December 26, 2019

by drplasticpicker.com

I have been a middle manager now for 2.5 years. In our organization my position is a 6-year-term, so I am 41% of the way through this term. For about 2 years, I had tension headaches (80% of the time as a middle manager). I had never had many headaches before I became a middle manager, and since becoming drplasticpicker about 4 months ago – my tension headaches are gone (0% of the time as drplasticpicker).

I want to emphasize that before going into middle management, I had gone through the gauntlet of medical training with children and had never had any headaches. Sometimes the stress of moving up the professional ladder can be too much.

In my small corner of the world, tension headaches are correlated with middle management. Mr. Plastic Picker also gets tension headaches https://drplasticpicker.com/mr-plastic-picker-had-a-headache/. His upper management manager was also suffering headaches recently due to manangement issues. Indeed, many of the personal finance early retirement bloggers I used to read religiously like Retireby40, Financial Samurai, and Mr. Money Mustache left work due to stress and headaches. Much of my blogging inspiration comes from the personal finance niche of the blogsphere. But they all left their jobs with their money. But not my internet hero Lenpenzo! He still works and blogs and provides humor for us all https://drplasticpicker.com/drplasticpicker-learns-that-half-the-internet-is-plastic-fake-but-not-lenpenzo-com-and-his-readers/

Let me summarize what I recently learned at the AAP New Orleans conference regarding tension type headaches https://drplasticpicker.com/drplasticpicker-goes-to-the-aap-national-conference-in-new-orleans-and-tries-to-use-less-plastic/. This is my personal commentary and reflections on the the Pediatric Headaches talk I attended by the Stanford group. The AAP app won’t let me in anymore so I can’t properly cite them, but if you want the citations – please send me a message and I’ll try to get into my notes.

Tension headaches are usually 10 or more lifetime headaches, between 30 min to 7 days in duration. Check! All those were in the first 2 years of becoming a middle-manager. Any 2 of the following 4:

• Bilateral location (CHECK!)
• Pressure quality pain (CHECK! CHECK!!)
• Mild to Moderate intensity (CHECK! CHECK!! CHECK!!!)
• Not aggravated by activity (QUADRUPLE CHECK!!!!)

Absense of

• Nausea and/or vomiting (Yes, I did not have any Nausea/Vomiting)
• Photophobia and/or phonophobia (Yes, none of those two)

Further characteristics of Tension-type Headaches

• Non-progressive
• Prevalence 18% (I bet you 90% of physician middle managers)
• Infrequently presents for evaluation (yes, I did not see anyone, my bad)

Tension Headache Management

• OTC agents (yes I was on Tyelnol 1000mg every 4 hours as times, Motrin 600-800mg evevry 8 hours at times)
• Integrative Therapies
• #1 Relaxation (Yes by plastic picking!)
• #2 Cognitivie Behavioral Therapy (Yes by blogging!)
• #3 Acupuncture (No, I did not stick any needles in myself unnecessarily unless its a vaccine. I do not generally advocate acupuncture as a first line).

Interestingly enough two recent studies they mentioned by Temper et al, Headache 2004 and Lampl et al, J. Headache Pain 2015 showed that

• 94% of adults coming in to primary care complaining of recurrent episodic headaches have likely migraine/probable migraine and 3% tension headaches
• Neck pain associated with migraines (70%)
• So if its disabling enough to go to the doctor’s office, its probably a migraine.

I never went into the clinic, and neither did Mr. Plastic Picker. In every headache lecture I have ever been to, the first answer is always “lifestyle” but as physicians we are horrible at helping ourselves and our patients with “lifestyle.”

I think it has to do with the word “lifestyle,” as if all those external factors that cause headaches are as easy to change as a pair of shoes. I wrote in the blog post Mr. Plastic Picker Had a Headache when I was reflecting on my own headaches, ” I had never had headaches in the past until 2 1/2 years ago when I moved up into middle management. I began getting blinding tension headaches for the first time in my life. Acteminophen, ibuprofen, trying to sleep more, weight watchers, keto, bought 2 bunnies, yoga – I went through the gauntlet trying to cure myself. Like Mr. Plastic Picker, I was professionally succeeding during these headaches. Accolades, rewards, metrics going sky high, congratulatory work emails, with a click of a send email able to be the savior of another work crisis or be the hero for another physician or patient matter. But I was getting headaches.” Headaches are truly a symptom of a life and soul in chaos. At least it was for me.

My headaches went away after starting my regular walks to the beach and picking up plastic because of the following reasons.

• I move more. Rather than worrying about the distance I am running or the times, I am just moving more. I am moving with purpose. 20 minutes of cardio, and then low impact walking and picking and trying to stretch at the same time. Usually on those plastic picking days I definitely hit 10,000 steps. But I don’t really keep track any more.
• Finding little bits of plastic slows the brain. I can’t really explain it better than concentrating on finding little bits of plastic slows my brain and slows down time. Literally. It’s like a super power. You should try it!
• The sounds of the waves and birds. Listening to nature has quietly silenced the cacophany of social media and the plastic modern world. I can concentrate now.
• Eat more fiber. I am eating more fiber (real fruit with peel and vegetables) because I am trying to eat less plastic covered food.
• I sleep better. Picking up plastic is done best early in the morning or before sunset. I don’t want to get a sunburn. My body rises and sets with the sun now.
• I am more creative. I started blogging, writing poetry, instagram, and now doing trash art! I am so happy now. I hope people are enjoying it but honestly I love rereading my pieces and looking at my own trash art. It makes me happy.
• I laugh, I cry and I share. I laugh at myself and I laugh at the world with joy. I smile at the silly birds. I cry when I see their dead bodies. This is why I have such dark poems at time. Here is a poem about the dead bird I found on Thanksgiving https://drplasticpicker.com/i-flew-home/. And I share all those thoughts with you, for better or for worse.

So these are the “lifestyle” changes I made to cure myself. I am now a happy middle manager. Our metrics are even better and my work is more effficient. But more importantly, I now realize that being a middle manager I have the power and responsibility to improve the lives of our physicians, our patients and our earth. Owning that higher mission at my gut level, has also helped make the headaches go away. I now look at work not as individual problems to be solved, but as an opportunity and a tool to help with the greater mission of physician healing and climate change mitigation. Stay tuned, there will be exciting developments soon on how drplasticpicker will help our organization be a positive force to combat climate change! I have two meetings scheduled on my return and they all came about because I am drplasticpicker! As I told my daughter a few months ago, when the crowd goes LEFT – you go RIGHT. Don’t follow the herd. Create your own path and choose to be unconventional https://drplasticpicker.com/drplasticpickers-advice-to-my-teenage-patients-and-young-physicians-pick-the-unconventional-path/