Thriving with college accommodations
Your patient has passed the next step, by graduating from high school. They have chosen their next path- going to college. They are so pleased to tell you all about it, and you are so proud of them. This is also a time of both positive and negative stress. Perhaps high school was really hard … Continue reading Thriving with college accommodations
Visiting the ED or Urgent care
There are times when all your patient’s rescue strategies just are not working. The migraine episode is going on and on for several days, or it is worse than usual, or they are vomiting and getting dehydrated. Your patient has taken their usual rescue medications, perhaps done their usual thing when the rescue does not … Continue reading Visiting the ED or Urgent care
Revisiting the headache-focused neuro exam
My most viewed blog post was the one about the headache-focused neurologic examination. I posted it 4 years ago, February 2019. Because of its popularity, I thought it would be a good idea to take a look and update it where needed. The most important part of any office visit is the conversation between provider, … Continue reading Revisiting the headache-focused neuro exam
Botox for teens under age 18, results
Greetings! I have been absent for a bit, dealing with a health issue, but now I am back and feeling great. I wanted to report back some findings, which we are submitting for publication, about using Onabotulinumtoxin A (BTX-A or Botox) for chronic migraine in teens under age 18. We have been able to get … Continue reading Botox for teens under age 18, results
My book- it’s been 2 years!
Getting Ahead of Pediatric Headaches: A comprehensive guide for Nurse Practitioners to manage headaches in children and adolescents So it has been 2 years since I published my book, seems like forever ago! I am glad I was able to do it. I do think in hindsight, that my timing could have been better- though … Continue reading My book- it’s been 2 years!
Migraine/head pain and autism spectrum disorder
In this post, I would like to share some information we are publishing soon, a case study related to headache, autism spectrum disorder (ASD), and self injurious behavior. In this population, anything that can reduce this kind of behavior would be a welcome addition to the care of these often challenging patients. We know that … Continue reading Migraine/head pain and autism spectrum disorder
Update on Botox for teens under 18
I did my first post about Botox for teens under 18 in July 2019, 3 years ago! My intention was to review our data and prepare for publication a paper supporting the use of Botox for those under age 18. The more academic publications there are available, the better to make the case with insurance … Continue reading Update on Botox for teens under 18
Revisiting the ‘new’ migraine prevention medications
When I first covered the anti-CGRP medications, it was 2019, just 1 year after they had come out. Since then, we have much gained more exposure to these medications, though none are approved by the FDA for those under age 18 yet. We get asked all the time about these medications, and while they do … Continue reading Revisiting the ‘new’ migraine prevention medications
Revisiting pediatric migraine: preventive medications, part 1
In this post, I revisit the prescribing a daily medication for migraine prophylaxis, the standard medications for those under age 18. I use one migraine/week as a benchmark for considering a daily preventive medication. Here’s some good information on the basic daily medications that pediatric primary care providers could start for their patients with frequent … Continue reading Revisiting pediatric migraine: preventive medications, part 1
Revisiting migraine: supplements
Primary preventive measures to reduce migraine, such as the healthy headache lifestyle, are key to keeping migraine frequency to a minimum. But even though your patient is really working hard with the multidisciplinary approach, your patient is still having frequent migraines which significantly impact their functioning. When do you consider adding a daily medication to … Continue reading Revisiting migraine: supplements