The pandemic and its impact on life and work have consumed most of us during the past 6 months. So many choices and many not in our power to make. All vacations cancelled-no trip to Africa this June, no headache conference. Limited in-person interaction both at work and in life. Lack of control over most things. Struggling to stay connected with friends and family in meaningful ways.
I had planned to post regularly this year and it just did not happen. Sometimes I just couldn’t think what to write about, or was too busy or just worn out physically, mentally or emotionally. But now is a good time to recap what has been keeping me busy this spring and summer.
After going into lockdown in mid-March, my clinic immediately started doing virtual visits. This was useful for many patients, to touch base, intervene with issues, and support. Unfortunately, this meant no in-person visits for Botox for chronic migraine or occipital nerve and trigger point injections (OC+TP). We tried to get as many in as possible before closing down but many were due to come back later in March and April. We did our best to help them through this time but it was tough. It certainly increased the suffering of my chronic migraineurs, and also made it clear the benefit of these injection treatments for my teens and young adults.
I was able to return to the office for necessary procedures only in late May. As you could imagine my June was incredibly busy with procedures, since our in-office time was limited. Basically I was in-office on Mondays and Thursdays, and since we work in a shared space, procedures were in the afternoon only. It took until around mid-July to get everyone caught up. For the OC+TP patients, it was taking 2-3 procedures, done monthly, to get them back to their baseline functioning, most doing better by Labor Day.
Back to school, has always a busy time with concerns, medication and 504 support letters, and stress about restarting school. This year has been different, since the public schools are all doing different brands of remote/hybrid learning, and colleges are all over the place with their plans. Too much online learning tends to be problematic for patients with headache (too much screen time). My team put together a document to send out to families to help them through it. Stress is high, uncertainty is dominating conversations, folks in need of lots of support. There are many questions about risk of exposure and headaches. I let them know that headache/migraine is not an immune-compromising disorder. Each family has to decide for themselves what to do, when faced with the all remote vs hybrid school models, taking into consideration who lives at home with the patient, and their health concerns.
Professionally, it has been my hope for a long time to put together a practical manual for pediatric providers about pediatric headache, an incredibly common concern in PCP offices. It started with this blog, a loose framework for the book. I had hoped, before Covid 19, to get the rough draft done by June, which seemed ambitious at the time. Well, there was benefit from the downtime, and the rough draft was done by mid-April. I then had a few trusted professionals review the manuscript for completeness, make suggestions and edits. It was starting to feel real- I was really going to publish a book about pediatric headache that would help providers in primary care (MD/NP/PA) have a better handle on caring for these patients. I found a small local publisher, and over the summer, put it all together. “Getting Ahead of Pediatric Headaches: A comprehensive guide for nurse practitioners to manage headaches in children and adolescents” is being released in the early fall! This is exciting and scary at the same time! I can hardly believe it.
Watch this space for more information about this book and its release. My hope in writing it is to make taking care of these patients easier for their primary care providers, and to make life better for these deserving patients.
HeadFirst PNP 