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