You and Your Headache Notes Page Final

Introduction

Welcome to a patient’s guide to managing chronic

headaches!

This packet will teach you about:

1. Different types of headaches and how they impact

patients and families?

2. The most common headaches and identify ways to

prevent and/or drastically reduce the frequency and

intensity of occurrences.

3. Headache “triggers” and how to avoid them.

4. And you’ll get information on how to partner with your

Headache Specialist to better manage your condition.

Why Suffer in Silence?

*More than half of people with

chronic headaches suffer for at

least one year before they are

diagnosed

*38% suffer for 3 or more years

before diagnosis

Which Doctor should I see?

If headaches are persist,

Primary Care Physicians

typically refer the patient

to a Neurologist.

Primary Care

Neurologist

Headache Specialist

Primary Care Physicians are

usually the first point of

contact for patients suffering

from chronic headaches.

Not all Neurologist

specialize in the

treatment of chronic and

recurrent headaches.

Neurologist are trained in

the management and

treatment of many

neurological disorders.

They handle headaches not

responsive to treatments

provided by primary care

physicians and/or general

nuerologist.

Headache specialist are

specially trained to manage

care for patients suffering

from acute and chronic

headaches.

Is it A Migraine?

*Usually one-sided

*Moderate or severe pain

*Throbbing pain

*Pain aggravated by routine activity

*Nausea or vomiting

*Aversion to light or sound

If you checked 3 or more of the YES boxes, you have several of the

diagnostic criteria for “migraine”.

Which is the most common type of chronic headache.

Yes No

Symptoms associated with your headaches

What Is A Migraine? *A neurological disorder characterized by

hyperexcitability

of the nervous system

*Defining characteristics

*Recurrent headache attacks lasting 4-72 hours

*One-sided, pulsating, moderate-to-severe pain

*Aggravated by or causing avoidance of routine activities

*May be accompanied by nausea/vomiting, photophobia, or

phonophobia

*Presence of 2 of 3 key characteristics suggests

migraine

* Inability to function

*Photophobia or phonophobia

*Nausea/vomiting

How Many People Have Migraines? 12% of adults (30 million patients in the US) * Most common between ages 15 and 55

* More common among women (17%) than men (6%)

0

2

4

6

8

10

12

1%

6% 6%

12% 12%

Affected Americans

Rheumatoid Arthritis

Asthma

Diabetes

Osteoarthritis

Migraine

Centers for Disease Control and Prevention and American Migraine Prevalence and Prevention study

results (Lipton RB et al. Neurology. 2007;68:343-349).

Why do I get migraine?

Neurons in the brain become

hyper-excited and:

*Release of inflammatory substances

surrounding the blood vessels of the

brain

*Inflammation of the blood vessels and

the surrounding tissue on the outside

of the brain

*Pain pathways are activated

Migraine Symptoms

Before an attack *Feeling of well-being or surge of

energy

*Talkativeness or restlessness

*Increased appetite

*Drowsiness or depression

*Irritability or tension

During an attack *Nausea, vomiting, or diarrhea

*Sweating or cold hands

*Sensitivity to light or sounds

*Scalp tenderness or pressure

pain

*Pale color

*Pulsing pain

Impact on Productivity

Missed ≥ 1 day of work/school 25%

Work/school productivity reduced by ≥ 50% 28%

Did no household work 48%

Household productivity reduced by ≥ 50% 34%

Missed family or social activity 29%

School, Work, and Social Impact in Previous 3 Months

American Migraine Prevalence and Prevention study results (Lipton RB et al. Neurology. 2007;68:343-

349).

Medications: Abortive vs. Preventive

Abortive *Taken when a

migraine first begins

*Treats the immediate

pain & symptoms

Preventive

*Taken daily to prevent

and/or reduce the

frequency & intensity

of headaches.

Tips for medication success

Acute Medications Tips

*More is not always better…

*Take acute medications specifically as instructed

*Limit acute medications to once or twice a week

*Take only the dose that was prescribed

*If medications appear to not work after treating 2 or 3

attacks, call your doctor

Preventive Medication Tips

*Take the dose instructed– no more… no less

*Give the medication time to work (2-3 months)

*Track your headache patterns… a gradual decrease in attack

frequency or severity may be hard to see

Holistic treatment is the Key

Holistic Approach *Focuses on “Headache

Hygiene”

*Focuses on physical, mental

and social factors that influence

chronic headaches.

*Identifying and reducing

situations, behaviors,

environments, food and/or

people that precipitate

headaches.

Multidisciplinary Team • Neurological Headache

Specialist: Coordinates and monitors care;

utilizes pharmacological and non-pharmacological

therapies to reduce frequency and intensity of

headaches.

• Registered Dietician: Nutritional

Counseling

• Psychiatrist: Behavioral Health Assessments,

Mental Health Therapy

• Neuropsychologist: Psychotherapy,

Biofeedback

• Physical Therapist: Stretching &

Strengthening Exercises

• Pain Management Specialist: Relaxation Therapy, Nonpharmacological Pain

Reduction Strategies.

Migraine Triggers

* Food

* Disturbed sleep pattern

* Hormonal changes

* Drugs

* Physical exertion

* Visual stimuli

* Auditory stimuli

* Olfactory stimuli

* Weather changes

* Hunger

* Psychological factors

Headache Triggers

Diet Alcohol

Some foods

Caffeine

Some medications

Changes in Daily Cycles Menses

Skipping meals

Late hours

Oversleeping

Environment Weather

Smoke, perfume, or odors

Altitude

Bright light or loud sounds

Mental Anxiety

Anger

Fear

Depression

Identify your triggers

Headache & Diet

Avoid skipping meals *An empty stomach or low blood sugar can

trigger a headache

*Eat regular, well-balanced meals

Avoid foods that can trigger a headache *Ripe cheeses

*Processed meats

*Chocolate

Headaches & Sleep

Maintain a regular sleeping schedule *Try to go to sleep and awaken at

the same time everyday

*Get enough sleep, but do not

oversleep

Headaches & Stress

Reduce your stress *Implement stress reduction techniques

into your daily routine

*Schedule personal (alone) time

*Exercise regularly

Headache Diary

Record

*Frequency, severity, and duration of

headache

*Treatments you used and how well

they worked

*Possible triggers (environmental,

diet, stress, sleep,

changes in daily routine)

Keep the journal for at least 3 months

Look for patterns and share the results

with your healthcare provider

Educate Yourself

Learn more about migraine and how

to manage your symptoms

*Talk to your healthcare provider

*Become better educated about your

condition

*Read patient education materials

Be an Active Partner in Your Treatment

*Make an appointment to discuss your headache

*Describe the headache

*Where is the pain? How severe is the pain? How long

does it last? How often do you have a headache?

*How do you feel before, during, and after?

Is there an aura?

*Do you have other symptoms?

*Nausea, vomiting or diarrhea

*Sensitivity to light or sound

*Other symptoms

*Communicate how migraine is affecting your life

*Develop a treatment plan; follow up on

your progress

Keys to treatment success

*Be pro-active, seek help

*Understand your headaches so that you

can appropriately communicate with

your provider

*Discuss your goals

*Develop realistic expectations

*Work closely with your provider and

follow instructions

*Ask for specific instructions for taking each

medication

*Understand the side effects of each medication

*Take only the medicines and dose prescribed

Summary 1. Although migraine is common and causes

substantial impairment, you can learn to

manage your symptoms

2. Multidisciplinary Treatment Works

* Nonpharmacologic and complementary therapies

* Acute and preventive medications

3. Make “headache trigger reduction” a part

of your everyday life.

4. Work with your healthcare provider to

develop and follow a treatment plan that

works for you