Migraine Tip of the Month: Ask, and ye shall receive
/
After the more complex management recommendations we have made in this “Tip of the Month” section over the years this tip may seem pretty simple. But here it goes…
If you have questions about your headache diagnosis and management, by all means ask your relevant medical provider for answers.
Having provided care to many thousands of headache patients for a number of decades, I can assure you that consequent to a number of factors the volume in our headache clinics has progressively increased. With no additional time falling out of the sky to accommodate that increased volume, our clinics have become a veritable horse race.
Patient education is key to optimal management of migraine and other primary headache disorders, and attempting to jam adequate patient education into an all too short clinic visit is a near impossibility. This is one of the major reasons we first developed Migraineur, anticipating that we could use this magazine to improve patient education and avoid answering the same (very appropriate) questions over and over (egs, what is involved with receiving Botox for suppression of chronic migraine? what are the most common potential side effects of these medications you are prescribing for me? what therapeutic response should I be hoping for?).
We refer each of our clinic patients to those specific articles in Migraineur that are most relevant to their specific needs. To assist in this we are in the process of developing what amounts to a “migraine Wikipedia”, and our first attempt at creating an encyclopedia of migraine can be found on the magazine’s website (migraineurmagazine.com) and accessed by clicking “Issues/Selected Topics” on the webpage.
What can happen if we the providers fail to advise patients that the triptan prescribed for acute headache may cause chest pressure or neck squeezing, annoying but ultimately benign side effects? I can assure you from bittersweet experience that with alarming frequency a patient using a triptan and experiencing these symptoms will present to the emergency room on Saturday evening understandably concerned that he or she is experiencing a heart attack or anaphylactic reaction. Many diagnostic tests unnecessarily are performed, and the patient often is hospitalized. Tens of thousands of dollars later it becomes clear that this time, effort and money were spent to evaluate an entirely benign and commonly occurring side effect of the medication. A little education… and none of this would have occurred.
So don’t be shy about asking your questions. There truly are no dumb questions when it comes to headache diagnosis and management. If you think you need a brain MRI scan, ask your provider why none has been ordered. If you are starting a new medication for migraine prevention or acute migraine treatment, ask your provider what are the most common side effects that may occur and what should you be looking for in terms of therapeutic benefit.
Ask! You have nothing to lose but your migraine burden.
