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HeadWay, Issue #090 -- Did You Tell Your Doctor This?
November 23, 2011

First, I apologize for the long period of time with no HeadWay!  Some of you have been wondering if there was a glitch in your email, but I'm afraid the truth is that the last HeadWay was published in June.

Well, sometimes life or health (or lack of health!) gets in the way.  But HeadWay is back, and hopefully it will come a little more often in the months ahead.

Thanks for your patience, and I hope this and future issues will be a help to you!


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In this month's issue:

Diagnosing Migraine: Other Headaches?

Botox gaining a reputation

Say what?!  Subdural hematoma

Diagnosing Migraine: Other Headaches?

Sometimes even doctors and specialists are just too narrow minded.  Oh, I don't mean that they're not open to new thoughts - I mean that they sometimes focus on certain symptoms or certain diseases too much, and miss out on the big picture.

I'm actually not picking on doctors, because we all do this - sometimes it's the doctor who helps us see the big picture!

What Ashley didn't tell her doctor

One example of this could be a patient I'll call Ashley.  Ashley has a horrible headache - the first of its' kind she has ever had.  She feels sick to her stomach, and has intense throbbing pain.

It only lasts a few hours (Only?? It seemed to last forever!!).  But she managed to get to a doctor, and the doctor suspected migraine.

But, it was the only attack she had ever had, so the doctor decided to prescribe medication to take if it ever happened again, and advised her to see him if she had another attack.

What might have been missing from this interview with the doctor?  One important question - have you had other headaches?

Missing the Obvious?

Frankly, it's the patient who often doesn't think of this.  Oh yes, I get a headache every few days - doesn't everybody?

No, actually.  Everybody doesn't.

Researchers are becoming more aware of the link between severe migraine attacks, and what we think of as "common" headaches.  It was once commonly thought that migraine was just a really bad headache.  Then it was commonly thought that migraine attacks were a completely different breed from "tension headaches".  After all, everyone gets tense muscles and a headache once in a while, right?

But a funny thing happened as we started to learn about the brain and as we studied headaches - particularly so-called tension headaches.  We discovered that they weren't all coming from muscle tension at all.  In fact, many people with "tension headache" have no muscle tension!  And now it has become a bit of a mystery exactly what is causing these common headaches!

Today, these are called tension-type headaches.  Are they a different beast from migraine?  Or do they come from a similar cause?

As we learn more, the answers may become more clear.

What your doctor needs to know...

In the mean time, your doctor or specialist needs to be aware of other symptoms you're having, and other headaches you're having.  She may treat you as if you have two types of headaches, or she may treat them together - that will depend on her experience and your symptoms.  But she needs to know if you're getting other headaches.

To add to the complexity, remember that a migraine headache (and remember, not every migraine attack involves headache) is not always severe pain.  You can have a migraine attack with moderate, or low-level pain, or no pain.

That leads some people to wrongly differentiate between migraine (the ones that really hurt bad and put you in bed) and other headaches (the mild ones that don't keep me from work).  They may both be migraine attacks.

In other words, migraine could be more of a problem in your life than you think.  And proper treatment could benefit you a lot more than you realize.

The main point of this reminder?  Sometimes we forget the impact that these low-level headaches have on our lives.  And we treat the major attacks and forget to look at the big picture.  Better treatment may be available if you recognize and treat other symptoms and other headaches at the same time.

Watch these headaches - document them - and recognize that they could be a part of a bigger problem.

Botox gaining a reputation

Botox treatment for migraine has had its ups and downs over the past few years.  But the news in recent days has been good.

Studies continue to show that Botox does help some migraine patients - particularly those with chronic migraine.

A recent study published in Neurology aimed to see if Botox actually helped with overall quality of life.  Some treatments, for example, may actually fight migraine, but produce so many side effects that overall quality of life is worse.

In the case of Botox, it seems that quality of life is improved overall.

Thanks to continued studies on Botox, it's becoming a more acceptable treatment for migraine.  Canada has been another country to officially sanction the use of Botox for chronic migraine.  It is hoped that insurance companies will recognize the value of covering Botox treatments.

For more read Botox and Quality of Life: Does it really help?

Say what?!  Subdural hematoma

Subdural hematoma or subdural hemorrhage is bleeding between the brain and the skull.  It's usually the result of severe head injury.  However, in the case of a more minor injury, the symptoms can be subtle and take days or even weeks to show up.

Symptoms may involve headache, confused speech, balance problems, weakness and nausea.

If you have a new headache or changes in symptoms, see a doctor right away.  Subdural hematoma is very serious.

For more, read Subdural hematoma from PubMed Health.

Thanks for reading!  Remember, if you have feedback or ideas for future issues, visit the HeadWay MailRoom.  Your password is nomoache.
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