Migraine Prevention and the Benefits of Ancestry Services


– Good morning, and
welcome to Access Health. We’ve all heard the expression
an ounce of prevention is worth a pound of cure. For the 38 million Americans
who suffer from migraines, prevention may be
exactly the solution they’ve been hoping for. Also, my husband and
I take on the health and ancestry
service from 23andMe to find out what our
genes might be telling us. All this, coming right
up, stay with us. (bubbly music)
∫ Access Health ∫ Often described as one of the
most debilitating conditions, migraines affect more
than 39 million Americans. In fact, the World
Health Organization considers them to be one
of the most disabling medical illnesses worldwide. With symptoms ranging from
vision changes to vomiting, migraines often leave 90%
of sufferers unable to work or function normally
during the attack. The focus of the
treatments in the past was on pain relief and
targeting the symptoms once the migraine
has already begun. The good news is that there
are migraine treatments designed to reduce the
frequency of migraine attacks. Seeking to better
understand the condition and uncover more
about innovations in migraine prevention,
Access Health traveled to Thomas Jefferson University
Hospital in Philadelphia to meet with Dr.
Stephen Silberstein, professor of
neurology and director of the Jefferson
Headache Center. – Migraine is an
extraordinarily common disorder. It’s estimated about 12
percent of the population of the United
States has migraine, 39 to 40 million Americans. Migraine is a disabling
headache that comes and goes. It’s often one sided, throbbing,
and aggravated if you move around. Migraine is associated
with sensitivity to light, sound, and odors. It’s often associated with
nausea and even vomiting. If you have a headache
that disables you, more than likely, it’s migraine. – [Ereka] Dr. Stephanie
Nahas, director of the Headache Medicine
Fellowship Program, sees countless
patients every year who are seeking diagnosis and
treatment for their migraines. Dr. Nahas explains the
complexities of the condition. – We take a
multidisciplinary approach at the Jefferson Headache Center
because we recognize how complex migraine is. It’s not just a headache. It’s also not just
the other symptoms like nausea, light
and sound sensitivity, neck pain, et cetera. It’s how the attacks affect
that person’s day to day existence. Even when they’re not in
the throes of an attack, migraine is still there
in the background, looming, waiting to emerge,
and to cause a problem. – The characteristics
of migraine are the fact it
impacts your life. Migraine affects the entire life
of the person, their job, and their family. – [Ereka] Many people
don’t understand how debilitating
a migraine can be. Nikkie knows this all too well. – Describing a migraine
is really difficult. The pain is overwhelming. It’s so intense, it’s
like the heaviest boulder is sitting on top of my head. My neck is really
stiff, I see spots, it’s like someone’s
poking me in the eye. You just want to curl up
in a ball and just sit in the darkest,
most soundproof room and just wait for it to pass. There’s really
nothing you can do. Living with this
pain for years just, slowly became my new normal. I would take an over the
counter pain reliever and just try to
go about my life. – [Ereka] There are millions
of people just like Nikkie who have resigned
themselves to thinking that migraine is
just a fact of life. – Migraine is a serious disease,
but it should never be something that a person just settles
with its existence, and learns to live
with and trudge on. It can be managed. Getting an accurate diagnosis
is perhaps the most important step
in all of headache management, and when it comes to headache,
it hinges upon the history, and what we mean by that
is a detailed description of the symptoms,
and the pattern of when these symptoms occur. Migraine is characterized
by recurrent attacks, and these attacks we
typically conceptualize as having four phases. The first phase,
or the prodrome, is before the attack
even really gets going, and this can be hours
to days beforehand, of changes in the way
that person feels. Certain cravings for food,
thirst, urinating to excess, being sleepy or being energetic,
mood changes, et cetera. The next phase could
be the aura phase, which doesn’t
occur in everybody, but about 30 percent of
patients with migraine. And these are
neurologic symptoms that gradually appear, spread,
hit a peak, and then fade away. The third phase tends to come
as those symptoms are peaking or fading away, and
that’s the headache phase. When the headache phase is
complete, after hours to days, we have the final
phase, or the postdrome. Some call it the
migraine hangover, where although the pain and
other symptoms are largely gone, that person still just
doesn’t feel quite right. – I believe there
are two or three real triggers of migraine. Not eating, not
getting adequate sleep, MSG, and withdrawal
from caffeine. Most of the things that we
think are triggers, are not. If you go out and eat
a box of chocolate, and get a migraine headache,
well, the chocolate gave me a headache. No, the migraine gave you
the desire to eat chocolate, and the reason that is is, the
day before a migraine attack, you’d have food cravings,
neck pain, not feeling right. That is part of the
migraine attack. – Triggers can be tricky,
because most triggers aren’t like an on and off switch. They’re more like
dials on the stereo, where you have to turn up the
volume to a certain degree before it will
trigger an attack, and sometimes,
you might need two or three triggers
in play at once. For example, the menstrual
cycle is often something that serves as a trigger,
but not every woman gets a migraine attack
with every menstrual cycle. It might only be if they
have their menstrual cycle and they’re stressed
out, or dehydrated, or the weather is bad,
so I tell patients, try not to focus too much
on identifying triggers. Go with the obvious ones,
and either avoid or mitigate those. – The goal of treating migraine
is to prevent you from having attacks
and to treat an attack when you get it. What’s important is
what the patient wants, desires, and gets. (bubbly music) (bubbly music)
– I decided to see a doctor because
I was having more days of pain than not,
and it was just becoming exhausting. The treatment he chose to
go with was an abortive, which is something you take
at the onset of a migraine. I found it hard to recognize
the onset of migraine because I felt like
I always had one, so the abortive medication
just wasn’t enough. I was getting pretty discouraged
just because I felt like I was chasing
after something that was never gonna happen. My doctor did recommend a
treatment called Topamax. It’s taken daily to prevent
migraines from occurring. I did find Topamax
to be beneficial, however, I did experience
some side effects from the medication. I had tingling in my
fingers, I was exhausted and I had occasionally a
hard time concentrating. After years searching
for answers, I was just really frustrated
and ready to give up and just quit. – We have a lot of
options when it comes to migraine prevention,
and in selecting a treatment for a particular person,
we have to consider a number of factors,
and one of the most important is how well that
treatment works. Topiramate has
high level evidence and comes with a
level A recommendation from the American
Headache Society and American
Academy of Neurology for the prevention of migraine,
and for that reason, it’s often one of our first choices. Based on the last
decade of research, the first line
preventive treatment is the prescription of
medicine such as topiramate. Trokendi XR is an extended
release version of topiramate available by prescription. Topamax is an immediate
release version of topiramate, a medicine that has been on
the market for two decades, and is approved by the FDA
for migraine prevention in adults and adolescents. Trokendi XR is a true once
daily migraine prevention. Trokendi XR provides steady,
24 hour migraine prevention coverage,
with slow rate of rise and low peak to trough fluctuation. – Patients taking topiramate
immediate release twice a day can easily convert
Trokendi XR once a day. – My doctor recommended
that I switch over to extended
release Trokendi XR, which is similar to topiramate,
which I was already taking. What appealed to me
about Trokendi XR was the fact that
just one pill a day would provide 24
hours of coverage. We discussed the possible risks,
which are similar to Topamax, and we decided to give it a try. I’ve been pleased
with how Trokendi XR has been working for me. The frequency of my
migraines have been reduced. The regimen is simple
and straightforward. It’s one pill a day. I make mine part of my routine. I take it at the
same time every day. Even though the medication
is working for me, I still do get migraines,
just not as frequently. Now, I do have pain free days,
which I’m really excited about. I still experience
some side effects from extended
release Trokendi XR, but for me, they’re manageable. Of course, this is
just my experience and others could have
a different outcome. – [Announcer] Do
not take Trokendi XR if you have recently consumed
or plan to consume alcohol, i.e. within six hours prior to
and six hours after Trokendi XR use. Swallow Trokendi
XR capsules whole. Do not sprinkle on
food, chew, or crush. Trokendi XR can cause
serious side effects, including eye problems. Serious eye problems include
sudden decrease in vision with or without eye
pain or redness, a blockage of fluid that
may cause increased pressure in the eye, secondary
angle closure glaucoma. Call your provider right away
if you have new eye symptoms, including any new
problems with your vision. The most common side
effects include tingling of the arms and
legs, paresthesia, not feeling hungry,
nausea, weight loss, abnormal vision, a change
in the way foods taste, nervousness, speech
problems, dizziness, slow reactions, upper
respiratory tract infection, sleepiness, diarrhea,
pain in abdomen, and difficulty with memory. – I think more
than anything else, we tell them, we give you hope. – What I do every day and
what really gives me joy is to see when patients
are getting better. When they come in and tell
me that I’ve given them hope, this is why we’re in this game. This is why we do this. – [Announcer] Talk
to your doctor today to see if Trokendi XR
may be right for you, and please stay tuned for
important safety information. For more on the migraine
prevention therapy discussed here today,
visit TrokendiXR.com and as always, you can go to
our website at AccessHealth.tv. (upbeat music)
(bubbly music) (bubbly music)
(moderate rock music) – Hi, everybody,
I’m Ereka Vetrini, and if there are two things
that I am passionate about, it’s my family and my health. I love my Italian
heritage and I embrace it by cooking homemade
meals for my family, and I do as much as I can
to maintain my strength and energy. But I was curious, was
there something more I could do to understand who
I am and how my body works? Am I more than just Italian? I heard about these DNA
kits, ones that can tell us about heritage and our health,
so my husband and I took a 23andMe health
and ancestry test. I mean, I’m pretty sure
I know where I’m from. Italian. But I have no idea what
my husband’s ancestry is. I don’t think he knows, either. The other portion
is that at 23andMe, they have a ton of health
and wellness reports which I think is super important
when you’re building a family, so,
we’re making this family together,
I think we could use all of this information
just to make smart decisions. So take a look, though,
and see what happened when Randy and I decided
to take the test. (moderate rock music)
I’m here with Randy, my husband, and we’re so excited because,
we get to submit our 23andMe kit,
which is pretty exciting. Didn’t you say you’ve
always wanted to do this? – I did. Yeah, mostly because, you know,
you like to make fun of me that, saying that I don’t
know where I come from, but I think you’re gonna
be a little surprised about how wide your lineage is. – Okay, okay, so this
is where it goes. I’m Italian, my parents,
they were born in Italy. I’m pretty sure I’m 100
percent Italiana, okay? (laughing)
This one, on the other hand. You have no idea. – Yours will be Mediterranean
and Northern Africa. You’re gonna be, maybe
more widespread than I am. When we got the 23andMe
Health and Ancestry, it couldn’t have been easier. When you open it up, it
really lays out very simply with just a few steps
what you need to do to get them the sample
and get started. – We have to register our kit.
(upbeat rock music) No food or drink for 30 minutes. – Deal, done. – I don’t trust him. He’s a snacker. – You might not want to
plan that around a meal, a major meal. – I was right. That was hard for us, wasn’t it. A little bit. Step two was filling
up the little vial with saliva. (laughing nervously)
– Favorite part, into it. – Just did it. A little bit, by the way. – You spit saliva into that? – And tell everything it
needs to from your saliva. – Sealed it up, we’re
gonna mail them in, and they give us a
wonderful little package that goes into the mail, so
I’m gonna send this off today, and soon enough,
we will find out all his awesome
information, is that good? – Fantastic, very. – I was genuinely
curious to know because your
grandfather was adopted, and we really legitimately
don’t know what that line was. – But then also, what’s
more important now is kind of the
health information and the health
reports that you get, so I was really
intrigued to get those. Any details like that
about your lineage, I don’t have anything. – The cool thing about 23andMe,
is that we learn much more than just our ancestry, right? We’ve got genetic
health risk report, wellness, information
about everything from our coffee consumption
to deep sleep, carrier status, so it shows us if
we are carriers for certain inherited
conditions like cystic fibrosis and sickle cell anemia. Traits shows us how our DNA
influences our facial features. That’s pretty cool! Eye color, well, he
does have the blue. He has the blue,
I have the brown, and she’s got
something in between. – Hazel. – So fun! I’m so excited. There was a lot to
learn about 23andMe, so Access Health traveled
to Silicon Valley to speak to Emily
Drabant Conley, VP of business development,
to get some answers. Take a look. – 23andMe is a DNA
test that can tell you what your DNA has to
say about your health and your ancestry, and
the process of doing it is very simple, you order a kit,
and spit into a tube, and you send that off to our lab,
and we look at hundreds of thousands of points
in your DNA, and we tell you what that information has to say
about your health and your ancestry. Genetic information is
a really powerful tool to learn about yourself,
and if you do the 23andMe Health and Ancestry service,
not only do you get information about your genetics
of your ancestry, but you can also learn about your health. With the 23andMe
ancestry reports, you can learn all kinds
of interesting information about where you’re from. We look at over 150
different geographic regions and we can link that to your DNA
so that you can better understand your ancestry. The genetic health risk
reports give you information about diseases that you
could be at risk for, so we actually received
authorization from the FDA to provide this information
directly to consumers, in a way that is easy to
understand and actionable. We had an entire family
that did the test. One of the family
members found out that he carried two copies
of a genetic variant for something called
hereditary hemochromatosis. He had a lot of
symptoms in his life, but he’d never been
diagnosed before, and so, he got the
23andMe result, and then shared it
with his doctor. They did confirmatory
testing and it turns out that in fact, he did
have hemochromatosis and now he’s being treated,
and the whole family has really become aware
of this particular condition and how it could be passed down
through the generations. There’s a variety
of wellness reports that are provided
through the 23andMe Health and Ancestry service,
and these are reports that are really
about how genetics can interact with the environment
to affect your health. So, for instance, how
do genetics impact the way that you sleep? So there’s a lot
that we can tell you that’s relevant to your wellness
that’s really connected to your DNA. The Carrier Status
reports are about diseases that could be passed
on to a child, so these are
hereditary conditions, things like cystic
fibrosis or Tay-Sachs or sickle cell anemia,
and really the only way to know if you’re a carrier
and could pass this on, is through a DNA test. There’s a whole variety
of physical traits that we have that are
linked to our DNA, so for instance,
if you’re a man, we can tell you if you’re
likely to go bald later in life and then a whole variety of
different physical aspects. Are you likely to have
blue eyes or brown eyes? Curly hair or straight hair? We believe that
knowledge is power and having access,
direct access, to your genetic information
is a really powerful tool in understanding your ancestry
and thinking about your health. You know, there are a
lot of different things, actions people can take
to prevent disease, but in order to do that,
you really have to have the information first
and this is a place where genetics can really help. – [Ereka] Coming up, Randy
and I get our results. Stay with us. (bubbly music) (bubbly music)
– Hey, the results are in. – No way! – Yes, check it out. – Already, that’s awesome. Hmm, who was right? – What do you mean? – I was right. – About what? – I’m pretty much
100 percent Italian. – I mean, 78 percent, right? In school, 78’s a C,
that’s barely passing. You’re barely passing
as an Italian. – [Ereka] What is
your breakdown? You’re primarily what? – French and German, and
then it’s British and Irish, and then it’s
largely Iberian, so, Spain and Portuguese, I guess. – Oh, that’s crazy. – Just a very surprising… – So cool. – One area that was
also really interesting was the genetic
health risk section because, obviously
when you go in, that’s one of the things
I went to pretty quickly. It was good to know I
don’t have the likelihood of getting Alzheimer’s
or Parkinson’s. Again, not knowing my
family history that well and having some
blank spots there, it’s good to see that
it’s not something likely for me to have. – [Ereka] The wellness
reports were pretty spot on. – [Randy] They were. – The sleep one was amazing,
it said that I’m likely to move more than average. I am likely
intolerant to lactose. My favorite one was that I
have the muscle composition of an elite power athlete,
and I was bragging to you about that. – Yes, and when
that came through, I knew I was gonna
be in big trouble if I didn’t have the
exact same thing, so luckily, I had that as well. – [Ereka] So traits, there
was some good news there. – [Randy] Very
interesting stuff. – Right, likely, no early
hair loss for this gentleman. – Big relief on that one. – Carrier Status report is
really insightful as well because while these variants
may not affect our health, they may affect the
health of our children. – The reports included sickle
cell and cystic fibrosis, and a lot of others that
we had never even heard of, so it’s important
when you have kids that you know about these
things and you plan for them. – All around, it was just
a wonderful experience. – I agree, and it’s
good, not just for us, but for the kids and
it’s funny because, now my brother’s taking
it, my nephew’s taking it, like everybody’s,
they want to know. – But also, it’s
just fun because we, you know, we get a
chance to look internally but then we also understand
sort of the community around us. I’m so glad we did it. – Me too. – Yeah. – Fine. – [Ereka] For more
information on 23andMe Health and Ancestry
test, go to 23andMe.com or just log on to
AccessHealth.tv. Thanks for watching,
we’ll see you next time on Access Health. (upbeat music)
∫ Access Health ∫

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