Yes, even doctors need to learn new things.  Surprised?  I'm sure it is no revelation that doctors DO NOT know everything.  In fact, I would venture to say most of us aren't even extremely smart.  Bright?  Yes.  Genius?  No. 

I always teach my medical students and residents that the best doctors are scientists.  We observe and learn.  I mean, someone had to describe the first migraine or stroke or Parkinson's Disease (yep, you're correct, that one was described by Dr. Parkinson in the 19th century).  I have become a good headache specialist largely because I have learned from my patients.  I have listened, examined, heard all types of different symptoms and have learned how to diagnose and treat migraines and other headache disorders in a way that no book could ever teach me.  The first patient who told me her "hair hurt" taught me the nature of something called "allodynia" - a condition where the skin becomes so sensitive that otherwise insignificant stimuli are felt as painful. 

Well, I have also learned from my own experiences with migraines - which, by the way, I started having AFTER becoming a headache specialist!  For the past week I have had the strangest symptoms and could not identify the source.  (Maybe I should have seen a doctor?)  Well, it dawned on me finally today that I was having a low grade headache each time the symptoms came - a feeling of tingling and dizziness as if I had hyperventilated.  So, I thought perhaps I was having new types of migraines than I am used to having, and I injected myself with Sumavel (really a miracle drug!) and the symptoms went away. 

So, the light touch of God's finger tapped me on the shoulder today and got my attention.  I have always thought of these types of symptoms as perhaps being due to migraine in some of my patients but now I know for sure.  I learned something new from the universe today.  Thanks.

Chronic pain is a daunting, often debilitating, and often not well-understood by many in the medical profession.  Even many "pain specialists" still have a firm hold on outdated theories on pain and its treatment.  This can lead to terrible stress and anxiety on the part of the patient with chronic pain (I include headache), who has often been to many doctors before finding one that can offer even a glimer of hope, or at the very least, empathy and a caring, compassionate approach.  Don't get me wrong, many doctors approach their patients in this way, but many don't - either because of time constraints from the low payments they receive per patient, ignorance about chronic pain and a tendency to view these patients as being "depressed" as the major component of their condition, or they just are not good doctors and don't care about your problem because it takes too much effort on their part. 

I know I am telling all of you with chronic pain many things you already know.  So, what is the answer?  Well, first we must understand what chronic pain is, on a basic level.  Chronic pain is a disease state in and of itself.  It begins to form after an acute injury, such as trauma or surgery; or it can begin as the result of injury to the central nervous system, such as after a stroke, multiple sclerosis and others.  The unifying feature is that it appears to be the results of what we call "maladaptive" nervous system responses to the initial pain or lesion.  This means that our brains and their neurons (nerve cells) form inappropriate connections that form a permanency to the pain perception in our consciousness.  But is it really permanent?  Probably, if you don't get treatment.  We know that treatment of acute pain prevents the onset of chronic pain.  We also have many treatments for patients with chronic pain that has been going on for a prolonged period of time, but we know that the longer the pain has been occurring, the longer it will take to treat it effectively. 

That means the patient needs to have patience.  Not such an easy thing to say, from the patient's perspective!  So, when you find a doctor that seems to understand you, take time with you, empathize with you and who wants to try every treatment available to help you, hold on to the initial euphoria you feel - hold on to it with every up and down emotion on your roller coaster ride through therapy until that light at the end of the tunnel becomes brighter and brighter and ultimately bathes you in a life of improved health, contentedness and an ability to live either pain free or with diminished pain that is manageable. 

Here we are, most of us in the country trying to struggle through one of the hottest summers on record, and many of us the worse off for it.  Many medical conditions are made worse by extreme swings in temperature, climate or barometric pressure - especially headache and pain syndromes.  I have a few patients that have fibromyalgia who experience worsening of their pain when in air conditioning.  Many people take advantage of summer weekends to go to a swimming pool, the beach, a park, or just sit around their air conditioned home and read the Sunday paper. 

I have, in the past, done the same thing.  Visit friends on Long Island, go to the ever famous New York street fairs, and take advantage of deals at restaurants that have sparce customers due to the weekend flight out of the city.  This summer, things are different. I am on a mission, and I'd like to share it with you.

I have for the past several months been getting busier and busier, finding myself rising from bed at 5:00am and flopping into bed, asleep before my head hits the pillow, at midnight.  Yes, I am seeing many patients, but no more than usual.  I am so very busy because I have for a very long time had a dream.  It started in 2005 when I attended a mind-body medicine course at Harvard for a week.  Emerging from that course, I resolved to build a center where patients could come and get the care they needed to treat their headaches, pain and other neurological conditions with a treatment paradigm that was focused on them and would allow them to learn how to heal themselves, with the help of traditional medicine and holistic techniques.  I quit my full time job at Lutheran Medical Center in March 2007 and opened my practice, which I have constantly been growing and nurturing to the point it is now.  But I cannot sit back and rest yet. 

I had the notion several years ago, based on what I had learned about the power of meditation, that I could somehow teach my patients how to meditate in a new way.  One that would allow them to heal their brains and recover from years of headaches or chronic pain.  I thought perhaps if patients knew the anatomy of their brains as they meditated, they would be able to train their minds to modify their brains, changing the way nerve cells communicate with each other and thereby effect permanent change and the end or reduction of their pain.

Well, recent research has inspired me to work even harder.  There is clear evidence that patients who know their own brain anatomy, through viewing specialized MRIs of their brains, are able to meditate and heal the damaged pain processing nerves in those areas of their brains.  Imagine!  My hunch was right!  I have worked on a meditation app for the i phone for 18 months and it was recently released to the app store this past May.  I am working now, with the backing of investors (this ain't cheap!) to develop a whole library of apps that will accomplish the same thing.  As technology advances at lightening speed, the coming years will see the development of these types of tools in a way that most of us can't even begin to imagine.  I would also like to write a book about this so that all patients, with or without an i phone, can learn the power of their own minds to heal what ails them - keep your fingers crossed!

So there it is.  My mission.  I KNOW in my heart of hearts that we can learn to treat out brains and bodies with methods that do not include several prescriptions for pills and narcotics.  Yes, there will always be patients who need a certain amount of those medications, but I am sure the coming years will see a new path to pain and headache relief.  And I won't rest until it is realized.