A Natural
WOMAN
Laurie W .* began having weekly , and sometimes daily , headaches shortly after she went to college . Two of her older siblings also suffered from migraines , and they each saw a specialist . So the next time Laurie was home from school , her mother took her to a local headache clinic . The doctors assessed Laurie and prescribed medications that worked for others in her family , but they were not as successful for her .
She continued to visit the clinic on her breaks from school , but her migraines grew more intense during her junior year .
“ I would wake up with them ,” she recalls . “ I got depressed , too , because I was in pain constantly .”
That summer , Laurie took an internship in Times Square in New York City — a location she admits may not have been the best place for a migraine sufferer . Sure enough , her migraines worsened until she was not getting any relief from her medications .
“ You just feel really fragile ,” she says . “ You tilt your head the wrong way , and you get [ a migraine ].”
The headache clinic referred Laurie to a neurologist , who then sent her to a pain therapist . “ The thing that really saved me and brought success was the pain therapy ,” she says . “ No drugs —[ the therapist ] gave me only advice about how to change my life .”
Laurie learned biofeedback methods and how to control her breathing . The therapist also addressed things Laurie had never considered , such as the way she held her hands and head while sitting at a desk .
When Laurie returned to school in the fall , she decided to “ go natural ” and manage her migraine solely through lifestyle choices . She read many books on the subject and began a regular exercise regimen . Today Laurie is a college graduate looking for a job , and she ’ s migraine-free most of the time .
“ If I get one once in awhile , I meditate and say to myself , ‘ OK , I can do this ,’” she says . “ There ’ s always an option , whether it ’ s medicine or nonmedicine . You just have to be willing to find what will work for you .” * Name changed
Headache-focused practices will usually have an array of valuable information for headache patients , including medication sheets for common drugs , lists of typical triggers and ideas for behavioral interventions . They also may use therapeutic techniques that are not widely available in a primary care setting , including nerve blocks , occipital nerve stimulators and treatments for people trapped in a cycle of medication overuse .
Another nice surprise for patients new to specialized care is the length of the appointments . Dr . Lipton says he often spends 45 minutes to an hour with a new patient — a luxury rarely afforded primary care physicians . “ The biggest resource I have in assessing headache patients is time ,” he says .
TIPS FOR A SUCCESSFUL SPECIALIST EXPERIENCE
For many migraine and headache sufferers , going to a specialist or headache clinic is the first step to finding relief . Your primary care doctor should be able to provide a referral to get you started . But if you choose to do the research on your own , “ look for a medical center — they often have a broader view of treatment options or are involved in research ,” Dr . Marcus suggests .
The National Headache Foundation offers an online physician referral service that can point you in the right direction ( www . headaches . org / physicians ). You also might be able to get a personal recommendation — someone who has helped a friend could be able to help you , as well .
No matter how you locate a specialist , creating positive outcomes starts with building a strong doctor-patient relationship . Make sure you ’ re having a two-way conversation . Your input should be a factor in determining your course of treatment .
“ One model I ’ ve been a strong proponent of is collaborative care ,” Dr . Cady says . “ The patient and health care professional form a relationship and consider each other experts . Both are working on the best solution to the migraine problem .”
To create an objective record of your symptoms , the specialist will likely ask you to start a headache diary . It ’ s important to keep track of all of your headache episodes ( not just the severe ones ) as well as any other pain you have . And be sure to note which treatments you tried and how well they worked . Without a complete picture of your pain , you and your doctor can ’ t create an effective treatment plan .
Following your appointment , your physician should ask you to return for a follow-up evaluation in a timely manner , Dr . Cady says . They also should provide tools and resources to help you learn more about your condition so you can take an active role in monitoring your progress . After you and the specialist get your condition under control , you ’ ll likely return to your general practitioner — particularly if you have other ongoing health problems .
“ Be up front with both of them about who you ’ re seeing , what you ’ re taking and what else you ’ re trying ,” Dr . Marcus says .
Remember — there is no quick fix . The solution to your head pain , and better overall health , is likely to be a long journey with many collaborators .
“ Like so many things in life ,” Dr . Cady says , “ it takes a village .” HW
www . headwisemag . org | National Headache Foundation 43