Ever notice that your patients with migraine and headache often have other medical issues? Well, there are a number of common coexisting medical conditions which are often associated with migraine and headache. Frequently these issues are associated with pain, and are referred to as overlapping pain conditions. Examples of these types of overlapping pain conditions … Continue reading Migraine and headache and pain conditions
Oh my goodness, along with the Covid 19 pandemic, there has been a significant uptick in anxiety, among my patients with headaches, especially the teens and young adults. This has been clear since about mid-October. Historically, there is the usual ramp up of anxiety, worry, lack of coping, that tends to happen around this time … Continue reading Anxiety!!!
Children and teens with headache and migraine have been affected in a variety of ways by these pandemic times. Thinking back, there has been a difference between last spring and this fall and the effect on my patients, particularly in the school environment. I will refer back to specific chapters in my book ‘Getting ahead … Continue reading Pandemic reflections
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 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
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
So I feel like we have comprehensively covered pediatric migraine in my previous posts. Let’s look at a few case studies to see migraine management in action in primary care, looking at a variety of typical patients with migraine over the years, childhood to young adolescent to start. I will present 3 patients to consider … Continue reading Migraine case studies
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 when does episodic migraine transform into chronic migraine? Well, it’s a matter of frequency. The International Headache Society defines chronic migraine as more than 15 headache days per month over a three month period of which more than eight are migrainous, in the absence of medication over use (2-3+ times per week). Often your … Continue reading When migraine turns chronic
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