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HeadWay, Issue #150 -- The Power of "Little by Little"
February 21, 2017

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In this issue:

Little by Little

Recent Posts

Say what?! Dietary Supplement

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Little by Little

Years ago, I was talking with my doctor about the improvement I had experienced due to a complimentary treatment. While I was pleased to see some improvement, my doctor was rather unimpressed. Looking back, I think he should have been a little more positive.

Early in their treatment, many people with chronic headache are looking for complete, or dramatic cures. If a medication only helps a little bit, they jump to something else. But although there are certainly times to look for treatments that offer greater improvement, we often overlook something important - a bunch of small improvements add up to big improvements.

American surgeon and journalist Atul Gawande has done a lot of thinking about health care from some unique perspectives. Last month, he created a buzz again with his article in the New Yorker, The Heroism of Incremental Care.

In the article, Gawande tells the story of "Bill", a man who spent years with migraine attacks, and not long ago he was contemplating suicide. Then he decided to go to one more clinic - and change came. Slowly.

When Gawande visited the clinic, he noticed the doctor doing some things that we don't always expect a doctor to do. First - listening to her patients - for a long time. Next - instead of suggesting a surprising new diagnosis, or a cutting edge treatment, or a dramatic surgery - she starts by telling her patients that treatment could take years.

That's not only honesty, it's actually a key to the clinic's success.

Too many patients go from one treatment to another - one drug, one diet, one alternative treatment - looking for that dramatic change. But what if the change could have come sooner - by small, incremental improvements? Yes, some patients do see sudden improvement. But there are many who now have few or even no headache attacks - who got there little by little.

This article was not only an encouragement to doctors who treat patients over the long haul - it's a reminder to all of us that "slow and steady" actually may "win the race". But how can we take advantage of the power of incrementalism?
  1. Find a doctor (preferably a specialist) who is committed to helping you over the long haul. This doesn't mean she won't work with other doctors too - it just means that there is one "anchor" doctor who will be determined to keep fighting your headache symptoms. Now, stick with that doctor if at all possible.
  2. Make sure your doctor knows your medical history. The more details the better. Migraine and other headache disorders involve the whole body - don't pretend that a "headache doctor" can just zap your head and make you better without context.
  3. Don't give up. Yes, you may want to take breaks from treatment. But keep coming back to your doctor, and be responsible for your own treatment. You're the only one who can make it happen.
  4. Be patient. I hope you do get rid of all your symptoms in 3 months. But it doesn't usually work that way. Celebrate small improvements, endure setbacks, and keep going.
  5. Keep track. It's critical to keep track of your symptoms. If you don't, you'll never notice the small improvements, and you'll live on the emotional roller coaster from one attack to the next. Keep a diary - take control.
Just remember the math. A 20% improvement may seem insignificant when you're in so much pain. But what if you had 5 treatments that you could take together that all gave you a 20% improvement? Well, anything that adds up to 100% is perfect for me.

By the way, here are 7 Ways to Stick to Your New Treatment (or not)

Recent Posts

Don't miss these recent posts at Headache and Migraine News:

Say what?! Dietary Supplement

We talk about supplements a lot - that is, dietary supplements, especially those that can help fight migraine and headache (such as magnesium). The FDA has this useful definition: A dietary supplement is a product intended for ingestion that contains a "dietary ingredient" intended to add further nutritional value to (supplement) the diet.

That's not just vitamins and minerals, but also amino acids, or an herb, for example. Often these are things that you should be getting in your diet, but for various reasons (a disease, or genetic factors, for example) you may not be able to get enough from your diet. If you can get the same thing from your diet, a common approach is to boost your diet and take the supplement if necessary.
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