Sunday, July 10, 2016

THE MIGRAINE RELIEF STUDY: Chronic Migraine, Chronic Daily Headache and Hemicrania Continua:

THE MIGRAINE RELIEF STUDY:
Chronic Migraine, Chronic Daily Headache and Hemicrania Continua: New Study on stopping the cycle of pain is seeking subjects with chronic daily headache, hemicrania continua and migraine pain resistant to other treatments.
A New Medical Study, "The Migraine Relief Study" is designed to Evaluate objective and subjective response of patients with severe continual headache that has been resistant to other medical treatments.
This initial study is for patients with continual headache for 30 days or more and requires a single visit at which surface EMG studies before and after treatment will be obtained. The procedure has been previously shown to be effective for headaches, migraines,anxiety, depression and other chronic pain conditions and is not considered experimental.
A simple headache severity diary is requested for one month following treatment. This is essential in all patients. The study location is in Highland Park, Illinois. There is ample free parking available and the office is conveniently located near a Metra station for Chicago and Milwaukee patients who do not drive.
Each patient will do a 1-2 minute video prior to starting treatment and a follow-up video on the same day after treatment.
There is no control group in the initial study so all participants will receive active treatment.
Requirements;
1.Previous Diagnosis of CDH, HC, or Migraine from physician or ideally neurologist
2. Male or Female patients are welcome
3. Patients cannot be pregnant.
4. No known allergies to Lidocaine anesthetic.
5. This study is for patients with head and neck pain but does not exclude disorders affecting the whole body such as Fibromyalgia
6. Injections are part of this study
7. Sphenopalatine Ganglion Blocks will be administered to each patient.
8. Patients will be present in the office with other patients participating in this study. Patients who feel this is not acceptable may still be considered but will not be part of initial day of testing.
Patients interested in this study should respond to "The Migraine Relief Study" at MigraineReliefStudy@gmail.com.
We will need both an e-mail address and phone number associated with each patient.
A short history of headaches, when they started, precipitating events and previous treatments that have been tried and how they worked. A rating on scale of 1-10, 10 being most severe headaches, typical daily headache, and "best days" and "worst days". A short description of each in the patients own words.
A short statement of how these headaches have affected your life.
There is no payment to patients for participating. There are no costs to patients or to patients insurance companies. Ideally these results will be used to demonstrate how insurance companies can help patients seeking a better quality of treatment while reducing medical costs to patients and insurance companies.
Ideally, there is an expectation that this block will break the cycle of pain in many patients, in essence "Rebooting the Brain" There are no guarantee of successful elimination of pain.
The results will be used in a scientific presentation.
This is only a one-time study and does not include follow-up treatment. Results of the study will be made available to all participants upon request.


Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org


#migraine #migrainereliefstudy #Chicagomigrainestudy#Hemicraniacontinua#hemicraniacontinuarelief#chronicdailyheadache, Chronicdailyheadachereliefstudy, #chronicdailyheadacherelief,#Freemigrainestudy#freechronicdailyheadachestudy#freehemicraniacontinuastudy#clinicaltrialsmigraine#clinicaltrialschronicdailyheadche#clinicaltrialhemicraniacontinua

THE MIGRAINE RELIEF STUDY: Chronic Migraine, Chronic Daily Headache and Hemicrania Continua:

THE MIGRAINE RELIEF STUDY:
Chronic Migraine, Chronic Daily Headache and Hemicrania Continua: New Study on stopping the cycle of pain is seeking subjects with chronic daily headache, hemicrania continua and migraine pain resistant to other treatments.
A New Medical Study, "The Migraine Relief Study" is designed to Evaluate objective and subjective response of patients with severe continual headache that has been resistant to other medical treatments.
This initial study is for patients with continual headache for 30 days or more and requires a single visit at which surface EMG studies before and after treatment will be obtained. The procedure has been previously shown to be effective for headaches, migraines,anxiety, depression and other chronic pain conditions and is not considered experimental.
A simple headache severity diary is requested for one month following treatment. This is essential in all patients. The study location is in Highland Park, Illinois. There is ample free parking available and the office is conveniently located near a Metra station for Chicago and Milwaukee patients who do not drive.
Each patient will do a 1-2 minute video prior to starting treatment and a follow-up video on the same day after treatment.
There is no control group in the initial study so all participants will receive active treatment.
Requirements;
1.Previous Diagnosis of CDH, HC, or Migraine from physician or ideally neurologist
2. Male or Female patients are welcome
3. Patients cannot be pregnant.
4. No known allergies to Lidocaine anesthetic.
5. This study is for patients with head and neck pain but does not exclude disorders affecting the whole body such as Fibromyalgia
6. Injections are part of this study
7. Sphenopalatine Ganglion Blocks will be administered to each patient.
8. Patients will be present in the office with other patients participating in this study. Patients who feel this is not acceptable may still be considered but will not be part of initial day of testing.
Patients interested in this study should respond to "The Migraine Relief Study" at MigraineReliefStudy@gmail.com.
We will need both an e-mail address and phone number associated with each patient.
A short history of headaches, when they started, precipitating events and previous treatments that have been tried and how they worked. A rating on scale of 1-10, 10 being most severe headaches, typical daily headache, and "best days" and "worst days". A short description of each in the patients own words.
A short statement of how these headaches have affected your life.
There is no payment to patients for participating. There are no costs to patients or to patients insurance companies. Ideally these results will be used to demonstrate how insurance companies can help patients seeking a better quality of treatment while reducing medical costs to patients and insurance companies.
Ideally, there is an expectation that this block will break the cycle of pain in many patients, in essence "Rebooting the Brain" There are no guarantee of successful elimination of pain.
The results will be used in a scientific presentation.
This is only a one-time study and does not include follow-up treatment. Results of the study will be made available to all participants upon request.


Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org


#migraine #migrainereliefstudy #Chicagomigrainestudy#Hemicraniacontinua#hemicraniacontinuarelief#chronicdailyheadache, Chronicdailyheadachereliefstudy, #chronicdailyheadacherelief,#Freemigrainestudy#freechronicdailyheadachestudy#freehemicraniacontinuastudy#clinicaltrialsmigraine#clinicaltrialschronicdailyheadche#clinicaltrialhemicraniacontinua

Sunday, April 3, 2016

Full Mouth Neuromuscular Reconstruction: Planning and Execution is essential for success.

This was originally a Google +  Post.  Due to an incredible response from viewers of that post I decided to repost with comments on the I Hate Headaches site.

A full mouth reconstruction is the ultimate in dentistry but it can also be a patient's worst nightmare.

The relation of the jaw to the head affects and is affected by the entire body. Ideally a full mouth reconstruction is done to physiologically healthy muscles joints breathing and function.

This video is of a patient who started with a single quadrant of crowns that morphed into a non-physiologic reconstruction. I saw him after three reconstructions of his entire mouth to treat his symptoms. The first was a Centric Relation Reconstruction and the second two were Neuromuscular Reconstruction. His final reconstruction was done well but failed to resolve many issues.
I did not do any of these reconstructions but worked to idealize his current restorations. These two videos describe a small part of the difficult journey this patient has travelled.

Correcting physiological issues should be done at the start of a case. This patient did not go looking for a full mouth reconstruction but fell into it.

It is unfortunate that a fabulous person and excellent physician fell into a trap not of his making.


https://www.youtube.com/watch?v=YxPB8eso5pg

https://www.youtube.com/watch?v=RaRqa2akLMA

Additional patient videos:  https://www.youtube.com/channel/UCk9Bfz6pklC7_UluWFHzLrg/videos

The reason there are so many issues with full mouth reconstruction is that many dentists, even etremely wel educated and proficient dentists do not understand the importance of head posture on their treatment.  Many take bites and do adjustments with the patient reclined in the dental chair.

The Quadrant Theorem of Guzay is extremely important to dentists because it explains in engineering terms how the center of jaw rotation is not in the TMJoint.  Rather, it is on the Dens process of the second vertebrae (Axis) that passes thru the first cervical vertebrae (atlas).
This is because the TMJoints acting together go thru two distinct movements rotation and translation.  These movements alwys happen simultaneously and there is no time during normal function in which pure rotation occurs.
The concepts of Centric Relation's approach to occlusion is that it is found by the dentist moving the patients jaw in a pure rotation at a border position of the joint.

The usefulness is that it is easy to transfer this information to the dental laboratory.  The problem is it is not a physiologic position and in fact the most dangerous position for all joints is in border positions.   Patients don't funtion there.

The use of TENS in  Neuromuscular Dentistry is to take the muscles to a healthy relaxed state.  This creates a three dimensional relation between the cranium (head) and mandible (lower jaw).

This relation changes when the head position changes.  It is vital to evaluate the bite in upright sitting and standing positions.  This also means that you cannot ignore the rest of the body when doing a full mouth reconstruction without risk of long term instability.


Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Diplomat, American Board of Dental Sleep Medicine
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
Member, Academy of Cosmetic Dentistry
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org


#fullmouthrecostruction #fullmouthneuromuscular #oralreconstruction #problemswithfullmouthreconstructions #disasterswithfullmouthreconstructions #fullmouthCRRecostruction #avoidingproblemswithfullmouthreconstructions #centricrelationfullmouthreconstruction #failedCRfullmouthrecosnstruction
#CentricRelationReconstruction #fullmouthreconstructiondisaster
#ChicagoFullMouthReconstruction #HighlandParkFullMouthReconstruction
#NewYorkFullMouthReconstruction #costfullmouthreconstruction #fullmouthreconstructionsteps #verticaldimension #verticaldimensionofocclusion

Friday, March 25, 2016

Hemicrania Continua: Successful Treatment with SPG Blocks

New Developments in Improving Quality of Life for Headache and Migraine Patients

A brand new article in Headache (see Abstract below) shows successful treatment of Hemicrania continua with Sphenopalatine Ganglion Blocks.  This is a very exciting development for patients who live with chronic pain of this disorder.

This disorder also responds well to Neuromuscular Dentistry but there is obviously a significant autonomic nervous system involvement in this disorder.  I am pleased to report that I taught a course to approximately 100 dentists at the ICCMO meeting in San Diego and that patients can now see their ICCMO trained Neuromuscular Dentist to treat this disabling disorder.

Top Neuromuscular Dentists can be found at the ICCMO website www.ICCMO.org

Patients with Hemicrania continuam , migraines, cluster headaches and other disorders should visit their local ICCMO Neuromuscular Dentist.

http://www.sleepandhealth.com/node/663
http://www.sleepandhealth.com/node/705
http://www.sleepandhealth.com/node/691
http://www.24-7pressrelease.com/press-release/migraine-relief-and-prevention-the-sphenopalatine-ganglion-block-spg-this-amazing-treatment-is-often-referred-to-as-the-miracle-migraine-treatment-doctors-learn-hands-on-techniques-at-iccmo-413955.php



Ira L Shapira DDS, D,ABDSM, D,AAPM, FICCMO
Chair, Alliance of TMD Organizations
Diplomat, American Academy of Pain Management
Regent & Fellow, International College of CranioMandibular Orthopedics
Board Eligible, American Academy of CranioFacial Pain
Dental Section Editor, Sleep & Health Journal
Member, American Equilibration Society
Member, Academy of Applied Myofunctional Sciences
www.ThinkBetterLife.com
www.DelanyDentalCare.com
www.IHateCPAP.com
www.iHateHeadaches.org



 2016 Mar;56(3):573-9. doi: 10.1111/head.12783. Epub 2016 Mar 1.

Hemicrania continua may respond to repetitive sphenopalatine ganglion block: A case report.

Abstract

BACKGROUND:

Hemicrania continua (HC) is a chronic headache disorder characterized by a continuous, strictly unilateral head pain accompanied by cranial autonomic symptoms, which completely responds to indomethacin; however, few alternative treatment options exist for the patients with this disorder who cannot tolerate indomethacin. Sphenopalatine ganglion (SPGblock has been used for the treatment of various headaches, with the strongest evidence for efficacy in cluster headache.

CASE REPORT:

A 52-year-old woman with a 7-year history of HC was evaluated in our clinic for management of her headaches after she had stopped using indomethacin due to a bleeding gastrointestinal ulcer. After failing multiple pharmacologic therapies, she was treated with repetitiveSPG blocks using bupivacaine (0.6 mL at 0.5%) twice a week for 6 weeks and followed by maintenance therapy. This treatment protocol resulted in significant improvement in her headaches, mood, and functional capacity.

CONCLUSION:

SPG block using a local anesthetic may be an effective treatment for patients with HC, specifically for those who cannot tolerate indomethacin, or when this drug is contraindicated.
© 2016 American Headache Society.


KEYWORDS:

chronic migraine; cranial autonomic symptoms; hemicrania continua; indomethacin; sphenopalatine ganglion block; trigeminal autonomic cephalagias

Wednesday, March 23, 2016

Sleep Problems and Chronic Migraines. New Study At Rush Medical School Looking For Participants

I received this message from a researcher at Rush,where I did research at Rush Sleep Center under Dr Cartwright as a Visiting Assistant Professor starting in 1985-1991 on jaw position and sleep apnea and found that Female TMJ (migraine/headache) patients had similar neuromuscular bite relations as male sleep apnea patients.

"Dr Shapira,

 My name is Megan Crawford and I am a researcher at the sleep center at Rush University Medical Center. It is with great enthusiasm that I read about your practice, and how you emphasize the importance of good sleep. We here in the Rush Sleep Center have become interested in understanding the relationship between sleep and migraine, and whether treating sleep problems would be beneficial for migraineurs with insomnia. I am a principal investigator of a clinical trial testing an online sleep intervention for women with chronic migraines. The online sleep intervention is called SLEEPIO (https://www.youtube.com/watch?v=zv-nn0KTwnw) and has been shown to be effective for individuals with insomnia in a clinical trial (http://www.ncbi.nlm.nih.gov/pubmed/22654196). We are looking for females over 18 who have sleep problems and chronic migraines.
Recruitment can sometimes be challenging, and so I am trying to reach out to local headache/pain clinics that might be interested in spreading the word about this study. It is helpful to have someone that individuals know and trust advertise for the research you are doing on their social media websites (blogs, facebook, twitter etc.), or in monthly pamphlets.
If you would like to speak to me on the phone/via email for more information about the study, please do not hesitate to contact me. I would be very happy to send a few fliers to distribute in your office. I look forward to hearing from you.
Kind regards,
Megan"

e-mail for Megan Crawford is megan_crawford@rush.edu 

Tuesday, March 15, 2016

Chicago Headaches, Migraines, Cluster Headaches and Sleep Apnea, The Sleep Connection to Chronic Daily Headaches.

There is a connection between Sleep Apnea and all headache types but especially Chronic Daily Headaches, Migraines and Cluster Headaches.  The following article is about treatment of Sleep Apnea not about headaches but most physicians feel these arte opposite sides of the same.  The National Heart Lung and Blood Institute published "The Cardiovascular and Sleep Related Consequences of Temporomandibular Disorders" that clearly spells out these connections.

Anyone who has headaches or migraines and also snores, is tired during the day, wakes with dry mouth or headaches should be evaluated for Sleep Apnea.

Reprinted with permission from:  Sleep and Health Journal


Chicago: Dental Sleep Medicine,Oral Appliances,OA, Oarl ApplianceTherapy, OAT, Mandibular Advancement Therapy, MAD,

Chicago Treatment of Sleep Apnea with Oral Appliance: Oral Appliance Therapy is the new comfortable and effective treatment patients prefer.
Learn More About Oral Appliance Therapy at: www.IHateCPAP.com
In Highland Park and on the Metra Line www.ThinkBetterlife.com
North Shore Suburbs of Chicago http://www.northshoresleepdentist.com/
In Gurnee for Northern Lake County and Southern Wisconsin www.DelanyDentalCare.com
SLEEP APNEA TREATMENT WITH ORAL APPLIANCES, PATIENT TESTIMONIAL VIDEOS:
The world of sleep medicine has changed in many ways over the last 40 years. In the beginning most of the sleep apnea patients were old fat men and the treatment was often a tracheotomy. Surgery to remove the uvula, soft palate and reconstrcyt the throat became the rage next in spite of extremely poor results, high morbidity and pain. The CPAP machine was invented by Australian Colin Sullivan and it provided a new world of sleep apnea treatment.
CPAP, or Continuos Positive Air Pressure is basically a Mask, A Hose and a Compressor that takes room air and forces it through the hose and mask and into the nose, mouth or both and into the lungs. It actually works to stent the airway open.
The first CPAP machines were crude, loud, bulky with uncomfortable masks and heavy hoses that delivered dry air. Most patients id not like or use CPAP due to discomfort but it was effective. In fact,only 25 % of patients actually used their CPAP machines all night on a regular basis.
The newest machines are quiet, humidified small, sleep and much more comfortable with hundreds if not thousands of possible combinations of masks, hoses (now heated) humidifiers , monitoring, and comfort feature like ramping, APAP, BiPAP and more.
Has CPAP usage expanded? Unfortunately only about 25% of patients use their machine as directed and most do not even meet the medicare guidlines of four hours/ night four nights a week. That combination leaves 70% of sleep Apnea untreated in those patient.
The big secret not told to most patients struggling with CPAP is that at least 60% of patients fail CPAP and give it up entirely. The scandalous part of this is that the majority of patients now receive no treatment and many are not informed about oral appliance therapy, the comfortable alternative to CPAP.
Oral Appliance therapy was a Chicago invention or at least was born into Chicago thanks to the mother of Oral Appliance Therapy Dr Rosalind Cartwright of Rush medical school who published the first peer reviewed articles on oral appliance therapy with the TRD or Tongue Retaining Device and importantly also was the first sleep expert to publish on position sleep apnea.
Positional Sleep Apnea treatment combined with oral appliance therapy actually makes oral appliance therapy a first line treatment for the majority of patients with Obstructive Sleep Apnea.
It should interest everyone who has had a problem with CPAP that Colin Sullivan, the man who invented CPAP utilizes an oral appliance to treat his sleep apnea. Dr John Remmers a Canadian physician who
invented the term Sleep Apnea is an enthusiastic supporter of oral appliance therapy as the first line treatment of Obstructive Sleep Apnea.
The number one reason patients don't use CPAP is "I Hate CPAP!!" The website I created www.IHateCPAP.comwas not named because I hate CPAP but was named because it was the number one reason patients gave when they came looking for an oral appliance treatment of Sleep Apnea. The I Hate CPAP website created a stir in the field of Dental Sleep Medicine and was on Radio, TV, Newspapers, Magazines and Social Media. It brought floods of patients who hat abandoned CPAP back to the field of sleep medicine. It was partially responsible for a boom in sleep treatment as patients were willing to have sleep tests if there were chices other than CPAP and ineffective painful surgery with low efficay and high levels of morbidity.
Politics blew in a powerful storm primarily due to the power and money of companies who made CPAP. I Hate CPAP was banned from Academy of Sleep Medicine and Academy of Dental Sleep Medicne meetings and I was actually told by an oral surgeon and past president of the AADSM that it was better to let people die then market I Hate CPAP! This in spite of the fact that 60% of patients abandoned CPAP. I hate CPAP was found by hundreds of thousands of patients who returned to treatment and far more who learned about oral appliance therapy for sleep apnea.
When I Hate CPAP first marketed we could get hudreds of phone calls a week from Illinos, across the country and around the world. These were patients but also the loved ones or patients who wre concerned about their health and watched them struggling to survive every night while the CPAP machine they hated sat in a closet.

Saturday, March 12, 2016

Houston: Neuromuscular Dentistry, TMJ and Migraine Treatment

Chronic Headaches, Migraines Facial Pain can often be allieved or eliminated with Neuromuscular Dentistry.  The first step is an accurate diagnosis followed by a Diagnostic Neuromuscular Orthotic. The Diagnostic Orthotic is utilized to correct the physiology of the head and neck muscles as well as the posture orthopedically diagnostically.

Treatment of Chronic TMJ and Headaches often includes auxillary treatments such as trigger point injections, Sphenopalatine Ganglion Blocks, Prolotherapy and other advanced techniques.

Learn more about Neuromuscular Dentistry and Treatment and elimination of headaches and migraines at the www.IHateHeadaches.org and at www.ThinkBetterLife.com.

View Patient Testimonial Videos about how neuromuscular dentistry, SPG Blocks and other treatments have changed their lives.

Dr Shapira frequently sees long distance patients in his Chicagoland offices and he can help you find a Neuromuscular Dentist in the Houston Area.  All Neuromuscular Dentists are not the same.

There are no Houston Neuromuscular Dentists currently connected to the I Hate Headaches website