So I will go on the record as having been skeptical about the effectiveness of Botox for chronic migraine from the beginning. I doubted whether our patients would actually go through with the 31-injection procedure more than once, in order to get full effect. But I was hoping for the best. These teens with chronic … Continue reading Botox and teens with chronic migraine
It’s the very end of the school year, summer is fast approaching. What does that mean for pediatric headache providers? Hopefully there will be fewer distress calls. It also means numerous camp medication forms and 504 support letters for the fall. Importantly, there are less hectic days with more time to reflect on the general … Continue reading Headaches and summer
Well, it has been just 1 year since the first anti-CGRP medication came on the market, approved by the FDA for both episodic and chronic migraine for patients over the age of 18 years. I have heard from adult providers that these medications have been really helpful for their patients, especially with chronic migraine. We … Continue reading What’s the deal with these new migraine medications?
So it’s been a tough past month here in the headache program. And experience shows that this rough patch will continue for another month toward the end of the school year. This time of year triggers lots of stress for our patients, especially the high schoolers. Lots of stress = lots of headache = lots … Continue reading Self-Care and the Headache Provider
I am always looking for good resources for patients. I am particularly interested in books/articles which would be helpful for my patients who are ‘aging out’ of pediatric care. My young adults are getting ready to move on and would benefit from some adult-focused headache reference material. Some of my kids do need follow up … Continue reading Headache Book Reviews
Ever notice that your kids and teens with headache/migraine also have some other symptoms? Like sweaty hands and feet? Tremor? Lightheadedness and dizziness? Dilated pupils? Palpitations? Constipation or diarrhea? Gastric upset? Cold extremities? Tingling or numbness in the hands or feet? Fatigue? What’s up with that? Well, a wide variety of these findings are very … Continue reading Dysautonomia symptoms and headaches
Whenever I see a patient in my office, I spend most of the visit talking, getting to know the patient and family and getting a thorough history. Really, this is the most important part of the visit. But I always do a mostly a neurological focused physical exam. There are certain findings which are common … Continue reading Headache-focused neuro exam
In this post, I will continue the conversation with Sarah Nelson, PhD, pain psychologist. Previously we talked about common psychological issues associated with headache, issues that affect coping and functioning for patients with chronic headache, dealing with resistance to accepting psychological help and barriers to care. What are the best screening measures to use in … Continue reading Psychology and headaches, part 2
Psychological factors are known to play a role in pediatric headache. We know that stress is the #1 trigger for migraine for people of all ages. We also know that stress is a contributor/cause of tension-type headaches (stress headaches). And finally we know that patients with constant/chronic headache often have increased pain and decreased functioning … Continue reading Psychology and headaches, part 1
So it’s been just 1 year since I started this blog, posting regularly every 2 weeks. That was one of my intentions for 2018 and I am so glad I made it happen. I have learned a lot more about headache management in the process. I also learned that I do actually know a lot … Continue reading Gratitude
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