botany, shoes, books, and justice
Which is to say, we are utterly shit at treating migraine and at least acupuncture won’t make you gain weight/lose weight/lose the ability to speak/make you suicidal/destroy your digestive system/make you stupid/etc.
Also, if you would like to come and give me fake acupuncture, I will cook you dinner.
Amitrityline and Flunarizine, commonly used for migraine, cause weight gain, likely by inducing leptin resistance.
For headache specialists, reducing the disorder to a specific mechanism in the brain doesn’t just relieve the symptoms of migraine [referring to development of Imitrex]; it also targets the stigma associated with it by shifting responsibility for the pain away from a weak or neurotic personality toward a body over which the patient has no control. In this, headache specialists are demonstrating a phenomenon known to cognitive psychologists, namely, that attributing low causal responsibility to stigmatized behaviors reduces blame and produces more positive feelings.
Joanna Kempner in Not Tonight
Sick enough to want help; well enough to not need it.
Another shit thing about the expectation to keep trying to get better: every treatment has risks and you can end up worse than you started.
providing services to headache patients—no matter how needed they are—is often described as a money-losing proposition. The problem is twofold: headache medicine requires few procedures, while at the same time, necessitates long doctor-patient appointments. This matters because in the United States reimbursement rates pay much higher dividends for procedures than “evaluation and management.”
Joanna Kempner in Not Tonight
Treatment and management of my migraines improved immensely once I left the US.