Thursday, June 7, 2012

Migraine Awareness Month #7: List Topper

Today's prompt is:
Migraine Awareness Month #7:  List Topper. There are lots of myths and misconceptions about Migraine. Which one tops your list as the biggest and most common? What can we do to get the truth out there?

There are so many Migraine myths that plague our community of patients, it’s really tough to choose just one. This is one I seem to see addressed by patients almost every day:

MYTH- There is a magical pill that will take all your Migraines away and make you all better.

The fact is, although we do have some medicines available to us now that do work fairly well for many people, there is no one medicine that treats/prevents Migraine for everyone.  

Moreover, there is no cure.

Migraine is not like a broken arm.  If you break an arm, the bones are put back where they belong, the arm is cast and healing takes place.  When the cast is removed… voila!  You are healed!

This type of one-size-fits-all medicine is often called “cookbook medicine”.  Treating a disease or disorder is thought to be like following a recipe in a cookbook.  Reality for our disease is very different.

Migraine is a genetic neurological disease.  The majority of drugs we use to treat and prevent attacks are not very effective because they were never designed to actually treat Migraine in the first place. 
In the last 50 years, there has been only one single unique type of medicine designed for Migraine.  All the rest that have come out since that time are “me too” drugs, similar, yet slightly different.  We simply don’t know enough about how a Migraine attack actually happens to design better treatments for patients.  

Because the physiology of each patient’s system and brain is different, the treatments that will help them are different.  

There is no one–size–fits–all magical pill that will make you better. 
In fact, the definition of *better* is quite different for patients than it is for physicians.  

In the doctor’s world, the word better usually means a reduction in frequency/severity of 50%.  In the patient’s world, the term better means the Migraines are gone, or at least extremely infrequent. 

How do we change the “magical pill” myth?

I believe in education.  In my dream scenario, there would be an in-depth online class for the newly diagnosed to take that would teach them about Migraine.  To eliminate communication problems and any disconnect between physicians and patients and their abilities and expectations, this multi-leveled class would be designed by a team of physicians and patients to take the patients from 0 – 60… going from no knowledge, to a good working knowledge of their body system, the pathophysiology of their disease, it’s diagnosis, treatment and prevention.

This free class would be open to everyone – patients, family, friends, care partners.  Insurance companies would offer discounts for patients that successfully complete the classes, and physicians would insist patients enroll regardless of their insurance situation, because an educated patient is a better patient. 

Each time a new medicine comes out, pharmaceutical companies would design a class to be taken on the drug.  Those who are insured either by private or government plans would be required to pass the class for the medication they are prescribed, or a discount given for those patients who comply.

I really think some form of this idea is the future of medicine.  Physicians no longer have the time to spend teaching their patients the details of their disease, but patients are insisting on being educated, and rightly so.  Insurance companies know that informed patients spend less health care dollars.  Patients are used to going online to find health information, and generally speaking, want to know about their conditions.

No comments: