Healthcare headache

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Every year, it seems, I meet more people who suffer from migraines, as I do. But even if you’re not one of the 29 million or so Americans who experience these enormously painful headaches, please keep reading, as I hope you’ll learn something that might prove helpful to you all the same.

I experienced my first migraines 36 years ago, shortly after I moved to Washington, D.C. I associated them with the area’s renowned pollen count, and called them “sinus headaches” — which is what my father had always called the severe headaches he used to get.

But when I went to a doctor for help, he immediately diagnosed me with migraines (and said my dad’s headaches were most likely the same: they’re often inherited).

Unfortunately, at the time, there wasn’t much more than aspirin and Tylenol to take for the head-crushing pain, and I would stumble to my bed, hands pressing on my temples, and have to sleep it off, often writhing in agony.

A few years later, researchers developed Imitrex (sumatriptan), the first of many “triptans” — prescription medicines that, for many of us, could stop a migraine in its tracks in minutes.

I remember the day my doctor told me of the new medicine and offered to call in a prescription for me. For some reason I no longer recall, I wasn’t able to pick it up before the pharmacy closed that day.

But then I started to get a terrible migraine that night, and my wife rushed to a 24-hour location of the same pharmacy chain to beg them to fill it.

After speaking with my doctor, they agreed to sell her one pill — at a price of $60. I remember thinking how outrageous a price that was for a single pill. (Sounds downright quaint now.)

When we picked up the rest of the prescription the next day, paying a much more reasonable co-pay, I saw that my insurance company had paid more than $500 towards the nine pills, a month’s supply. But the medicine worked like magic, and gave me back days of my life.

Today, decades later, there are generic versions of Imitrex and many other triptans, as well as numerous inexpensive older meds that, while developed for other conditions, have been found to reduce the incidence of migraines in many sufferers, including myself. I have generally found my co-pays on these drugs cover their entire cost.

So imagine my amazement when, earlier this month, I read a first-person account in the Washington Post of a writer with migraines whose doctor prescribed “a new pain-relief pill” that “set my insurance company back about $900 for eight tablets.” While the medicine stopped her migraines, it caused her terrible nausea and stomach pain, making her reluctant to take them.

So, did she complain to her doctor (about both the price and the side effects) and ask for another medication? Did she discover in the many Internet searches she described that there are numerous inexpensive generics for migraines that work in different ways and thus might bring on less severe (or even no) side effects?

Apparently not, according to the article. Instead, she went on a lengthy search for different doctors and different approaches, trying Botox injections, yoga, acetaminophen with codeine (obtained from a Canadian friend), and ultimately acupuncture, the last of which she feels basically cured her.

I’m glad she found a solution, and a non-medicinal one that that. But I don’t understand why such an intelligent person, who spent hours researching her condition, had not discovered or even asked about other medications or generics.

Some doctors, it seems, start out prescribing the latest pill to their patients, perhaps believing the manufacturer’s assurance that newer is somehow better, and most likely without awareness of its cost to patients and insurance companies.

For this reason, I think all of us need to be proactive medical care consumers, and ask up front whether there is a cheaper or more-tested medication that we can try first. Or if, upon trying a new medicine, we experience serious side effects, we should certainly go back to the doctor and ask for something else.

One more point. I, too, tried various non-prescription alternatives, including massage, acupressure and Botox. Also, I participated in a number of clinical studies of new products over the years.

It was through one such study that I met my current neurologist, who now appears to have truly solved my migraine problem through something as simple as stretches and exercise.

In our first conversation, the doctor asked me extensively about the location and progression of my migraines. Based on my particular symptoms, she prescribed a couple of months of physical therapy focusing on my shoulders and upper back.

The PTs helped me develop a daily 20-minute exercise regimen that seems to have all but ended my decades of migraines. Furthermore, when I still occasionally get one, I have learned the stretches I can do to make it go away, usually without resorting to medication.

So, in the end, I think the other writer and I did find our respective solutions in the same way: through dogged research and continued experimentation.

I know not all health problems are susceptible to these types of simple solutions, but I certainly now believe they are worth seeking.

If you have found a simple or alternative solution to a medical problem, please let us hear from you. Email our managing editor, barbara@thebeaconnewspapers.com, or write to us.