Self-management of recurrent headache

Na primeira parte desta revisão sobre terapêutica não-farmacológica das cefaléias, são discutidos os príncipios e a eficácia das principais formas de intervenção psicológica para enxaqueca recorrente e cefaléia tensional (técnicas de relaxamento ou de “biofeedback”e controle do estresse). Na segunda parte, são apresentados programas detalhados de treinamento de relaxamento ou de biofeedback pelo aquecimento das mãos. Finalmente, são discutidas brevemente os critérios para alterar ou terminar o tratamento.In this first part of this review of nonpharmacological therapies for headache, principles and efficacy of main categories of psychological interventions for recurrent migraine and tension-type headache (relaxation training, biofeedback training and stress management) are discussed. In the second part, detailed programs of relaxation training and handwarming biofeedback training are presented. Finally, criteria for altering or terminating treatment are briefly discussed

Reassuring patients about normal test results

Face to face communication strategies are effectiv

Lifesaving Labradors: Stories from Families with Diabetic Alert Dogs

“Diabetes is hell!” says Capri Smith, struggling with the debilitating disease that struck her daughter Ciara at age nine. Angie Simonton felt that a monster attacked her family when Lily succumbed before she was two years old. An equestrian in college, Devon Wright feared stigma and tried to shield her disease from public view. Animal EMT Megan DeHaven and Manhattan businessman Tom Arsenault worried that they would die in their sleep. Tom came to know borough EMTs by name, because he blacked out so frequently. Sharon Stinson, married and in her twenties, thought she would die like Shelby in Steel Magnolias. Sharon and her husband made many 911 calls and visited the local ER so frequently that they felt they had practically paid for the hospital. Sweet Ciara, little Lily, and the rest of the people in this book are all Type 1 Diabetics. Like three million other Americans they suffer from an incurable autoimmune disease that destroys the insulin producing beta cells in the pancreas. Sugar rides a rollercoaster in each diabetic’s blood stream, sending the body into a catastrophic state. Death casts its shadow over each of them. All of the parents in this group, the around the clock caregivers for their children, have frantically administered Glucagon shots or force fed sugar drinks in desperate attempts to steady erratic blood sugar events. Like Capri Smith, all of them have gone on daredevil car rides to the ER, frantic to save their daughters’ lives. Desperate, each one sought a diabetic alert dog from Wildrose Kennels. Known as DADs, these British Labradors use their keen sense of smell to notify the diabetic or the caregiver of low and high blood sugar levels, thereby allowing prompt corrections to avert the episode or lessen its severity. Each one of these diabetics and the other authors in this collection has experienced attacks that led to seizure, or coma, dangerously close to death. Each one attests that the dog is a true lifesaver—daily. Lifesaving Labradors explains how the dogs do it, and how they are used to change and save lives.https://egrove.olemiss.edu/libarts_book/1018/thumbnail.jp

Hormones, Menstrual Distress, and Migraine Across the Phases of the Menstrual Cycle

Objective—The primary objectives of the present study were to (1) contrast reproductive hormone levels and ratings of menstrual distress of female migraineurs with those of a control group in each menstrual cycle phase, (2) examine correlations between hormone levels and migraine frequency, severity, and migraine-related disability, and (3) examine correlations between menstrual distress and migraine frequency, severity, and migraine-related disability. A secondary objective was to evaluate the validity of a migraine disability measure modified to reflect 7-day recall. Background—Further controlled, prospective study is needed regarding the temporal relationships between reproductive hormones at each stage of the menstrual cycle and fluctuations in migraine activity across the cycle. Methods—Twenty-three women (17 with migraine, 6 control participants) completed laboratory hormone assays and measures of menstrual distress and disability at each phase of one menstrual cycle, and monitored their headache activity daily during the same cycle. Results—The migraine group evidenced lower premenstrual luteinizing hormone and more menstrual distress symptoms at each phase of the menstrual cycle. Hormones were associated with migraine activity and disability within cycle phases, and across phases in a time-lagged manner. Menstrual distress was associated with ovulatory phase migraine activity and with migraine-related disability across the menstrual cycle. A retrospective 7-day migraine disability measure appeared to be a consistently valid index. Conclusions—Both reproductive hormones and menstrually related distress appear to predict migraine activity and disability. These associations were evident not only for perimenstrual migraine, but also for migraine at each phase of the menstrual cycle

Chest pain self-management training for patients with coronary artery disease

This study was designed to evaluate the efficacy of a brief, structured pain management program to improve control over chest pain episodes in patients diagnosed with coronary artery disease. Twenty-six male veterans who attended the three-session program were compared with twenty-six matched controls. Results indicated significant short-term reductions in self-report of number of chest pain episodes in treated subjects. Self-report of pretreatment daily physical activity level moderated treatment outcome, as individuals reporting lower levels of physical activity derived greater benefit than their high-activity counterparts. These results suggest the potential utility of incorporating chest pain control strategies into comprehensive cardiac rehabilitation programs