My Headaches From Tracking Headaches
Jakob Eg Larsen
Jakob Eg Larsen thought tracking headaches would be an easy task. But the very first question turned out to be less straightforward than it seemed: What counts as a headache?
My Headaches from Tracking Headache
So I’m Jacob and my talk is about headaches. I’d like to start off by asking you, how many of you experience headaches? So right, it’s very common. And when I was preparing this talk I was looking for the talks in the QS community about headaches, and actually found out there’s actually very few which was a surprise to me.
So, I can go on and ask you sort of what kind of headaches do you experience, how often, how severe are they, what’s the cause. And those were the kind of questions that I started asking myself about two and a half years ago.
It wasn’t because I was suffering from migraine or sort of chronic headaches, but I would experience headaches from time to time and I just sort of wanted to check it out and what was going on.
But before going into thinking about what potentially to do about the headache, the first thing to figure out sort of what was my baseline. Perhaps my intuition about these headaches was perhaps was my recollection about them was completely off, so I needed some data.
Unfortunately, there is no such thing as a Fitbit for headaches, so some kind of manual tracking scheme was needed. I just had to figure out which one to use.
So, I tried various approaches such as rating as you can see here using standard pain rating scales. But I found them surprisingly difficult to do, because when is a headache a headache and when would I do the rating in the moment that I have experience, or should I do it multiple times a day or should I be doing it at the end of the day, giving like an overall assessment. But then I would have to find the core, but does that really provide reliable data.
So, eventually after a couple of weeks trying this, I just gave up using these. I learned it was necessary to be very specific about the protocol to use in order to obtain reliable data on a phenomenon like this that is subjective. And the other issues was that these various schemes, they were just too much of a burden to use in my daily life. I want something that is much simpler. I want the data, but I really don’t want to do the tracking. I just want the tracking to get out of the way so that I can move on with my life.
So the kind of intuitive conclusion that I arrived at was that in order to track my headaches I shouldn’t actually be tracking the headaches. Instead I arrived at that I should just be tracking whenever I was taking Aspirin and that became my protocol. Because that would indicate that my headache had reached a certain level, a threshold where it bothered me. That way I could get data. And in terms of instrumentation it became really simple, because I would just keep a spreadsheet where I would record the number of Aspirins taken per day if I took any and then also sometimes adding a comment to give a little bit of context around why I took an Aspirin.
So here is a plot of the number of Aspirin taken over time the first year, and the first thing I learned when looking at this was that I took Aspirin more often than I thought. More than one day per week on average, and that is way below the average use of Aspirins in Denmark which was more than I thought.
The second important thing that I learned was that I often took them on several days in a row and that was kind of interesting and led me to study the patient package insert more carefully.
It’s here. I also have it here. So you probably know this, so that’s actually like one meter of 40 inches of text in very small font. And I can ask how many of you read everything that’s on these. Okay, Aaron does and there’s a few of course.
So, you know, one of the things that it turns out that there’s actually if you take too many Aspirins’s there’s an interesting side effect, you get headaches. And that fact is hidden on the bottom of one of these pages where it says it’s recommended to only take up to 10 days in 30 days.
Then I also checked out that there’s a Danish headache research center, and they have a different recommendation. They recommend to only take two days in a week.
Okay, so know I have some new knowledge and that led me to plot my data in a new way. So here’s the number of days taking Aspirin’s in this 30-day window, that’s the white line covering one and a half years. As you can see, I actually exceeded that recommended 10, the orange line on a couple of occasions.
And if we instead look at it according to the Danish recommendations, then I exceeded the recommended two per week that first year several times.
So these learnings and that established baseline made me to rethink this self-tracking project. I started focusing on headaches and now I turn my attention more towards the use of Aspirins and how could I reduce that, and how could I reduce my headaches.
In that process the project turned into the anti-packman game you could say, where the object was to not eat the pills. And the score in the game became the number of consecutive days without taking any Aspirins.
So this is another way of looking at the data, a sort of new visualization providing like this sort of overview of streaks of not taking any Aspirins.
So looking at the first year of data, you can see I actually only had one time where I was able to sort of not take Aspirins for 40 days in a row in that first year. So I’m not going to go into all the details of the many interventions that I tried. I’m sharing my methods, my sort of visualizations of the projects and you have to figure out what works for you. But I can cay for me, drinking enough water, getting good sleep and not taking too many Aspirins they were decisive.
You can see here are the results of my interventions. It had a dramatic effect on my use of Aspirins. If you look at the data from 2017, I’ve had 180 days in a row without taking any Aspirins.
And here’s is an overview of the two and a half years of this tracking project. As you can see, I haven’t taken a single Aspirin during 2018. I haven’t taken one since October. As of today, my score is 333 days in a row.
So in this process I’ve introduced several interventions to avoid a headache and ways to handle them, and of course that does not mean I don’t experience headaches anymore. But what has happened in this process is I’ve actually pushed my tolerance for headaches, and now I’m no longer getting any data as you can see because I’m not taking any Aspirins.
So at some point last summer I had to sort of go back and revise my tracking protocol, so that I also now track the urge to take an Aspirin, that is when I’m very close to my threshold, and that is the yellow dots that you see on the right side.
And it shows that I still experience headaches, but only like once or twice a month and that’s way less than before.
So, to summarize my learnings, that is sort of my headaches from tracking headaches, a headache first of all is not just a headache. First in order to understand this sort of seemingly very simple phenomena I had to start off by establishing the baseline and it turns out that my intuition about it needed some recalibration.
I also found that I had to spend the time necessary to figure out which protocols to use. The protocol to use for tracking this seemingly simple phenomenon was not obvious to me. And this elaborate scheme that I used initially meant that I wouldn’t get the data that I needed to understand the phenomena.
It was also very irritative the learning process that was needed, and I had to go back several times and revise. And while doing the analysis I found that creating multiple plots even with this very simple dataset gave new perspectives and led to new learnings in each step. And also, I had to keep good notes because if a certain iterative process with a lot of changes, so keep good notes of what was going on.
Right that’s it. I hope this talk has not given you any headaches and thank you.