hours in which I could run errands, write, make it to appointments, or do chores when I otherwise would have been relegated to the couch. That’s worth $230 and $10 per electrode for this chronic migraineur.

Books & Products, Chronic Migraine, Treatment

Cefaly External Neurostimulation Device for Preventing & Aborting Migraine Attacks

Kerrie Smyres

Cefaly, an electrical nerve stimulation device that is worn like a headband across the forehead and stimulates the nerves through the skin, is my latest experiment in preventing and aborting migraines. There’s a ton of information to share, so I’m breaking it up into several posts, starting with the basics. If you can’t wait to read about the study, here’s Medscape’s writeup: Neurostimulation Effective in Migraine Prevention. (You can get a login from Bugmenot.)

First off, what the heck is Cefaly? It is basically a TENS unit with an electrode shaped to cover the peripheral branches of the trigeminal nerves in the forehead. Instead of being able to adjust the settings freely as you do on a TENS unit, Cefaly is pre-programmed with three therapeutic settings, one for aborting migraine attacks, one for preventing them, and one for relaxation.

According to Cefaly’s website,

Cefaly treats migraine pain with neurostimulation. A stimulus that limits pain signals from the nerve centre by working on the trigeminal nerve where migraine headaches start. The patented Cefaly treatment changes the trigger threshold of migraine headaches. As the pain threshold becomes harder to reach, migraine headaches are less frequent, less painful, and simply disappear. Cefaly offers patients suffering from migraine pain and headaches an efficient electrotherapeutical system delivered via an extremely comfortable, ergonomic and simple-to-use medical device.

An easy-to-follow marketing video:

Harder to follow without knowledge of scientific terms, this video provides a high-level explanation of the science behind the device:

While the marketing materials focus on migraine (and that’s what my experience represents), the manual recommends its use for tension-type headache, cluster headache, and trigeminal neuralgia. It also claims to reduce stress, promote relaxation, and ease the symptoms of sinusitis, though it does not treat the underlying sinus infection.

Cefaly has not been approved for sale in the US and is is not available here. It is available in Canada, Australia, and Europe. I ordered mine from Costco Canada for $230 USD and had it shipped to a friend in Canada who sent it on to me, though I’m not sure this is strictly legal. My headache specialist said his US patients have ordered it directly from Roxon.ca for $299 USD and Oximetry.ca for $340 USD. Although not inexpensive, $230 is reasonable considering the cost of various preventive and abortive meds.

Replacement electrodes come out to $10 each when shipping is factored in. The life of electrodes is listed at 10 uses in the manual, though reviewers on Costco.ca list various strategies for extending their usefulness. I wash my hands and forehead well before applying the electrode and store it in a Ziploc bag with a cotton ball soaked in alcohol next to it. At 11 uses, my original electrode still seems to be working fine. Even if it costs $1 in electrodes each time I use it, that’s still a savings over what I pay for triptans.

There’s enough hype about Cefaly on the internet that I wouldn’t have even tried it had by headache specialist not recommended it. It just seems too good to be true. At the time I saw my headache specialist in May, he had suggested it to 20 of his patients with intractable chronic migraine and half reported at least some relief from it. One had just written him a letter saying the results were close to miraculous for her. Because I trust my headache specialist immensely, I went for it.

Writing this post, I discovered that headache specialist Alexander Mauskop questions whether Cefaly provides advantages over readily available $50 TENS units. While I could have done with saving some money, I derive comfort from the pre-set programs and am not sure if I could have found the right therapeutic settings on my own. If you already have a TENS unit, it might be worth trying it out on your forehead!

I’m still sorting out the kinks and it is too early to establish any preventive effect, but the device has definitely aborted migraine attacks for me. In Monday’s post, I’ll detail my first week with it.