Archive for tag: migraine

Journal Club, Halloween Preparation, and the Chicago Marathon

Journal Club

At the beginning of the clinic week, I presented my Journal Club article. The point of the Journal Club is to have the interns bring articles on treatment options for patients and discuss whether or not we would use them with our patients. 

My article was on the use of acupuncture for patients with migraine headaches. The conclusion of the article was that acupuncture does show a decrease in the number of days with a migraine, and a decrease in the patient's quality of life. After I finished with my presentation, we were all able to discuss our opinions. We also talked about what other treatment options we would use with a patient experiencing migraine headaches. My current treatment plan for patients with migraines, which can be changed per patient, includes acupuncture, chiropractic manipulative therapy, post-isometric relaxation of the sub-occipital muscles, and supplementation of magnesium, riboflavin, and CoQ10.

Halloween

Throughout the rest of the week, I finished my decorating for Halloween, which is quite extensive. If you haven't noticed yet, it's my very favorite time of the year. This included any final touches, putting up the remainder of the decorations, more spider webbing, and hanging my newest decoration. Every year the day after Halloween, I check out the sales on decorations, and I buy one big decoration to add to my collection. The decoration I added last year was a five-foot tall hanging ghoul that I placed on my balcony. It looks great out there, and I can't wait for people to see it next weekend!

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My newest Halloween decoration

Chicago Marathon

On Sunday, Dr. Miller, several ninth and tenth trimester interns, and I volunteered at the Bank of America Chicago Marathon. It was the perfect fall day for the race with temperatures in the mid-60s, which was ideal for the runners. Marathon Day in Chicago is always a fun day because so many people come out to watch, support, and cheer on the runners. Talking with some of the experienced marathoners after the race, they said it's almost impossible to get tired during the Chicago Marathon due to the amazing crowds that come out to cheer them along.

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Jeff Jones, Candace Gesicki, and me at the Chicago Marathon on Sunday

We were in the Chicago Diabetes Project tent where we were available for post-race care for the runners. The majority of the runners were in a lot of pain and had very tight muscles, so we helped by stretching and massaging as needed. I have volunteered at the marathon before, but I haven't had as much one-on-one post-race care. It was crazy to see how much pain some people were in, while others looked like they could run the marathon again. I'm sure that has a lot to do with training and experience with running. Overall, it was a great experience, and as always it is so inspiring watching people finish something as impressive as a marathon!

Journal Club

Every other week on Tuesday mornings during ninth trimester, I have a class called Journal Club. The objectives of the course are to sharpen the student's research knowledge and evidence-based practice skills. The final project for the class consists of performing a literature search and finding a paper on a topic of interest to us. We then need to put together a presentation on the research article and share the information with the other interns in the Journal Club.

I performed my literature search on the topic of acupuncture and migraine prophylaxis. The article I found was a randomized-controlled trial in which almost 500 patients were randomly assigned to one of four groups. The first three groups were three different acupuncture protocols, and the fourth group was sham (control) acupuncture. Sham acupuncture means that traditional acupuncture meridian points were not used in the treatment. All four groups received the same amount of treatment, electrical stimulation, and follow-up care. The primary outcomes included the migraine frequency, migraine intensity, and migraine specific quality of life surveys. 

The results of the clinical trial showed that the patients in the acupuncture groups reported fewer days with a migraine compared to the control group. There was no difference in number of days between the three acupuncture groups. The conclusion of the paper was that acupuncture has a prophylactic effect for migraine headaches. It also suggested that further research into the topic is needed. The study was limited by short follow-up periods, the physicians were not blinded, and a small number of acupuncture points were used.

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NUHS Whole Health Center - Chicago

Clinic has been getting progressively busier week by week. The Saturday morning shifts are especially busy. It's a great day for a clinic to be open since some patients can't make certain hours during the week. This last Saturday in particular, I saw seven patients during my six-hour shift. That isn't too large of a patient load for a regular practice, but it is in a teaching facility. In a teaching facility, you need to check in with your clinician throughout the patient visit, and there is a large amount of paper work to do. The reason there is a lot of paperwork is that the clinicians want us to be comfortable with multiple types of forms and paperwork so that when we are out on our own we are comfortable with charting.

The Meaning Behind the Month of June

In Ethical Business Management class this week, we had a guest speaker talk to us about clinical psychology. Dr. David M. Gursky has his PhD in psychology and has over 20 years of experience in the field. The main focus of the talk was being open to any kind of pysch issues that our patients may have in the future, and knowing what issues can be dealt with in the office, and which need to be referred out for specialized care.

Patients tend to be more open with chiropractic or other alternative medicine physicians because we focus on the entire person, focus on the patient in their environment, and because of the treatment setting. The treatment setting in most chiropractic offices has patients gowned for physical examination/treatment, requires physical contact, and induces physical relaxation, all of which sets the stage for patient openness. Some issues that patients might bring up with you include marital dysfunction, anxiety, interpersonal issues, fears, stress, etc. Since well-being is a combination of physical, mental and emotional health, it is very important to help your patients with these psychological issues as well as their musculoskeletal complaints, or refer them to a counselor who can. 

Again, during my downtime this week in class and clinic, I am continuing my reading of Dr. Vasquez's textbook Migraine Headaches, Hypothyroidism, and Fibromyalgia. I finished the chapter on classification, diagnosis, and treatment of headaches. I won't bore you with the hairy details on the types of headaches and treatment, but there were some great treatments that Dr. Vasquez recommended.

Food triggers are the cause of many headaches, especially migraines, and by pinpointing these triggers via a food/headache diary you are able to remove them to remain headache-free. Some common triggers include red wine, aged cheeses, sardines, sausage, and foods containing monosodium glutamate (MSG). These triggers contain tyramine, nitrites or other neuroexcitatory substances that start the cascade toward a headache.

Another big cause of headaches is nutritional deficiencies that are so common among Americans today. The standard American diet (S.A.D.) is composed of red meat, sugary desserts, high-fat foods, and refined grains. The S.A.D. is severely lacking in a lot of the nutrients, vitamins, and minerals that your body needs daily. Some major things to supplement with to avoid headaches are magnesium, CoQ10, fish oil, vitamin D, and riboflavin. Other treatment options include myofascial trigger point work, chiropractic manipulative therapy, acupuncture, and oxygen therapy.

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My partner and I

This week marks the start of June, which is LGBT Pride Month. Here's a little history of this important month:  Lesbian, Gay, Bisexual and Transgender Pride Month is currently celebrated each year in the month of June to honor the 1969 Stonewall riots in Manhattan. The Stonewall riots were a tipping point for the Gay Liberation Movement in the United States. In the United States, the last Sunday in June was initially celebrated as "Gay Pride Day," but the actual day was flexible. In major cities across the nation the "day" soon grew to encompass a month-long series of events. Today, celebrations include pride parades, picnics, parties, workshops, symposia, and concerts, which attract millions of participants around the world. Memorials are held during this month for those members of the community who have been lost to hate crimes or HIV/AIDS. The purpose of the commemorative month is to recognize the impact that lesbian, gay, bisexual, and transgender individuals have had on history locally, nationally and internationally. My partner and I will be heading to Milwaukee, Wisconsin, this weekend to join in this wonderful celebration with close friends and family.