DID YOU
KNOW?
According to Dr. Seymour Diamond, 30 percent of migraine sufferers have some sort of dietary problem that triggers their condition, and nearly half of chronic migraines and 10 percent of all headaches are caused by medication overuse.
The inpatient unit of the clinic has since moved to its current location at Chicago’ s Saint Joseph Hospital.
“ Nobody really thought of a [ headache ] unit to help people who were acutely ill or had a medication problem,” Dr. Seymour Diamond says.“ The model of our unit was distinct.”
Despite collaborating closely with a hospital, Dr. Seymour Diamond recognized the importance of keeping the unit separate.
“ We didn’ t rotate nurses from a surgical ward to our ward— our staff was trained to take care of [ headache ] patients,” he says.“ That includes the nursing assistants, the unit secretary— everybody was attuned to the headache patient rather than the confusion of a general hospital.”
The Diamond Inpatient Headache Unit— still the only dedicated unit of its kind in the United States— has always focused on multidisciplinary care, which was a unique treatment philosophy when the facility opened nearly 30 years ago. In addition to the physicians and nursing staff, the unit staff includes a full-time pharmacist, biofeedback therapist, dietitian, physical therapist, psychiatrist and two psychologists to treat all aspects of pain. The unit even incorporated special lighting in its design that is easier on headache patients.
“ At the onset, we incorporated a lot of elements that people wouldn’ t think of doing in terms of headache care,” Dr. Seymour Diamond says.“ Today we’ re nationally and internationally accepted, but at that time, our efforts were questioned.”
A Look Inside
Merle Diamond, MD, managing director of the Diamond Headache Clinic( and Dr. Seymour Diamond’ s daughter), says inpatient headache care is a good option for people who don’ t respond to traditional outpatient treatments. Although inpatient care likely won’ t make headache disorders go away, it can significantly improve quality of life— the clinic’ s inpatient population has a 75 percent improvement rate, she says.
“ Our goal is to give patients the ability to recover from chronic headache and become part of their family’ s life again and part of the world again,” Dr. Merle Diamond says.“ A lot of these people have lost that ability because they are bedridden and often don’ t work.”
The Diamond Inpatient Headache Unit offers 38 adult beds and eight pediatric and adolescent beds. Approximately 2,000 patients are admitted each year— some even travel from other countries because this type of treatment is so rare.
Getting Patients On Board
One of the biggest challenges of treating complex headache disorders from an inpatient standpoint is setting realistic expectations.
“ Virtually every patient we see says they want to be cured of their headaches,” Dr. Merle Diamond says.“ We have to adjust their expectations to the extent that they will be better, but sometimes they will still have headaches.”
Many headache sufferers, especially those who have become accustomed to taking medication for quick bouts of relief, find it hard to accept a multidisciplinary inpatient treatment approach. According to Richard Wenzel, PharmD, the pharmacist at The Diamond Inpatient Headache Unit, changing ingrained patient behaviors takes time.
“ Many would rather take a medication to treat their pain instead of trying nonmedication options, including biofeedback or stress coping techniques,” Wenzel says.
Wenzel, who also teaches classes to help patients fully understand their medications, says medication-induced, or rebound, headaches are a major problem. He estimates at least half the patients who walk into the inpatient unit are overusing medication.
“ Some people didn’ t know what else to do, so they just took more medication— that’ s one side of the spectrum,” he says.“ On the other side, we do have a small number of people with some kind of substance abuse disorder.”
42 HEAD WISE | Volume 1, Issue 3 • 2011