When I started writing for Brain & Life 15 years ago, I interviewed a group of headache specialists who not only were experts in the field but had migraines themselves. They shared their perspectives on this headache disorder in the story “Your Neurologist Gets Migraines.” I found their tips so valuable that they changed how I care for people with migraine. Five years later, I wrote about neurologists who have sleep apnea in the story “Your Neurologist Has Sleep Apnea” to raise awareness of the seriousness of the condition and the need for appropriate diagnosis and proper care. Now in this issue, four neurologists explain how they manage their epilepsy and the ways their condition informs their practice in the feature “Neurologists with Epilepsy Explain How It Informs Their Practice.”
Doctors don't need to experience a neurologic disorder to treat it, but having a condition may help them identify more closely with patients and better understand their symptoms. Like many physicians, I was trained to be dispassionate so I could be objective, but it came at the expense of empathy. It wasn't until I became a patient myself that I understood that not every condition fits a textbook description and that it's important to listen carefully and with an open mind. I used to dismiss the role of environmental factors until I developed Ménière's disease and discovered a connection between high humidity and my attacks of vertigo. I also realized that the feeling of clogging in my ear, which preceded the attacks, could be a window to treatment, and that drinking coffee or exercising could escalate symptoms dramatically.
Recently, Brain & Life's associate editor, stroke specialist Sarah Song, MD, FAAN, had her own treatment epiphany when she was pregnant with her first child at the age of 43. In her eighth month, she was surprised when a routine urine test showed an elevated amount of protein, indicating preeclampsia. She had no idea her blood pressure had risen to such a dangerously high level. Within a few days, she was hospitalized and required an emergency C-section. Fortunately she and her daughter, Willa, are healthy today, but Dr. Song, who never had symptoms, now knows firsthand why hypertension is often called a silent killer. Read her important advice in our cover story about Olympic skier Lindsey Vonn, whose mother had a stroke at the time Lindsey was born.
I also had preeclampsia with my two pregnancies, and two emergency C-sections to avoid its complications. Hospitalized for weeks while waiting for my first baby's lungs to mature, I had difficulty following conversations and only later realized how profound my “brain fog” had been. Kathleen Melin, who survived a brain bleed and shares her story in the Speak Up essay “Rebirth Marks,” had to recover from both cognitive and physical disabilities. And Crystal Gail Welcome, who is the subject of our Pictures of You column, describes her own challenges when she developed intracranial hypertension, in which spinal fluid builds up in the brain. She is hypersensitive to barometric pressure changes, but it has not stopped her from hiking the most difficult trails in the United States—an endeavor through which she has found peace and healing.
Like many of you, I've found that my favorite respite during the pandemic has been walking with my friends and our dogs, and I can attest to the therapeutic benefits of fresh air and exercise with canine companions. Our Wellness column in Healthy Living, “Pets May Be Good for Brain Health,” offers some scientific backing.
This issue also features two stories on current trends that may apply to you or someone you know. “How to Return to the Office on Your Own Terms” discusses the pros and cons of working remotely as many employers enforce a return to the office. If you have a neurologic condition, read how others are easing their transition with accommodations and smart strategies. And our story in Caregiving showcases men as caregivers, a role that has become more common over the years.
As always, your letters are full of excellent suggestions about conditions we could cover. We will be sure to raise them at our editorial meetings. Our team also meets regularly with the neurologist experts who make up the Brain & Life advisory board, to ensure the accuracy of our stories and keep us up-to-date on new and evolving diagnostic tests and treatments. Thank you for being such engaged readers and allowing Dr. Song and me to share our neurologic tales with you for a change.
Orly Avitzur, MD, MBA, FAAN, Editor-in-Chief
