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Headache-Adviser Newsletter, Issue #25 Tools For The Headache Toolbox
October 22, 2010

Tools For The Headache Toolbox

If you are receiving your first Headache Adviser Newsletter, welcome! If you are an existing subscriber I am sorry for the delay of several months between newsletters. I have been quite busy traveling around our region lecturing on migraines and headaches...and still maintaining a full time practice!

The term "Headache Toolbox" is a new one coined by the International Headache Society within the last year. The concept is that all headache patients should have a toolbox available to fight off headaches. Unfortunately, when people suffer form chronic pain (of any kind), eventually over time, they may tend to fall into the trap of feeling like a victim.

This is no ones fault!! It is part of what is now called invisible chronic illness. The important thing to remember is to stay proactive. So that is where the toolbox comes in!

Lifestyle Tools

Lifestyle, lifestyle, lifestyle...hearing it over and over these days from your providers right? Well that is because Western medicine has shifted in the last 15 years from pure "treat 'n go" to more proactive prevention.

Patients who make lifestyle changes get rid of headaches faster..period. I can't emphasize this enough! Those who do this usually respond within a few months. Those who don't are still waiting years later for some improvement.

So the most important are as follows:

  • Reduce caffeine to 1-2 8oz servings per day.
  • Stop smoking! Nicotine irritates the brain.
  • Start exercising. Raises brain serotonin levels, reducing headaches.
  • Go to bed and get up same time everyday for regular sleep.
  • Don't skip meals! Low blood sugar = headache.

Preventative Treatments

There are so many choices available today but it is important to remember that your provider will tailor your treatment to your needs. These options include:

And of course let's not forget Botox. I had the honor this past week to be filmed by one of our local TV stations. They wanted to discuss the new indication for Botox in migraines.

That's right! Botox is now indicated for use in chronic migraine which occur in patients who are having more than 15 migraine days per month. Here is the link to the article and the video about Botox injections for a migraine patient. The physician in the video is Dr. Mechtler who is the director of the Dent Headache Center where I work. You can see from the video that the injections are not that painful and the patient did well.

I have been doing Botox for our migraineurs and chronic tension headache patients for over a year and a half. If you live in the Western NY area and wish to discuss this with a provider from the Dent Headache Center please call (716)250-2000.

But What Do I Take For My Headache??

This is the part of the toolbox that you really get to customize. Once you find what treats your headache most effectively, you must carry this with you! Once again we are getting more and more new options on a yearly basis. These include:

  • Triptans for migraines (Imitrex, Maxalt)
  • Anti-inflammatories for mild headache
  • Dihydroergotamine spray (Migranol Nasal Spray)
  • Sumavel Dose Pro needle free injectable
  • Low dose opiods if you have cardiac or vascular disease.
  • Compazine or Reglan for the nausea.
So as you can see, there are many options! As always, treat your headache within the first "Golden Hour" as you will have a 90% chance of getting rid of the pain. By waiting beyond this time results in only a 15% chance of getting rid of the headache.

Work with your provider, make a plan to participate in your own care by making lifestyle changes. Never forget that there are new and exciting options coming to us on a yearly (sometimes more frequent!) basis for combating headaches and migraine attacks.

Here's To Headache Free Days

Take care..

Mary Kay Betz MS RPA-C
Physician Assistant

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