Working in pediatrics means guiding our patients from childhood to adolescence to adulthood. This is usually a natural progression, based on society’s norms and our schooling systems. It is an exciting and scary time for our children and for their parents. Having headaches and migraines is not something that just goes away once your child … Continue reading Moving into adulthood
This post is about a community initiative I am involved with that does not concern headaches. However, so many of my patients are teenagers, turning into young adults, and their struggles are of great interest to me. I hope you find it interesting. Turning a desire for community service into action is not the easiest … Continue reading Turning Community Involvement Ideas into Results
About 5 years ago, we started an initiative for the treatment of New Daily Persistent Headache. We have a large population of teens with this difficult, constant headache. There’s a reason why they call it persistent, as it is fairly refractory to treatment with the usual headache/migraine approaches, and the average lifespan of NDPH is … Continue reading NDPH update- lidocaine infusion
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
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
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
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
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
Since I am revisiting the topic of caring for kids with migraine, I thought I would jump right into medications next, treatment and then preventive. I am a firm believer in headache healthy lifestyle factors and their important for preventing migraines. I have discussed these quite a bit in the blog. So let’s talk about … Continue reading Revisiting Migraine part 2: abortive medications
Mild dysfunction in the autonomic nervous system (ANS), also called mild dysautonomia is commonly comorbid with all primary headaches (migraine, TTH, NDPH). The ANS controls those body functions that we consciously have no control over, such as breathing, blood pressure regulation, heart rate regulation, digestion/GI motility, temperature regulation, sweating, or nervous system over-stimulation. Common causes … Continue reading Autonomic Nervous System Sensitivity
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