It’s the tail end of the summer, and I have been spending a lot of time with my patients getting ready to go off to college for the first time. It is an exciting and scary time for them (and their parents). I have had a relationship with many of these kids for years, sometimes … Continue reading Going off to college with headaches!
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?
There comes a time, in any primary care pediatrician’s office, when a patient is in need of a higher or more intense level of care. For most patients with headaches, their care can be managed effectively by their primary care team. Their presentation and history are straightforward, they respond to the usual rescue medications, and … Continue reading When to refer to a pediatric headache specialist
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
So the second weekend in March, I had the pleasure and privilege to attend the National NAPNAP annual conference in New Orleans. I had submitted a poster and was fortunate to have it accepted for presentation. I am generally not excited about conferences but was curious about this very large gathering of pediatric nurse practitioners … Continue reading NAPNAP conference reflections
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