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Patients need to be specific
This is a good time to be a headache sufferer, according to Suzanne Simons, MS, executive director of the National Headache Foundation in Chicago. That’s because there are many new medications currently on the market that are taken at the onset of a migraine so people can be taught to manage their symptoms. For best results, however, headache sufferers should become partners with their health care provider in their headache care, says Simons.
"People who get frequent, disabling headaches should see their health care provider to determine what is causing the headaches and how they can best be managed," says Simons. It’s fine to start with over-the-counter medications, but if people find that they are exceeding the labeling recommendation, that’s a signal to seek professional help. Also, if headaches interrupt people’s quality of life by keeping them from performing their responsibilities either at home or at work, they should see a physician to be diagnosed and get the right therapy.
The first step in learning to manage chronic headaches is an appointment with a health care provider made specifically to discuss the problem. "What we find is that people mention their headache problem in passing, usually at the end of a physician’s visit when there isn’t adequate time to deal with it. Also, because it is a passing comment, the doctor may not realize how the headaches are impacting their life," says Simons. A specific appointment provides time for the patient to have questions addressed, and for the physician to diagnosis the problem.
Patients should be prepared to discuss whether the headaches are tension or vascular, under which migraine they fall, and whether they interfere with their quality of life and their lifestyle so the physician can prescribe the most suitable medication. Patients also need to reveal what herbal preparations, vitamins and over-the-counter products they take, so the physician will know if they might hinder the effectiveness of the prescription medication.
A headache diary is a helpful tool for uncovering a pattern to the onset of symptoms. For example, the diary might reveal that a headache develops on Wednesdays after the patient eats spaghetti with Parmesan cheese and a glass of red wine on Tuesday evenings. Together, the physician and patient might determine that the cheese and red wine caused the headaches.
"Sometimes people get headaches only on the weekend and they can’t understand why, but they go to bed later or sleep later than they normally do," says Simons. In that case, the patient might try getting up at the same time he or she does on weekdays, having a bite to eat and then going back to bed to avoid triggering a headache.
Never one right’ therapy
There’s no one "right" therapy for headache sufferers; therefore, patients need to work with their physicians to determine what is best for them. Also, patients must be compliant and
take the medication as prescribed so they know whether it works. With preventative medications, it often takes seven to 10 days for patients to see any improvement in their condition. "If patients experience side effects, they should talk to their doctor, because it’s possible to prescribe a similar medication that would not produce the same side effects," says Simons.
Often it is a combination of therapies that prevent headaches. For example, people might take abortive medications at the onset of their headache, practice biofeedback, and avoid certain foods that seem to trigger headaches. Many people try herbal therapies such as feverfew, which studies have shown helps prevent migraine headaches. While complementary therapies, including herbal medications, can play a role in the management of headaches, Simons warns that herbs can vary from growing region to growing region and from crop to crop; therefore, they may not be consistent in their effectiveness. "If a person purchases feverfew in capsule form one week, and the next week, buys fresh leaves, it will work differently," explains Simons.
Headaches are very treatable; therefore, if patients don’t get adequate relief within three months, they should ask their physician for a referral to a headache specialist or another physician. The National Headache Foundation has a list of specialists in each state that is available upon request.
To determine if a specialist is right for them, patients need to ask a few questions, according
to Simons. They include the following:
• What percentage of the practice is dedicated to headache management and treatment?
• Does the medical provider take any continuing education courses in headache management and treatment?
• What is the treatment philosophy of the provider? Patients need to find someone with
the same philosophy as theirs. For example, if patients want to try complementary therapies, and the physician does not believe in them, it isn’t a good match.
• Does the physician understand that headaches are disabling and impair a person’s quality of life?
Many people say they have been in and out of the health care system, have tried everything, and been told that they have to live with their condition. "There are so many new medications and different types of medications that if patients are in the hands of a competent health care provider, they can get relief. At least 95% of all headaches can be controlled," says Simons.
For more information about teaching people about headache management, contact:
• Suzanne Simons, MS, Executive Director, National Headache Foundation, 428 W. St. James Place, 2nd Floor, Chicago, IL 60614-2750. Telephone: (888) NHF (643)-5552 or (773) 388-6395. E-mail: firstname.lastname@example.org. Web: www.headaches.org.