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
Getting Ahead of Pediatric Headaches: A comprehensive guide for Nurse Practitioners to manage headaches in children and adolescents I started my blog as a way to communicate to pediatric providers about the care of pediatric patients with all kinds of headaches. Over time, I decided to turn it into a book. I felt that the … Continue reading My book is available!!!
Let’s talk today about the story of NDPH, a primary headache not well understood or recognized, a zebra among headaches. The more we know about it, the more it is recognized. But that does not make it any easier to deal with as a provider or a patient. The first documented description of NDPH was … Continue reading More about NDPH
In this post, I am going to introduce you to another primary headache, new daily persistent headache (NDPH). This primary headache is not often seen in primary care, but I think our clinic population has about 25% of teens with this diagnosis. There’s a good reason why a referral to a specialty headache program is … Continue reading Introducing……… New Daily Persistent Headache
In this case study we’ll look at a fairly straightforward patient, with some twists and turns and decision points along the way. Case Study: Patty is currently an 18 year-old teenage girl with a history of migraine headaches since age 9. You have been seeing her for years, and this is her story. At the … Continue reading Migraine case study, part 3
Here are the case studies with your possible interventions. Case Study #1: Sally is an 8 year-old little girl who you have known since birth. She’s happy and friendly, loves to play soccer and school, especially math. She met all of her developmental milestones, though you do remember that she did have colic as an infant. … Continue reading Migraine case studies, part 2
So your patient has developed chronic migraine, which is defined as 3-4 migraine per week, 15 migraine days per month, and is predictably miserable. Developing chronic migraine does happen in pediatrics, but it happens much more often in older teens and adults. You’ve done what you could to prevent it from happening: did a course … Continue reading Chronic migraine, what to do?
So we have talked about lifestyle habits to prevent migraines, all the things your patient can do to prevent migraines. But your patient is still having frequent migraines or the migraines are significantly impacting the patient’s functioning. When do you consider adding a daily medication to prevent migraines? The mark I use for deciding when … Continue reading Daily medications for migraine, part 1
There are 3 groups of medications that are used to treat a migraine attack: migraine abortives, analgesia, and adjuncts. We have covered the migraine abortives (those medications specifically designed to stop the migraine attack) and analgesia (used to reduce pain) in the past 2 posts. There are several medications that are used either in combination … Continue reading Migraine medications to the rescue…..adjunct and combination therapies
So in the previous few posts I talked about the lifestyle factors important for migraine and headache patients. But even someone with excellent self-care, can still suffer from a migraine attack. After all, we have no control over weather changes, fire alarms, Aunt Betty’s strong perfume and other common triggers. So let’s talk about medications … Continue reading Migraine medications to the rescue