1 00:00:03,400 --> 00:00:07,360 Speaker 1: Ruby. 2 00:00:08,200 --> 00:00:10,720 Speaker 2: Life sometimes has a way of blindsiding you with a 3 00:00:10,760 --> 00:00:15,480 Speaker 2: feeling of being overwhelmed at the worst possible time. That's 4 00:00:15,520 --> 00:00:19,120 Speaker 2: why you have your self care, your coping strategies, That's 5 00:00:19,120 --> 00:00:22,680 Speaker 2: why you have us. I'm Norah Mcinernie and this is 6 00:00:22,720 --> 00:00:26,279 Speaker 2: the head start Embracing the Journey, a podcast where we'll 7 00:00:26,320 --> 00:00:29,080 Speaker 2: be taking all those things you usually say for your 8 00:00:29,080 --> 00:00:32,120 Speaker 2: friend group out into the open so we can all 9 00:00:32,200 --> 00:00:36,600 Speaker 2: find a bit of optimism for those battling chronic migraine. 10 00:00:36,640 --> 00:00:40,680 Speaker 2: These conversations are going to be even more helpful and relatable, 11 00:00:40,760 --> 00:00:45,080 Speaker 2: so definitely stick around. This show is brought to you 12 00:00:45,120 --> 00:00:48,879 Speaker 2: in partnership with ABVI, So first let's hear some important 13 00:00:48,920 --> 00:00:51,440 Speaker 2: safety information and stay tuned to the end of the 14 00:00:51,520 --> 00:00:53,040 Speaker 2: podcast for more. 15 00:01:00,120 --> 00:01:04,680 Speaker 3: Indication. Botox on abochulinum toxin A is a prescription medicine 16 00:01:04,720 --> 00:01:07,400 Speaker 3: that is injected into muscles and used to prevent headaches 17 00:01:07,440 --> 00:01:09,959 Speaker 3: and adults with chronic migraine who have fifteen or more 18 00:01:10,040 --> 00:01:13,120 Speaker 3: days each month with headache lasting four or more hours 19 00:01:13,160 --> 00:01:15,959 Speaker 3: each day in people eighteen years in older. It is 20 00:01:16,040 --> 00:01:18,880 Speaker 3: not known whether botox is safe and effective to prevent 21 00:01:18,920 --> 00:01:21,919 Speaker 3: headaches in patients with migraine. Who have fourteen or fewer 22 00:01:21,959 --> 00:01:26,800 Speaker 3: headache days each month or episodic migraine. Important safety information. 23 00:01:27,120 --> 00:01:30,480 Speaker 3: Botox may cause serious side effects that can be life threatening. 24 00:01:30,680 --> 00:01:32,760 Speaker 3: Get medical help right away. If you have any of 25 00:01:32,800 --> 00:01:36,720 Speaker 3: these problems any time hours to weeks after injection of botox. 26 00:01:36,880 --> 00:01:40,920 Speaker 3: Problems swallowing, speaking, or breathing due to weakening of associated 27 00:01:41,000 --> 00:01:43,840 Speaker 3: muscles can be severe and result in loss of life. 28 00:01:43,920 --> 00:01:46,200 Speaker 3: You are at the highest risk if these problems are 29 00:01:46,200 --> 00:01:50,640 Speaker 3: pre existing before injection. Swallowing problems may last for several months. 30 00:01:50,920 --> 00:01:54,320 Speaker 3: Spread of toxin effects. The effect of botulinum toxin may 31 00:01:54,360 --> 00:01:57,920 Speaker 3: affect areas away from the injection site and cause serious symptoms, 32 00:01:58,000 --> 00:02:01,639 Speaker 3: including loss of strength and all over muscle weakness, double vision, 33 00:02:01,800 --> 00:02:05,760 Speaker 3: blurred vision, drooping eyelets, coarseness or change or loss of voice, 34 00:02:05,800 --> 00:02:09,160 Speaker 3: trouble saying words clearly, loss of bladder control, trouble breathing, 35 00:02:09,320 --> 00:02:13,200 Speaker 3: and trouble swallowing. Please stay tuned for additional important safety 36 00:02:13,200 --> 00:02:17,880 Speaker 3: information within this podcast. Today's guests. Tom Piserno is an 37 00:02:17,919 --> 00:02:20,800 Speaker 3: actual botox patient who was on prescribed therapy when he 38 00:02:20,800 --> 00:02:23,760 Speaker 3: shared his story. Changes in therapy status may have occurred 39 00:02:23,760 --> 00:02:27,040 Speaker 3: since that time. Cheryl is not a botox patient Tom 40 00:02:27,040 --> 00:02:44,799 Speaker 3: and Cheryl were not compensated by ABVI for sharing their story. 41 00:02:45,520 --> 00:02:48,000 Speaker 2: I don't know if anyone has ever told you this before, 42 00:02:48,040 --> 00:02:52,240 Speaker 2: but relationships can be hard work. It is, of course, 43 00:02:52,400 --> 00:02:57,120 Speaker 2: the work that is worth doing, showing up, communicating, learning 44 00:02:57,240 --> 00:03:00,920 Speaker 2: and relearning your own needs and another person's needs, and 45 00:03:01,000 --> 00:03:05,280 Speaker 2: then doing it all over again. This is the work 46 00:03:05,360 --> 00:03:10,240 Speaker 2: of intimacy, of letting yourself be seen and known, and 47 00:03:10,320 --> 00:03:14,000 Speaker 2: taking the time and effort to see and know another person. 48 00:03:15,040 --> 00:03:18,680 Speaker 2: It is rewarding, and it is exhausting, even more so 49 00:03:18,880 --> 00:03:22,560 Speaker 2: when you add chronic migraine into the equation, because it 50 00:03:22,600 --> 00:03:25,320 Speaker 2: can be hard to tend to another person when you 51 00:03:25,400 --> 00:03:27,720 Speaker 2: are in the middle of a migraine attack, and it 52 00:03:27,760 --> 00:03:30,959 Speaker 2: can be hard to let someone tend to you when 53 00:03:31,000 --> 00:03:33,240 Speaker 2: you just want to be left alone in a dark room. 54 00:03:33,960 --> 00:03:38,080 Speaker 2: How can you experience intimacy when one or both partners 55 00:03:38,200 --> 00:03:41,200 Speaker 2: are living with chronic illness? How do we meet the 56 00:03:41,240 --> 00:03:43,080 Speaker 2: needs of the one we love when we can barely 57 00:03:43,120 --> 00:03:46,160 Speaker 2: take care of our own. It can be hard to 58 00:03:46,200 --> 00:03:49,680 Speaker 2: talk about this publicly, which means it's important to talk 59 00:03:49,720 --> 00:03:53,160 Speaker 2: about it publicly. And that's why I'm so grateful for 60 00:03:53,280 --> 00:03:57,920 Speaker 2: today's guest Tom Paserno. Tom is living with chronic migraine 61 00:03:57,960 --> 00:04:01,320 Speaker 2: and his wife Cheryl experience it's hiss migraine attacks and 62 00:04:01,400 --> 00:04:04,480 Speaker 2: in the decades they've been together they met when they 63 00:04:04,520 --> 00:04:09,600 Speaker 2: were fourteen, they have learned to communicate, to adapt, and 64 00:04:09,640 --> 00:04:15,040 Speaker 2: to redefine intimacy within their own boundaries and limitations. And 65 00:04:15,240 --> 00:04:18,200 Speaker 2: in an act of true generosity, Tom has shared this 66 00:04:18,320 --> 00:04:22,360 Speaker 2: hard won knowledge with the migraine community, sharing his story 67 00:04:22,440 --> 00:04:27,760 Speaker 2: and moderating conversations on migrain dot com. Before we meet Tom, 68 00:04:27,880 --> 00:04:33,800 Speaker 2: a quick check in with doctor Rhyn, Doctor Ryan. It's 69 00:04:33,839 --> 00:04:34,720 Speaker 2: so good to see you. 70 00:04:34,640 --> 00:04:38,159 Speaker 4: Again, Hey Nora. So cool to be back with you again. 71 00:04:38,720 --> 00:04:43,279 Speaker 2: So we have some very nuanced and dare I say, 72 00:04:43,320 --> 00:04:47,799 Speaker 2: personal conversations to have today. We have explored many different 73 00:04:47,839 --> 00:04:51,120 Speaker 2: parts of the experience of living with chronic migraine, but 74 00:04:51,839 --> 00:04:57,400 Speaker 2: we have never explored how it can affect intimacy. How 75 00:04:57,400 --> 00:04:59,920 Speaker 2: often does this part of life and a patient's expe 76 00:05:00,000 --> 00:05:02,200 Speaker 2: experience come up in your office? 77 00:05:02,440 --> 00:05:04,920 Speaker 4: Yeah, this issue is brought up by nearly every adult 78 00:05:04,960 --> 00:05:08,160 Speaker 4: patient in conversation around their migraine attacks and their migraine triggers. 79 00:05:08,760 --> 00:05:10,800 Speaker 4: The concerns often brought up while discussing the impact of 80 00:05:10,839 --> 00:05:13,560 Speaker 4: the symptoms and the way that that could impact their intimacy, 81 00:05:13,920 --> 00:05:15,320 Speaker 4: and so I'm really glad that we get a chance 82 00:05:15,320 --> 00:05:16,880 Speaker 4: to explore that with this episode. 83 00:05:16,960 --> 00:05:28,719 Speaker 2: Me too. Okay, let's meet today's guest, Tom Paserno. Hi, Tom, 84 00:05:28,960 --> 00:05:29,440 Speaker 2: Hey Nora. 85 00:05:29,520 --> 00:05:30,400 Speaker 1: It's great to be here. 86 00:05:30,560 --> 00:05:32,680 Speaker 2: I'm so glad you're able to join us and we 87 00:05:32,760 --> 00:05:36,240 Speaker 2: can get to hear more of your story. But before 88 00:05:36,279 --> 00:05:39,080 Speaker 2: we get into that, I want to ask you about 89 00:05:39,640 --> 00:05:43,560 Speaker 2: music because I saw that you sometimes use music to 90 00:05:43,680 --> 00:05:47,159 Speaker 2: help you cope with a migraine attack, which is actually 91 00:05:47,160 --> 00:05:49,359 Speaker 2: really interesting to me because most of the people that 92 00:05:49,400 --> 00:05:53,000 Speaker 2: we've spoken to have said that they actually prefer silence 93 00:05:53,120 --> 00:05:55,279 Speaker 2: when they have a migraine attack. So I have to 94 00:05:55,360 --> 00:05:58,960 Speaker 2: know what kind of music helps you during a migraine 95 00:05:58,960 --> 00:06:01,720 Speaker 2: attack and is a different and from the music you 96 00:06:01,839 --> 00:06:04,440 Speaker 2: might enjoy at other times. 97 00:06:04,880 --> 00:06:07,920 Speaker 1: I use the music that I normally listen to just 98 00:06:08,440 --> 00:06:12,520 Speaker 1: every day, so sometimes I could use anything from classical 99 00:06:12,640 --> 00:06:17,360 Speaker 1: music to more hard rocking type music. 100 00:06:17,920 --> 00:06:18,440 Speaker 2: Hard rock. 101 00:06:19,279 --> 00:06:22,719 Speaker 1: Yeah, I have a few favorite tunes that are on 102 00:06:22,760 --> 00:06:24,400 Speaker 1: my migraine playlist. 103 00:06:23,960 --> 00:06:27,799 Speaker 2: So yeah, yeah, that makes sense to me. So Tom, 104 00:06:27,880 --> 00:06:30,040 Speaker 2: I want you to set the scene for us a 105 00:06:30,040 --> 00:06:33,120 Speaker 2: little bit. Can you give our listeners an example of 106 00:06:33,160 --> 00:06:35,599 Speaker 2: what a migraine attack feels like for you. 107 00:06:36,440 --> 00:06:42,599 Speaker 1: For me, I have chronic migraine. So usually when I'm 108 00:06:42,600 --> 00:06:45,760 Speaker 1: getting a migraine attack, one of the key indicators for 109 00:06:45,920 --> 00:06:50,400 Speaker 1: me is my aura. I usually start to see my 110 00:06:50,520 --> 00:06:54,120 Speaker 1: field division like an accrescent and it starts to blur, 111 00:06:54,680 --> 00:06:57,560 Speaker 1: and that blur moves across my field division. So that's 112 00:06:57,600 --> 00:07:00,440 Speaker 1: when I know that I'm truly having a migraine attack. 113 00:07:00,680 --> 00:07:03,320 Speaker 1: So I know that if I'm feeling discomfort at the 114 00:07:03,320 --> 00:07:05,760 Speaker 1: same time as the aura, then I know that I'm 115 00:07:05,800 --> 00:07:07,760 Speaker 1: in for a rough ride. And if I'm driving in 116 00:07:07,800 --> 00:07:10,640 Speaker 1: a car, I immediately know I need to pull over 117 00:07:10,760 --> 00:07:12,920 Speaker 1: and I just have to wait it out and see 118 00:07:12,920 --> 00:07:15,480 Speaker 1: what happens. That's how it all starts for me, for 119 00:07:15,520 --> 00:07:16,160 Speaker 1: the most part. 120 00:07:16,800 --> 00:07:20,480 Speaker 2: Do you have a particular moment or a particular time 121 00:07:20,760 --> 00:07:24,120 Speaker 2: when you felt that coming, Like you can feel the 122 00:07:24,160 --> 00:07:29,040 Speaker 2: migraine attack coming and you have to make an adjustment 123 00:07:29,160 --> 00:07:31,640 Speaker 2: to what your life is going to look like that day. 124 00:07:31,920 --> 00:07:36,040 Speaker 1: Definitely, while I was still working, I had to educate 125 00:07:36,080 --> 00:07:39,200 Speaker 1: my team on what migrain was like for me so 126 00:07:39,240 --> 00:07:44,760 Speaker 1: that they can understand when they notice that I'm not 127 00:07:45,120 --> 00:07:48,400 Speaker 1: feeling like I'm not mentally engaged in what we're talking about, 128 00:07:48,560 --> 00:07:50,360 Speaker 1: so I have to bring them all up to speed. 129 00:07:51,320 --> 00:07:54,520 Speaker 1: But if I'm on my way to the workplace or 130 00:07:54,560 --> 00:07:58,160 Speaker 1: something like that, one of my first things after pulling 131 00:07:58,160 --> 00:08:00,160 Speaker 1: off the road if I'm driving, is I need to 132 00:08:00,200 --> 00:08:03,680 Speaker 1: notify someone where I'm going, to let them know I 133 00:08:03,800 --> 00:08:06,800 Speaker 1: was on my way. This is what's happening. If it 134 00:08:06,800 --> 00:08:09,960 Speaker 1: gets worse, I will not be there. If it improves 135 00:08:10,000 --> 00:08:12,360 Speaker 1: to the point that I can function, I will be there. 136 00:08:13,440 --> 00:08:15,560 Speaker 1: So there's a lot of education just to make my 137 00:08:15,640 --> 00:08:16,320 Speaker 1: life easier. 138 00:08:16,600 --> 00:08:20,360 Speaker 2: And also, I think that kind of communication makes everybody's 139 00:08:21,120 --> 00:08:23,480 Speaker 2: life better, even the people who are around you and 140 00:08:23,520 --> 00:08:27,200 Speaker 2: not experiencing a migrain attack. I do think most people 141 00:08:27,280 --> 00:08:30,320 Speaker 2: want to be as good as possible for the people 142 00:08:30,360 --> 00:08:33,040 Speaker 2: around us. Right, Your colleagues want to know how you're 143 00:08:33,040 --> 00:08:36,240 Speaker 2: feeling so they can jump into action pick up slack 144 00:08:36,360 --> 00:08:38,960 Speaker 2: if you can't, because you would do the same for them. 145 00:08:39,280 --> 00:08:39,480 Speaker 5: Right. 146 00:08:39,640 --> 00:08:44,200 Speaker 2: Absolutely, I'm really appreciative of the work that you have 147 00:08:44,320 --> 00:08:48,240 Speaker 2: done being so open, and you're writing about your experience 148 00:08:48,280 --> 00:08:53,199 Speaker 2: living with chronic migrain and especially how that affects your 149 00:08:53,200 --> 00:08:57,880 Speaker 2: relationship with your wife, who also experiences migrain attacks, because 150 00:08:58,520 --> 00:09:01,240 Speaker 2: that is not easy to talk about. We don't really 151 00:09:01,320 --> 00:09:07,920 Speaker 2: talk about intimacy very much. You wrote that you have 152 00:09:08,880 --> 00:09:13,640 Speaker 2: started to reframe what intimacy means, knowing that it is 153 00:09:13,679 --> 00:09:18,520 Speaker 2: something that has to be flexible to your reality. Will 154 00:09:18,520 --> 00:09:20,640 Speaker 2: you tell us about that? What does it mean to 155 00:09:20,720 --> 00:09:21,800 Speaker 2: be intimate? 156 00:09:23,360 --> 00:09:27,800 Speaker 1: For me? The little things? Now, if we get a 157 00:09:27,880 --> 00:09:32,320 Speaker 1: chance to sit together on the couch and watch a movie, 158 00:09:32,600 --> 00:09:35,040 Speaker 1: will hold hands just so that we have some kind 159 00:09:35,120 --> 00:09:39,960 Speaker 1: of physical connection when we sleep at night, Quite often 160 00:09:40,640 --> 00:09:45,280 Speaker 1: we'll just hold hands when we're lying in bed. It's 161 00:09:45,320 --> 00:09:46,760 Speaker 1: just like the things that a lot of people take 162 00:09:46,760 --> 00:09:50,840 Speaker 1: for granted. Those are the things that get reframed as 163 00:09:51,240 --> 00:09:54,560 Speaker 1: our intimate times. We don't do the whole dating thing 164 00:09:54,720 --> 00:09:57,120 Speaker 1: like other couples do a lot of times. So we 165 00:09:57,200 --> 00:09:59,160 Speaker 1: need to go to the store and get paper, towels 166 00:09:59,160 --> 00:10:02,280 Speaker 1: and toilet paper. Okay, that's a date. We're going to 167 00:10:02,360 --> 00:10:05,040 Speaker 1: go and maybe we'll get an ice cream or something, 168 00:10:05,240 --> 00:10:07,880 Speaker 1: either going or coming back, and that's it right there. 169 00:10:08,480 --> 00:10:08,880 Speaker 5: Yeah. 170 00:10:09,160 --> 00:10:12,840 Speaker 2: I really love that. I fully agree. There's also, of course, 171 00:10:12,880 --> 00:10:18,200 Speaker 2: like the traditional definition of physical intimacy, which is for 172 00:10:18,640 --> 00:10:20,480 Speaker 2: a lot of people saying that is like a very 173 00:10:20,520 --> 00:10:25,240 Speaker 2: physical need or a desire. Is there anything that you 174 00:10:25,520 --> 00:10:29,320 Speaker 2: have found that has worked in your marriage for how 175 00:10:29,360 --> 00:10:33,880 Speaker 2: you both approach that part of your relationship knowing that 176 00:10:34,400 --> 00:10:37,960 Speaker 2: chronic migraine can affect that at any moment. 177 00:10:38,880 --> 00:10:41,160 Speaker 1: Yeah, don't want to sound cold about things, but we 178 00:10:41,240 --> 00:10:44,000 Speaker 1: kind of plan things out. Yeah, we know we're going 179 00:10:44,080 --> 00:10:47,040 Speaker 1: to go away for this weekend and we're going to 180 00:10:47,679 --> 00:10:50,000 Speaker 1: just do something that we both enjoy, go look at 181 00:10:50,000 --> 00:10:51,880 Speaker 1: antiques or something like that. But we know that we're 182 00:10:51,880 --> 00:10:55,880 Speaker 1: going to be by ourselves, so that opportunity to have 183 00:10:55,920 --> 00:11:00,360 Speaker 1: that physical intimacy is definitely going to be there. Whether 184 00:11:00,559 --> 00:11:03,440 Speaker 1: you know, my head, my body and her head and 185 00:11:03,440 --> 00:11:08,040 Speaker 1: her body will all sync up at that time. Maybe 186 00:11:08,240 --> 00:11:11,439 Speaker 1: it happens, and maybe it doesn't, and it's like we're 187 00:11:11,480 --> 00:11:13,920 Speaker 1: past the point where it's I don't really get upset 188 00:11:13,960 --> 00:11:17,360 Speaker 1: about it anymore. Yeah, she doesn't get upset about it anymore. 189 00:11:17,440 --> 00:11:21,120 Speaker 1: It just is what it is. We just we really 190 00:11:21,160 --> 00:11:23,600 Speaker 1: focus on trying to appreciate the time that we have 191 00:11:23,720 --> 00:11:27,600 Speaker 1: together and the like something that's soothing for both of 192 00:11:27,679 --> 00:11:31,920 Speaker 1: us is shower time. Yeah, that's always been like a 193 00:11:32,000 --> 00:11:34,680 Speaker 1: time for us to be together and to relax and 194 00:11:34,720 --> 00:11:35,840 Speaker 1: we can decompress. 195 00:11:36,240 --> 00:11:40,640 Speaker 2: I also think that there's something too, like the scheduling 196 00:11:40,720 --> 00:11:42,839 Speaker 2: aspect of it. I think you are getting to this 197 00:11:42,960 --> 00:11:47,000 Speaker 2: point like even that can build up in anticipation more 198 00:11:47,040 --> 00:11:49,400 Speaker 2: than just the maybe it'll happen, maybe it won't. So 199 00:11:50,160 --> 00:11:52,839 Speaker 2: I love that. I love that, and I love your relationship, 200 00:11:52,880 --> 00:11:57,920 Speaker 2: which is why I am so glad that we get 201 00:11:57,960 --> 00:12:02,680 Speaker 2: to bring your wife into this conversation. Before we meet 202 00:12:02,760 --> 00:12:12,320 Speaker 2: Tom's wife, Cheryl, I'm going to check in with doctor Rhin. Okay, 203 00:12:12,360 --> 00:12:14,480 Speaker 2: I want to bring you back into the conversation here, 204 00:12:14,520 --> 00:12:18,480 Speaker 2: doctor Ryan. Tom has brought up some really good ideas 205 00:12:18,520 --> 00:12:22,319 Speaker 2: around how we can reframe our definition of intimacy and 206 00:12:22,760 --> 00:12:27,000 Speaker 2: be more intentional with scheduling time for intimacy with our partner, 207 00:12:27,600 --> 00:12:30,479 Speaker 2: with the goal of creating a partnership that can accommodate 208 00:12:31,080 --> 00:12:35,360 Speaker 2: migraine attacks. But the current underneath all of this is 209 00:12:35,960 --> 00:12:38,640 Speaker 2: around the stigmas that are faced by people living with 210 00:12:38,720 --> 00:12:42,839 Speaker 2: chronic migraine and how they have to mask their experience 211 00:12:42,920 --> 00:12:46,000 Speaker 2: to fit in. So let's refresh people's memories a bit. 212 00:12:46,320 --> 00:12:49,280 Speaker 2: What are some of the most common stigmas you hear 213 00:12:49,320 --> 00:12:51,120 Speaker 2: about from your patients. 214 00:12:51,120 --> 00:12:53,439 Speaker 4: Nora, The stigma that breaks my heart the most is 215 00:12:53,480 --> 00:12:56,960 Speaker 4: that people don't trust the migraine patient. They think that 216 00:12:57,040 --> 00:12:59,640 Speaker 4: they're faking it. They think that they're faking the intensity 217 00:12:59,679 --> 00:13:02,480 Speaker 4: of the illness or the impact that the disability has 218 00:13:02,559 --> 00:13:05,240 Speaker 4: on their everyday life. Worse than that, patients are often 219 00:13:05,240 --> 00:13:08,199 Speaker 4: made to feel like they're scapegoaded, that their illness is 220 00:13:08,240 --> 00:13:11,960 Speaker 4: there for personal gain or personal preference, as ridiculous as 221 00:13:11,960 --> 00:13:15,200 Speaker 4: that sounds. Their coworkers make them feel like they're using 222 00:13:15,240 --> 00:13:18,839 Speaker 4: chronic migraine diagnosis to avoid work or to work less. 223 00:13:19,120 --> 00:13:21,880 Speaker 4: Their partners sometimes make them feel like they're using their 224 00:13:21,920 --> 00:13:25,760 Speaker 4: diagnosis to avoid intimate encounters. Family members make them feel 225 00:13:25,840 --> 00:13:29,360 Speaker 4: like they're using their diagnosis to avoid family responsibilities or 226 00:13:29,360 --> 00:13:32,560 Speaker 4: even family interactions, which is the exact opposite of what 227 00:13:32,640 --> 00:13:35,480 Speaker 4: these patients really feel and want. What we end up 228 00:13:35,480 --> 00:13:37,960 Speaker 4: then with is an impact that isolates people living with 229 00:13:38,040 --> 00:13:41,720 Speaker 4: chronic migraine even further. It keeps them from developing open 230 00:13:41,760 --> 00:13:44,559 Speaker 4: and honest communication around what they're experiencing. 231 00:13:45,120 --> 00:13:49,439 Speaker 2: Yeah, I would imagine that seeing and feeling these stigmas 232 00:13:49,480 --> 00:13:53,320 Speaker 2: every day would make you hesitant to be vulnerable and 233 00:13:53,400 --> 00:13:56,200 Speaker 2: to share your story with other people and even with 234 00:13:56,320 --> 00:13:59,440 Speaker 2: your doctor. Is this a factor in why you've seen 235 00:13:59,480 --> 00:14:04,080 Speaker 2: people has to seek care and what other reasons have 236 00:14:04,160 --> 00:14:06,680 Speaker 2: you seen that makes people hesitate a. 237 00:14:06,559 --> 00:14:08,559 Speaker 4: Bit nor this blows in my mind. A couple of 238 00:14:08,600 --> 00:14:11,040 Speaker 4: years ago, study came out that found that nearly half 239 00:14:11,080 --> 00:14:14,160 Speaker 4: of people with migraine hesitate to seek care. It's a 240 00:14:14,200 --> 00:14:17,600 Speaker 4: huge number and sadly not surprising. In the study, they 241 00:14:17,679 --> 00:14:20,000 Speaker 4: also try to get a better picture of why those 242 00:14:20,040 --> 00:14:22,680 Speaker 4: people hesitated. What they found was that over a third 243 00:14:22,720 --> 00:14:25,360 Speaker 4: of those people said that they hesitated because they were 244 00:14:25,400 --> 00:14:28,920 Speaker 4: afraid their symptoms weren't going to be taken seriously. And 245 00:14:29,640 --> 00:14:32,320 Speaker 4: it's sad to see for me and my practice. I mean, 246 00:14:32,480 --> 00:14:35,080 Speaker 4: they're internalizing all of the questioning that they've received their 247 00:14:35,080 --> 00:14:37,480 Speaker 4: whole life about whether or not their disease is legitimate, 248 00:14:37,840 --> 00:14:40,680 Speaker 4: are they really having symptoms? Are the symptoms that bad? 249 00:14:41,440 --> 00:14:43,800 Speaker 4: And they're afraid that they're not going to have their 250 00:14:43,840 --> 00:14:46,240 Speaker 4: needs met again when they finally do get the chance 251 00:14:46,280 --> 00:14:50,520 Speaker 4: to see the physician. They're scared of the cynicism and disbelief. 252 00:14:50,520 --> 00:14:53,480 Speaker 4: They're scared of the stigma that they've experienced already. And 253 00:14:53,520 --> 00:14:55,400 Speaker 4: it's why I try so hard to save space for 254 00:14:55,480 --> 00:14:57,920 Speaker 4: them when they do share their story at the very 255 00:14:58,000 --> 00:15:01,440 Speaker 4: beginning of the relationship that we're building. Clinically, it's really 256 00:15:01,480 --> 00:15:04,160 Speaker 4: important for that treatment journey, but it's also really important 257 00:15:04,160 --> 00:15:05,720 Speaker 4: for them to have that level of trust. 258 00:15:06,960 --> 00:15:09,480 Speaker 2: All right, thanks doctor Ryan. After the break, we'll get 259 00:15:09,480 --> 00:15:39,760 Speaker 2: back to the conversation and meet Tom's wife, Cheryl. It's 260 00:15:39,800 --> 00:15:41,720 Speaker 2: time to bring Cheryl into the chat. 261 00:15:42,120 --> 00:15:44,880 Speaker 5: Hi, Nora, it's great to be here. Thanks for having me. 262 00:15:45,400 --> 00:15:49,200 Speaker 2: Cheryl. It's so good to meet you, and I am 263 00:15:49,280 --> 00:15:52,360 Speaker 2: grateful that our audience gets to hear about this partnership 264 00:15:52,880 --> 00:15:54,760 Speaker 2: that you two have and that you have built and 265 00:15:54,760 --> 00:15:57,560 Speaker 2: that you have maintained, and that you've been able to 266 00:15:58,360 --> 00:16:02,720 Speaker 2: navigate this experience and stay close to each other through 267 00:16:02,840 --> 00:16:06,880 Speaker 2: all of this. A lot of a relationship comes down 268 00:16:06,880 --> 00:16:11,240 Speaker 2: to communication. How do you to communicate, check in with 269 00:16:11,280 --> 00:16:13,359 Speaker 2: each other, and stay connected. 270 00:16:13,920 --> 00:16:17,160 Speaker 5: So, yes, the answer to your question, we just have 271 00:16:17,200 --> 00:16:20,000 Speaker 5: to feel it out. Because he'll pretend he doesn't have 272 00:16:20,040 --> 00:16:22,720 Speaker 5: a headache, or he'll take medicine and say, oh, I'm fine, 273 00:16:23,320 --> 00:16:26,200 Speaker 5: and I'll be like, are you sure, because you're acting 274 00:16:26,840 --> 00:16:29,840 Speaker 5: like I really don't want to be with you right now, 275 00:16:29,880 --> 00:16:34,120 Speaker 5: And of course I understand that being uncomfortable makes those 276 00:16:34,160 --> 00:16:37,160 Speaker 5: times difficult. And then I was chuckling to myself because 277 00:16:37,200 --> 00:16:41,400 Speaker 5: we went away for our anniversary last year and we 278 00:16:42,000 --> 00:16:46,520 Speaker 5: thought we'd be together, and first day we're there, I'm like, honey, 279 00:16:46,520 --> 00:16:49,040 Speaker 5: I'm getting an aura and I had a migrant attack 280 00:16:49,200 --> 00:16:51,720 Speaker 5: for two days and we're just like those times we 281 00:16:51,720 --> 00:16:54,200 Speaker 5: were just laying in bed together and I was listening 282 00:16:54,240 --> 00:16:56,400 Speaker 5: to a movie and he was watching the movie, and 283 00:16:56,480 --> 00:16:59,120 Speaker 5: so it was flip sides. We just worked through it. 284 00:16:59,200 --> 00:17:04,320 Speaker 5: So intimacy is more than a feeling. It's part of 285 00:17:04,359 --> 00:17:07,159 Speaker 5: a being who you are and that you're together. 286 00:17:07,600 --> 00:17:10,920 Speaker 2: Yeah, that's really beautiful and I love that you just 287 00:17:11,480 --> 00:17:13,440 Speaker 2: you talked about the example of you're going away for 288 00:17:13,480 --> 00:17:17,240 Speaker 2: your anniversary. Everyone thinks the anniversary trip is going to 289 00:17:17,280 --> 00:17:20,399 Speaker 2: be the time that's the most relatable thing. We're going 290 00:17:20,440 --> 00:17:25,720 Speaker 2: away together, we're celebrating, you're getting a migrant attack, you're 291 00:17:25,800 --> 00:17:29,359 Speaker 2: listening to a movie. Now, Like, I don't think that 292 00:17:29,560 --> 00:17:32,159 Speaker 2: there's anything more relatable than that. Whether or not you 293 00:17:32,280 --> 00:17:37,479 Speaker 2: experience chronic migraine, like the expectations versus reality require, it 294 00:17:37,560 --> 00:17:39,800 Speaker 2: just requires a lot of flexibility. It requires like that 295 00:17:39,880 --> 00:17:43,159 Speaker 2: deeper intimacy that you're talking about, which is compassion for 296 00:17:43,200 --> 00:17:46,840 Speaker 2: each other and compassion for yourselves. I want to talk 297 00:17:46,880 --> 00:17:53,520 Speaker 2: about how you've navigated those not tonight moments, because I 298 00:17:53,520 --> 00:17:55,399 Speaker 2: think that's a hard thing. It's a hard thing for 299 00:17:55,440 --> 00:17:58,199 Speaker 2: somebody to say. At times, it's a hard thing for 300 00:17:58,240 --> 00:18:00,480 Speaker 2: somebody to hear as well. 301 00:18:01,400 --> 00:18:04,959 Speaker 5: It's really funny because my chronic migraine, I had four 302 00:18:05,080 --> 00:18:09,520 Speaker 5: or five migraine attacks a week. Fortunately Tom didn't have migraine. 303 00:18:09,520 --> 00:18:13,920 Speaker 5: Then for me, it'd be like, I've taken care of 304 00:18:14,000 --> 00:18:17,040 Speaker 5: all the kids today, I've vomited like four times today. 305 00:18:17,400 --> 00:18:21,080 Speaker 5: I feel ugly, like I don't want to do anything. 306 00:18:22,000 --> 00:18:24,800 Speaker 5: And he, believe it or not, has it that is 307 00:18:24,840 --> 00:18:27,000 Speaker 5: in him all the time because he always wants me 308 00:18:27,160 --> 00:18:28,640 Speaker 5: to be happy as well. 309 00:18:29,040 --> 00:18:30,919 Speaker 2: Yeah, so now it's the flip. 310 00:18:30,680 --> 00:18:33,320 Speaker 5: Side, and women are a little different than men. Meant 311 00:18:33,359 --> 00:18:36,399 Speaker 5: to strive to be more intimate and women are like, 312 00:18:36,480 --> 00:18:39,639 Speaker 5: oh okay, I can sleep tonight. So for us, like 313 00:18:39,680 --> 00:18:42,240 Speaker 5: Tom said, we could sit on the couch and hold 314 00:18:42,320 --> 00:18:45,960 Speaker 5: hands and just snuggle and they'll be okay, and he'll 315 00:18:45,960 --> 00:18:49,520 Speaker 5: apologize to me, and I'm like, there's no need to apologize. 316 00:18:49,560 --> 00:18:52,639 Speaker 5: I loved just sitting there and watching the movie with you, 317 00:18:53,240 --> 00:18:56,520 Speaker 5: or having you lay there and snore. Either way, I 318 00:18:56,560 --> 00:19:00,679 Speaker 5: know that he's here, so I'm just grateful that I 319 00:19:00,760 --> 00:19:03,000 Speaker 5: have him snoring next to me, or with an ice 320 00:19:03,040 --> 00:19:03,920 Speaker 5: pack or whatever. 321 00:19:04,600 --> 00:19:08,000 Speaker 2: So in world where media often presents one version of 322 00:19:08,000 --> 00:19:12,240 Speaker 2: intimacy above all others, this is a softer form of it. 323 00:19:12,240 --> 00:19:14,639 Speaker 2: It's one that respects the bodies don't always do what 324 00:19:14,680 --> 00:19:17,200 Speaker 2: we want them to do, and that love and connection 325 00:19:17,440 --> 00:19:20,320 Speaker 2: can take many forms. Tom, I want to ask you, 326 00:19:20,359 --> 00:19:23,720 Speaker 2: there's a lot culturally, there's a lot of pressure as 327 00:19:23,720 --> 00:19:28,040 Speaker 2: a man to not, oh, don't experience any vulnerability and 328 00:19:28,160 --> 00:19:32,760 Speaker 2: weakness in quotation marks. Certainly don't talk about it if 329 00:19:33,280 --> 00:19:38,080 Speaker 2: you are experiencing it, and it's very toxic. It's very 330 00:19:38,119 --> 00:19:40,880 Speaker 2: toxic to men, it's toxic to the people they love. 331 00:19:40,920 --> 00:19:45,920 Speaker 2: And there's so much strength to be found, like inner strength, 332 00:19:45,960 --> 00:19:51,000 Speaker 2: but also connection with other people in sharing those experiences openly. 333 00:19:51,080 --> 00:19:52,880 Speaker 2: Can you talk to us about that? 334 00:19:53,760 --> 00:19:56,080 Speaker 1: Yeah, I just you just happen to get to the 335 00:19:56,119 --> 00:19:59,720 Speaker 1: point where I was able to do that because your 336 00:19:59,760 --> 00:20:02,359 Speaker 1: work with a group of people, you're talking with your 337 00:20:02,359 --> 00:20:04,960 Speaker 1: supervisor or something like that, and they're used to you 338 00:20:05,040 --> 00:20:07,920 Speaker 1: being very on top of things, very sharp. And one 339 00:20:07,920 --> 00:20:10,040 Speaker 1: of my bosses used to tell me it didn't hire 340 00:20:10,119 --> 00:20:13,560 Speaker 1: you for anything, but the space between your ears. He says, 341 00:20:13,600 --> 00:20:16,919 Speaker 1: I want that three inches between your ears. That's great, 342 00:20:17,440 --> 00:20:20,720 Speaker 1: but during a migraine attack, I'm not at my best 343 00:20:20,920 --> 00:20:23,800 Speaker 1: at that point in time. I just had to come 344 00:20:23,840 --> 00:20:28,480 Speaker 1: to the realization that I could try and quote man 345 00:20:28,560 --> 00:20:32,119 Speaker 1: up and try and cover it up and put on 346 00:20:32,200 --> 00:20:34,480 Speaker 1: the little happy face or whatever and say, oh no, 347 00:20:34,640 --> 00:20:37,560 Speaker 1: I'm fine, I've got this. I've got that. I'm also 348 00:20:37,600 --> 00:20:40,080 Speaker 1: the kind of person where if I'm going to do something, 349 00:20:40,160 --> 00:20:42,400 Speaker 1: I like to try and do it at the best 350 00:20:42,480 --> 00:20:47,280 Speaker 1: level that I can. And I just knew that wasn't happening. 351 00:20:47,320 --> 00:20:49,679 Speaker 1: I could just feel it in myself. See, yeah, I 352 00:20:49,720 --> 00:20:53,439 Speaker 1: see that this project is done, but I could have 353 00:20:53,480 --> 00:20:55,600 Speaker 1: done better. But I just don't know how I could 354 00:20:55,640 --> 00:20:58,720 Speaker 1: have done better. So it was like, I have to 355 00:20:58,760 --> 00:21:02,560 Speaker 1: start telling the people that work with me, telling the 356 00:21:02,600 --> 00:21:05,280 Speaker 1: people that are above me. I've been seeing a doctor 357 00:21:05,320 --> 00:21:08,320 Speaker 1: about this, and this is how it has to be 358 00:21:08,359 --> 00:21:11,199 Speaker 1: for me, and I'd like you guys to be on 359 00:21:11,280 --> 00:21:15,360 Speaker 1: board with it. So it's like it was very difficult. 360 00:21:15,400 --> 00:21:20,359 Speaker 1: I lived on fmla intermittent leave for three years at 361 00:21:20,359 --> 00:21:22,919 Speaker 1: the end of my career. It was a tough conversation 362 00:21:23,040 --> 00:21:26,120 Speaker 1: to have because I had to admit to myself that 363 00:21:26,720 --> 00:21:30,400 Speaker 1: you're not who you were. That person is no longer 364 00:21:31,000 --> 00:21:35,639 Speaker 1: viable in your life. So I had to kind of 365 00:21:35,640 --> 00:21:40,720 Speaker 1: recreate myself and repurpose myself into something else. And that's 366 00:21:40,760 --> 00:21:45,720 Speaker 1: when I found migrain dot Com and I submitted some 367 00:21:45,800 --> 00:21:48,560 Speaker 1: writing and they liked it and they brought me on 368 00:21:48,680 --> 00:21:53,920 Speaker 1: to do some content for them, and that really allowed 369 00:21:53,920 --> 00:21:57,240 Speaker 1: me to kind of repurpose myself. Now I can help 370 00:21:57,320 --> 00:22:01,439 Speaker 1: another set of people by sharing my experience and just 371 00:22:01,480 --> 00:22:05,200 Speaker 1: trying it to be open, honest, and, as I guess, vulnerable, 372 00:22:05,880 --> 00:22:10,520 Speaker 1: because it's one of those things that's if I'm suffering, 373 00:22:10,600 --> 00:22:13,159 Speaker 1: then other people are suffering. But what I've learned with 374 00:22:13,240 --> 00:22:16,800 Speaker 1: chronic migraine is that you can talk to ten different 375 00:22:16,800 --> 00:22:20,119 Speaker 1: people and they're going to have ten different angles on 376 00:22:20,600 --> 00:22:27,120 Speaker 1: how it impacts their life. 377 00:22:30,560 --> 00:22:33,640 Speaker 2: Okay, doctor Ryan, how much do you love these two? 378 00:22:33,680 --> 00:22:38,320 Speaker 2: They are like the shining stars of the migraine classroom. Now. 379 00:22:38,400 --> 00:22:41,080 Speaker 2: I always love hearing your thoughts on how people living 380 00:22:41,080 --> 00:22:44,800 Speaker 2: with chronic migraine could approach doctors and their workplaces with 381 00:22:44,880 --> 00:22:48,240 Speaker 2: this conversation, but we have never really talked about how 382 00:22:48,240 --> 00:22:52,679 Speaker 2: they could approach their partners, their spouses, their boyfriends, their girlfriends. 383 00:22:53,400 --> 00:22:56,520 Speaker 2: Do you have any numbers that help illustrate how hesitant 384 00:22:56,560 --> 00:22:59,920 Speaker 2: people are to share their migraine experience and how do 385 00:22:59,920 --> 00:23:03,760 Speaker 2: you try to help them navigate these conversations with their partners? 386 00:23:04,680 --> 00:23:07,320 Speaker 4: Nora, This is I think the piece that helps these 387 00:23:07,359 --> 00:23:11,119 Speaker 4: patients realize that they are not alone. So there are 388 00:23:11,160 --> 00:23:14,520 Speaker 4: and unfortunately, the first one is really concerning. There was 389 00:23:14,560 --> 00:23:17,719 Speaker 4: a large observational study that was done with almost twelve 390 00:23:17,760 --> 00:23:21,560 Speaker 4: thousand episodic and chronic migraine respondents, So a huge study 391 00:23:21,920 --> 00:23:25,399 Speaker 4: that basically showed that the closer you are in a 392 00:23:25,480 --> 00:23:29,280 Speaker 4: relationship to someone who experienced migraine attacks, the more stigmatizing 393 00:23:29,280 --> 00:23:33,160 Speaker 4: your attitude is toward them. So the closer that you are, 394 00:23:33,880 --> 00:23:37,320 Speaker 4: the worst that you're treating that individual that suffers with migraine. 395 00:23:37,400 --> 00:23:39,800 Speaker 4: Of the twelve thousand people with both episodic and chronic 396 00:23:39,840 --> 00:23:43,560 Speaker 4: migraine that were surveyed, seventy percent endorsed a stigma toward 397 00:23:43,640 --> 00:23:47,760 Speaker 4: individuals living with migraine. So these people were asked, who 398 00:23:47,800 --> 00:23:50,720 Speaker 4: had a relationship with someone who had either episodic or 399 00:23:50,800 --> 00:23:54,679 Speaker 4: chronic migraine, do you do stigmatizing things to that person? 400 00:23:55,160 --> 00:23:58,560 Speaker 4: And seventy percent of them said yes, and this was 401 00:23:58,640 --> 00:24:02,200 Speaker 4: more common in those responds who had even closer relationships 402 00:24:02,280 --> 00:24:05,760 Speaker 4: through a partnership or family relationship, a friendship to those 403 00:24:05,760 --> 00:24:08,200 Speaker 4: that were living with migraine clinically. The way that we 404 00:24:08,240 --> 00:24:10,240 Speaker 4: address this in my office, Nora, is that we put 405 00:24:10,240 --> 00:24:12,080 Speaker 4: it all out in the open, that they made an 406 00:24:12,119 --> 00:24:14,439 Speaker 4: awesome choice in coming to seek care, and we validate 407 00:24:14,480 --> 00:24:17,560 Speaker 4: their experience. Finally, and really importantly, after we have that 408 00:24:17,640 --> 00:24:20,720 Speaker 4: sort of bridge to trust and understanding, look toward exploring 409 00:24:20,760 --> 00:24:23,000 Speaker 4: treatment options with really specific goals in mine. 410 00:24:23,240 --> 00:24:34,440 Speaker 2: All right, let's get back to Tom. Tom, you said something 411 00:24:34,480 --> 00:24:37,000 Speaker 2: earlier that I want to revisit, which is you had 412 00:24:37,040 --> 00:24:40,479 Speaker 2: to disassemble who you thought you were and what your 413 00:24:40,520 --> 00:24:43,560 Speaker 2: life was going to be like and rebuild that. I imagine 414 00:24:43,480 --> 00:24:47,399 Speaker 2: that had to be pretty hard emotionally. How did that 415 00:24:47,560 --> 00:24:52,040 Speaker 2: feel for you? And then, Cheryl, I want to hear 416 00:24:52,160 --> 00:24:55,480 Speaker 2: how that felt for you watching Tom go through that. 417 00:24:56,160 --> 00:24:58,800 Speaker 1: For me, it was a very emotional thing for me 418 00:24:58,920 --> 00:25:05,920 Speaker 1: because I had always been the provider and I got 419 00:25:05,920 --> 00:25:08,640 Speaker 1: to the point where it's I just I couldn't do 420 00:25:08,720 --> 00:25:11,639 Speaker 1: that anymore, at least not to the level that I 421 00:25:11,720 --> 00:25:15,160 Speaker 1: thought that I could do, and it was a hard 422 00:25:15,400 --> 00:25:20,080 Speaker 1: transition to make, but my wife was there to support me, 423 00:25:20,480 --> 00:25:23,040 Speaker 1: and we knew where things were going to be going, 424 00:25:23,280 --> 00:25:26,480 Speaker 1: and we planned the best way that we could to 425 00:25:26,920 --> 00:25:30,760 Speaker 1: make a way for the future. I made concessions to 426 00:25:30,800 --> 00:25:34,680 Speaker 1: pull back out of my career and go on disability, 427 00:25:34,960 --> 00:25:40,080 Speaker 1: and she made plans to step back up into the 428 00:25:40,280 --> 00:25:42,400 Speaker 1: out of the home workforce. I have to be real 429 00:25:42,440 --> 00:25:44,920 Speaker 1: about it. I have to be honest and to set 430 00:25:44,920 --> 00:25:50,159 Speaker 1: myself aside. And I tried not to project the emotion 431 00:25:50,280 --> 00:25:52,920 Speaker 1: that I'm feeling on the people around me and people 432 00:25:53,000 --> 00:25:56,040 Speaker 1: in my family and things like that, but sometimes it's 433 00:25:56,160 --> 00:25:56,880 Speaker 1: just how it is. 434 00:25:58,480 --> 00:26:01,960 Speaker 5: So as I'm sitting in listening to all of this 435 00:26:02,280 --> 00:26:06,920 Speaker 5: and I'm thinking and thinking of my answer, I can 436 00:26:06,960 --> 00:26:10,600 Speaker 5: recall when he first started getting his migrant attacks, he 437 00:26:10,680 --> 00:26:14,359 Speaker 5: missed out on a daddy daughter dance with his daughter, 438 00:26:14,440 --> 00:26:16,800 Speaker 5: and we have pictures of someone who stepped in for him, 439 00:26:17,000 --> 00:26:18,840 Speaker 5: and he felt really bad about it, but he just 440 00:26:18,840 --> 00:26:21,639 Speaker 5: couldn't bring himself to do it. And that was the 441 00:26:21,680 --> 00:26:26,679 Speaker 5: first time where I'm like, this has to be a 442 00:26:26,760 --> 00:26:31,879 Speaker 5: debilitating feeling, like he can't make himself go to a 443 00:26:31,960 --> 00:26:36,199 Speaker 5: daddy daughter dinner that's only two hours long, you know, 444 00:26:36,640 --> 00:26:39,119 Speaker 5: So that's when you're like, maybe there is something a 445 00:26:39,119 --> 00:26:42,719 Speaker 5: little more to this headache than it being just a headache. 446 00:26:42,880 --> 00:26:45,960 Speaker 5: It wasn't until about six years ago that I really 447 00:26:46,000 --> 00:26:50,280 Speaker 5: started to realize that he really was struggling trying to 448 00:26:50,560 --> 00:26:52,520 Speaker 5: keep his head on top of the cheese per se. 449 00:26:52,800 --> 00:26:59,080 Speaker 5: And Christmas was coming and we're pretty good financially with 450 00:26:59,119 --> 00:27:02,760 Speaker 5: our money and spending it wisely and everything. But I 451 00:27:02,800 --> 00:27:06,800 Speaker 5: went up to a local department store and I went in. 452 00:27:07,320 --> 00:27:09,840 Speaker 5: I'll never forget it. I went in for my interview 453 00:27:10,560 --> 00:27:14,040 Speaker 5: and I just broke down tears, and the lady was like, 454 00:27:14,320 --> 00:27:16,920 Speaker 5: and I'm like, look, I'm not asking you to hire 455 00:27:17,000 --> 00:27:20,679 Speaker 5: me because I'm crying, but I'm like, my husband has 456 00:27:20,760 --> 00:27:23,240 Speaker 5: chronic migraine, and I don't want you to hire me 457 00:27:23,359 --> 00:27:26,560 Speaker 5: because my husband has chronic migraine. I may call out 458 00:27:26,560 --> 00:27:29,040 Speaker 5: a couple of times because of that, but I'm like, 459 00:27:29,119 --> 00:27:31,280 Speaker 5: I'm just trying to get back into the workforce. And 460 00:27:31,320 --> 00:27:33,720 Speaker 5: they did hire me, which was amazing because I was 461 00:27:33,760 --> 00:27:36,040 Speaker 5: bawling like a baby. But it wasn't until then that 462 00:27:36,640 --> 00:27:42,040 Speaker 5: I realized that this is now who I am redefined 463 00:27:42,119 --> 00:27:44,960 Speaker 5: as like I'm the person that's going to have to 464 00:27:45,359 --> 00:27:49,200 Speaker 5: provide or whatever. So we're walking into a different era. 465 00:27:49,720 --> 00:27:52,080 Speaker 5: So that's one of the realizations that we have as well, 466 00:27:52,080 --> 00:27:54,639 Speaker 5: and he understands that, and so that's a lot on 467 00:27:54,680 --> 00:27:55,399 Speaker 5: my shoulders. 468 00:27:55,520 --> 00:27:57,760 Speaker 2: Yeah, I think it's really beautiful for people to hear 469 00:27:57,800 --> 00:28:01,800 Speaker 2: that any relationship can change any Yeah, it's like you 470 00:28:01,960 --> 00:28:05,320 Speaker 2: change that changes the marriage, the marriage changes you, you 471 00:28:05,440 --> 00:28:09,800 Speaker 2: change each other, like it's all just constant evolution. I 472 00:28:09,840 --> 00:28:12,480 Speaker 2: think that's really valuable for people to hear. Tom. I 473 00:28:12,520 --> 00:28:16,200 Speaker 2: want to and by talking about the writing that you've done, 474 00:28:16,800 --> 00:28:20,240 Speaker 2: what does it feel like to hear from people who 475 00:28:20,240 --> 00:28:24,440 Speaker 2: have read your story and connected with it? 476 00:28:24,440 --> 00:28:28,160 Speaker 1: It feels good and I'm very grateful that they acknowledge 477 00:28:28,520 --> 00:28:33,639 Speaker 1: that I've written something that resonates with them. It just 478 00:28:33,840 --> 00:28:37,640 Speaker 1: it gives me a good feeling. It reinforces the new 479 00:28:37,680 --> 00:28:44,080 Speaker 1: purpose that I have, that I can touch other people 480 00:28:44,160 --> 00:28:47,240 Speaker 1: that are not even in my area and stuff like that. 481 00:28:47,360 --> 00:28:52,320 Speaker 1: I think I've developed maybe the most meaningful connections with 482 00:28:52,480 --> 00:28:55,000 Speaker 1: some of the people that are across the world. I've 483 00:28:55,040 --> 00:28:59,840 Speaker 1: connected with someone from Germany and what I wrote impacted him, 484 00:29:00,520 --> 00:29:03,520 Speaker 1: and the comments that he wrote in response to what 485 00:29:03,600 --> 00:29:09,200 Speaker 1: I had written resonated with me, so we traded information. 486 00:29:09,440 --> 00:29:13,280 Speaker 2: And yeah, yeah, you made him feel seen. He made 487 00:29:13,320 --> 00:29:17,120 Speaker 2: you feel seen, and that's so powerful and it's so 488 00:29:17,200 --> 00:29:20,000 Speaker 2: valuable and so generous of you to do, Tom, And 489 00:29:20,400 --> 00:29:24,000 Speaker 2: it's so generous of both of you to share so 490 00:29:24,400 --> 00:29:27,000 Speaker 2: much of yourselves and your relationship with us and with 491 00:29:27,040 --> 00:29:29,640 Speaker 2: our listeners. It is truly a gift. And I'm so 492 00:29:30,040 --> 00:29:32,880 Speaker 2: grateful to you both for being here. So thank you, 493 00:29:33,360 --> 00:29:34,360 Speaker 2: Thank you for having us. 494 00:29:34,720 --> 00:29:35,120 Speaker 5: Thank you. 495 00:29:37,720 --> 00:29:41,719 Speaker 2: Okay, doctor Ryan. Tom brought up something that's really important, 496 00:29:41,760 --> 00:29:45,640 Speaker 2: the idea that men feel this pressure to not open 497 00:29:45,760 --> 00:29:50,200 Speaker 2: up about their experience, that sharing all their symptoms or 498 00:29:50,480 --> 00:29:54,360 Speaker 2: being vulnerable could be seen as being weak, and that 499 00:29:55,040 --> 00:29:59,400 Speaker 2: it makes them hesitate. We've touched a bit on this before, 500 00:29:59,480 --> 00:30:01,880 Speaker 2: but what do the numbers show us? 501 00:30:02,080 --> 00:30:04,280 Speaker 4: Yeah, I think, Nora, it's super important for us to 502 00:30:04,360 --> 00:30:06,840 Speaker 4: keep this out in front, because this really is one 503 00:30:06,880 --> 00:30:09,440 Speaker 4: of the first hurdles that patients are going to experience, 504 00:30:09,760 --> 00:30:12,920 Speaker 4: is that hesitancy. So the prevalence of people with migraine 505 00:30:12,960 --> 00:30:15,920 Speaker 4: is significantly higher in females than in males. Studies have 506 00:30:15,960 --> 00:30:18,440 Speaker 4: shown that the ratio of female to male people with 507 00:30:18,640 --> 00:30:20,760 Speaker 4: migraine is roughly three to one, meaning that for every 508 00:30:20,760 --> 00:30:23,600 Speaker 4: male migraine patient out there, there are three female migraine patients. 509 00:30:23,920 --> 00:30:27,360 Speaker 4: The Global Burden of Disease Study is a comprehensive research 510 00:30:27,360 --> 00:30:30,760 Speaker 4: effort that is consistently highlighted migraine as a leading cause 511 00:30:30,800 --> 00:30:34,120 Speaker 4: of disability worldwide, and that's where this data is coming from. 512 00:30:34,480 --> 00:30:37,600 Speaker 4: Migraine attacks affect more than one billion people worldwide, according 513 00:30:37,640 --> 00:30:40,640 Speaker 4: to the study, women even more so so. Men with 514 00:30:40,760 --> 00:30:44,880 Speaker 4: migraine generally have less severe migraine attacks, and unfortunately, what 515 00:30:44,920 --> 00:30:47,640 Speaker 4: that translates into is that they're less likely to seek treatment, 516 00:30:47,920 --> 00:30:50,120 Speaker 4: and if they do seek treatment, they're less likely to 517 00:30:50,160 --> 00:30:51,960 Speaker 4: receive a diagnosis versus women. 518 00:30:52,360 --> 00:30:57,200 Speaker 2: So, with all that in mind, are their unique challenges 519 00:30:57,320 --> 00:31:01,320 Speaker 2: to men with chronic mind migraine finding care? 520 00:31:02,200 --> 00:31:04,840 Speaker 4: Yeah, I look at the patients that I've treated in 521 00:31:04,880 --> 00:31:08,200 Speaker 4: the past. There are several challenges. Let's take the perception 522 00:31:08,280 --> 00:31:11,320 Speaker 4: and awareness. For example, men might not recognize their symptoms 523 00:31:11,360 --> 00:31:14,280 Speaker 4: as migraine attacks. They might underestimate the severity of their 524 00:31:14,280 --> 00:31:18,040 Speaker 4: symptoms and then ultimately dismiss what they're experiencing as you know, 525 00:31:18,080 --> 00:31:21,160 Speaker 4: quote unquote just a headache. To avoid that stigma and 526 00:31:21,240 --> 00:31:24,600 Speaker 4: ultimately avoid the conversation altogether, nor the bottom line is 527 00:31:24,600 --> 00:31:26,560 Speaker 4: that men are less likely to talk to a doctor 528 00:31:26,600 --> 00:31:29,800 Speaker 4: about their migraine attacks and about the symptoms that they're experiencing. 529 00:31:30,280 --> 00:31:33,320 Speaker 2: Thank you, doctor Rian, that was truly one of the 530 00:31:33,360 --> 00:31:37,600 Speaker 2: most beautiful conversations that I've had. I am so grateful 531 00:31:37,880 --> 00:31:42,080 Speaker 2: for Tom for sharing everything, for Cheryl for joining in, 532 00:31:42,880 --> 00:31:48,760 Speaker 2: and for them laying out so much of their relationship, 533 00:31:49,000 --> 00:31:53,720 Speaker 2: their marriage, their personal and shared experiences for all of us. 534 00:31:54,960 --> 00:31:58,560 Speaker 2: No two marriages are alike, just like Tom noted that 535 00:31:59,000 --> 00:32:04,600 Speaker 2: no two migrain experiences are exactly alike. And I think 536 00:32:04,640 --> 00:32:12,160 Speaker 2: it's so valuable to hear that reinventing yourself when you 537 00:32:12,600 --> 00:32:19,080 Speaker 2: don't necessarily want to been reconfiguring your marriage, your relationship 538 00:32:19,120 --> 00:32:22,920 Speaker 2: with each other, your relationship with yourself. This is necessary 539 00:32:23,000 --> 00:32:26,560 Speaker 2: often and it can be beautiful. It can be beautiful 540 00:32:26,680 --> 00:32:30,440 Speaker 2: even if we didn't choose it. So I hope you 541 00:32:30,840 --> 00:32:36,240 Speaker 2: loved today's conversation. I know I did. Thanks for listening 542 00:32:36,320 --> 00:32:39,120 Speaker 2: to the head start embracing the journey. We hope you 543 00:32:39,200 --> 00:32:42,959 Speaker 2: found something worthwhile here with us today. A new coping strategy, 544 00:32:43,160 --> 00:32:47,160 Speaker 2: a relatable story, the comfort of knowing you're not alone. 545 00:32:48,040 --> 00:32:50,600 Speaker 2: I'm so happy to be a part of creating this 546 00:32:50,720 --> 00:32:54,440 Speaker 2: community for all of us, and especially for people living 547 00:32:54,440 --> 00:32:57,480 Speaker 2: with chronic migrain. If you haven't found a treatment plan 548 00:32:57,520 --> 00:33:00,240 Speaker 2: that is working for you, please do reach out to 549 00:33:00,280 --> 00:33:05,200 Speaker 2: your headache specialist to explore your options. I truly hope 550 00:33:05,200 --> 00:33:07,520 Speaker 2: this has helped you find a bit of comfort and 551 00:33:08,040 --> 00:33:11,720 Speaker 2: maybe a smile. Maybe see you next episode and stay 552 00:33:11,720 --> 00:33:17,680 Speaker 2: tuned for more important safety information. The head Start Embracing 553 00:33:17,720 --> 00:33:21,560 Speaker 2: the Journey is hosted by myself Norah McNerney, Executive produced 554 00:33:21,600 --> 00:33:24,960 Speaker 2: by Van Shechian. Our head of post production is James Foster, 555 00:33:25,200 --> 00:33:28,680 Speaker 2: our researcher is Sierra Kaiser, and our writer is John Irwin. 556 00:33:29,200 --> 00:33:32,840 Speaker 2: The show is mixed by Michael Hardman, original music by 557 00:33:32,920 --> 00:33:37,320 Speaker 2: Soundcat Productions and Art List. 558 00:33:41,720 --> 00:33:45,720 Speaker 3: Important safety information continued. There has not been a confirmed 559 00:33:45,840 --> 00:33:48,440 Speaker 3: serious case of spread of talks and effect away from 560 00:33:48,440 --> 00:33:51,080 Speaker 3: the injection site. When botox has been used at the 561 00:33:51,160 --> 00:33:54,880 Speaker 3: recommended dose to treat chronic migraine. Botox may cause loss 562 00:33:54,920 --> 00:33:58,760 Speaker 3: of strength or general muscle weakness, vision problems, or dizziness 563 00:33:58,800 --> 00:34:02,160 Speaker 3: within hours to week of receiving botox. If this happens, 564 00:34:02,280 --> 00:34:05,120 Speaker 3: do not drive a car, operate machinery, or do other 565 00:34:05,240 --> 00:34:08,840 Speaker 3: dangerous activities. Do not receive botox. If you are allergic 566 00:34:08,920 --> 00:34:12,280 Speaker 3: to any of the ingredients in botox, see medication guide 567 00:34:12,280 --> 00:34:15,600 Speaker 3: for ingredients. Had an allergic reaction to any other botchu 568 00:34:15,680 --> 00:34:20,120 Speaker 3: linum toxin product, such as myoblock rhymo bochelinum toxin B 569 00:34:20,600 --> 00:34:26,200 Speaker 3: disport abobochelinum toxin A, zeomin inco, botcheltem toxin A, JEVO, 570 00:34:26,480 --> 00:34:31,960 Speaker 3: probochul item toxin A XVFS, daxify daxibochelnum toxin A l 571 00:34:32,000 --> 00:34:37,080 Speaker 3: A n M, or lettibo letty botcheltem toxin AWLBG. This 572 00:34:37,200 --> 00:34:39,880 Speaker 3: may not be a complete list of all botchelnum toxin 573 00:34:39,920 --> 00:34:43,400 Speaker 3: products have a skin infection at the planned injection site. 574 00:34:43,880 --> 00:34:46,400 Speaker 3: The dose of botox is not the same as or 575 00:34:46,480 --> 00:34:51,120 Speaker 3: comparable to another botchulnum toxin product. Serious and or immediate 576 00:34:51,160 --> 00:34:57,080 Speaker 3: allergic reactions have been reported, including itching, rash, red, itchy weltz, wheezing, 577 00:34:57,280 --> 00:35:01,480 Speaker 3: asthma symptoms, dizziness or feeling faint. Get medical help right 578 00:35:01,520 --> 00:35:05,239 Speaker 3: away if you experience symptoms, further injection of botox should 579 00:35:05,280 --> 00:35:08,440 Speaker 3: be discontinued. Tell your doctor about all your muscle or 580 00:35:08,480 --> 00:35:12,640 Speaker 3: nerve conditions, such as als or lou Gehrig's disease, Myasthenia 581 00:35:12,680 --> 00:35:15,680 Speaker 3: gravis or lambert Eton syndrome, as you may be at 582 00:35:15,719 --> 00:35:19,640 Speaker 3: increased risk of serious side effects, including difficulty swallowing and 583 00:35:19,760 --> 00:35:23,560 Speaker 3: difficulty breathing from typical doses of botox. Tell your doctor 584 00:35:23,640 --> 00:35:26,719 Speaker 3: about all your medical conditions, including if you have or 585 00:35:26,760 --> 00:35:29,839 Speaker 3: have had bleeding problems, have plans to have surgery, had 586 00:35:29,880 --> 00:35:33,400 Speaker 3: surgery on your face, have weakness of forehead muscles, trouble 587 00:35:33,480 --> 00:35:37,560 Speaker 3: raising your eyebrows, drooping eyelids, and any other abnormal facial change. 588 00:35:37,680 --> 00:35:40,239 Speaker 3: Are pregnant or plan to become pregnant. It is not 589 00:35:40,320 --> 00:35:43,440 Speaker 3: known if botox can harm your unborn baby, our breastfeeding 590 00:35:43,600 --> 00:35:46,240 Speaker 3: or plan to. It is not known if botox passes 591 00:35:46,280 --> 00:35:49,320 Speaker 3: into breast milk. Tell your doctor about all the medicines 592 00:35:49,360 --> 00:35:53,000 Speaker 3: you take, including prescription and over the counter medicines, vitamins, 593 00:35:53,040 --> 00:35:56,879 Speaker 3: and herbal supplements. Using botox with certain other medicines may 594 00:35:56,920 --> 00:36:00,000 Speaker 3: cause serious side effects. Do not start any new medicine 595 00:36:00,280 --> 00:36:02,560 Speaker 3: until you have told your doctor that you have received 596 00:36:02,600 --> 00:36:05,520 Speaker 3: botox in the past. Tell your doctor if you received 597 00:36:05,560 --> 00:36:08,760 Speaker 3: any other bochulinum toxin product in the last four months. 598 00:36:08,920 --> 00:36:15,560 Speaker 3: Have received injections of bochulinum toxin such as myoblock, disport, zamin, Jevo, Daxify, 599 00:36:15,880 --> 00:36:18,440 Speaker 3: or Letibo in the past. This may not be a 600 00:36:18,480 --> 00:36:21,960 Speaker 3: complete list of all bochulinum toxin products. Tell your doctor 601 00:36:22,200 --> 00:36:26,160 Speaker 3: exactly which product you received. Have recently received an antibiotic 602 00:36:26,200 --> 00:36:30,280 Speaker 3: by injection, Take muscle relaxance, take an allergy or cold medicine, 603 00:36:30,320 --> 00:36:33,800 Speaker 3: take a sleep medicine, Take aspirin like products, or blood thinner. 604 00:36:34,040 --> 00:36:37,440 Speaker 3: Other side effects of botox include dry mouth, discomfort or 605 00:36:37,440 --> 00:36:41,239 Speaker 3: pain at the injection site, tiredness, headache, neck pain, eye 606 00:36:41,320 --> 00:36:44,719 Speaker 3: problems such as double vision, blurred vision, decreased eye sight, 607 00:36:44,840 --> 00:36:49,279 Speaker 3: drooping eyelids, swelling of your eyelids and dry eyes, drooping eyebrows, 608 00:36:49,360 --> 00:36:53,360 Speaker 3: and upper respiratory tract infection. For more information, refer to 609 00:36:53,400 --> 00:36:56,239 Speaker 3: the medication guide or talk with your doctor. You are 610 00:36:56,360 --> 00:36:59,400 Speaker 3: encouraged to report negative side effects of prescription drugs to 611 00:36:59,440 --> 00:37:04,600 Speaker 3: the FDA. Visit www dot FDA dot gov, slash MedWatch, 612 00:37:04,840 --> 00:37:08,319 Speaker 3: or call one eight hundred FDA one zero eight eight. 613 00:37:08,920 --> 00:37:12,759 Speaker 3: Please see botox full product information, including boxed warning and 614 00:37:12,880 --> 00:37:16,600 Speaker 3: medication guide by clicking the link provided in the podcast description, 615 00:37:16,840 --> 00:37:21,960 Speaker 3: or by visiting www dot RXABV dot com slash pdf, 616 00:37:22,080 --> 00:37:26,319 Speaker 3: slash botox underscore PI dot pdf. If you are having 617 00:37:26,320 --> 00:37:29,480 Speaker 3: difficulty paying for your medicine, abvmy be able to help, 618 00:37:29,719 --> 00:37:33,439 Speaker 3: visit ABV dot com slash Patient Access Support to learn more.