Dr. Christopher Ryne (4:25)

Nora, you're so sweet. I want to try to figure out how to get you like an honorary doctor.

Nora McInerney (4:30)

You can't give me any awards.

Dr. Christopher Ryne (4:33)

Yeah, we can try to figure out how to get you the honorary MD because of all of the effort that you're putting in to look out for people living with chronic migraine. And the way that you're bringing this to light for the listeners is special and something that you do. So we can get you a couple of letters to put at the end of your name. It'll be great.

Nora McInerney (4:52)

But it is an honor to do this work. It is an honor to be a place where people will share their stories. And it's been very meaningful to get all the feedback from people who have experienced chronic migraine who have such similar stories. I think this is why it's so important for people to share what they're going through because someone else needs that story. Now let's hear from today's guest, Erin Matthew Atkisson. Aaron, before we get started.

Aaron Matthew Atkisson (5:32)

Yes.

Nora McInerney (5:33)

I have a question for you and I like to start out with the hardest hitting questions possible. What is a movie you could watch a million times and never get sick of?

Aaron Matthew Atkisson (5:44)

Gosh, this is gonna be so cliche, but I'm gonna say the Matrix.

Nora McInerney (5:48)

The only thing that I remember about the Matrix is that we rented it the old fashioned way. We had to go to the store and rent it and the entire movie all my siblings, my mom, my dad, all like on a tiny three person couch in our living room. And my mom kept going, are we in the Matrix now?

Aaron Matthew Atkisson (6:05)

That is great.

Nora McInerney (6:06)

Okay, so Erin, you are an actor now, which is so cool. But obviously that wasn't always the case. I love talking about people's careers. Did you always lean towards the arts? What is it like to change careers?

Aaron Matthew Atkisson (6:24)

Yeah, I've always been a creative person. Music was my first love. I painted a little bit, you know, when I was a kid, but music I kind of really gravitated towards and I kind of got sucked into the rat race of the 9 to 5 or more like 9 to 10pm I worked a very, very strenuous labor job for almost two decades, and then I had a work injury that didn't allow me to do my career. So I needed to find something to fill my time, something to put food on the table, money in my pocket. And there were some films going on in the Detroit area and I thought, you know what, let's give this a shot. This looks fun. It wasn't until, I dunno, I'd say the last five years, really, that I've really kind of hit it hard and gone professional mode and really have been able to make a living off of it.

Nora McInerney (7:15)

That is so cool and that is so brave. So you also live with chronic migraine, which I have learned from doing this podcast, is something that is so much more complex than many of us understand. Tell me what triggers a migraine attack for you? What are your symptoms?

Aaron Matthew Atkisson (7:38)

Wow. So there's a lot of things that could trigger a migraine attack. For me, one of my top triggers is heat, getting overheated. Unfortunately, I don't get to enjoy the outdoors during the summer as much because I'm constantly trying to cool myself down. So one of my first migraine attacks that I can remember was when I got overheated. I had a migraine attack and it was terrifying not knowing what was going on. So throughout the years, I've recognized that heat is one of my top triggers. So I have to make sure that I stay hydrated. I use ice packs to cool myself down. There's so many different things that I've had to try over the years. Some work great, some don't work at all. Sometimes it depends on the migraine attack and sometimes it depends on the trigger. I could have a rough night's sleep and wake up with one, and if that happens, my day's usually over. You might as well just say goodbye to me for the next Day or two.

Nora McInerney (8:34)

What you just said too, that's something that was really touching about your story, is that when you're in the middle of a migraine attack, you just said, well, say goodbye to me for the day. That it's really hard to be there for the people who rely on you. And when you're in the middle of it, it's very hard to vocalize what you're going through. Walk us through what you're feeling when those migraine attacks hit.

Aaron Matthew Atkisson (9:00)

Well, there's a couple different layers to that. You know, emotionally you feel very defeated. You're scared because you don't know if this is going to take up your entire day or if this is going to last days or if you're going to get away with it for a few hours. I'm a single parent, so I have to make sure that I'm doing everything possible to take care of my kids and make sure that they're set up. Thankfully, they're older now, so they're kind of self sufficient and they understand, you know, if dad has a migraine attack, this is what has to happen. So being able to take care of them, that's my top priority. But I also know that if I don't take care of myself, then I can't take care of them at all. So there's a balance there as far as, like a physical aspect. I'll get real dizzy. I experience nausea. Nausea isn't there all the time, thankfully. So I have ginger gummies that I take for that sometimes. They help settle the stomach. So I'm fortunate with that because I know there's a lot of people that have different triggers and we all have those different things.

Nora McInerney (10:00)

We've actually talked about this in various ways throughout the show and I want to get your take on it, but there is a bit of a disparity between how women and men are treated when they voice the need for space during a migraine attack. We have a culture that really insists that men be tough, suck it up, get over it, that kind of stuff. What's been your experience with that when you have a migraine attack?

Aaron Matthew Atkisson (10:31)

So that stigma definitely follows me around. I don't exactly look like the type that would just lay down and tap out. But, you know, over the years when I was climbing tall poles for a living, I did everything possible to hide the struggle. I remember an instance where it took everything in me to not fall off my ladder coming down. And it took so much for me to have the courage to call my supervisor and say, hey, Look, I can't work the rest of the day. I do remember my work parking lot, trying to recuperate so that I could drive an hour home. So the emotional side of that, of having the courage as a man to say, okay, I can't do this after doing that kind of work for at that point for probably 15 years. And it takes a lot to say that I can't do this. It's a lot to say that I'm not strong enough on my own to manage my disease. It takes a lot to go to your doctor and say, hey, look, something's going on, you know, because as men, like you said, you're told to tough it up, you're told to man up, you know, swallow it, deal with it on your own. Nobody wants to hear what you're saying. We just want you to do the things that you're supposed to do as a man. And I'd say over the last five or six years, I personally have shifted my mindset with that because I have reached out for help, because it's not just about me. It's about my family. It's about my kids. It's about how I affect them as a parent and as a father. And showing my children that it is strong to reach out for help when you can't do it on your own is much bigger than saying that you can do it by yourself.

Nora McInerney (12:24)

So, Dr. Rhine, back in season one, we talked with Qasem quite a bit, and he said that it felt like there was a very, very small community of men who speak up and admit that they have chronic migraine. And he had said that it's that lack of conversation that is probably preventing men from seeking help and getting diagnosed or getting treated. Do you have any stats on the gender breakdown of men versus women who have chronic migraine? And if there's a measurable disparity between the care for both?

Dr. Christopher Ryne (12:59)

So the prevalence of chronic migraine is significantly higher in females than in males. So studies have shown that the ratio of female to male migraine patients is roughly 3 to 1, meaning that for every male migraine patient out there, then there's approximately three female migraine patients. The Global Burden of Disease Study is a comprehensive research effort that has consistently highlighted migraines as a leading cause of disability worldwide. We're talking about more than a billion people per, particularly amongst women. So men with migraine generally have less severe migraine attacks. And unfortunately, what that translates into is that they're less likely to seek treatment. And if they do, they're less likely to receive a diagnosis versus women when.

Nora McInerney (13:43)

It comes to men with chronic migraine, are there unique challenges to finding care that you've seen?

Dr. Christopher Ryne (13:49)

Yeah, in my experience and as I look at the patients that I've treated in the past, there are several challenges. Let's take the perception and awareness, for example. Men might not recognize their symptoms as migraine attacks. They might underestimate that severity of their symptoms and then ultimately dismiss what they're experiencing as just a headache to avoid that stigma and ultimately avoid that conversation. And I've seen that stigma, you know, around expressing that vulnerability or acknowledging need for help be a barrier to diagnosis and treatment for men. Nora the bottom line is that men are less likely to talk to a doctor about their migraine attacks and about the symptoms they're experiencing.

Nora McInerney (14:32)

We'll be right back with more from Erin, so stick around.

Botox Safety Information (14:48)

Can Botox Onobotulinum toxin a help if I have chronic migraine 15 or more headache days a month, each lasting four hours or more, Botox prevents headaches in adults with chronic migraine. It's not approved for adults with migraine.

Nora McInerney (15:00)

Who have 14 or fewer headache days a month.

Botox Safety Information (15:02)

It's the number one prescribed branded chronic.

E (15:04)

Migraine treatment prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection, causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk. Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, welts, asthma symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions including als, Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton syndrome and medications including botulinum toxins as these may increase the risk of serious side effects.

Botox Safety Information (15:42)

Ask your doctor and visit botoxchronicmigraine.com or call 1-800-for-BOTOX to learn more.

Nora McInerney (15:56)

Welcome back to the Head. Start embracing the journey. Let's get back into my conversation with Erin. Matthew Atkison I love what you said about like, it's very important for our kids to see that it's very normal to need people. Like that's normal. That's actually like what we're here on earth for is not to just get through everything alone but to like help each other through too. And that's such a powerful thing to model for them as any adult, but particularly As a father, I know that, you know, you're also the primary caregiver for your mother. So you are a part of that sandwich generation where you have kids who count on you and you have a parent who counts on you. And that is a lot of care giving in the best of circumstances. Tell me about supporting your mom, how that has shaped your perspective on your own chronic migraine journey and where you yourself get support. And I realize that's three questions, so just do your best.

Aaron Matthew Atkisson (17:02)

Okay. So as far as my mother goes, it's been challenging at the very least, because my parents divorced when I was a kid, so my mom was a single parent as well. We don't have any family besides each other nearby right now. My mother cannot drive. She's been a very independent person her entire life. There's all these things that she relies on herself to do that now she has to rely on me to do so. Yeah. The flip side of the coin is I also relied on my mother to help out with the kids, my girls and Girl Scouts. My oldest daughter is now in soccer. That just started last week. So I'm very excited for that. So, you know, I relied on my mom to help out with some of the extracurriculars for the kids, and if I booked something out of state, especially, you know, she would be able to come in and help out. So now I have to also shuffle the things that I'm responsible for as a parent that I was able to lean on my mom for, and she has to lean on me for a lot of the things. So there's a lot of learning curves. I help out with laundry or food or take the garbage out or feed the cats, that kind of stuff. I still have to take her to doctor's appointments, and I have to make sure that my schedule is clear for that. And if something comes up in the acting world, you might audition for 100 things, and all of a sudden you get five of those things that you auditioned for, and they're all in the same week or some of them the same day. You have to constantly juggle all that stuff as well.

Nora McInerney (18:34)

Yeah, life is unpredictable. Everybody loves to say that. But also often people who say that are people who have like a 9 to 5 job and don't have chronic migraine or another, you know, chronic disease or, you know, also aren't taking care of somebody. You have such a calm, stable energy. And I also do want to talk about your career, because acting is rather unpredictable. How have you created a schedule at home or when you're on set, knowing that migraine attacks could be lurking.

Aaron Matthew Atkisson (19:16)

Well, we're just gonna throw out that word schedule and just strike that because we. There's no. It's so unpredictable. You just kind of learn to roll with the punches when it comes with that. We have a loose schedule, if you will, from an acting standpoint and somebody who for many, many years just powered through it. That's what I do. That's what I do when I'm on set. I watch stuff back that I've been on before where I know that I have had an excruciating migraine attack. I did a campaign and I remember the last like three hours. I could feel the migraine attack creeping up. I was five hours away from home. So we wrapped up, I drove to the closest rest area and I slept for probably two hours. I know my body signals, so I'm, you know, I'm very fortunate to recognize that and pay attention to my body. So I'm like, okay, yeah, I need to pull over somewhere safe and not try to push it there because not only am I endangering myself, but I'm endangering those around me. So. And obviously driving and having an attack like that is very unsafe. So that can happen sometimes. I've been on set where, well, I just truck through it. You know, I do the best that I can. And I thankfully have not had to call off of any acting jobs because it's a lottery really, with acting. You know, you throw the spaghetti at the wall and you hold something sticks. And when that does stick, you know, you get that one job. Not only is it a reputation thing, but it's also a financial thing. You know, it's a financial blow. If I miss out on a day's worth of work, it's very important that I stay consistent with that and do everything possible to push through that.

Nora McInerney (20:52)

Are there practical things that you have implemented that have made this unpredictable work as an actor more manageable alongside your chronic migraine?

Aaron Matthew Atkisson (21:04)

So one of the things that I, as an actor I have to do for self care is I don't do overnight shoots. Messing up my sleep schedule is a perfect combination for a migraine attack. Unless it's a career changing move. There has to be some very important things for me to do an overnight shooting. Most of the time it's not worth it. Another thing that I do is, because I have light sensitivity is I have sunglasses in bulk. I've got sunglasses for fashion, but I mostly have them for function. So I have sunglasses stashed everywhere. So those Are two of the major things that I do to try to self care and make sure that I've got an order. As I was saying earlier, I have these ginger gummies which are very soothing to the stomach if you've got nausea. They're great.

Nora McInerney (21:51)

I have one last question for you, Erin, which is that you do so much. There's so much going on. What is something that you do just for yourself?

Aaron Matthew Atkisson (21:59)

Well, I enjoy acting. That's for me. I'm a musician too, so I play piano and guitar. My guitar is in my bedroom. I've had this thing for 20 something years.

Nora McInerney (22:10)

Oh, my God. Your first child?

Aaron Matthew Atkisson (22:12)

Yeah, pretty much. Yeah. Yeah, I used to play music. I used to play the, like the sports bars and the coffee shops and that kind of stuff. Yeah, so that was fun.

Nora McInerney (22:20)

I am. I'm honestly, I'm a sucker for people like doing what they want to do. It's actually kind of magical when you get to that you love. And so I actually love hearing like acting is for me, like, yes, it's a job and, you know, it makes these other aspects of your life possible. But I really think there's beauty in that. And Erin, this was such a great conversation. I am so glad I got to talk to you today. Thank you, Erin. Matthew Atkison, thank you so much for being here. You are a treasure. This was a delight. This was an honor. Thank you for your time. Thank you for the generosity of sharing your story with all of us.

Aaron Matthew Atkisson (22:54)

Thank you. Thank you.

Nora McInerney (23:01)

So, Dr. Ryan, we often hear from guests that they wish that they had found a headache specialist sooner or that they wish they had found a treatment plan that worked for them earlier. Can we talk about that a little bit more?

Dr. Christopher Ryne (23:16)

Yeah. This is by far the most common response once patients receive their diagnosis and start an effective treatment for them that I hear from them. So the national headache foundation did a survey on migraine, the preventing migraine attacks, a current perspective, and found that when asked about treating their disease, overall, 62% of those respondents wish that they had seen a healthcare provider sooner. They're happy they finally talked to somebody. They're happy that they found a therapy that's helping them, but they're disappointed because, again, they wish they had done it sooner. So I have a wonderful patient that absolutely speaks to this. She is a chronic migraine patient and I've been seeing her for several years. She expressed her regret for not seeking out a headache specialist sooner. And every time she comes in to see me, she reminds me about that. And so this is a disappointment that doesn't just sort of come and go, that every time that they have another quarter, another year, another month where they've been better and they finally come back and see me, they say, man, I wish I'd done this sooner. That's really the thing that I see the most.

Nora McInerney (24:21)

That's really heartbreaking to hear. And I have to imagine that a delay like that has a pretty big effect on somebody's treatment journey.

Dr. Christopher Ryne (24:32)

It does. I mean, so what we see is that about one in four people living with chronic migraine are candidates for preventive therapy for chronic migraine, and a substantial portion of those who might benefit from prevention do not receive it. One of the reasons patients may not receive preventive therapies could be delay in seeking out care, delay in receiving the appropriate diagnosis. This again, thinking about some of the conversation today, stigma that's preventing you from pursuing that, downplaying and dismissing those symptoms more. One of the academic pieces that jumps out is the Cameo study, which showed that 75% of patients who sought evaluation from a healthcare professional for their headaches did not receive a chronic migraine diagnosis, though they met the criteria. Another study on migraine disease in general shows that it can take five or more years before patients living with migraine will even start to seek out care from a specialist for their headache and migraine symptoms. And so it just takes too long. And I think that's one of the really special things about the conversations we have with our patients on the podcast is to try to let the listeners hear what we're talking about and maybe something rings true for them and they go seek out that care. They go, just try to start that journey.

Nora McInerney (25:49)

Dr. Ryan, you know, I appreciate you. I love your perspective, always one that informs me, and I love that I feel like I am getting such an education, not only from our guests, but from also my friendship with you. So thanks for being here.

Dr. Christopher Ryne (26:03)

Absolutely.

Nora McInerney (26:08)

I loved this conversation with Erin Matthew Atkison so much. As you can probably tell, it was such a good reminder that everyone that you see on this earth, earth is carrying a lot more than they let on and that even people who appear that they have it all together might not. It's a very truly vulnerable thing to be able to speak so openly about your life in the way that Aaron did. And I am so grateful to him for sharing his story, especially as a father. I think it's really important for our kids to know that even, even the people who are in charge, even the grownups are just people, and that it is a very deeply human thing to need one another and it is a deep honor to be there for one another in all kinds of ways. It's easy to think of the grownups as just supporting the kids and I was really, really touched by the way that Aaron said his kids support him. We are all connected. We all need one another. Thank you so much Erin. Matthew Atkison if you haven't found a chronic migraine treatment plan that is working for you, please reach out to your headache specialist to explore your options. I truly hope this has helped you find a bit of comfort and maybe a smile. Maybe. See you next episode and stay tuned for more important safety information. The Head Start Embracing the Journey is hosted by myself, Nora McNerney and executive produced by Yvonne Sheehan. Our EP of post production is James Foster, our supervising producer is Sierra Kaiser, our writer is John Irwin and the show is mixed by Nick Cipriano for Bang Audio Post. Original music by Soundcat Productions and Artlist Foreign.

Botox Safety Information (28:07)

Safety information continued There has not been a confirmed serious case of spread of toxin effect away from the injection site when Botox has been used at the recommended dose to treat chronic migraine. Botox may cause loss of strength or general muscle weakness, vision problems or dizziness within hours to weeks of receiving Botox. If this happens, do not drive a car, operate machinery or do other dangerous activities. Do not receive Botox if you are allergic to any of the ingredients in Botox. See Medication Guide for ingredients. Had an allergic reaction to any other botulinum toxin product such Myobloc Rimabotulinum toxin B Dysport Abobobotulinum toxin A Zeomin Incubotulinum toxin A Jeuveau Probotulinum toxin A xvfs Daxify Daxybotulinum toxin A Lansing or Letibo. This may not be a complete list of all botulinum toxin products have a skin infection at the planned injection site. The dose of Botox is not the same as or comparable to another botulinum toxin product. Serious and or immediate allergic reactions have been reported including itching, rash, red itchy welts, wheezing, asthma symptoms, dizziness or feeling faint. Get medical help right away if you experience symptoms, further injection of Botox should be discontinued. Tell your doctor about all your muscle or nerve conditions such as ALS or Lou Gehrig's disease, Myasthenia gravis or Lambert Eaton Syndrome as you may be at increased risk of serious side effects including difficulty swallowing and difficulty breathing from typical doses of Botox. Tell your doctor about all your medical conditions including if you have or have had bleeding problems, have plans to have surgery, had surgery on your face, have weakness of forehead muscles, trouble raising your eyebrows, drooping eyelids and any other abnormal facial change. Are pregnant or plan to become pregnant. It is not known if Botox can harm your unborn baby, are breastfeeding or planned to it is not known if Botox passes into breast milk. Tell your doctor about all the medicines you take, including prescription and over the counter medicine, vitamins and herbal supplements. Using Botox with certain other medicines may cause serious side effects. Do not start any new medicines until you have told your doctor that you have received Botox in the past. Tell your doctor if you received any other botulinum toxin product in the last four months. Have received injections of botulinum toxin such as Myobloc, Dysport, Xeomin, Jeuveau, Daxify or Letibo in the past. This may not be a complete list of all botulinum toxin products. Tell your doctor exactly which product you received have recently received an antibiotic by injection Take muscle relaxants, take an allergy or cold medicine, take a sleep medicine, take aspirin like products or blood thinner. Other side effects of Botox include dry mouth, discomfort or pain at the injection site, tiredness, headache, neck pain, eye problems such as double vision, blurred vision, decreased eyesight, drooping eyelids, swelling of your eyelids and dry eyes, drooping eyebrows and upper respiratory tract infection. For more information, refer to the Medication Guide or talk with your doctor. You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov medwatch or call 1-800-FDA-1088. If you are having difficulty paying for your medicine. AbbVie may be able to help. Visit abbvie.com patientaccesssupport to learn more. Can Botox Onobotulinum toxin a help if I have chronic migraine? 15 or more headache days a month, each lasting four hours or more. Botox prevents headaches in adults with chronic migraine. It's not approved for adults with migraine.

Nora McInerney (31:57)

Who have 14 or fewer headache days a month.

Botox Safety Information (31:59)

It's the number one prescribed branded chronic migraine treatment.

E (32:03)

Prescription Botox is injected by your doctor. Effects of Botox may spread hours to weeks after injection causing serious symptoms. Alert your doctor right away as difficulty swallowing, speaking, breathing, eye problems or muscle weakness can be signs of a life threatening condition. Patients with these conditions before injection are at highest risk. Side effects may include allergic reactions, neck and injection site pain, fatigue and headache. Allergic reactions can include rash, welts, asthma, symptoms and dizziness. Don't receive Botox if there's a skin infection. Tell your doctor your medical history, muscle or nerve conditions, including als, Lou Gehrig's disease, myasthenia gravis or Lambert Eaton syndrome, and medications including botulinum toxins, as these may increase the risk of serious side effects.

Botox Safety Information (32:40)

Ask your doctor and visit botoxchronicmigraine.com or call 1-800-44-BOTOX to learn more. This is an I Heart podcast.