Archive for September, 2008

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Tuesday Round-up for Friends

2008 September 30

Not a lot of people know this(?)

(This is a longer post than usual and may be of interest to anyone claiming Incapacity Benefit (IB) in the UK where severe migraine is part or all of the claim.)

In the UK, welfare benefits like IB are decided by a points system. The system is now changing, but as far as I know it’s still a points system. (Unless you know different!) Anyway. To qualify for IB for a physical incapacity you must either:

  • Score a minimum of 15 points, or
  • Satisfy a government hired medical practitioner that your need is sufficient.

My IB is now up for what is called normal review. When this happens depends on how you last qualified. But the minimum period seems to be one year. As part of that review I once more have to complete the questionnaire on my health. It’s called a personal capacity assessment (PCA), and officially labelled an IB50. (The form itself is titled “Incapacity for Work Questionnaire“.)

After the problems I had previously with claims, which I won’t go into here, I thought I’d look around for advice. One site I found is Benefits and Work, included in my Migraine FAQs page: http://www.benefitsandwork.co.uk/

Benefits and Work use the UK’s Freedom of Information Act to find out what the Benefits Agency don’t tell you. This includes this points system stuff. It turns out that although I now know I have two conditions causing headache, migraine may score some points under “fits or something like this“. The section includes a box where you can write more information if needs be. Benefits and Work say in their booklet (from the government’s own guide) that this refers to “an involuntary episode of lost or altered consciousness“. They go on to point out (one of the site’s creators is a barrister): “the law in this area is rather confused, but it may be the case that vertigo, severe migraines and other conditions that cause ‘altered consciousness’ may score points under this activity.”

Now in order to make a lawful claim, you must answer the question honestly and as completely as you can. This means you can’t claim to have epilepsy instead of migraine, for example. But it also means that you should answer if you have severe migraines. That’s what the box is for. Looking back on my migraine diary, I can honestly tick the box for “I have a fit or something like this at least once a month” (on average). Or certainly “I have a fit or something like this occasionally”. I will then complete the box with more information. Why?

Again, from the government by Work and Benefits, the system as it stands awards:

  • 15 points if you have a “fit or something like this” at least once a month,
  • 12 points if you have had one at least twice in the last 6 months before the claim date,
  • 8 points if you have had one once in the last 6 months before the claim date.

It is then up to the Benefits Agency to assess whether the episodes reported qualify. To give non-migraineurs who may not understand how migraine could qualify under this I’ll give you examples of those altered consciousness I have had which fall in that 6 month period:

  • 2008/04/24: Aphasia – complete loss of ability to use or process language,
  • 2008/07/11: (1st attack) Aphasia and confusion,
  • 2008/07/11: (2nd attack) Anxiety and a sense of a malign presence in an empty room,
  • 2008/07/14: Hemiplegic attack followed by aphasia,
  • 2008/07/28: Hemiplegic attack followed by jamais-vu – where things, places, people that are familiar become unfamiliar – and partial inability to recognise faces or understand written language.
  • 2008/08/11: Sense of a malign presence in an empty room,
  • 2008/08/21: Confusion.
  • 2008/08/24: Hemiplegic attack followed by confusion.

I also suffer a general malaise with and after migraine. This also affects my ability to think, and has affected me generally 20 of the 69 days since I started by detailed diary on 23rd July.

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US House Rejects Bail Out Plan

2008 September 29

The US House of Representatives has just rejected the $700Bn bail out plan (Yahoo Finance, Sky News, BBC News).

The Dow Jones fell 6% on the news that Representative rejected the bill by a vote of 228 to 205.

Sources

http://uk.biz.yahoo.com/29092008/140/bail-plan-rejected.html
http://news.bbc.co.uk/1/hi/business/7641733.stm

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Persistent Migraine Aura & Visual Snow (Part One) (Last Edited: 2009 Nov 19)

2008 September 27

This is part one of a three part series on persistent aura without infarction, also called persistent migraine aura (PMA), and on visual snow (VS).

You can continue to part two from the link at the bottom of this page. Or you can jump to any part from the PMA & Visual Snow FAQs page link.

In this series I have used reputable sources for the science of persistent aura and visual snow. I’ll include the sources in the final post.


What is Persistent Migraine Aura?

Persistent migraine aura, or PMA, used to be called prolonged migraine aura status. Its proper diagnostic name is persistent aura without infarction. “Without infarction” means without the death of brain cells (or other cells). It is a little understood medical condition. Its cause, called its pathogenesis, is unknown. This means that it is not known how its symptoms are caused. It is also not known what medical examinations are useful in diagnosing PMA. Though at least one medical site says:

  • Description: Aura symptoms persisting more than one week without radiographic evidence of infarction,
  • Diagnostic criteria: (A) The present attack in a patient with 1.2 Migraine* with aura is typical of previous attacks except that one or more aura symptoms persist for more than one week, and (B) Not attributed to another disorder.

*”1.2 Migraine” means migraine with aura under today’s medical diagnostic criteria, the IHS Members Handbook (1997/1998). See the sources list at the end of this post for a download location. The International Headache Society (IHS) now classifies it as type 1.5.3.

Neurological symptoms that can be associated with PMA include:

  • Visual snow,
  • Vision loss,
  • Increased afterimages,
  • Tinnitus,
  • and others.

Medication that has been tried for treatment includes:

  • acetazolamide (also called Diamox),
  • valproate (also called valproic acid, sodium valproate or Epilim),
  • lamotrigine (also called Lamictal, Lamogine or Lamictin),
  • topiramate (also called Topamax),
  • furosemide (also called frusemide or Lasix).

This, from PubMed the USA’s National Institute of Health, says something of the current state of understanding:

“To the best of our knowledge, persistent visual symptoms, lasting months or years without evidence of infarction, a rare complication of migraine with aura, has been reported in only 20 patients. We report the case of a 43-year-old woman with a 31-year history of migraine with typical visual aura. At presentation, she experienced a visual aura in her right hemifield followed by a pulsating headache. The visual symptoms persisted.”

It is my experience, from my own research and talking on forums, this laughably underestimates the prevalence of persistent aura. Though another record did conclude:

“This case {of hemiplegic migraine} illustrates the potential for permanent neurological deficits to occur as a sequelae {sic} of HM in the absence of infarction, and highlights potentially important pathophysiological and treatment implications.”

A third says:

“Migraine with aura is a common disorder in industrialised countries, affecting up to 5% of the adult population. Although migraine aura is usually a benign disorder, in rare instances it can be the cause of serious neurologic {sic} complications … Other complications are … persistent auras without infarction. These disorders are of both clinical and scientific interest, as they throw light on the complex and not yet fully understood relationship between migraine with aura, stroke and epilepsy.”

Go on to Part 2

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Axing of the UK’s Energy Consumer Watchdog

2008 September 25

The BBC this week reported that the consumer watchdog Energywatch will be scrapped at the end of this month. Energywatch is an independent body that monitors the gas and electricity industries. In a move criticised my MPs as a “spectacularly bad idea”, Energywatch will be absorbed by a new multi-purpose agency, Consumer Focus.

MPs on the Commons Business and Enterprise Committee said consumer protection was being risked. The new body will replace the National Consumer Council and Postwatch as well as Energywatch.

The chief executive of Energywatch, Alan Asher, said: “There will be some support for consumers under threat of disconnection, and some other vulnerable customers, but I fear that it’s going to be a rather limited service and most of us will be left to fend for ourselves.” Labour committee member Michael Clapham said: “We require somebody in that market who is robust and is going to take aggressive action to make sure the interests of consumers are looked after. By removing Energywatch, we are not going to have that.” Energywatch has helped five million customers recoup £35M since being set up in November 2000.

The government said Energywatch lacked powers and was inefficient. Consumer affairs minister Gareth Thomas said: “What we are bringing in is not only a body which will continue to represent consumers, we are also forcing companies to handle complaints better. People shouldn’t have to go to a complaints handling body.”

But the Child Poverty Action Group is worried about the timing. And that the new body will be focussed on setting itself up while families struggle to pay bills.

Already reported in Thursday Series, energy companies talk of passing on the £910M for help to consumers – to consumers. And they are receiving covert subsidies from government. And they are charging consumers around £38 a year each for generating stations they have yet to build.

Meanwhile, Times Online reported on the 14th that these same energy companies are still tricking customers out of money.

Times Online reported a number of tactics that energy companies use to boost profits from customers:

  • Energywatch warned in the week 7th-14th September of customers who have underpaid for long periods due to estimated bills. In some cases, these have been charged for up to two years. When an actual reading is sent, they can be overcharged by up to £100. Why? Because when calculating the back-readings, the companies have used today’s – higher – prices and not those at the time. Energy companies deny the practice is widespread.
  • Energy companies have changed from announcing price rises a week or more in advance to just hours. This prevents customers switching before being charged higher rates.
  • In an anti-competitive move, companies have started charging exit penalties for switching suppliers. British Gas and Scottish Power charge up to £100 and £50 respectively.
  • In defiance of European Union rules, lawyers say customers not paying by direct debit are being over-charged £699M. EU rules say the supplier charges must reflect the cost to the supplier. Individually this is only £20. But suppliers are charging up to £69 more according to Ofgem.
  • And energy companies are also lowering the reductions for paying by direct debit. British Gas raised bills by 35% for quarterly paying customers and 42% for direct debit paying ones.

Sources

http://news.bbc.co.uk/1/hi/uk/7626620.stm
http://www.timesonline.co.uk/tol/money/article4747151.ece

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Tuesday Round-up for Friends

2008 September 23

One of those rare things: A migraine-free week! This means I’m starting to catch up. Hurrah! Though my back is still playing me up from time to time. So I guess I’d better see my doc. (Hopefully by the time the appointment comes, it’ll be better so I can cancel and let someone else see him.)

Tomorrow the contractors come to do electrical testing in my flat for the housing trust. (A flat is an “appartment” for any American readers!) If I haven’t mentioned it before, it’s because they gave just a few days’ notice. This is common practice for the housing trust. Though sometimes they give a day or two’s notice. Back when I was working in my local university this period end of September to New Year was the busy one. So I wouldn’t have been able to get time off to supervise. Still, hopefully all will pass smoothly.

In the letter it says, “The electrical testing … can take between 4-6 hours to complete … If any defects are found on an electrical installation, another visit may be necessary in order to rectify.”

Which leaves me wondering:

  • What do they do for 4 to 6 hours to test 18 plug sockets, 5 light fixtures and two plummed-in points? Do the same contractors do roadworks?
  • If they find a fault, do I get left without power? “Er, sorry sir, we’ve found a fault. Is a week next Tuesday good for you?”
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Migraine FAQs Page Added

2008 September 20

I have added a new tab or page called “Migraine FAQs” as promised. You can find it at any time from the tabs near the top of this web page. Or you can click here from this post: Migraine FAQs.

This means that I have no post prepared for today in the Saturday Series. But I will start a new series next week, looking at persistent aura without infarction, or persistent migraine aura, and at visual snow.

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UK: Lights Out in Five Years

2008 September 18

In last week’s Thursday Post, we looked at the UK government scheme to help households with rising fuel prices. We saw that a deal was struck with privately-owned energy companies. And we saw that straight away those companies hinted they would pass on the costs to households.

We also saw that the UK government said they allowed the companies to keep huge windfalls to finance future power generation. And we also saw that a National Housing Federation report warned the companies were instead passing the windfall on to shareholders.

This week, how energy companies are:

  • Charging consumers £1Bn a year in bills for wind farms that aren’t being built fast enough,
  • Yet we will have blackouts as early as five years from now, because
  • The companies cannot build nuclear plants fast enough to meet the government programme, and yet
  • Despite saying publicly the nuclear industry must fund the building, taxpayers’ money is being offered.

Read the rest of this entry ?