Jun 15, 2021

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Troy: We're here.

Scot: Welcome to the "Who Cares About Men's Health Sideshow." We're all here.

Mitch: Yeah.

Troy: We're here.

Scot: Are you here, Mitch? You're here. Good.

Troy: Mitch is here.

Scot: All right.

Troy: Scot is here.

Scot: All right. My name's Scot. His name's Troy, he's an emergency room doctor. He brings the MD, I bring the BS, and then Mitch brings the microphones. He's our producer.

Mitch: Hello.

Scot: Just in case you're tuning in for the first time "Who Cares About Men's Health?" we have three different types of shows that we do, so you can pick the one that's most interesting to you. We talk about the "Core Four," which is nutrition, exercise, sleep, and mental health and we have episodes that focus just on the Core Four. So if that's of interest to you, you might want to check those out. We have our "Men's Health Essentials" episodes. Those are the issues that affect men like men's health conditions.

And then we have the "Sideshow." It's a little loose but we do talk about health things, it's just more of a personal slant. So if you're into that, you're in the right place. So a few episodes back, we had a headache expert on. Her name was Karly Pippitt, and we talked about men and migraines. And that's a great episode to listen to. The interesting discovery that we made during Karly Pippitt's show is we knew Troy had them, but Mitch learned that he had them too. And this episode of the "Sideshow" is to see if either one of you two went in to get treatment to do something about them because Troy self-diagnosed, he's never seen anybody about them. Mitch didn't realize he had them until after the episode. So give us an update. Let's start with Troy.

Troy: It's funny because we talked about it on the show and I said, "Yes, I'm going to go talk to my doctor." And then I kind of wavered a little bit, but then I worked the next two days shifts in the emergency department, with just this horrible migraine. And at the end of that, I just thought, "I've got to do something about this. This is ridiculous." So I saw my primary care physician and I made sure beforehand when I filled out the stuff, like a week ahead online, I said, "Migraines, I got to talk about migraines," so that I did not back out. So it was on there. And I was committed. Then I talked to him and I said, you know, "I record the podcast," and he's an avid listener. Just kidding. He's not. He's not an avid listener.

But I said, "We had Karly Pippitt on there. We talked about migraines." He knows Dr. Pippitt. And I said, "I kind of self-diagnosed this. This is what I have." He says, "Yeah, I think you're right on. It sounds like you have migraines and here's what I'd recommend." So he prescribed some medication for me. I have not, fortunately, yet had the opportunity to use it, but I have a night shift coming up in about three days. And I expect . . . Usually the pattern is two days after that I've got a migraine so I've got the medication and I sure hope it works. So that's where I am.

Scot: And when we talked to Dr. Pippitt, there's a few different types of medications. One is, like, a recovery, isn't it? To help you recover?

Troy: A rescue.

Scot: A rescue.

Troy: Rescue. So it's when you're having the migraine, you take it, or as soon as you know, you're going to have it.

Scot: And then there's other medications that you would take more consistently that would help prevent them. What kind did you get?

Troy: I got the rescue medication. And that's exactly the discussion I had with him too. He said, "Well, it sounds like you're having these about once a month, which has been the pattern. So that's not frequently enough where you would need to be on a preventive medication." And that's what Dr. Pippitt talked about as well. Like if it's frequent enough, you know, more than, like, every two weeks I think was the cutoff, she said, or at least every two weeks, they'll do a preventative.

He said, "I don't think you need to do that." He said, "Let's try this, see how it goes, and then we'll circle back and see if we need to do something differently." So I hope it works. I've got the medication, ready to use it. Hopefully, I don't get a migraine coming up in the next week. But if previous experience holds true, I probably will. And again, hoping this does the trick.

Scot: All right. And Mitch, you went. What'd you discover?

Mitch: Well, first I realized that I still have some toxic masculinity I need to work through because I, like, bust in there. And it's just the . . . it's just my annual checkup that I started doing and I'm like, "Oh, and by the way, there's this thing. I'm on this podcast, whatever, like, it's probably nothing." No, she gave me a side-eye and she's like, "That sounds like migraines," you know? It was just . . . that was just it, is it was like, "Oh, well, I get these headaches every so . . ." Same thing that happened on the episode, you know?

And she's like, well, "Do sound and light really bother you?" I'm like, "Yeah. But, like, you know, that happens with headaches." She's like, "No, like, and how long do these last?" I'm like, "Oh, just a couple hours. I just, you know, curl up in a ball in a corner of a room and, you know, I just do that." And she's like, "That sounds pretty terrible. We should probably fix that," you know? And so sure enough, she diagnosed me with migraines, and I got the rescue agent as well. She got me on Imitrex or sumatriptan, I guess, is the generic.

Scot: Same sort of thing.

Mitch: Sumatriptan.

Troy: Same med for me, Mitch. So it's, you know . . . I was hoping you got something different so we could just, kind of, swap meds and see which works. I'm just kidding. I would never recommend swapping meds.

Scot: Do not do that.

Troy: Just for . . . Make sure I'm clear. I would not recommend swapping meds. We joked about it.

Mitch: The interesting thing that I think I'm different than Troy is Troy, you've been having these long enough and recognizing them and diagnosing them that you kind of know your triggers. I have no idea what causes mine. And so she's like, just add it to my diary of pain that I work on. So now, I'm tracking both my ankle pain and any time I have headaches. So I have not had a migraine since, so I can't tell how effective it was or whatever, but I'm oddly, like, looking forward to the next one.

Troy: You're really excited about it.

Mitch: I'm like, "Oh my God. I have some emergency meds in a cabinet I can use to make this better," so . . .

Troy: I'm kind of feeling the same way, Mitch. I don't want another migraine, but I know it'll hit so I'm kind of like, "Bring it on. I'm ready."

Mitch: Let me try this.

Troy: I'm kind of excited, too. I'm like, "Bring it on," because I want to try it and see if it works. Just because it has been such a frustrating thing that I've just dealt with. And, you know, I've tried different treatments and we'll talk a little bit more about one of those treatments I've tried that there is some evidence to support, but hopefully, this works and hopefully, it does the trick.

Scot: I hope so too. I mean, talking about this, I'm getting all nervous for you guys that, you know, they'll hit and then it won't . . . and there'll be disappointment. I hate disappointment.

Troy: I know.

Scot: Like, you'll take your medication . . .

Troy: That's kind of how I'm feeling too. Like, I don't want to take it and . . . yeah.

Scot: . . . and it doesn't work. I'm going to feel terrible. I mean, but I guess, you know, if it doesn't work, when we talked to Dr. Pippitt, sometimes it takes time to figure out what's going to work for you, right? There's a lot of different medications out there so, you know, maybe it not working would be good because we could play that out, and not that I wish a migraine upon you, but we could play that out in real-time and see what that process looks like so . . .

Troy: Right. And, and that's kind of how I look at it. I've got something to try. I'll try it for six months. That probably means, you know, six migraines over the course of those six months. See if it works, see what the best approach is. If it doesn't work, then I can circle back with my primary care physician and look into some other options. So it's good to know there are a lot of other options out there, like she said. You know, it's great. It's a great time to have a migraine. There are multiple treatment options.

Scot: And you know, they are associated a lot of times more with women than men, but men absolutely do get them. A lot of times we deny that we get them or we blow them off or we don't acknowledge them.

Troy: Or we self-diagnose and self-treat.

Scot: So if you, you know, do suffer, check out that episode 78, migraines. We called it "Man Up and Get Help." I don't know, maybe that's a little too much.

Troy: Those were her words. Not ours.

Scot: It's true. That would be a good next step if you want to learn more about, you know, getting relief from your migraines or if you think you might have migraines. There's just no point in suffering. There really isn't. All right. So yeah, this week, then on the Sideshow Troy's article is going to focus on migraines, all right? What did I call this segment again? "Checking Out Troy's Articles?" "Troy presents his articles?"

Troy: Can we do a better . . .

Mitch: It's "Troy Is Presenting His Articles."

Scot: All right. It's time for "Check It Out, Troy's Articles." He's going to talk about perhaps something that you could use for your migraines that the research supports. So go ahead. Let's check out Troy's article.

Troy: Let's check it out. So we're not giving you choices today, Scot. You get one choice and the choice is "The effect of ginger for the treatment of migraine, a meta-analysis of randomized controlled studies." The question is, do you choose to hear more about my article or not?

Scot: Yeah, I will.

Troy: You don't get to pick. Usually, we'll give you a series of articles you can choose from, but . . .

Scot: No, we do.

Troy: . . . we're keeping it focused today.

Scot: I find it fascinating, the concept that ginger could help migraines. I mean, probably . . .

Troy: You know . . .

Scot: Yeah.

Troy: I do too. And this is something . . . We're talking about this because we talked about a little bit with Dr. Pippitt and it's something I have used for several months now after reading this article. This article appeared in November of 2020 in the "American Journal of Emergency Medicine." And they did a meta-analysis, which means they found several studies that were done, they combine these studies and then look to see, does ginger help people who have migraines? They found that ginger, when they gave people ginger supplements, so ginger is just an over-the-counter medication. You can buy it anywhere. It's just a supplement. You know, granted the formulation's probably going to differ from one to the other. Usually buy it as ginger root, comes in these capsules.

So they just treated people with ginger who came into the emergency department for treatment with migraines, and they found that people at two hours had a significant improvement than those who said they had zero pain. And those who didn't have zero pain, but still had pain, still had much less pain than those who didn't get ginger who got the placebo. So the placebo just being, you know, being, like, a sugar pill. And they found that there was no significant worsening in, like, adverse events, and those who had ginger, it's not like they were having a lot of side effects, which you wouldn't expect. This is just . . . it's ginger. It's, you know, like, ginger ale, ginger, you know, people take ginger for nausea when they fly. It's not, like, a big deal taking this stuff.

They also found that people who took ginger had much less nausea and vomiting. So their takeaway from this was that in the emergency department setting, it's probably something you could use to help treat people with migraines. The way I use this was I, you know, after I read this article, I thought, "Well, that's a great idea." Like, ginger is something that you often use for just saying, "Hey, you can try this when you fly." That's why ginger ale is such a popular drink on flights. The ginger kind of settles your stomach, helps with nausea, maybe a little bit of vomiting. So I thought, well, "Try it with the migraines," and what I've done, I've just gotten these ginger capsules, just, you know, standard sort of supplement and taken that, like, every four to six hours when I've had migraines.

And it has absolutely made things better for me. One takeaway, though, I think from our discussion with Dr. Pippitt last time is if it is something where it's debilitating, where it's very distracting, it may be worth just saying, "Don't do the ginger. Just talk to your doctor, try getting on a prescription medication." That's the conclusion I came to after trying, even with ginger and Tylenol and all this over-the-counter stuff, you know, which I've been trying to self-treat for years. The conclusion I came to is, "Hey, I probably just need something else."

Scot: So, for some people, it might work?

Troy: Yeah. For some people, it might work. And, you know, if your migraines are something where you do fine with Tylenol, you feel fine and maybe a little bit of nausea, try some ginger with it too. It probably will help.

Mitch: So are these like tablets? Like, what's the dosage? Or were you just gnawing on a chunk of ginger?

Scot: That would be a cool new trend. I love it.

Troy: I love it.

Scot: I love it. Just . . . Guys . . .

Troy: Just getting ginger root?

Scot: Yeah. Gnawing some ginger root.

Troy: Ginger.

Scot: Like, instead of cigars, when you got to invite the guys over for poker, you're all gnawing on ginger root.

Troy: "Hey, guys."

Mitch: And spitting it out.

Troy: "Here's some ginger." No, these are ginger capsules. The formulation, it differs, it differed across these studies. If you go online or you go to a store and you just buy the ginger, it will tell you how much of that they recommend taking, how often. Again, that's part of the challenge is this is not an exact science. I think you can try it. You could try, like, one capsule and see if it makes a difference. And then if it says you could take two capsules every six hours, you could try that. And there's not a lot of downside to taking a lot of ginger. I wouldn't take more than it recommends, but ginger is a pretty safe thing to take. And so it's again one of those things you can, kind of, try it out and see what seems to work for you and adjust that dose based on your experience.

Scot: All right. That was the Sideshow, guys.

Troy: That was the Sideshow. I know.

Scot: It's done.

Troy: Hopefully, you like it. Hopefully, people like it. I don't know. It's pretty loose.

Scot: If you want to learn more about the "Core Four," you know, go ahead and go back through our . . . We're trying to get them labeled so you can, kind of, very quickly at a glance see if it's a "Sideshow" or if it's a "Men's Health Essential" or if it's a "Core Four." You might find that more interesting than Sideshow. It's a little bit more straightforward information and advice. Thanks for listening to "Who Cares About Men's Health?" Blah. You guys have a sign-off noise you'd like to make?

Mitch: Like a "Woo?"

Scot: Well, I just went "Blah." I guess that's my sign-off noise.

Troy: Womp womp. That's my sign-off noise.

Scot: That's great.

Troy: Sorry. What other noises should I make? I mean I don't know. We got to have a better one than that.

Mitch: Fun noises with the boys.

Troy: Exactly. We're just like an acapella group.

Scot: We haven't heard your noise, Mitch.

Mitch: Like a "Cuckakachoo."

Troy: What was that?

Mitch: I don't know.

Troy: Is that a bird? Sounds like a bird.

Mitch: I think so. It was like a . . . Yeah, it was definitely a bird.

Scot: I'm going to stop recording now. This is a waste of bits.


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