Migraine: Managing Migraine Misery (cont.)
Member: My husband gets auras -- flashing lights, etc. -- just before getting a cluster headache. He takes Excedrin Migraine, but, being a migraineur myself, do you think that the OTC drugs may eventually 'rebound'? And, should I take him in for an appointment to my neurologist?
Diamond: Yes, I think taking an OTC on a regular basis can lead to rebounds. A good rule of thumb is two treatment days per week. If he needs more than that or the treatment is not effective, he should see the doctor.
Member: My fiancé is a migraine sufferer. He has been to many, many neurologists. None have really helped any. His current neurologist has sent him to pain management. All they do is give him methadone and morphine. How do we proceed? Do we go to a big hospital like Johns Hopkins?
Diamond: I would take him to see a headache specialist. Sometimes in very severe cases, long acting opioids like methadone can be used. But you are really masking the pain, not preventing it. There are many good headache specialists who deal with this every day. It might be helpful for him to see one.
Member: How do you find a headache specialist? His neurologist specializes in headaches.
Diamond: Most of them will have headache after their name -- like our clinic, as an example. A good resource is the National Headache Foundation. It's important to ask the questions "how many headache patients do you see?" and "is your practice mostly headaches?" You may want to go to a place that just does headaches. The National Headache Foundation is an excellent resource and I would recommend using them.
Member: A few years ago, I was diagnosed with chronic daily headaches. I kept a journal for six months with everything I ate and all the activities I did during that time. The physician's diagnosis was that I had cluster headaches and there was nothing they could really do for them. The physician also ordered a CAT scan, which was negative. I have headaches that last for months with no relief, sometimes becoming migraines (on average about twice a week, sometimes more, sometimes less). Have there been enough significant advances in this field that it would be worth my time and energy to go back to a physician regarding my headaches?
Diamond: Absolutely. We know a lot more than we used to. There are many new treatments available. The most important thing is to find a doctor who cares. With a motivated doctor or healthcare provider and a motivated patient, a lot of good things can be accomplished.
Member: Dr. Diamond, we are almost out of time. Before we wrap up for today, do you have any final comments for us?
Diamond: Thank you very much for chatting with me and having me on. The questions were great. What I would tell those who suffer with chronic headache and chronic migraine and cluster headaches, is to get an effective treatment, communicate with your doctor if treatment isn't working. Get a therapy that will allow you to have a normal life. That's a reasonable goal.
Moderator: We are out of time. Our thanks to Merle Diamond, MD, and thank you, members, for joining us today. For more information about the Diamond Headache Clinic, visit their website at www.diamondheadache.com. For more information about the National Headache Foundation, please visit their website at www.headaches.org, or call 1-888-NHF-5552. Please check out our news stories, features, and archived interviews with experts for more information about migraines -- visit our Migraines/Headache Center. Also, visit our Migraine Message Board to talk with other members and have your questions answered by Gary Vogin, MD.
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