Abortives: peppermint oil, lavender, passion flower, rosemary, chamomile, rose hips, valerian, boswellia, rizatriptan, diclofenac sodium. Rescues: coriander seed, mustard oil, apple vinegar, dihydroergotamine selleck screening library (DHE) intramuscular (IM), promethazine, and parenteral ketorolac. We often see patients who report having tried “everything under the sun.” If you work in a secondary or tertiary headache center, it is rare to see a patient who has not tried “the usual suspects.” And while we might not see as elaborate an alternative treatment strategy as AG presents, many of us will have

seen some or all of these in one or another patient. If not, then your entire patient population is made of the more than 50% of patients who never tell their physicians about their complementary and alternative treatments.[3] But what do we tell a patient who comes to us learn more with this kind of a story? The clinical history

seems pretty straightforward, yet she is presenting with a treatment strategy that bears little resemblance to anything in our training. More importantly, what do we even know about many of the substances AG is ingesting? Some of the more common responses that have been reported to me by my patients (when they come to me for the third or twenty-third opinion) are: There is no scientific basis for these “so-called” natural cures. Stop them, you’re wasting your money and might even be harming yourself. Have you considered seeing a Pain Psychologist? Generally, when a patient goes to

such extremes, there is some underlying psychiatric issue. There is a variety of prescription medications that may be more effective for you, and these other things you are taking might be interfering with the real medicines, making them ineffective. While there may be an element of truth in each of these responses, they all beg the issue, and not very subtly, that most of us have no clue what most of these substances are or what they do and don’t do, why they might be prescribed, and whether they are likely to interact with prescription medicines that are being taken at the same time. Obviously, 上海皓元 we cannot be expected to know about every treatment option in every medical system under the sun. The armamentarium of the homeopathic or Classical Chinese healer or Ayurvedic doctor is every bit as complex as that used in Western medicine. Each practitioner is obligated to provide enough information to allow our patients to make informed decisions about their health care. Moreover, we need to know enough about different therapies to help protect our patients from potentially dangerous practices, and finally, we need to be as non-judgmental as possible without compromising our own critical thinking. A description of Ayurvedic medicine is included in this issue by Dr. Trupti Gokani.